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PubMed1980

Age, degree of mental retardation, institutionalization, and socioeconomic status as determinants in the oral hygiene status of mentally retarded individuals.

Oral hygiene has been implicated as a casual factor in the development of dental caries and periodontal disease in mentally retarded individuals. Little attention, however, has been given to the determinants of oral hygiene status. The present paper assesses the oral hygiene status of institutionalized (I) and noninstitutionalized (NI) mentally retarded (MR) individuals aged 4 through 25, in relation to age, degree of mental retardation, and socioeconomic status. Institutional status was found to be a major determinant in oral hygiene conditions of the study group, as IMR individuals had significantly higher OHI scores than NIMR individuals. Associations of age and OHI were significant only for NIMR. Although differences between I and NI groups, with respect to degree of mental retardation, were seen for mildly, moderately, and severely retarded, no significant difference in OHI scores between I and NI profoundly retarded was seen. Socioeconomic status was not found to be a significant factor in the oral hygiene status of MR individuals. This study emphasizes the need to assess age, degree of mental retardation, and institutional status when implicating oral hygiene in caries and periodontal disease prevalence in MR individuals.

Adolescent↗
PubMed1990

Social behavior and knowledge of social "scripts" among mentally retarded adults.

Mentally retarded individuals' script-based knowledge and performance of routine events was explored. Twenty mentally retarded adults and 20 nonretarded preschoolers were asked to sequence photographs of events depicted in familiar and novel contexts. Retarded individuals were better able to sequence events depicted in familiar contexts than in novel contexts, suggesting deficits in generalizing social knowledge. Preschoolers performed above chance levels in the familiar context only. Observations of retarded individuals during naturally occurring events indicated that actual social behavior was unrelated to event knowledge.

Activities of Daily Living↗
PubMed1982

Macroorchidism and fragile X in mentally retarded males. Clinical, cytogenetic, and some hormonal investigations in mentally retarded males, including two with the fragile site at Xq28, fra(X)(q28).

One hundred and seventy eight males resident in an institution for the mentally retarded were screened clinically for the presence of macroorchidism, using the standard orchidometer. In this way 52 males with a testicular volume of 25 ml and over were found. Of these, 11 had pronounced macroorchidism (above 25 ml). All 52 males were examined cytogenetically for the fragile X. Two patients with pronounced macroorchidism showed this abnormality. Although the other nine patients with pronounced macroorchidism were reexamined with FUdR-addition to blood cultures, no further cases positive for the fragile X were found. Also, the thyroid function as well as the prolactin level in serum were investigated in all 52 males. No significant abnormalities were found. The high incidence of macroorchidism in mentally retarded males is underlined; however, it is suggested that the definition of macroorchidism should take into account several parameters.

Adult↗
PubMed1988

The number of mentally retarded--a result of steps taken by society? Changes in the age structure among mentally retarded persons in Sweden 1973-1982.

The statistics for 1983, issued by the Swedish National Board of Health and Welfare, show among other things, that the age structure among mentally retarded persons has undergone a striking change since 1973, but that the number and proportion of mentally retarded persons in the total population has not changed; there are fewer children and young persons and more adults. The author of this article considers that the reasons for the changes which have taken place during one single decade may preliminarily and hypothetically be attributed to prenatal diagnosis, improved techniques in obstetrics, the introduction of antibiotics in 1948, as well as further noticeable improvements in the medical and social care provided for mentally retarded persons. Apart from prenatal diagnosis, the measures mentioned were not intended to have exactly this result in each specific case, but if the hypotheses--totally or partly--are true, knowledge of the underlying factors will have consequences, first and foremost for future public health and medical services planning. Steps cannot be taken for the restriction or increase of the number of Caesarean sections or prenatal diagnosis, for example, with no thought of the consequences for the increase, respectively decrease in the number of mentally retarded persons. This means that the number of mentally retarded persons in society can be controlled.

