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Query: UMLS:C0917816 (mental retardation)
 15,867 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Schizophrenic patients in long-term care programs may not have been carefully diagnosed according to current criteria. As part of a clinical reassessment program at a state hospital, the author randomly assessed 72 patients who carried a diagnosis of schizophrenia. The diagnosis of schizophrenia by DSM-III-R criteria was confirmed in 45 patients. Various organic disorders were diagnosed in seven patients. Four patients had bipolar affective disorder, manic; one patient had schizoaffective disorder, depressed; one patient had a substance use disorder; and two had primary mental retardation or pervasive developmental disorder. Twelve patients had unclear or atypical syndromes.
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PMID:Reassessment of state hospital patients diagnosed with schizophrenia. 252 Oct 89

Thirty-six chronically psychotic patients (nine men and 27 women, mean age 56.7 +/- S.D. 13.4 years) were found to have elevated thyroid stimulating hormone (TSH) levels during review of thyroid function screening tests of 1150 patients over a 15 month period in a 700 bed state mental hospital. This study population of 36 patients was more likely to be female and older than the general hospital population. The spectrum and frequency of psychiatric diagnoses included dementia (3); schizoaffective disorder (12); bipolar disorder (6); schizophrenic disorder (4); organic affective disorder (7); major depression (3); and mental retardation (1). Only nine of these 36 patients failed to receive the goitrogens lithium (LI), carbamazepine (CBZ) and/or phenytoin (PTN) and five of those nine patients had a history of thyroid disease. Sex did not predict age, thyroxine (T4) level, triiodothyronine (T3) uptake, or TSH. The distribution of psychiatric diagnoses were the same for both sexes. Expectedly, there was an inverse relationship between TSH and T4 and T3 uptake. Using T4 to separate grades 1 and 2 hypothyroidism revealed that six (17%) patients had grade 1 disease. Men were more likely to have a seizure disorder and receive LI, CBZ, and PTN. Women were more likely to have a history of thyroid disease. The goitrogenic effects of LI + CBZ seemed additive compared with patients receiving LI alone. While T4, T3 uptake, and LI levels were the same for the two groups, patients receiving LI + CBZ had higher TSH values (p = 0.028) than did patients receiving LI alone.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Grades 1 and 2 hypothyroidism in a state mental hospital: risk factors and clinical findings. 310 44

Fragile X (or Martin-Bell) syndrome, a common, genetic, mental retardation disorder is increasingly being recognized as a major cause of cognitive disability and psychiatric illness in boys. Here, we present a study in which relatives in 4 generations of a large family with the fra(X) chromosome were given comprehensive psychiatric evaluations in order to further describe the psychopathology associated with this condition. Three of 4 males with the fra(X) chromosome were found to have autistic behavior. An adult fra(X) male had a chronic schizoaffective disorder and mental retardation. In female relatives, a relationship was found between the fra(X) carrier status and psychopathology including schizoaffective and major affective disorders.
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PMID:Psychiatric disability associated with the fragile X chromosome. 395 57

The effect of clozapine, an atypical antipsychotic medication, in five patients with treatment-resistant schizophrenia or schizoaffective disorder and borderline intellectual functioning or mental retardation (MR) was studied. Four of the five patients responded favorably to clozapine with few side effects. Progressive improvement in psychopathology, social functioning, and ability to participate in daily activities were noted.
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PMID:The use of clozapine in borderline-intellectual-functioning and mentally retarded schizophrenic patients. 814 26

The present study examined 35 mothers (29 premutation carriers) of children with fragile-X syndrome in measures of intelligence and psychiatric disorders by comparing them with two control groups: a) 30 mothers of children in the general population and b) 17 mothers of non-fra-X retarded children with autism. Premutation carriers had a higher frequency of affective disorders than mothers from the general population. Preliminary data indicate that normally intelligent premutation carriers of the fra-X genetic abnormality have a similar frequency of affective disorders (DSM-III-R criteria [APA, 1987]) than mothers of autistic children. Neither carriers of the premutation nor carriers of the full mutation in the fra-X group obtained a diagnosis of the schizophrenia-spectrum (schizophrenia, schizophreniform disorder, and schizoaffective disorder). Carriers of the fra-X full mutation had considerably lower IQ than carriers of the fra-X premutation. There was a negative correlation between length of CGG repeats and IQ which failed to reach significance in both groups of fra-X carriers. Psychiatric morbidity was not restricted to carriers of the fra-X full mutation only but was also present in normal intelligent premutation carriers. Furthermore the age of onset of psychiatric morbidity in both groups of mothers of fra-X children as well as the group of mothers with autistic children was much earlier than the age when mental retardation had been diagnosed in their children. Increased psychosocial burden of raising a developmentally retarded child and/or feelings of guilt of being a fra-X carrier can therefore not fully explain our findings (three-fold higher frequencies of affective disorders compared to mothers from the general population).
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PMID:Fragile-X carrier females: evidence for a distinct psychopathological phenotype? 884 76

