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

To investigate the relationship between psychiatric disorders and severe behavior problems in mental retardation, statewide client databases from developmental disabilities services in California (N = 89,419) and New York (N = 45,683) were analyzed and juxtaposed. The study focussed on nine major DSM-III-R psychiatric categories (or their equivalents), and severe forms of aggressive behavior, property destruction, self-injurious behavior, and stereotyped behavior in individuals 45 years old and younger with mental retardation of all levels of severity. In California, 3.9% had at least one psychiatric diagnosis; in New York, 5.4%. The rate of specific psychiatric diagnoses was variable across states, suggesting local preferences in diagnostic practices. Severe behavior problems occurred in 22.1% in California and in 41.4% in New York. This difference in rates can be attributed in part to different recording criteria for behavior problems. With regard to the association between psychiatric diagnoses and problem behaviors the results were consistent across databases: No compelling correlations were found. This means that neither aggression, self-injury, destruction, nor stereotypies determine whether a person receives a psychiatric diagnosis or not.
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PMID:The association between psychiatric diagnoses and severe behavior problems in mental retardation. 790 16

Patterns of psychiatric morbidity were studied retrospectively in children who attended the psychiatric outpatient clinic of a general hospital over a period of two years (January 1991-December 1992). Three hundred and eighty six children attended the clinic during this period. Twenty three percent of the children were diagnosed as mental retardation, whereas epilepsy was the diagnosis in 21% cases. A formal psychiatric diagnosis could be made only in less than half of the cases. The findings are discussed in terms of public awareness about child psychiatric disorders.
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PMID:Pattern of psychiatric morbidity in children attending a general psychiatric unit. 796 2

Little research or attention has been focused on identifying sexual problems or difficulties that people with mental retardation commonly experience. Scale development represents an important area for study to help identify these problems and to evaluate treatment outcome. To address this need, the Psychopathology Instrument for Mentally Retarded Adults-Sexuality Scale (PIMRA-S) was designed to assess psychosexual disorders in mild and moderate mentally retarded persons. Eighty-six mild and moderately mentally retarded adults, ages 20 to 60, were studied using the PIMRA-S. Scale development of this type was considered important because little has been done to assess sexual problems among mentally retarded persons. Fifty-eight items were developed based on evaluations of the research literature and interviews of experienced professionals. A preliminary assessment of reliability was conducted. The psychometric characteristics of these preliminary analyses were favorable. In addition, information was reported on the rate of sexually aberrant behavior exhibited by people identified with mild and moderate mental retardation. Differences in the rate of sexually aberrant behavior were addressed as a function of living and work placement, positive history of sexual abuse, need for treatment of sexual problems, and psychiatric diagnosis. Implications of these results for further scale development are discussed.
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PMID:Development of the psychopathology instrument for Mentally Retarded Adults-Sexuality Scale (PIMRA-S). 799 37

This paper reports on a national project to investigate the numbers, health status and service needs of people with mental retardation born before 1940. A prevalence of 1.43 per thousand was established nationally, with wide regional variation. Intensive local case finding produced 19% of the study group, not otherwise known to service agencies. In 1990, 42% of the population resided in institutions, 7% with family, 13% in rest homes, and 38% in community-based residential facilities. Of 1063 cases identified, 13% were people with Down's syndrome, 25% were identified as having a psychiatric diagnosis and 17% as having epilepsy, but 23% had no major disability. About 32% had visual problems, 40% had weight problems and 75% received regular medication. Seventy-five per cent have at least occasional contact with their families. The service system is in the process of change as a result of shifts in public policy, responsibility and funding. Personal interview data, reported elsewhere, demonstrated the desire and ability of the people concerned to be included in these decisions. Major needs identified were therapeutic services, medical care, community and recreational services, and support for families. Research areas recommended as priorities are consensus classification and definition of the population, identification of patterns of ageing among different subgroups, and studies of public policy.
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PMID:Report of a national survey of older people with lifelong intellectual handicap in New Zealand. 806 73

This article reports on age-specific findings of mental health problems among residents with Down's syndrome (DS) (n = 307) and without (non-DS) (n = 1274 in dutch group homes and institutes for people with mental retardation. Whereas a proportional increase of psychological problems was found for elderly DS persons with severe mental retardation, non-DS residents did not show such age-specific differences. High ratings of psychological problems for the elderly DS residents corresponded very well with the diagnosis of 'dementia' made by the physicians. Only for non-DS persons with severe mental retardation was a proportional decrease of challenging behaviour found with advanced age. Whereas psychological problems in elderly DS persons could be explained for the greater part of the diagnosis 'dementia', challenging behaviour--although also common in elderly DS--was shown to be a more independent phenomenon. With regard to psychiatric diagnosis, non-DS residents with mild retardation had six times as much a mental disorder, and non-DS residents with severe or profound mental retardation had up to 15 times as much, compared with their DS peers.
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PMID:Mental health problems in elderly people with and without Down's syndrome. 806 78

