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PubMed1989

Developing a unit for mentally retarded-mentally ill patients on the grounds of a state hospital.

For some time patients with the dual diagnosis of mental retardation and mental illness have been recognized as a distinct patient population, but development of programs meeting their special needs is slow. In October 1986 a Massachusetts state psychiatric facility opened a rehabilitative program for such patients in a separate 40-bed unit on the hospital grounds. All patients admitted to the Specialized Habilitative and Rehabilitative Environment (SHARE) program had long histories of institutionalization, and many had been treated with neuroleptic drugs for several years. Most patients now attend day programming, and a few have been able to move on to less restrictive environments. Patients' average neuroleptic dosage has been substantially reduced. This progress has been made in spite of such program-development problems as the need to change staff's long-held perspectives about dual-diagnosis patients, lack of funding, and high staff turnover.

Health Services Needs and Demand↗
PubMed2002

Effects of visual arts instruction on the mental health of adults with mental retardation and mental illness.

Single-subject multiple probe designs were employed in two studies with 5 young adults who had a dual diagnosis of mental retardation and mental illness. Our aim was to determine effects of instruction designed to teach visual arts activity skills and promote personal expressiveness on acquisition, maintenance, and generalization of these skills and behaviors associated with these persons' mental health. In Study 1, a 5-second constant time delay procedure was used to teach three chosen art activities. In Study 2, an instructional package was used to promote personally expressive behaviors. After learning the skills in Study 1, participants in Study 2 displayed improvement in occurrence of behaviors associated with mental illness and increases in personally expressive behaviors.

Adolescent↗
PubMed1995

Discontinuation of neuroleptics in community-dwelling individuals with mental retardation and mental illness.

Many individuals with mental retardation and mental illness who are on neuroleptics can have the dose reduced or discontinued. A recent study, however, suggests that individuals with psychosis not only may be difficult to discontinue from neuroleptics but also may require an increased neuroleptic dose. The current study is a retrospective chart review. Individuals were followed for 12 months postneuroleptic discontinuation. Individuals with a "psychotic" disorder were significantly more likely to be restarted on neuroleptics at 3 months and 12 months. A logistic regression failed to reveal any psychotic symptoms that predicted resumption on neuroleptics. An absent history of delusions, however, was significantly associated with remaining neuroleptic-free at 3 months.

Activities of Daily Living↗
PubMed1989

Model services for treatment/management of the mentally retarded-mentally ill.

Mental illness affects nearly 25-30% of America's mentally retarded population. While a small number of these individuals will require institutional care, it is clearly possible to serve the majority in community-based residential settings. This paper will provide an overview of the various types of mental illness found in the mentally retarded population currently served by the Eastern Nebraska Community Office of Retardation (ENCOR), examine the treatment challenges which the provision of services to this special population have presented, and share recommendations as to how the ENCOR model can assist other communities in serving similar complex subpopulations in a developmental and cost-efficient manner.

Adult↗
PubMed1983

Organicity and mental retardation: organic mental syndrome battery.

Fifteen mentally retarded children were tested and compared to 10 normal school children. They were administered a battery of tests reflecting organic brain disease, consisting of the Face-Hand, Midline Crossing and Independent Eye Movements Tests. Normals performed correctly 98% of the time on the three combined tests, while the mentally retarded scored only 34% correct. There was a significant correlation between IQ and this battery of tests (the 'OMSB'). When the IQ and OMSB were conflicting, a repeat of the former indicated that the IQ value was erroneous. The OMSB may be useful along with IQ testing as a rapid screening method to evaluate the presence of organicity and its severity.

Adolescent↗
PubMed1984

Research with the mentally retarded and mentally ill: rights and duties versus compelling state interest.

This paper examines the assumptions underlying the ethical reasoning involved when the natural right to informed consent has been violated. Ramifications of the compelling need of the state to protect society by overriding the rights of individual freedom receive special attention. Specifically these issues are addressed: natural rights versus state's rights to preserve rights, state's rights versus parental autonomy, rights and duties versus paternalism, self interest and self survival versus the common good, coercion versus progress in research, and benefit versus cost. Building on these ethical considerations, the authors present a theoretical framework for ethical decision making with research involving the mentally retarded and the mentally ill.

Civil Rights↗
PubMed1985

Social validation of heterosexual social behavior in community settings: a comparison of mentally retarded and non-mentally retarded adults.

Adaptive heterosexual social interaction in community settings is an age-appropriate social skill. Subjective evaluation methodology was used as a social validation procedure to establish the appropriateness and optimal rate of occurrence of heterosexual social behaviors in bar and restaurant settings. Professionals working with mentally retarded persons and college students completed rating scales for hypothetical mentally retarded as well as non-mentally retarded subjects, respectively. The results show congruity between the behavioral expectations for mentally retarded and non-mentally retarded people in community settings. The findings suggest appropriate behaviors for training mentally retarded clients who lack adequate heterosexual community social skills.