Age Factors↗
PubMed1999

Practice parameters for the assessment and treatment of children, adolescents, and adults with mental retardation and comorbid mental disorders. American Academy of Child and Adolescent Psychiatry Working Group on Quality Issues.

Mental retardation (MR) is a heterogeneous condition defined by significantly subaverage intellectual and adaptive functioning and onset before age 18 years. With an approach underscored by principles of normalization and the availability of appropriate education and habilitation, persons with MR generally live, are educated, and work in the community. Mental disorders occur more commonly in persons with MR than in the general population. However, the disorders themselves are essentially the same. Clinical presentations can be modified by poor language skills and by life circumstances, so a diagnosis might hinge more heavily on observable behavioral symptoms. The diagnostic assessment considers and synthesizes the biological, psychological, and psychosocial context of mental disorders. Comprehensive treatment integrating various approaches, including family counseling, pharmacological, educational, habilitative, and milieu interventions is the rule.

Adolescent↗
PubMed1993

Neuroleptic and antiepileptic treatment in the mentally retarded.

The mentally retarded often need concomitant antiepileptic and neuroleptic drug treatment. High doses of neuroleptic drugs may provoke seizures. Antiepileptic drugs may aggravate behavioural problems. The mutual influence of neuroleptic and antiepileptic drug treatment and the effect of seizure control were studied in 20 mentally retarded patients between 1980 and 1989. The treatment was tailored individually, aiming at the lowest effective dose. Carbamazepine was preferred to phenobarbital and phenytoin. The mean defined daily dose (DDD) of neuroleptics and antiepileptics was reduced by 64% and 5%, respectively. Changing the mean DDD of neuroleptics neither correlated significantly with seizure activity nor with the change of the mean DDD of the antiepileptics. Evidently, seizure control may be improved by small neuroleptic doses in some patients. In one patient, however, a non-convulsive status epilepticus was associated with the introduction of neuroleptics. The assumption that carbamazepine has a beneficial effect on behavioural problems was not supported. Apparently, changing the regime of antiepileptics contributed to less neuroleptic requirements, possibly through reduced side-effects and/or improved seizure control. When combining neuroleptics and antiepileptics, interactions should always be considered. The epileptogenic effect of small to standard doses of neuroleptic drugs should, however, not be overemphasized.

Adult↗
PubMed2003

The use of telomere probes to investigate submicroscopic rearrangements associated with mental retardation.

Idiopathic mental retardation is a common condition the origins of which are poorly understood. Following initial reports that small chromosomal rearrangements affecting telomeres could be an important aetiological contributor, several new methods for screening patients have been developed. Over the past few years, 22 studies have reported results from 2585 patients. The prevalence of abnormalities in the entire group is 5.1%; but the figure is higher (6.8%) in individuals with moderate to severe mental retardation. About half the cases are caused by a de novo deletion, and about half by a balanced translocation segregating in a patient's family. Despite the large sample size available, it is still not clear whether a combination of thorough clinical examination and assiduous cytogenetic investigation might not be as effective at detecting subtelomeric anomalies as molecular assays.

Chromosome Aberrations↗
PubMed1996

[Acute gastric dilatation and superior mesenteric artery syndrome in the mentally retarded].

Three mentally retarded male patients, 24, 30 and 14 years old, died from acute gastric dilatation leading to rupture and perforation. Superior mesenteric artery syndrome (SMA) was the cause of gastric dilatation in two of them. In the third patient the cause was not clear. The three patients had scoliosis and were underweight or thin. Two had spastic quadriplegia of perinatal origin and one had Down's syndrome. One patient with SMA was treated by Nissen fundoplication because of hiatus hernia with vomiting and gastro-oesophageal reflux one week before he died. Another patient had a severe gastric bleeding after decompression of the dilatation. In mentally retarded patients there are often several predisposing factors for SMA (anorexia, severe weight loss in a short time, pronounced lumbar lordosis, scoliosis, correction of scoliosis by operation or plaster cast, prolonged lying position, boulimia). Gastric dilatation may be prevented by ensuring adequate nutritional status.

