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

The unusual finding of an abnormal seasonal distribution of schizophrenic births, showing an excess of 10% in the winter or spring months and an equal deficit in the summer or autumn months, cannot be explained by artefacts. It has not yet been established whether the finding is specific to schizophrenia. We observed an excess of schizophrenic births of some 10% in March to May, significant at the 5% level, and a deficit of approximately the same size in June to August on the birth data of first-admission patients with the clinical diagnosis of schizophrenia. The data, obtained from the Mannheim Psychiatric Case Register, were compared with those of the Mannheim population and a control group matched by birth year and sex. The total population of mentally retarded children aged 7 to 16 years from the Mannheim population showed an excess of some 20% in April to June and an equal deficit in the last two quarters of the year, compared with the Mannheim population of the same birth years. The finding was not significant, but allowance must be made for the low case number of 415. We also compared 3409 first-admission patients with depressive syndromes (ICD 296 and 300.4) and 5615 first-admission patients with the diagnosis of "neurosis and personality disorders" (ICD 300-302, except 300.4, and 305-309) from the Mannheim Case Register with a control population and a parallel control group. Depressed males showed an excess of births in March to May, which was significant at the 1% level; the birth peak for females was smaller and not significant. The same findings were obtained for the category of neurosis and personality disorders, i.e. an excess of about 10% in March to May for males, significant at the 1% level, and a non-significant excess for females. Our findings are awaiting replication. Causal explanations will be discussed with great reservation. The procreational hypothesis, assuming those factors that lead to an equidirectional seasonal pattern of births with a slight deviation from the average of a year in the general population, to be reinforced in the disease categories mentioned, is regarded as the most simple and plausible explanation. It is based on the assumption that some of the parents of individuals suffering from schizophrenia, mental retardation or probably also some other mental disorders running from generation to generation, have a higher threshold in partner-seeking behaviour, which is overcome more easily in the summer months with the consequence of increased pregnancies.
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PMID:Abnormal seasonality of schizophrenic births. A specific finding? 367 92

Our investigation was concerned with 25 children, 10-13 years old, with an IQ 50-70 ("mild mental retardation," following the ICD). Among these, 14 attended a school for the mentally retarded and 11 one for the learning disabled. A control group was recruited, matched in age, sex and social class. The unipolar 8-channel record of EEG at rest was subjected to blind clinical rating, and a computerized analysis (broad band spectral parameters delta, theta, alpha 1, alpha 2, beta 1, beta 2). A significantly higher frequency of paroxysms was found by the clinical rating. It also allowed the diagnosis of a maturational lag with respect to the items "maturity" and "prominence of alpha rhythm"). Spectral parameters differentiated the two matched groups particularly in bands and leads of developmental relevance (theta, delta, and fronto-central beta in absolute power and theta, delta occipitally and alpha 2, with the exception of frontal leads for relative power).: As is well known, the mentally retarded constitute a heterogeneous group: this could also be verified with respect to EEG activity for the segment of mild mental retardation. A multivariate classification by nonmetric multidimensional scaling yielded a subgroup of 10 children deviant with respect to its overall EEG activity and a group of 15 children within the normal range. This assignment did not overlap with the assignment to the two schools. By computing ratios of broad band power in antero-posterior and symmetric-interhemispheric leads a reduced topographic differentiation was found for the experimental group in their antero-posterior distribution.
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PMID:The EEG of mildly retarded children: developmental, classificatory, and topographic aspects. 618 9

Several factors appear to impede the development of a valid taxonomy of psychopathology in children and adolescents with mental retardation. These include (a) the lack of a widely accepted definition of psychopathology in mental retardation, (b) disagreement on the nature of the relationship between mental retardation and psychopathology, and (c) insufficient evidence for the reliability and validity of current DSM or ICD systems in this population. In this article, we offer a definition of psychopathology in children with mental retardation; review concepts of the relationship between psychopathology and mental retardation; argue that in moving toward a valid taxonomy factors to be considered should include data from multivariate studies, findings related to behavior phenotypes, and diagnostic considerations with stereotypic behavior and self-injury, organic brain syndromes and pervasive developmental disorders. Finally, we outline a research strategy that may serve as a useful framework for developing a valid taxonomy of psychopathology in this population.
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PMID:Issues in the taxonomy of psychopathology in mental retardation. 755 82

