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

Mental retardation is defined using two criteria: intelligence quotient and adaptive functioning. Subclassification based on IQ is helpful in predicting outcome and determining educational program. Advances continue to be made in identifying specific medical causes of intellectual deficits. As the natural history of conditions such as fragile-X becomes better understood, treatment approaches based on medical diagnosis will likely evolve. Clinicians working with mentally retarded patients should pursue vigorously medical diagnosis because of its implications for genetic counseling, family management, and full recognition of other handicapping conditions which may affect the patient. Psychopathology in the mentally retarded resembles that in nonretarded individuals, but occurs more frequently. Treatment of psychiatric disorders must be individualized. Mildly and some moderately retarded persons can benefit from psychotherapy. Behavioral approaches, particularly applied behavior analysis, are the most effective treatment for specific aberrant behaviors. Pharmacotherapy should be based on psychiatric diagnosis. Medications may be used, together with behavioral interventions, to treat specific destructive behaviors, but the scientific support for such use is new and somewhat limited.
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PMID:Mental retardation. 160 37

Data based on a national classification of mental disorders were collected continuously between 1968 and 1976, and then every two years from 1976 to 1982, following the same standards, in French public sector psychiatric hospitals. It was possible to study the evolution of deaths over this period taking all causes combined and by psychiatric diagnosis. The hospitalized population was estimated using data on length of stay and analysing them by the person-years method. The number of observed deaths was compared with the number of deaths expected applying the mortality rate of the general population to the numbers of inpatients of the same sex and age group and this gave us a standardised mortality ratio:SMR. Excess mortality in psychiatric inpatients, still apparent in this population, is decreasing except among women aged under 45, for whom it remains very high. Taking all causes of death combined, the mortality level in 1982 was almost 10 times higher than in the same female age group in the general population. Even when mortality is studied after exclusion of traffic accident deaths, the gap between men and women remained almost the same. The SMR for psychoses and mental retardation should no tendency to decrease in women aged under 55 and the SMR for neuroses showed a regular increase from 1972. A reduction was observed for all diagnostic groups studied in the 55 plus age group, for both men and women.
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PMID:Changes in mortality among psychiatric inpatients, 1968-1982. 204 8

A cytogenetic survey of 67 individuals previously identified as having mental retardation and autistic behaviors revealed 1 person (1.5%) with the fragile X chromosome (fra[X]) and 3 (4.5%) with autosome abnormalities. This low prevalence of fra(X) indicates that most persons with fra(X) in this mental retardation center did not have autistic behaviors severe enough to be identified as a secondary psychiatric diagnosis. The presence of other chromosomal abnormalities is consistent with the known causal heterogeneity of autism in mental retardation populations.
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PMID:Cytogenetic survey for autistic fragile X carriers in a mental retardation center. 229 26

A two-step methodology was used to estimate the prevalence of dual diagnosis among persons participating in community-based day programs in the Chicago metropolitan area. In Step 1, a dual diagnosis screening test was administered to a random sample of 205 people with mental retardation. In Step 2, 59 subjects were evaluated by clinical psychologists who did not know the results of the screening test. The results consistently suggested very high rates, with the best data suggesting an overall rate of about 39%. The rates were high primarily because personality disorders were very common. The fact that only 11.7% of the subjects had a psychiatric diagnosis in their case files suggests that dual diagnosis was underdiagnosed for this sample.
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PMID:Prevalence of dual diagnosis in community-based day programs in the Chicago metropolitan area. 234 Jan 35

Mortality was investigated in 881 male and 450 female formerly hospitalized child psychiatric patients in a four- to 15-year follow-up. Death from natural causes was not increased, but death from unnatural causes occurred at a rate more than twice as high as expected based on age- and sex-matched comparisons with the general population of the state of Iowa. Increased risk of unnatural death was found in five of eight psychiatric diagnostic categories but was significant only for Mental Reasoning, a category that combined patients with organic mental disorders, schizophrenia, or mental retardation. Clinical variables associated with an excess rate of unnatural death included age 15 years or older at the time of admission, the absence of a second psychiatric diagnosis, the presence of previous psychiatric hospitalizations, and the presence of a seizure disorder. Among the 23 unnatural deaths, the 11 (47.8%) suicides were excessive, but accidents and homicides were not.
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PMID:Excess mortality among formerly hospitalized child psychiatric patients. 334 82

