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

This report is based upon a model project financially assisted by a grant from the German Federal Ministry for Families, Senior Citizens, Women and Youth, starting in 1999 and ending at the end of 2003. In cooperation with two disability care residential institutions, a conceptual approach and method to the questions of sexual self-determination and sexualized violence is being developed. Through qualitative methods of research e.g. focus groups, professional helpers of all hierarchies of the institution, including management, and the residents themselves, all had the chance to contribute their own opinions and experiences to the research topic. Specifically, to ensure their voice was heard, the people with mental retardation had an important impact on the questionnaire themselves. All aspects of sexuality were discussed--with notable difficulty arising in particular over the subject of sexual violence. It turned out that nonverbal communication and the interaction between the group members in the residents group were most indicative of their concerns. The staff at the nursing and living areas discussed the following topics: distance and closeness in the interaction between staff and residents, standards, reflections of their own professional attitudes, questions of legality as well as the tense topic of individual needs and tasks of the group. How those questioned described their solutions and ways of coping, and the impressions of the researchers forms the starting point for the compiled work. The initial ideas for the topics and the design of the concept are now laid out.
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PMID:[Managing self determination and sexual violence in homes for young adults with mental handicap--report from an ongoing German model project]. 1242 32

After literature review, this paper presents the largest study to date (n = 270) of psychiatric and neurological characteristics of accused murderers in the United States. This retrospective record review of pretrial detainees undergoing competency to stand trial and criminal responsibility evaluations examined demographic characteristics, psychiatric diagnosis, substance use patterns, Intelligence Quotient (IQ), and results of electroencephalogram (EEG), neuroimaging (MRI or CT) and neurological examination. Substance use and mood/adjustment disorders were common. Neuroimaging was abnormal in 18% of subjects and was associated with lower Performance IQ. EEG and neurological exam findings were not associated with measured cognitive impairment. While 16% of subjects had a FS IQ < 70, only 6% were diagnosed with mental retardation. Subjects with a psychotic disorder (p = 0.001) or an anxiety disorder (p = 0.005) were more likely to use a knife than other subjects in the study. Violence risk assessment in these patients must not only involve inquiry about firearm availability.
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PMID:Psychiatric and neurological characteristics of murder defendants referred for pretrial evaluation. 1517 Nov 85

Managing violent patients is a dilemma that every clinician faces. This article reviews the current literature and assesses the evidence on the management of violent patients in the clinical setting. Risk factors (dispositional, historical, contextual and clinical) and early warning signs of violence will be outlined. Understanding these issues will facilitate the short-term prediction and prevention of violence in clinical settings. Interventions have been categorized for use according to the urgency of the situation. This degree of urgency has been designated as either potential, imminent or emergent violence. Special considerations that may alter the management of violence will be delineated. Specifically, we will highlight issues related to gender, age and mental retardation. Aspects of professional training in regards to the management of the violent patient will be underscored as well. Finally, the review of the literature has led to a decision tree that can inform the reader in the evidence-based management of the violent patient. This decision tree is offered to the busy practitioner as a practical clinical tool for using evidence based practices in managing violent patients.
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PMID:Assessing psychiatric patients for violence. 1545 88

This paper gives the results of a needs assessment of a group of learning-disabled forensic patients from two Strategic Health Authority areas in the north of England. The patients were found to be a heterogeneous group with wide-ranging psychiatric needs. The majority were cared for outside their geographical area of origin, either in specialist NHS facilities or the independent sector. Those with an additional diagnosis of mental illness were most likely to be detained in NHS facilities within the region: a diagnosis of personality disorder was associated with placement in either a high secure setting or the independent sector. Individuals with a clinical diagnosis of mental retardation were most likely to be detained in services provided by specialist learning disability/mental health trusts out of area. There was a small group of females who were all placed outside the region. Offending behaviour was most likely to consist of violence against the person, sexual offences and arson. The majority assessed were felt to have long term needs. The study raised important implications for future provision of forensic services in the area, particularly the need to offer services with treatment programmes tailored to the needs of the population under review.
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PMID:Needs assessment in forensic learning disability. 1589 41

The current study demonstrates the use of patient case mix to evaluate the probability of aggression occurring on an inpatient psychiatric unit. The impact of combining young adult psychiatric patients with patients classified with mental retardation on the overall negative events and injuries on an inpatient psychiatric unit was evaluated. Results suggest when the combined number of young adults and patients classified with mental retardation exceeds 10 the unit is at high risk for aggressive behavior occurring. Recommendations for evaluating violence at a unit level using case mix are provided.
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PMID:Evaluating risk factors for violence at the inpatient unit level: combining young adult patients and those with mental retardation. 1599 Nov 11