Adolescent↗
PubMed1997

A consumer satisfaction survey of people with mental retardation and mental illness.

This study investigated consumer satisfaction among 98 members of the Thomas S. class action lawsuit in North Carolina, in which the court ordered implementation of habilitative and residential service plans. Class members have mental retardation, and most also have a mental illness. Before the court order, 83 of the consumers were inappropriately placed in state psychiatric hospitals; one year after, 82 were living in community residences. A survey at baseline and one year later indicated that consumers' satisfaction had increased significantly. They were more satisfied with where they lived, the food, and the level of freedom. They also felt that staff were more helpful, and that more staff were "nice" rather than "mean."

Adult↗
PubMed1975

[Uncommon form of idiopathic osteoporosis with hypercalciuria, growth retardation and mental retardation].

Case report of a 18 year old boy with short stature, microceophaly, mental retardation and multiple dysmorphic signs. At the age of 9 years a severe generalised osteoporosis was discovered. A pathological fracture of the greenwoor type healed without proper callus formation. The osteoporosis persists without signs of either deterioration or improvement. The serum phosphorus is slightly decreased, while serum calcium, alkaline phosphatase and renal functions are normal. The main biochemical finding is a constant hyperclaciuria of 6-13 mg/kg/24 h, which can be corrected by treatment with oral sodium phosphate. No other chronic disease could be found which would explain the bone disease. The complex disease of this boy does not fit into the known pictures of osteogenesis imperfecta, idiopathic juvenile osteoporosis or of idiopathic hypercalciuria, and might therefore be another type of demineralising bone disease. It is suggested, that the cause might be an impairment of the calcium fixation of collagen fibres during desmal ossification.

Abnormalities, Multiple↗
PubMed2000

MCA/MR syndrome with severe pre- and postnatal growth retardation, deep mental retardation, distinct facial appearance with nasal hypoplasia, cleft palate and retino-choroidal coloboma in two unrelated female patients.

We describe the clinical findings and natural history in two unrelated deeply mentally retarded females, now 28 and 20 years old respectively. Both presented prenatal growth retardation and severe postnatal growth retardation. Their craniofacial appearance is distinct with nasal hypoplasia, triangular mouth and thin lips. Both have a cleft palate and a retinal coloboma at the right eye. Motor development is below the age of 1 year with a complex neurological syndrome with axial hypotonia and spastic quadriplegia.

Abnormalities, Multiple↗
PubMed1991

Towards defining adequate lithium trials for individuals with mental retardation and mental illness.

Lithium has been recommended for some psychiatric conditions and/or behavior disturbances in patients with mental retardation. Components of an adequate clinical trial were described here and case studies and double-blind cases reviewed. Based on existing data, there are few guidelines for the use of lithium with this population. Of the various indicators for lithium, the most solid are for aggression, although the type of aggression is not specified: (a) achieve a serum concentration of at least 0.5 mEq/1 to 1.0 mEq/1 unless the patient responds or trial-ending side effects appear and (b) treat for 6 to 8 weeks before concluding that the patient will not respond.

Aggression↗
PubMed1990

On the nosology of moderate mental retardation with special attention to X-linked mental retardation. A diagnostic genetic survey of 274 institutionalized moderately mentally retarded men.

In this paper we report the results of a genetic-diagnostic survey of 274 institutionalized moderately mentally retarded adult males and compare these data with those from our previous studies in the severely mentally retarded and from a comparable population of 262 institutionalized moderately mentally retarded males and females (The Borgenstein experience). Special attention is paid to the nosology of X-linked mental retardation and familial mental retardation in general.

Belgium↗
PubMed1980

[Clinical systematics of retarded mental development].

The clinical classification of mental retardation is reported. Three main clinical groups were screened: 1) mental retardation, due to the immaturity of the emotional-volitional sphere (different forms of mental infantilism); 2) mental retardation due to disturbances in the cognitive sphere (in stable neurodynamical and encephalopathic disturbances, deficiency in the higher cortical and subcortical functions; in disturbed regulation of cognitive activity); 3) general mental retardation, due to a combination of a disturbed cognitive sphere with organic infantilism. The paper concerns differential criteria for oligophrenia. It is recommended that children with stable retardation of the cognitive sphere be taught in special schools.

Brain Diseases↗
PubMed1995

FRAXE and mental retardation.

Mental impairment and instability of the CCG repeat at FRAXE is described in six kindreds. Cosegregation of FRAXA and FRAXE was found within one of these kindreds. Cytogenetic expression of FRAXE was shown to skip a generation when associated with a reduction in size of the CCG expansion when transmitted through a male; however, in general, transmission occurred through females and a copy number increased from one generation to the next. In these respects the behaviour of FRAXE paralleled that of FRAXA. A relationship between FRAXE and non-specific mental impairment is strongly suggested by the occurrence in these families of more mentally impaired male and female carriers, after removal of index cases, than could reasonably be expected by chance.

Adolescent↗