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Query: UMLS:C0025362 (mental retardation)
 15,878 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The violence inherent in the world of substance abuse is conspicuously absent as a research issue in published studies in this area. Computer searches surfaced articles dealing with mental health/mental retardation. A synthesis of these articles indicates that the setting, therapy, and staff identified as most effective in the treatment of violent patients coincide with those found in drug and alcohol therapeutic communities. (The use by some drug and alcohol clinicians of radical confrontation therapy was the only practice seemingly counterindicated on treatment effectiveness and ethical and legal grounds). We emphasize the need for a drug and alcohol research focus on violence.
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PMID:What is the role of violence in the therapeutic community? 704 2

Interictal violence among epileptic patients could result from factors other than epileptiform activity. We characterized 44 patients who presented for psychiatric evaluation because of violent behavior. Most violent acts consisted of verbal or minor physical aggression. Twenty (45%) of these patients met criteria for a schizophrenic disorder, and one committed murder during a paranoid schizophrenic relapse. In addition to schizophrenia, the violence patients had significantly more mental retardation when compared with 88 age- and sex-matched epileptic patients without prior violent behavior. However, violent and nonviolent patients did not differ on seizure variables such as type and frequency of seizures, auras, electroencephalographic changes, epilepsy age of onset, or anticonvulsant therapy. These findings suggest that interictal violence is associated more with psychopathology and mental retardation than with epileptiform activity or other seizure variables.
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PMID:Interictal violence in epilepsy. Relationship to behavior and seizure variables. 824 25

This study evaluated the clinical correlates and inpatient course of self-mutilation in a diagnostically diverse sample of hospitalized forensic patients. Fifty-three male forensic inpatients, treated in a maximum-security hospital, who engaged in at least one instance of self-mutilation during a 2-year period, were studied and compared with 50 male forensic patients at the same hospital who had not engaged in self-mutilation. Self-mutilating patients were younger, more likely to carry a diagnosis of personality disorder or mental retardation, engaged in more outwardly directed aggressive behavior as assessed by the Overt Aggression Scale, were treated with substantially higher doses of neuroleptics, and were more likely to be civil or correctional patients than insanity acquittees. The two groups did not differ on variables such as history of suicide, history of violence, neurological characteristics, and other demographic variables. After an incident of self-mutilation, the probability of recurrence was high. The substantially higher level of outwardly directed aggression of self-mutilating patients, along with their higher apparent need for neuroleptization and the high risk of recurrence of the self-mutilation, suggest that they are a subset of violent individuals who are relatively unresponsive to treatment and who are dangerous to self and others.
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PMID:Clinical predictors of self-mutilation in hospitalized forensic patients. 827 5

This study reports a clinical experience among twenty schizophrenic patients treated by clozapine during two years and eight months within a range extending from three months to seven years. These twenty patients had previously shown long-term resistance to usual neuroleptics but three out of them met the diagnosis of mental retardation or childhood disintegrative disorder (F.84.3-ICD 10). These patients were put under clozapine for their violent behavior. The methodology was retrospective, descriptive with intra-individual comparison, each patient being his own reference before and after treatment. Diagnosis met CD 10 criteria and were assessed without using standard examination. This study aimed at assessing once more clozapine efficacy and tolerance upon a long time follow up. Single therapy has been the rule and dosages have been progressively increased reaching a mean daily dosage of 350 mg per day. The efficacy, assessed by the way of BPRS, GAF (DSM III-R) and simplified form of CGIS, has been verified in approximately 30% of the patients, mainly concerning positive symptoms. Clozapine was also able to alleviate severe behavior troubles brought about by delusional states, without this latter being markedly softened when it was a long term one. Clozapine tolerance has shown it to be satisfactory, however we noticed the occurrence of a leucopenia with neutropenia after seventeen weeks of treatment, followed, some days later, by a Quincke oedema, which forced to interrupt the treatment. White blood cells came back in a normal range fifteen days later. The other side effects (transitory hypersialorrhea, tachycardia, without clinical and ECG perturbations) have been usually well tolerated and have never caused treatment interruption. No extrapyramidal side effect have been noticed among our twenty patients. The end of this paper consists in the presentation of four clinical cases: one about the efficacy of clozapine upon violent antisocial behaviour in a schizotypital disorder; one delusional chronic schizophrenic patient whose violence has been controlled despite of the delusion; one paranoid schizophrenic patient who has been able to maintain a satisfactory professional and family adaptation; and finally a childhood disintegrative disorder (F.84.3-ICD 10) in whom occurred the only leucopenia side effect of our study. These four clinical cases have seemed particularly meaningful regarding our clinical experience of clozapine which has been lasting for almost seven years now.
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PMID:[Long-term clinical experience with clozapine]. 945 32

Shaken baby syndrome is a serious form of physical child abuse, which is frequently overlooked. It should be suspected in all children younger than one year of age, who present with drowsiness, coma, seizures or apnoea. A combination of subdural haematomas and retinal haemorrhages with minimal or no trauma and no coagulopathy is almost pathognomonic of the syndrome. The findings are caused by shaking with or without impact. Physical signs of violence are often absent and the syndrome may easily be mistaken for serious infection or seizure disorder. Many cases are fatal or lead to severe disability including blindness, cerebral palsy, mental retardation or epilepsy in about 60% of the children. There are many unresolved problems regarding diagnosis, pathophysiology, treatment, prognosis, prophylaxis and legal actions. We discuss these problems and in addition present eleven children with shaken baby syndrome.
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PMID:[Shaken baby syndrome]. 982 79