The autosomal recessive disorder homocystinuria involves, in all its subgroups, an abnormality of methionine metabolism. The metabolism of methionine has been a central focus of interest for those who propose the transmethylation hypothesis of schizophrenia. The "methionine effect," as described in the research literature, is thus a theoretical link between these two disorders. The authors review the literature and describe those cases where both have occurred in the same patient. They indicate that whereas many patients with homocystinuria have been psychotic, few have been actually labeled schizophrenic. A patient with homocystinuria, mental retardation, and episodic psychosis is described and this case is used to point to the difficulties in making a definite psychiatric diagnosis in these patients. A relationship between the two syndromes is suggested.
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PMID:Homocystinuria and schizophrenia. Literature review and case report. 396 12

302 mentally retarded adults, sampled by epidemiological criteria, were examined with regard to epilepsy and psychiatric disorder. Each of the complications was frequent and related to degree and origin of mental retardation. In 55 (18.2%) epilepsy had occurred at some time during their lives, in 25 (8.3%) of these in the past year. In 52% of persons with seizures in the past year a present state psychiatric diagnosis was established, compared to 26% in those without seizures. The nature of the combination of epilepsy and psychiatric disorder is complex, but in the mentally retarded most often reflecting underlying brain pathology in the form of widespread cortical and subcortical cerebral damage causing epilepsy of generalised or mixed type, and predominantly interictal psychiatric disorders unrelated in time to seizures and dominated by behaviour problems.
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PMID:Epilepsy and psychiatric disorder in the mentally retarded adult. 408 60

The principal reason for this epidemiological study was the lack of psychiatric morbidity studies in a predominantly urban population, by psychiatrists in direct interviews. The psychiatric examination, covering 1970-71, included a representative selection of 2,283 persons, 18-65 years old from "former" Stockholm County, and the 12-month prevalence of mental disorders was measured. The total of non-participants was 12%. Forty-seven percent had a psychiatric diagnosis - significantly more women (54%) than men (40%). Excluding the psychosomatic diagnoses, 31% of the population received a psychiatric diagnosis, which agrees closely with other contemporary studies of mental disorder in the Nordic countries. The primary diagnoses were: neuroses 26%, psychosomatic diagnoses 16%, schizophrenic/paranoid conditions or other psychoses 0.6%, affective disorders 0.2%, psychoorganic syndromes 1.2%, psychopathy 0.2%, character neurosis 1%, drug dependence 0.2% (as a primary or a secondary diagnosis 0.6%), alcoholism 1.4% (as a primary or a secondary diagnosis 3.1%) and mental retardation 0.4% (as a primary or a secondary diagnosis 0.8%).
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PMID:Prevalence of mental disorder in an urban population in central Sweden. 661 Oct 17

There are some indications that Becker muscular dystrophy (BMD) might be related to mental disorders and mental retardation (MR). To investigate this question, we made a standardized psychiatric and intellectual level assessment of 22 BMD patients in comparison with 22 limb-girdle muscular dystrophy (LGMD) patients. There were not significant differences between the two groups. Twelve patients (54.5%) in each group received at least one lifetime psychiatric diagnosis, the most frequent being depressive disorders. The intelligence quotient means for BMD was 85.9 and 87.8 for LGMD. There was one case of mild MR among BMD patients and two cases among LGMD patients.
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PMID:Becker and limb-girdle muscular dystrophies: a psychiatric and intellectual level comparative study. 748 32

Despite increasing attention to psychiatric disorders in the mentally retarded, suicidal behavior remains an underreported phenomenon in this population, particularly in children and adolescents. This study was aimed at documenting the existence of suicidal behavior among 90 consecutive admissions to a specialty unit for dually diagnosed children and adolescents in a medical school-affiliated children's psychiatric hospital. Archival chart review yielded a total of 19 patients, or 21%, for whom suicidal behavior was a presenting complaint upon admission or during hospitalization. Suicidality was distributed across gender, level of mental retardation, and psychiatric diagnosis. Additional findings of note with regard to family dysfunction and/or abuse history are summarized. Clearly, in this sample, children and adolescents with mental retardation were capable of formulating and engaging in potentially fatal acts. Results of this study suggest that suicidal behavior is an underrecognized, yet significant phenomenon in children and adolescents with mental retardation and psychiatric disorder.
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PMID:Suicidal behavior in children and adolescents with mental retardation. 779 10


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