Electroconvulsive therapy (ECT) in patients with mental retardation has received limited study and is a subject of controversy. Specific difficulties in using ECT for this patient population include diagnostic dilemmas, difficulties with measuring outcome and monitoring side effects, and problems with professional attitudes. We report our experience with two cases in which ECT was applied to treat severe psychotic and catatonic symptoms. In case 1, a 22-year-old male patient with a history of moderate mental retardation, bipolar disorder, and neuroleptic malignant syndrome was admitted to manage his disruptive behavior and psychotic symptoms. The patient responded well to six bilateral ECTs with diminution of his psychotic symptoms and behavioral disturbances. In Case 2, a 39-year-old female patient with a history of mental retardation, schizoaffective disorder, and catatonic symptoms successfully responded to 11 bilateral ECTs. We conclude that ECT can be used safely and effectively in patients with mental retardation and severe or refractory psychotic symptoms.
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PMID:ECT and mental retardation: a review and case reports. 1141 28

U.S. courts frequently require forensic examiners to offer opinions concerning the likelihood that criminal defendants found incompetent to stand trial can have their competence "restored" through treatment. Yet no jurisdiction has established legal guidelines for testimony concerning restorability, and several authors have suggested that mental health professionals cannot accurately predict whether treatment to restore competence will succeed. This study asked whether reliable information that is consistently available at the time of examination might support empirically grounded opinions about the likelihood of restoration. Using records from all 351 inpatient pretrial defendants who underwent competence restoration at a state psychiatric hospital from 1995 through 1999, I evaluated whether several types of information that are reliable and that could consistently be made available to forensic examiners--including evaluees' demographic characteristics, diagnoses, symptom patterns, criminal charges, number of prior public sector hospitalizations, and cumulative prior length of stay (LOS)--would predict outcome of restoration efforts. I modeled the probability of successful restoration using logistic regression equations, and evaluated the equations' predictive accuracy using k-fold cross-validation and receiver operating characteristic (ROC) analysis. Lower probability of restoration was associated with having a misdemeanor charge, longer cumulative LOS, older age, and diagnoses of mental retardation, schizophrenia, and schizoaffective disorder. Although the overall rate of successful restoration for felony defendants was 75 percent, logistic equations allowed selection of subgroups with high predicted probabilities of restoration (>90%) and low probabilities of restoration (<35%). In cross-validation simulations, predictive equations had ROC areas of 0.727 for all defendants, and 0.735 for felony defendants. These findings provide scientific support for testimony that two types of incompetent evaluees have well-below-average probabilities of being restored: chronically psychotic defendants with histories of lengthy inpatient hospitalizations and defendants whose incompetence stems from irremediable cognitive disorders (such as mental retardation). Nonetheless, courts may still deem low probabilities of success to be "substantial" enough to warrant attempts at restoration.
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PMID:Predicting restorability of incompetent criminal defendants. 1738 44

Dyke-Davidoff-Masson syndrome, or cerebral hemiatrophy, is a pre- or perinatally acquired entity characterized by predominantly neurologic symptoms, such as seizures, facial asymmetry, contralateral hemiplegia, and mental retardation. Psychiatric symptoms are rarely reported. We report the first case of left cerebral hemiatrophy and a late onset of treatment-resistant schizoaffective disorder after a stressful life event. The patient finally responded well to clozapine. The clinical history and results from structural neuroimaging are highlighted to discuss the possible developmental bias for psychotic disorders.
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PMID:Treatment-refractory schizoaffective disorder in a patient with dyke-davidoff-masson syndrome. 1916 86

ABSTRACT Neuroleptic malignant syndrome (NMS) is a potentially fatal disorder associated with the use of neuroleptics. Clinical research on NMS to date has focused exclusively on adults, but increasing numbers of juvenile cases have been reported. Two cases of juvenile NMS treated by the authors are discussed to demonstrate early warning signs, possible contributory factors, and effective treatment strategies. Forty-nine reported cases of NMS in children and adolescents are then reviewed in order to assess frequency, possible risk factors, predictors of poor outcome, and effective treatment. The most common diagnosis is schizophrenia (35%) followed by bipolar disease (12%), schizoaffective disorder (8%), and mental retardation (8%). Over half the reported cases involve treatment with high potency neuroleptics (57%), compared to only 14% with low potency neuroleptics. The death rate in patients 18 years or younger is 16%. In adolescent patients, the death rate is 13%; this rate increases to 27% in patients 12 years or younger. A recent adult study, by contrast, estimates a mortality rate of only 4%. We conclude that NMS in children, may be underdiagnosed, and that failure to diagnose may contribute to relatively high juvenile mortality rates.
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PMID:Neuroleptic malignant syndrome in children and adolescents: two case reports and a warning. 1963 Jun 50

Coprophagia or the ingestion of feces, considered to be a variant of pica, has been associated with medical disorders like seizure disorders, cerebral atrophy, and tumors and with psychiatric disorders like mental retardation, alcoholism, depression, obsessive compulsive disorder, schizophrenia, schizoaffective disorder, fetishes, delirium, and dementia. But entomophagy or the practice of eating live or dead insects as food by humans has only been reported as part of eating habits by some cultures in the world and not in association with any medical or neuropsychiatric disorders. Till date, there is no report in medical literature of entomophagy as an association with any neuropsychiatric or medical illnesses. Coprophagy and entomophagy has not been together reported as well. We describe the first ever case report of a 19-year- old male patient diagnosed with undifferentiated schizophrenia and associated with both entomophagy and coprophagy. His schizophrenic symptoms, the entomophagic, coprophagic behaviors improved with olanzapine therapy. Entomophagy and coprophagy, two very unusual human behaviors, can be seen in association with schizophrenia.
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PMID:Entomophagy and coprophagy in undifferentiated schizophrenia. 2193 94


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