Emergency departments (EDs) are vital in the management of pediatric patients with mental health emergencies (MHE). Pediatric MHE are an increasing part of emergency medical practice because EDs have become the safety net for a fragmented mental health infrastructure which is experiencing critical shortages in services in all sectors. EDs must safely, humanely, and in a culturally and developmentally appropriate manner manage pediatric patients with undiagnosed and known mental illnesses including those with mental retardation, autistic spectrum disorders, attention deficit hyperactivity disorder (ADHD), and those experiencing a behavioral crisis. EDs also manage patients with suicidal ideation, depression, escalating aggression, substance abuse, post traumatic stress disorder, maltreatment, and those exposed to violence and unexpected deaths. EDs must address not only the physical but also the mental health needs of patients during and after mass casualty incidents and disasters. The American Academy of Pediatrics and the American College of Emergency Physicians support the following actions: advocacy for increased mental health resources, including improved pediatric mental health tools for the ED, increased mental health insurance coverage, adequate reimbursement at all levels; acknowledgment of the importance of the child's medical home, and promotion of education and research for mental health emergencies.
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PMID:Pediatric mental health emergencies in the emergency medical services system. American College of Emergency Physicians. 1699 98

Emergency departments are vital in the management of pediatric patients with mental health emergencies. Pediatric mental health emergencies are an increasing part of emergency medical practice because emergency departments have become the safety net for a fragmented mental health infrastructure that is experiencing critical shortages in services in all sectors. Emergency departments must safely, humanely, and in a culturally and developmentally appropriate manner manage pediatric patients with undiagnosed and known mental illnesses, including those with mental retardation, autistic spectrum disorders, and attention-deficit/hyperactivity disorder and those experiencing a behavioral crisis. Emergency departments also manage patients with suicidal ideation, depression, escalating aggression, substance abuse, posttraumatic stress disorder, and maltreatment and those exposed to violence and unexpected deaths. Emergency departments must address not only the physical but also the mental health needs of patients during and after mass-casualty incidents and disasters. The American Academy of Pediatrics and the American College of Emergency Physicians support advocacy for increased mental health resources, including improved pediatric mental health tools for the emergency department, increased mental health insurance coverage, and adequate reimbursement at all levels; acknowledgment of the importance of the child's medical home; and promotion of education and research for mental health emergencies.
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PMID:Pediatric mental health emergencies in the emergency medical services system. 1701 73

The aim of this study was to describe the present and past experiences of 14 siblings from five families in terms of having a brother or sister with autism and mental retardation. Personal interviews were conducted with the siblings before their brothers or sisters were moved to a newly opened group home. Qualitative content analysis was used for the analysis of the transcribed texts. The analysis resulted in seven content categories: precocious responsibility, feeling sorry, exposed to frightening behavior, empathetic feelings, hoping that a group home will be a relief, physical violence made siblings feel unsafe and anxious, and relations with friends were affected negatively. The conclusion is that these siblings' experiences revealed stressful life conditions. Counseling for the family and for siblings is recommended to help them deal with their feelings and problems. For the siblings in these five families, a group home was a relevant alternative as a temporary or permanent placement for the child with autism and mental retardation.
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PMID:Siblings' experiences of having a brother or sister with autism and mental retardation: a case study of 14 siblings from five families. 1788 35

Concerning the discussion about the connection of personality traits, personality disorders, and mental illness, this study focused on the personality profiles of male forensic patients, prison inmates, and young men without criminal reports. The main topic centered on group-specific personality profiles and identifying personality facets corresponding with mental illness. The authors therefore used the Rasch model-based Trier Integrated Personality Inventory. They individually tested 141 German forensic patients with different crime backgrounds, 122 prison inmates, and 111 soldiers of the German army. Within group differences they found that the individuals with mental retardation differ from patients with a personality disorder or psychosis. Patients with mental retardation displayed higher neurotic and/or paranoid personality accents and tended to be low organized and self-confident.
J Interpers Violence 2009 Jan
PMID:Violence and personality in forensic patients: is there a forensic patient-specific personality profile? 1868 40

The impairment and distress due to trichotillomania should not be underestimated. It can be associated with serious sociological and psychological effects (e.g. strong feelings of shame and embarrassment) as well as avoidance behavior including potentially dangerous avoidance of medical care. It can easily lead into a significant decline in quality of life for patients and their family members. In the background, violence or abuse can often be ruled out, but can be associated with other disease such as mental retardation, schizophrenia, autism and drug-abuse. For the effective treatment collaboration with the family, involving the help of a psychologist or a psychiatrist is required.
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PMID:[Trichotillomania]. 1981 22


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