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

Studied are changes in diagnosis in a random sample of 10% of all first admissions to psychiatric hospitals and psychiatric wards of general hospitals in Israel from 1983 to 1990 with follow-up evaluation to 1991. This included 4,570 hospitalizations of 2,220 patients. Data were extracted from the National Psychiatric Case Registry of the Ministry of Health. Almost 59% of the sample had one admission, 18% had two, 9% had three, and 14% had four or more. From the first admission to the last discharge (a mean of 2.15 years), 59.2% of the patients' diagnoses did not change. In 89.46% of the cases in which the diagnosis changed, the changes took place during the first admission. Diagnostic change differed between diagnostic groups. In descending order of stability in diagnosis from the first admission to the last discharge were neurotic and personality disorder (73.6%), mental retardation (73.5%), schizophrenia (73.0%), organic conditions (70.6%), affective disorders (66.2%), substance abuse (65.6%), childhood disorders (60%), paranoid disorder (43.6%), other nonorganic psychosis (30.3%), and V-codes (25.0%). The average level of diagnostic agreement between the first admission and the last discharge was a kappa of .52. The average length of stay for patients whose diagnosis became more severe was considerably longer than for patients whose diagnosis became less severe or did not change in level of severity. Older age was related to less change in diagnosis. For patients aged less than 18 years, diagnosis changed in 46.7% of the cases, for patients aged 19 to 44, 31.2%, and for patients older than 45, 27.8%.
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PMID:Changes in diagnosis in a 9-year national longitudinal sample. 799 28

The charts of 660 consecutive admissions to a university psychiatric hospital were examined. After excluding those with mental retardation, 32 patients who had mutilated themselves and 88 patients admitted for unsuccessful suicide attempts were identified. Women were significantly overrepresented among the mutilators, but the groups did not differ with respect to age. Most analyses were restricted to women, of whom 27 were self-mutilators and 51 were nonmutilating suicide attempters. Mutilators were less likely to receive diagnoses of major depression or adjustment disorder but were more likely to have a history of substance abuse and receive Axis II diagnoses. The mutilative behavior was generally repetitive. The most common form was superficial cutting of the arms and wrists. Reports of lifetime sexual or physical abuse were more common among mutilators. Mutilators also had frequent histories of suicide attempts distinct from their mutilation behavior, multiple hospitalizations, and transfer to state hospitals for longer-term care. These findings suggest a chronic course with significant morbidity and associated features which may be of clinical significance.
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PMID:Clinical correlates of self-mutilation among psychiatric inpatients. 834 98

The demographic and diagnostic characteristics of inmates in State adult correctional facilities who received 24-hour hospital mental health care, residential treatment care, and counseling/therapy in 1988 are reported by State and by type of administrative auspices under which the services are provided. Rates under treatment for 24-hour hospital mental health care were highest for the youngest (under 18) and oldest (65 and over) age groups, for females, and for whites. For counseling/therapy, rates were also highest for the youngest, for females, and for whites, but they declined with age. Rates in residential treatment were highest for the young and old and for whites, but about equal for males and females. Primary diagnoses of major psychoses predominated in 24-hour hospital mental health care. In residential treatment, a comparatively small proportion of the caseload had major psychotic disorders and a comparatively large proportion had substance abuse and mental retardation diagnoses. In counseling/therapy, personality disorders predominated. Individual State figures vary widely on these characteristics, both within and between service auspice types.
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PMID:Demographic and diagnostic characteristics of inmates receiving mental health services in state adult correctional facilities: United States, 1988. 841 23

The goal of this study was to describe patterns of diagnosis and to explore the extent to which diagnosis changes during first-in-life psychiatric admissions. All 2,998 first admissions to Israeli psychiatric wards in 1989 were studied. Diagnosis did not change in at least 60% of the cases. Diagnoses in order of stability were: mental retardation (84%), substance abuse (82%), organic conditions (77.5%), neurotic (75%), schizophrenia (74%), personality disorders (73%), affective (68%), childhood (55%), paranoid (45%) and V-codes (22%). There was less change in diagnosis for patients over 45 (37.5%), than for patients aged 19-44 (43.2%) and 15-18 (57.8%). Diagnoses assigned at admission to first hospitalization are not likely to change during that hospitalization.
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PMID:Patterns of use and changes in diagnosis during first admission. National Case Register Study. 871 Oct 74