Clinician safety is a serious concern for health care professionals because of the great risk of violence in health care workplaces, especially emergency and mental health departments. Assaults on mental health staff are often encountered from patients who are intoxicated with, or suffering withdrawal symptoms from, substances. Additionally, violence toward mental health professionals is frequently encountered from patients diagnosed with paranoid schizophrenia, personality disorders, learning disabilities, and mental retardation. Incidents of assault are often ignored by victims and administrators. Administrators must implement several measures to prevent clinician assault.
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PMID:Clinician safety. 1062 79

mental retardation: timing and thresholds; (italic)b(/italic)) endocrine dysfunction and developmental disabilities: dose and target implications; (italic)c(/italic)) attention-deficit disorder-ADHD and learning disabilities; and (italic)d(/italic)) new horizons: extending the boundaries. Support for the Rochester conference came from both public and private sources. The National Institute of Environmental Health Sciences (NIEHS), the National Institute of Child Health and Human Development, and the EPA represented the federal government. The conference also received grants from several foundations: the Jennifer Altman Foundation, the Heinz Family Foundation, the National Alliance for Autism Research, the Violence Research Foundation, the Wacker Foundation, and the Winslow Foundation. The second of these conferences helped launch a new Center for Children's Health and the Environment at the Mount Sinai School of Medicine. It was held in New York City on 24-25 May 1999, and was convened specifically to consider the intersection between neurodevelopmental impairment, environmental chemicals, and prevention. Over 300 health scientists, pediatricians, and public health professionals examined the growing body of evidence linking environmental toxins to neurobehavioral disorders. The conference title was Environmental Influences on Children: Brain, Development, and Behavior. The conference began by reviewing well-known examples of deleterious effects of environmental chemicals, including lead and PCBs, on children's brains. The conferees then considered the potential impact of environmental chemicals on neurological disorders with particular focus on ADHD, autism, and Parkinson's disease. The inclusion of Parkinson's disease was intended to signal the notion that exposures in early life may have an influence on the evolution of neurological disease in later life. Support for the Mount Sinai conference came from the Superfund Basic Research Program (NIEHS); The Pew Charitable Trusts; the Institute for Health and the Environment at the University of Albany School of Public Health; the Agency for Toxic Substances and Disease Research (ATSDR); the Ambulatory Pediatric Association; Myron A. Mehlman, PhD; the National Center for Environmental Assessment (EPA); the National Center for Environmental Health (CDC); the National Institute of Child Health and Human Development; the Office of Children's Health Protection (EPA); Physicians for Social Responsibility; The New York Academy of Medicine; The New York Community Trust; and the Wallace Genetic Foundation. The impact of environmental toxins on children's health has become a topic of major concern in the federal government. Eight new research centers in children's environmental health have been established in the past 2 years with joint funding from EPA and NIEHS. Clinical units that specialize in the treatment of children with environmentally induced illness have been developed across the nation with grant support from ATSDR. The American Academy of Pediatrics has just published its (italic)Handbook of Pediatric Environmental Health (/italic)((italic)17(/italic)), the "Green Book," which is available to pediatricians throughout the Americas. Children's environmental health has climbed to a critical position as we launch the new millennium. This monograph marks a significant milestone in the evolution of this emerging discipline.
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PMID:The developing brain and the environment: an introduction. 1085 30

We report a cross-sectional descriptive study of 90 new long-stay patients (NLS) (i.e. those who had been resident for six months to three years in Permai Mental Hospital, Johor) and studied from April to June, 1995. The age of this sample ranged from 18 to 85 years. Two subgroups were observed (i.e. younger NLS patients aged 18 to 34 years and older NLS patients aged 35 to 85 years). Among the younger NLS patients, the commonest diagnosis was schizophrenia (51.2%), followed by mental retardation with related problems (24.4%). Sixty-one percent of these younger patients had a history of serious violence or dangerous behaviour. Older NLS patients were likely to have a diagnosis of schizophrenia (79.6%), followed by mood disorder (6.1%) and dementia (4.1%). Forty seven percent of these older group had history of danger to others and 57.1% were at moderate or severe risk of non-deliberate self-harm. Focusing on the schizophrenic patients, all of them had some form of psychopathology, either positive, negative or general symptoms and about one-fourth were assessed to pose a risk for aggression.
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PMID:Audit of new long-stay patients in Permai Mental Hospital, Johor. 1096 71

Although family violence and mental retardation are both prevalent in today's society; very little research has been conducted to investigate the relationship between them. Characteristics that make individuals with mental retardation more vulnerable to family violence are discussed in the areas of child, adult, and sexual abuse. Common psychological effects of this trauma are then explored followed by implications for practice. Because family violence and mental retardation are both societal as well as personal issues, intervention and prevention efforts must occur at both a direct service level and a community/macro service level. With such intervention and prevention efforts, persons with mental retardation will receive superior service when dealing with issues related to family violence.
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PMID:Interaction between family violence and mental retardation. 1171 83

This article presents the evaluation findings of a Kentucky Adoptions Opportunities Project (KAOP), a three-year project funded by the U.S. Department of Health and Human Services, Administration on Children, Youth and Families, Children's Bureau. The primary goal of the KAOP was implementation of three permanency planning activities: (1) risk assessment/concurrent planning, (2) one child/one legal voice, and (3) early placement in kinship or foster/adoptive homes. These activities were designed to expedite a permanency placement decision within 12 months for high-risk children. The evaluation of 124 high-risk children in the KAOP revealed that the majority of children had one or both parents coping with multiple risk factors, including mental illness, substance abuse, mental retardation, or family violence. The major barriers to permanency are discussed, as well as the policy and practice implications in the context of Adoption and Safe Families Act of 1997.
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PMID:Expedited permanency planning: evaluation of the Kentucky Adoptions Opportunities Project. 1201 66


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