Adolescent↗
PubMed1997

Bilateral periventricular nodular heterotopia with mental retardation and syndactyly in boys: a new X-linked mental retardation syndrome.

Bilateral periventricular nodular heterotopia (BPNH) is a recently recognized malformation of neuronal migration, and perhaps proliferation, in which nodular masses of gray matter line the walls of the lateral ventricles. Most affected individuals have epilepsy and normal intelligence with no other congenital anomalies. A striking skew of the sex ratio has been observed because 31 of 38 probands have been female, and one gene associated with BPNH was recently mapped to chromosome Xq28. We report three unrelated boys with a new multiple congenital anomaly-mental retardation syndrome that consists of BPNH, cerebellar hypoplasia, severe mental retardation, epilepsy, and syndactyly. Variable abnormalities included focal or regional cortical dysplasia, cataracts, and hypospadius. We hypothesize that this syndrome involves the same Xq28 locus as isolated BPNH, and we review the expanding number of syndromes associated with BPNH.

Adolescent↗
PubMed1987

Facial expressions of mentally retarded and nonretarded children: II. Recognition by nonretarded adults with varying experience with mental retardation.

The influence of experience with mental retardation on nonretarded adults' ability to recognize facial expressions of emotion by young retarded children was examined. Four emotions were studied: happiness, anger, sadness, and neutrality (absence of affect). Slides of retarded and nonretarded children were presented to three groups: adults without experience in mental retardation, parents of retarded children, and teachers of the retarded stimulus children. Inexperienced adults identified fewer expressions of retarded children than did parents who, in turn, identified fewer expressions than did teachers. Teachers recognized expressions of retarded children best, inexperienced adults recognized expressions of nonretarded children best, and parents recognized expressions equally well in both retarded and nonretarded children. Happiness was recognized best in all children by all participants.

Adult↗
PubMed1971

The nosology of mental retardation: including the report of a survey of 1378 mentally retarded individuals at the Walter E. Fernald State School.

The mentally retarded here are divided into two groups. The first group consists of the mildly retarded (IQ 50-70) whose deficit, for the most part is a reflection of the expected variability of human intelligence and of adverse sociocultural factors. The second and smaller group includes the moderately, severely and profoundly retarded (IQ smaller than 50), most of whom have brain damage. A new clinical survey indicates that acquired brain disease is the most common cause (26 percent), followed by chromosome disorders (18.7 percent).

Abnormalities, Multiple↗
PubMed1998

A survey of county boards' views of funding for mental retardation versus funding for mental illness.

The state of Iowa mandates services for persons with mental retardation but not for those with mental illness, resulting in widely divergent spending for the two populations. Members of 98 of the 99 county boards of supervisors were interviewed to determine differences in attitudes about services and funding priorities. Respondents were more willing to provide supportive services to persons with mental retardation and acute treatment to persons with mental illness. Only 16 percent believed that persons with chronic mental illness should be a first priority for mental health funds. Respondents tended to disagree not about whether services should be funded but about who should fund them. Three-fourths believed that the state should fund such services.

Attitude to Health↗
PubMedDate not supplied

Classifying mental retardation and specific strength and deficit areas in severe and profoundly mentally retarded persons with the MESSIER.

The MESSIER, a measure of social and communication skills and the Vineland Social Maturity Scale were administered to 618 severe and profoundly mentally retarded adults. The goal of the study was to establish the potential utility of the MESSIER for classifying level of intellectual disability in this group. Comparing MESSIER scores to previously established DSM-IV-TR diagnosis, 86% of the severe and 80% of the profoundly mentally retarded persons were correctly classified. The implications of these data in using the MESSIER for classification and treatment planning are discussed.

Adolescent↗