As the new generation of atypical antipsychotics becomes available, the limitations of the older typical agents become apparent. The new medications, which have benefits other than the alleviation of positive symptoms of schizophrenia, may also be beneficial for psychotic disorders that have responded poorly to conventional neuroleptics. This article will describe the potential use of the atypical antipsychotics, especially olanzapine, for affective mood disturbances in schizophrenia, psychotic depression and mania, first-break schizophrenia, comorbid schizophrenia and substance abuse disorders, dementia in the elderly and those with late-onset schizophrenia, and behavioral problems in patients with mental retardation or developmental delays.
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PMID:Olanzapine and the new generation of antipsychotic agents: patterns of use. 926 12

The frequency and clinical presentation of autism in 28 probands with tuberous sclerosis complex (TSC) are reported and risk factors that may influence the development of autism in TSC are examined. Eight probands meet ICD-10 and DSM-IV criteria for autism, an additional 4 meet criteria for pervasive developmental disorder (PDD). Twelve TSC probands with autism/PDD are compared to 16 TSC probands without these conditions for factors which may underlie the association of autism and TSC. A specific seizure type, infantile spasms, as well as mental retardation, are increased in the TSC, autistic/PDD group. Furthermore, rates of social phobia and substance abuse are elevated among first-degree relatives of TSC probands with autism compared to first-degree relatives of TSC probands without autism. Implications of these findings in understanding the association of autism and TSC are discussed.
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PMID:Autism in tuberous sclerosis complex. 958 71

This study examines gender and racial differences among Missouri insanity acquittees, which included 42 African American females, 279 African American males, 63 Caucasian females, and 458 Caucasian males. Significant differences across the four groups were not found in age, current marital status, a diagnosis of borderline intellectual functioning/mental retardation, committing crimes of assault and burglary, and whether insanity acquittees ever received conditional releases to reside in the community. Some variations across the four gender/race categories were related to race (diagnoses of schizophrenia, mood disorders, and other Axis I diagnoses), but variations were more frequently related to gender (whether ever married; diagnoses of substance abuse, sexual disorders, antisocial personality disorder, borderline personality disorder, and any personality disorder; committing crimes of murder, sexual offenses, and serious offenses; and current residential status). African American males were identified as being an at-risk population. They were the most likely to have a schizophrenia diagnosis, a substance abuse diagnosis, an antisocial personality disorder diagnosis, and to be hospitalized on the survey date. Implications for treatment and future research are explored.
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PMID:An examination of gender and racial differences among Missouri insanity acquittees. 978 85

The joint Commission on Accreditation of Healthcare Organizations has accredited behavioral health care organizations since 1957. Accredited behavioral health care organizations include organizations providing services to persons with psychiatric disorders, substance abuse disorders, or developmental disabilities/mental retardation; or, provide social services to other related populations. In the late 1980s, the Joint Commission initiated the redesign of accreditation to include performance measurement. Performance measurement initiatives include the IMSystem, Requests for Indicators, National Library of Healthcare Indicators, and a national Council on Performance Measurement. These initiatives are steps toward the integration of performance measurement data into the accreditation process.
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PMID:Joint commission evaluation of behavioral health care organizations. 1018 84

This paper surveys the epidemiological characteristics of the first 100 patients committed to a new private psychiatric hospital in Upper East Tennessee, under a pilot program of the Tennessee Department of Mental Health and Mental Retardation. The number of psychiatric commitments in the region has increased since the opening of a local hospital required, by contract, to accept them. While all commitments were because of a psychiatric diagnosis, many patients might have been treated as outpatients had their illness not been complicated by substance abuse. Greater integration of all levels of psychiatric care would make it possible for such patients to receive care in settings more appropriate to their condition before they experience a crisis requiring inpatient commitment.
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PMID:Commitment patients in a private psychiatric hospital: a pilot program in Tennessee. 1031 69

Alcohol and drug use among individuals with mental retardation (MR) has received little empirical attention. Two studies are reported: In Study 1, individuals (n = 122) with MR were surveyed regarding their personality characteristics, alcohol and drug use, and skills to avoid substance abuse. Results indicate that although the majority of participants did not drink alcohol, among those who did, the ratio of misusers to users was nearly 1:1. In addition, misusers were deficient in specific skill areas. In Study 2, participants (n = 84) were randomly assigned to receive a prevention program in either (a) assertiveness building, (b) modeling and social inference, or (c) a delayed treatment, control condition. Results suggest that each program, at least in the short-term, improved substance knowledge and enhanced skills. Overall, these results suggest that substance use interventions focused toward individuals with MR may be beneficial.
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PMID:Substance use in individuals with mental retardation. 1062 19


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