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

We examined whether a leading instrument for the prediction of future violence in those with a mental disorder. The Historical, Clinical, Risk Management-20 (HCR-20) was equally effective across a wide range of mental health diagnoses. Records at the time of discharge from secure psychiatric services were used to score the HCR-20 risk assessment scheme. Patients were stratified according to whether they had received a particular mental health diagnosis. Reconvictions within 2 years of discharge were obtained from official sources and classified as to whether the offence was violent or not. Those with a diagnosis of either personality disorder or substance abuse were most likely to be reconvicted, whilst those with either a diagnosis of schizophrenia or mental retardation were the least likely. The HCR-20 was a statistically significant predictor of future violence in all groups; however, it returned only weak effects for the personality disordered group, but strong effects for those in the schizophrenia or mental retardation group. The HCR-20 risk assessment scheme is effective across a wide range of diagnoses. Nevertheless, the prediction of future events appears more difficult in those disorders characterized by impulsive behaviors and further research efforts are needed to understand how such prediction can be improved.
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PMID:Predicting violence using structured professional judgment in patients with different mental and behavioral disorders. 2109 13

In Portugal, offenders found not guilty by reason of insanity (NGRI), may be given a restricted order to a special hospital as an alternative to prison. In European countries there is a recognized need for data concerning this special population. The aim of the present study was to examine the characteristics of all the NGRI subjects (n = 274) detained in the country in a descriptive and retrospective survey conducted in January 2009. Offence committed, demographic factors, diagnosis at admission, background of substance abuse and diagnostic stability were recorded. Schizophrenia was the commonest diagnosis (51.5%). Mean population age was 42.6 years, with only 6.2% women. Homicide was the most common offense (41.2%). A background of substance abuse was found in 42.3% of subjects. There were significant differences in the schizophrenia and mental retardation patient groups when compared individually with the other diagnoses concerning homicide and arson as the offence. Mean duration of inpatient stay did not differ significantly between diagnoses. The findings also point to poor follow-up of the NGRI patients after admission.
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PMID:Characteristics of offenders deemed not guilty by reason of insanity in Portugal. 2113 64

The present investigation was aimed at studying the efficacy of cognitive behavior therapy (CBT) in reducing the symptoms of stuttering and dysfunctional cognitions and in enhancing assertiveness and quality of life in clients with stuttering. Five clients with stuttering who met the inclusion criteria (male clients with diagnosis of stuttering) and exclusion criteria (clients with brian damage), substance abuse or mental retardation were enrolled for the study. A single-case design was adopted. The pre-, mid- and post-assessment were carried out using Stuttering Severity Scale (SSI), Perception of Stuttering Inventory (PSI), Beck's Anxiety Inventory (BAI), Dysfunctional Attitude (DAS), Fear of Negative Evaluation (FNE), Assertiveness Scale (AS), Rosenberg's Self-Esteem Scale (RSES), and World Health Organization - Quality of Life Scale (WHO-QOL). Five clients received cognitive behavioral intervention comprising of psycho-education, relaxation, deep breathing, humming, prolongation, cognitive restructuring, problem-solving strategies and assertiveness. At post-treatment assessment, there was improvement. The findings of the study are discussed in the light of available research work, implications, limitations of the study and suggestions for future research.
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PMID:Cognitive behavior therapy for stuttering: a case series. 2179 60

In part 1, we discussed the mechanism of alcohol exposure, dosimetry, and the teratogenic pathways of damage to the fetus. In part 2, we review the diagnosis of fetal alcohol spectrum disorders and the developmental implications of prenatal alcohol exposure. Fetal alcohol spectrum disorders are associated with increased rates of mental retardation, seizure disorders, brain malformations, and premature mortality. The risk of comorbid disorders is increased among this population, which enhances phenotype severity and complexity of management. Recurrence rates are high and younger siblings tend to be more severely affected. Detection of prenatal alcohol use warrants substance abuse intervention, which can avoid exposure in subsequent pregnancies. Fetal alcohol spectrum disorders are common developmental disorders with a phenotype that is influenced by both age and development and require long-term management. Child neurologists are essential in the diagnosis and management of fetal alcohol spectrum disorders.
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PMID:Fetal alcohol spectrum disorders--implications for child neurology, part 2: diagnosis and management. 2224 13