The present paper is a summary of a national project to investigate prevalence, health status, and service needs of people with mental retardation born before 1940. In 1990, 42% of this population resided in institutions, 7% with family, 13% in nursing homes, and 38% in community-based residential facilities. Of 1,063 identified, 135 had Down syndrome, 25% had psychiatric diagnosis, 17% had epilepsy, and 23% had no major disability. About 32% had visual problems, 40% had weight problems, and 75% received regular medication. Of this population, 75% had at least occasional contact with their families. Major needs identified were medical care, community, and recreational services.
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PMID:Summary of national survey of older people with mental retardation in New Zealand. 815 89

The use of lithium to treat child and adolescent psychiatric disorders is becoming more common. Since the publication of the report of The Committee on Biological Aspects of Child Psychiatry of the American Academy of Child Psychiatry in 1978, a considerable body of literature has accumulated on the efficacy of lithium in treating adolescent bipolar disorders, childhood aggression, and behavioral disorders associated with mental retardation and developmental disorders. Efforts to understand lithium's mechanism(s) and refinements in psychiatric diagnosis have contributed to its growing use.
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PMID:Update on lithium carbonate therapy in children and adolescents. 799 3

The reliability of psychiatric diagnosis has a direct effect on the validity of post-mortem analyses of neuropathological data, yet little is known about the reliability of retrospective diagnostic procedures which rely on review of medical records. In this paper, we report on the reliability of DSM-III-R psychiatric diagnoses assigned by a pool of 8 raters to a set of 106 state hospital charts of elderly, chronic patients who had died while institutionalized and were autopsied. Diagnoses were grouped by general diagnostic class, and Kappa coefficients computed for agreement among raters, as well as for agreement between ultimate consensus diagnoses and those made while subjects were living. Interrater agreement for those diagnoses that occurred most frequently in this sample (e.g. Schizophrenia and Dementia) was excellent, and comparable to the the agreement observed for ratings of live patients. Interrater agreement for less frequently occurring diagnoses (e.g. Mental Retardation, Mood Disorders, other non-Schizophrenic Psychoses) ranged from excellent to poor. We found high agreement between our rates diagnoses and those assigned by state hospital personnel while patients were living, although post-mortem review produced lower rates of diagnosis of both schizophrenia and Alzheimer-type dementias. Overall, results suggest that the reliability of chart review diagnosis is comparable to that obtained from interviews of live patients when experienced raters are used and diagnostic base rates are high enough to produce stable estimates of reliability.
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PMID:Reliability of post-mortem chart diagnoses of schizophrenia and dementia. 856 97

This study tested the hypothesis that separate ratings of frequency and duration add significant information to ratings of problem severity in the assessment of psychopathology in people with mental retardation. The Reiss Screen was modified to require ratings of problem severity, frequency and duration for each of 38 maladaptive behaviours. The 171 adolescents and adults were rated by caretakers and supervisory staff on the modified Reiss Screen. The three ratings were found to be very highly intercorrelated. Moreover, multiple linear regression analyses revealed that the ratings of frequency and duration did not add significant information to that provided by ratings of problem severity in the prediction of psychiatric diagnosis in the person's case file. The results support the use of composite scaling over multiple-ratings in the assessment of psychopathology in persons with mental retardation.
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PMID:Composite versus multiple-rating scales in the assessment of psychopathology in people with mental retardation. 873 75

Children and adolescents with mental retardation and developmental disabilities are thriving in their communities owing to special education programs that provide full inclusion in school and community life. Many youngsters, however, do not reach their full potential because of the limitations imposed by untreated psychiatric disorders. Although striking behavioral symptoms may be present, care providers often mistake them for typical aberrant behavior associated with developmental disabilities. When this occurs, these children do not receive proper psychiatric care and may suffer restrictive behavioral programming and exclusion from community living. On the other hand, children and adolescents with mental retardation and developmental disabilities frequently present with unusual symptoms associated with psychotic disorders, leading to misdiagnosis and inappropriate treatment with antipsychotic agents. The problems due to stress on these children and their families, long-terms costs in loss of educational and vocational opportunities, and the development of serious adult psychiatric disorders are enormous. By exploring the risk factors for psychiatric diagnosis in this population and presenting illustrative cases, awareness of the indicators for pediatric practice with this population is provided in this review.
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PMID:Psychiatric disorders in children and adolescents with mental retardation and developmental disabilities. 895 67


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