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

This article examines the epidemiological data on chronic akathisia, tardive akathisia, and withdrawal akathisia. The limitations of the data are discussed--in particular, the lack of consistent definitions of the syndromes. The studies suggest that a significant proportion of patients chronically treated with neuroleptics suffer from akathisia. The prevalence may be as high as 40 percent, although a conservative estimate would be closer to 30 percent. Risk factors for the development of chronic akathisia and tardive akathisia are poorly understood, but old age, female sex, iron deficiency, negative symptoms, cognitive dysfunction, and affective disorder diagnosis need to be studied further for their potential role. While there is convincing evidence that akathisia may develop after neuroleptic cessation or reduction in dose, the prevalence and risk factors for withdrawal akathisia are not known. Reports of akathisia in children and the elderly have been few, and more systematic research is necessary. Akathisia appears to be common in individuals with mental retardation treated chronically with neuroleptics.
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PMID:The epidemiology of drug-induced akathisia: Part II. Chronic, tardive, and withdrawal akathisias. 748 75

We contrasted a sample of children and adolescents with affective disorders and mental retardation with a comparison group on behavioral symptoms, associated diagnoses, and psychopharmacologic treatment. Fifty consecutive patients with both impaired intellectual functioning and at least one affective disorder admitted to a psychiatric inpatient unit for children and adolescents with developmental disabilities and psychiatric disorders were matched to a group of 50 inpatients without depression. Behavioral symptoms such as suicidal ideation or gestures, crying, irritability, sleep problems, agitation, mood lability, and social withdrawal/isolation occurred significantly more often in the affective group than in the comparison group. Aggression, however, was the most frequent behavior concern for both groups, whereas disruption/destruction was identified significantly more often in the comparison group. Regarding Axis I diagnoses, the comparison group was more often identified with externalizing disorders (ADHD, ODD), though there was a high rate of comorbidity in the affective disorder group. The behavioral symptoms used to diagnosis normally developing children and adolescents appear to be applied in making affective disorders diagnoses in this sample of children and adolescents with mental retardation.
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PMID:Affective disorders in hospitalized children and adolescents with mental retardation: a retrospective study. 765 3

Darier's disease is a rare autosomal dominant skin disorder in which there is abnormal adhesion between keratinocytes. It appears to be associated with an increased prevalence of neuropsychiatric disorders including mental retardation and epilepsy. In addition we have previously reported a family in which major affective disorder cosegregates with Darier's disease. In the present study we have localized the gene for Darier's disease to chromosome 12q23-q24.1 by linkage analysis in five British pedigrees. We obtained a maximum two point lod score of 4.29 with marker D12S84 at zero recombination fraction. All five families showed evidence of linkage between the disease gene and markers in this region. Subsequent identification of the Darier's disease gene will provide insights into normal mechanisms of cell adhesion and may be of importance in the genetic investigation of neuropsychiatric disorders as well as elucidating the pathogenesis of Darier's disease itself.
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PMID:The gene for Darier's disease maps to chromosome 12q23-q24.1. 828 Nov 34

Anticipation describes an inheritance pattern within a pedigree with an increase in disease severity and/or decrease in age at onset in successive generations. The phenomenon of anticipation has recently been shown to be correlated with the expansion of trinucleotide repeat sequences in a neuromuscular disease, various neurodegenerative disorders and mental retardation. We have studied parent-offspring differences in age at onset and disease severity in 31 pairs with unilineal inheritance of unipolar affective disorder (UPAD). Life-table analyses showed a significant decrease in survival to 1st episode of major depression in the offspring generation compared with the parental generation (P = 0.0007). There was also a significant difference in age at onset (P < 0.001) between parents and offsprings. The offspring generation experienced onset 15.6 years earlier and illness 1.5 x more severe than did the parent generation. Furthermore, there was a significant correlation (P < 0.05) in age at onset between parent and offspring generations. When we excluded pairs where the affected parent has an age of onset greater than the age of the child at the time of ascertainment (i.e., 23 pairs left), there was still a significant (P = 0.02) decrease in age at onset (8.4 years) and 1.5 x more severe disease in the offspring generation. No evidence for specific maternal or paternal inheritance was found. We found evidence of anticipation in 75-80% of this sample of unilineal family pairs of UPAD. Anticipation is, thus, an inheritance pattern in a large group of UPAD which suggests that the expansion of trinucleotide repeat sequences is a possible mode of inheritance in this group of UPAD. The findings of anticipation in this study of families with UPAD and previous findings in families with BPAD suggest that the variable expression of unstable expansions of trinucleotide repeats may turn out to be the basis of the continuum of liability in affective disorders.
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PMID:Anticipation in unipolar affective disorder. 855 85