Although fetal alcohol syndrome (FAS) is a major preventable cause of mental retardation in the United States (1), surveillance for this problem is subject to at least five constraints: difficulty in identifying the syndrome at birth (2); the subjective nature of the diagnosis; variability in the severity and type of conditions associated with FAS; age-specific variations in the expression of the phenotype; and the lack of specificity in the International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) code for FAS. Previous studies have documented high rates of FAS among American Indians and Alaskan Natives (ANs) (3,4). To better ascertain cases of FAS in Alaska and to determine the prevalence of this problem among ANs, the Alaska Department of Health and Social Services (ADHSS), the Indian Health Service (IHS), and CDC linked and analyzed data from state sources (i.e., birth and death certificates and Medicaid claims), an IHS case file, and a private pediatric practice case file. This report summarizes the findings from this analysis and presents a preliminary minimum FAS prevalence rate for ANs.
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PMID:Linking multiple data sources in fetal alcohol syndrome surveillance--Alaska. 847 26

The Berlin Deinstitutionalization Study investigates effects of the planned reduction of psychiatric hospital beds in Berlin prospectively. In the beginning cross-sectional survey all adult psychiatric patients from two and a half districts, who had been hospitalized for more than 6 months, were examined. The total sample was 422 patients. Treatment situation and needs for nursing care are reported. The primary diagnosis according to ICD-10 was organic disorder (incl. Korsakov's syndrome) in 70 patients and mental retardation in 61. Psychopathology and social disabilities were examined in 237 of the remaining 291 patients. On average, psychopathology and disabilities were moderate. A cluster analysis classified three groups. When patients should be discharged, special protective measures might be necessary only for the two smaller groups (together 31%).
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PMID:[Clinical characteristics of long-term hospitalized patients. Part I of the Berlin Deinstitutionalization Study]. 885 Dec 26

The prevalence of Developmental Coordination Disorder (DCD) among 6- to 9- year-old Singaporean primary school children was studied from a random sample (N = 427) through a two-step identification procedure contained within Henderson's and Sugden's Movement Assessment Battery for Children. The prevalence rate from this two step procedure was 4% when the first step included the bottom 15% of the random sample. The two-step procedure moves towards fulfilling the diagnostic criteria for DCD set out by the American Psychiatric Association (DSM-IV) and the World Health Organisation (ICD-10) of a serious motor impairment in the development of motor coordination and significant interference with the activities of daily living not due in children to mental retardation or a known physical disability.
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PMID:A two-step procedure for the identification of children with developmental co-ordination disorder in Singapore. 897 95

The controversy regarding the exact nature of the relationship between psychopathology and epilepsy continues. We studied the rate of mental disorder in 150 adults with mental retardation and epilepsy among the residents of a health district of the United Kingdom who lived either in institutions or in the community, and compared them with an age-, sex-, and IQ-matched nonepileptic adult mentally retarded population from the same institution and community. Mental disorder was assessed under three headings, namely severe maladaptive behavior, psychiatric illness according to ICD-9 criteria, and personality disorder. Sixty-five percent of the whole cohort had a diagnosis of mental disorder, and 55% showed severe maladaptive behavior. No significant difference in the rate of mental disorder emerged between the epileptic and nonepileptic groups, although the institutionalized subjects as opposed to the community-based subjects and severely mentally retarded adults compared with the mild to moderately mentally retarded adults showed a significantly higher rate of mental disorder in general and severe maladaptive behavior in particular. We hypothesized that underlying brain damage rather than epilepsy per se is a stronger determinant of psychopathology in the studied patient group.
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PMID:Mental disorder in adults with mental retardation and epilepsy. 915 75