Involuntary psychiatric admission is a central issue in mental health care, especially in the treatment of children and adolescents. Its legal regulations do not only differ between European countries, but also on a federal level. Only few studies so far dealt with rates of involuntary admission (RIA), mainly focusing on adults, rather than children and adolescents. None of the studies analyzed this topic in a large cohort. The aim of this regional cross-sectional study was to compare voluntary and involuntary admissions in child and adolescent psychiatry (CAP) regarding personal and admission characteristics. Furthermore, risk factors and predictors of involuntary admission should be identified. A retrospective analysis of hospital admission registers from three major German CAP hospitals over a period of 6 years (2004-2009) was conducted (N = 10,547 inpatients). Group comparisons between involuntarily and voluntarily treated minors and a logistic regression to determine predictors of legal status were performed. Information on harm to self or others prior to the admission, medication and clinical outcome was not available due to data structure. 70.8 % of patients were voluntarily and 29.2 % involuntarily admitted. Both subsamples comprised more males. The RIA decreased consistently over the years, ranging from 25.7 to 32.4 %. The strongest predictor of being admitted involuntarily was suffering from mental retardation (OR = 15.74). Adolescence, substance abuse, psychotic disorders and admission on duty time were also strongly associated (OR > 3). In this first large cohort study on involuntary treatment of children and adolescents in Germany, about every fourth patient was treated involuntarily. Certain personal and disease-related factors increased the risk. Commitment laws and other legal instruments for regulating involuntary placements are inconsistent and a standardized description or systematic analysis is needed. The influence of demographic, institutional variables and care and health services aspects should also be investigated.
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PMID:Voluntary versus involuntary hospital admission in child and adolescent psychiatry: a German sample. 2379 31

Speaking to the participants of Virginia's First Prevention Institute in 1988, Stephen Goldston, previous Director of NIMH'S Prevention Division asked, "Why is it that as I go from state to state learning about their prevention programs I hear that fewer and fewer dollars are going into prevention, but in Virginia prevention seems to be growing at a steady pace"? Goldston's perception of Virginia is quite accurate. Moreover, 1988 will probably be seen as a major benchmark in the growth of prevention services in the Commonwealth because the Virginia Department of Mental Health, Mental Retardation and Substance Abuse Services (VA DMHMRSAS) established specific priorities for prevention services and a separate funding stream so that these priorities could be offered by the localities. These actions represent major strides for Virginia's prevention community, strides that began with the Legislature in 1980.
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PMID:Prevention in Virginia: Ten years of progress. 2426 7

The protein kinase C (PKC) isoforms, which play an essential role in transmembrane signal conduction, can be viewed as a family of "memory kinases." Evidence is emerging that they are critically involved in memory acquisition and maintenance, in addition to their involvement in other functions of cells. Deficits in PKC signal cascades in neurons are one of the earliest abnormalities in the brains of patients suffering from Alzheimer's disease. Their dysfunction is also involved in several other types of memory impairments, including those related to emotion, mental retardation, brain injury, and vascular dementia/ischemic stroke. Inhibition of PKC activity leads to a reduced capacity of many types of learning and memory, but may have therapeutic values in treating substance abuse or aversive memories. PKC activators, on the other hand, have been shown to possess memory-enhancing and antidementia actions. PKC pharmacology may, therefore, represent an attractive area for developing effective cognitive drugs for the treatment of many types of memory disorders and dementias.
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PMID:The "memory kinases": roles of PKC isoforms in signal processing and memory formation. 2448 97