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

An association between personality disorder (PD) pathology, including symptoms of all PD types and Axis I disorders, and suicidal behaviour was studied in a series of 90 non-schizophrenic, non-bipolar in-patients of both sexes without mental retardation or organic brain syndrome. All of these patients, who scored positively on the SCID-II-PQ, were interviewed with the PDE and SCID-P, and with the Structured interview for the study of childhood trauma provided with supplementary items reflecting suicidal behaviour. Mood disorders were found to be significantly correlated with cluster C pathology (PD pathology always being expressed by dimensional PDE scores) and eating disorders were significantly correlated with cluster B pathology in women. Psychoactive substance use disorders were mainly correlated with cluster B pathology and anxiety disorders with cluster C pathology in both sexes. Suicidal behaviour was correlated with PD pathology of all clusters in women, but not in men. In women a strong correlation was found between suicidal behaviour and history of childhood trauma, especially sexual abuse. The results of this study indicate that there is some specificity with regard to the Axis I/Axis II association, more so in relation to PD clusters than in relation to the individual PD types. However, the relationships between PD pathology and Axis I disorders and suicidal behaviour are complex, and they differ between the sexes.
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PMID:Possible correlates of DSM-III-R personality disorders. 942 38

Although concern about the prescription pattern of psychotropics is growing, there have been very few surveys in Japan. In this survey conducted in 1993, prescription data, patient characteristics, etc. were collected for 2,395 inpatients from 18 psychiatric hospitals. Their mean age was 48.4 (S.D. = 13.6). Of these patients, 1,818 (75.9%) were diagnosed with schizophrenia, 115 (4.8%) with mood disorder, and 102 (4.3%) with mental retardation. The results were as follows. 1) They were prescribed an average of 10.1 different drugs: of these, 5.6 were various psychotropics (2.6 neuroleptics, 1.2 antiparkinsonian drugs, 1.0 hypnotics). 2) The mean daily dose of antipsychotics was 1,082 mg of chlorpromazine equivalent. 3) The most commonly prescribed neuroleptic was haloperidol (53.2% of the total patients) followed by levomepromazine (48.7%), chlorpromazine (24.8%), bromperidol (18.7%), and zotepine (18.3%).
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PMID:[A survey of drug utilization in psychiatric hospitals in Japan: the basic analysis of the current status of prescription patterns]. 955 43

Velo-cardio-facial syndrome (VCFS) is caused by a microdeletion in the long arm of chromosome 22 and is associated with an increased frequency of schizophrenia and bipolar mood disorder. The purpose of this study was to investigate the genetic, physical, developmental and psychiatric features of schizophrenic patients with VCFS microdeletion. It describes the clinical findings in four schizophrenic inpatients with the characteristic chromosomal deletion. The four patients displayed delayed motor development, language deficits, learning disabilities, mental retardation, early age of onset, chronic and disabling course of illness and poor response to classical neuroleptic drugs and electroconvulsive therapy. Two patients benefited from treatment with clozapine. We suggest that schizophrenic patients with a history of delayed motor development, early onset of the disorder, history of learning disability, mental retardation, congenital cardiac anomalies and/or hypernasal speech should be screened for the velo-cardio-facial syndrome deletion. The implications of this study for psychiatric phenotype, nosology, disease mechanism, and possible new treatments in the future are discussed.
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PMID:Clinical characteristics of schizophrenia associated with velo-cardio-facial syndrome. 998 47

We evaluated the effects of an enriched environment, based on a paired-choice preference assessment, on both rates of self-injurious behavior (SIB) and percentage of session intervals during which signs of negative affect were displayed by a woman with mental retardation and a mood disorder. Results suggested that SIB and signs of negative affect were highly correlated and that the enriched environment effectively reduced both.
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PMID:Decreasing signs of negative affect and correlated self-injury in an individual with mental retardation and mood disturbances. 1020 Nov 7

Mentally retarded children and adolescents not infrequently develop affective disorders, including a pattern of rapid cycling bipolar disorder. From work with nonretarded adults this pattern is known to have a tendency to chronicity and treatment resistance. Among persons with mental retardation, such a pattern is often marked by periods of severe overexcitation and underexcitation, often producing serious caretaking stress. Generally, it has been difficult to make this diagnosis in persons with severe to profound mental retardation and other severe disabilities, and it is probably often missed. However, knowing which questions to ask may facilitate diagnosis. It is our hypothesis that a positive family history of affective disorder in the presence of brain dysfunction increases the risk of rapid cycling affective disorder. Treatment results so far are limited to case reports and open trials. Much more research needs to be done to identify predictors of bipolar disorder and rapid cycling, the extent to which findings from studies of adults without mental retardation apply, and the most effective methods of treatment.
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PMID:Rapid Cycling Disorders in Mentally Retarded Children. 1032 Apr 12


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