In-utero exposure to influenza has been implicated as a risk factor for developmental CNS damage. This study tests the hypothesis that in-utero exposure to influenza: (1) in the second gestational trimester is associated with an increased risk of schizophrenia and affective psychoses; and (2) in the first gestational trimester is associated with an increased risk of mental retardation. Analysis was confined to 1852 cases on the Western Australian psychiatric case register with ICD-9 diagnoses of schizophrenia, affective psychoses, or neurotic depression (comparison group), and 804 cases on the Intellectual Handicap Register with mental retardation that were related to 82,963 'exposed' and 32,462 'non-exposed' births between 1950 and 1960 in the total population of Western Australia. The data were examined for effects associated with six influenza epidemics in the period 1950-1960. Using relative risk ratios for individual epidemics as well as Poisson regression and a proportional hazards model to examine systematic effects for the whole period, no major effect could be identified for maternal influenza on the incidence of schizophrenia, affective psychoses and neurotic depression, despite sufficient statistical power to detect an effect. However, a possible effect was found for mental retardation in males exposed in the first and second gestational trimester.
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PMID:Influenza epidemics and incidence of schizophrenia, affective disorders and mental retardation in Western Australia: no evidence of a major effect. 937 35

Elective mutism (EM) is not regarded as a separate diagnostic category in the ICD-9, but is included under the heading "313: Disturbance of emotions specific to childhood and adolescence." In the ICD-10 EM is acknowledged as a separate diagnosis defined as "a marked, emotionally determined lack of speech in certain situations in a child with a normal or near normal speech/language ability." The diagnosis excludes pervasive developmental disorder and specific developmental disorders of speech and language. Two patients referred for EM to a child and adolescent psychiatry outpatient clinic, showed specific developmental delays and assessment indicated slight mental retardation in one of them. The question arose regarding how extensively EM is reported in the literature as associated with developmental disorder/delay. A search was carried out in four data-bases where most references were listed under the keyword "mutism". This paper presents the two case studies, and the results of the literature inventory. It concludes that EM may be associated with developmental disorder/delay and suggests that this could be a predisposing factor for an emotionally determined lack of speech in certain situations.
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PMID:Elective mutism--associated with developmental disorder/delay. Two case studies. 944 3

This study reports a clinical experience among twenty schizophrenic patients treated by clozapine during two years and eight months within a range extending from three months to seven years. These twenty patients had previously shown long-term resistance to usual neuroleptics but three out of them met the diagnosis of mental retardation or childhood disintegrative disorder (F.84.3-ICD 10). These patients were put under clozapine for their violent behavior. The methodology was retrospective, descriptive with intra-individual comparison, each patient being his own reference before and after treatment. Diagnosis met CD 10 criteria and were assessed without using standard examination. This study aimed at assessing once more clozapine efficacy and tolerance upon a long time follow up. Single therapy has been the rule and dosages have been progressively increased reaching a mean daily dosage of 350 mg per day. The efficacy, assessed by the way of BPRS, GAF (DSM III-R) and simplified form of CGIS, has been verified in approximately 30% of the patients, mainly concerning positive symptoms. Clozapine was also able to alleviate severe behavior troubles brought about by delusional states, without this latter being markedly softened when it was a long term one. Clozapine tolerance has shown it to be satisfactory, however we noticed the occurrence of a leucopenia with neutropenia after seventeen weeks of treatment, followed, some days later, by a Quincke oedema, which forced to interrupt the treatment. White blood cells came back in a normal range fifteen days later. The other side effects (transitory hypersialorrhea, tachycardia, without clinical and ECG perturbations) have been usually well tolerated and have never caused treatment interruption. No extrapyramidal side effect have been noticed among our twenty patients. The end of this paper consists in the presentation of four clinical cases: one about the efficacy of clozapine upon violent antisocial behaviour in a schizotypital disorder; one delusional chronic schizophrenic patient whose violence has been controlled despite of the delusion; one paranoid schizophrenic patient who has been able to maintain a satisfactory professional and family adaptation; and finally a childhood disintegrative disorder (F.84.3-ICD 10) in whom occurred the only leucopenia side effect of our study. These four clinical cases have seemed particularly meaningful regarding our clinical experience of clozapine which has been lasting for almost seven years now.
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PMID:[Long-term clinical experience with clozapine]. 945 32


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