The percentage of people with mental retardation in the general population is estimated at about 2.3%, with adolescence (15-20 years) constituting the development period during which a peak in rates of mental retardation is observed. The increased prevalence of adolescence may be explained from the fact that the specified requirements of the school initially, and society later, inevitably lead to comparative evaluation of the teen with mental retardation in relation to peers, thus making mental retardation more apparent. Adolescents with mental retardation face a number of physical and psychological needs which are not often distinguishable and as a consequence undergo the deterioration of their already burdened quality of life. In particular, mental health problems occur 3 to 4 times more often in adolescents with mental retardation compared with adolescents of the general population. This review presents the most recent epidemiological findings regarding the correlation between behavioral disorders, substance use and the possible comorbidity in adolescents with intellectual disability, both at community level and residential care level. Epidemiological data indicate that behavioral disorders are among the most common types of psychopathology in mentally retarded adolescents with the severity and symptoms varying depending on the personal characteristics of each adolescent. Regarding substance use, the available data show that the rates of substance use (alcohol, smoking, illicit drugs) are lower in this specific population group but the differences over the last years tend to be eliminated. Finally, according to the few surveys that were examined referring to the comorbidity of behavioral disorders and substance use in adolescents with intellectual disability, the results were contradictory. Specifically, while behavioral disorders continued to be one of the most common types of psychopathology, the related substances disorders indicated lower rates compared to normal intelligence adolescents with behavioral disorders. Risk factors that increase the chances of developing either simple or more complicated types of psychopathology in adolescents with mental retardation have been found to be based on individual, family and social levels. On the other hand, the individual characteristics of adolescents (intellectual level, attention capacity, understandable linguistic expression, overall progress until adolescence), the existence of a supportive family environment and the presence of social support and awareness through the creation of special counseling, education and medical services, are the most important protective factors which contribute to the prevention of several forms of psychopathology in adolescents with mental retardation. For the writing of the literature review, the following electronic databases were used: PubMed, Scopus, Psycinfo, Cochrane Library, Web of Science and Google Scholar. The key words used were: Intellectual Disability, Behavioral disorders, Adolescents, Mental Retardation, Learning disabilities, Developmental Disabilities, Disruptive behaviour disorders, Conduct disorder, Substance Abuse, Substance Misuse, Oppositional defiant disorder, Alcohol and illicit drug use, Smoking Use, Young people, Teenagers, Youths.
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PMID:[Behavioral disorders and substance abuse in adolescents with mental retardation]. 2503 83

Fragile X syndrome (FXS) is caused by the full mutation (>200 CGG repeats) in the Fragile X Mental Retardation 1 (FMR1) gene. It is the most common inherited cause of intellectual disability (ID) and autism. This review focuses on neuropsychiatric disorders frequently experienced by premutation carriers with 55 to 200 CGG repeats and the pathophysiology involves elevated FMR1 mRNA levels, which is different from the absence or deficiency of fragile X mental retardation protein (FMRP) seen in FXS. Neuropsychiatric disorders are the most common problems associated with the premutation, and they affect approximately 50% of individuals with 55 to 200 CGG repeats in the FMR1 gene. Neuropsychiatric disorders in children with the premutation include anxiety, ADHD, social deficits, or autism spectrum disorders (ASD). In adults with the premutation, anxiety and depression are the most common problems, although obsessive compulsive disorder, ADHD, and substance abuse are also common. These problems are often exacerbated by chronic fatigue, chronic pain, fibromyalgia, autoimmune disorders and sleep problems, which are also associated with the premutation. Here we review the clinical studies, neuropathology and molecular underpinnings of RNA toxicity associated with the premutation. We also propose the name Fragile X-associated Neuropsychiatric Disorders (FXAND) in an effort to promote research and the use of fragile X DNA testing to enhance recognition and treatment for these disorders.
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PMID:Fragile X-Associated Neuropsychiatric Disorders (FXAND). 3048 60

Numerous studies have shown that the rate of sexual victimization against children with disabilities is higher than the rate for children without disabilities. The study focuses on examining sexual crime against children with disabilities and explaining differences in victimization to elucidate to what extent types of disability, family disadvantages, gender, high-risk behavior, and location influence adolescents' risk of sexual victimization. Data are based on a national study of reported sexual crime against children in Denmark aged between 7 and 18 years using total birth cohorts (N = 679,683). The statistical analysis is a discrete-time Cox model. An extended list of potential risk factors was included in the analysis to adjust for confounding. The potentially confounding risk factors were collected independently from various population-based registers, for example, employment statistics, housing statistics, education statistics, income compensation benefits, and population statistics (e.g., gender, age, location). Hospital records with information on types of disability based on the national inpatient register and national psychiatric register were collected independently of the collection of law enforcement records about reported sexual offenses under the Danish Central Crime Register. Among total birth cohorts, 8,039 persons or 1.18%. were victims of a reported sexual crime once or several times. Children with intellectual disabilities were more likely to be victimized of a reported sexual crime than non-disabled children were: attention-deficit/hyperactivity disorder (ADHD), odds ratio: 3.7 (3.5-3.9); mental retardation, odds ratio: 3.8 (3.6-4.0); and autism, odds ratio: 3.8 (3.6-4.0). This contrasts with children with speech disability, stuttering, and dyslexia who were less likely to be victimized when adjusted for family vulnerability and other confounding risk factors. Intellectual disability and family vulnerability, for example, parental substance abuse, parental violence, family separation, the child in care, and parental unemployment, indicate an increased risk of being a victim of a sexual crime, while speech disability seems to be ensuring protection.
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PMID:Sexual Crime Against Schoolchildren With Disabilities: A Nationwide Prospective Birth Cohort Study. 3260 4


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