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PubMed1993

Social interactions in the neighborhood: cultural approach to social integration of individuals with mental retardation.

Research conducted in Tréguier (Brittany) on community integration of individuals with mental retardation was reported. Change in social status as reflected in social interactions in a community was examined. Douglas' (1978) grid-group typology of cultural regimens was employed to measure this status. Each regime links the presence of individuals with mental retardation to the construction of a community of shared values and produces different responses of integration.

Culture↗
PubMed2004

Dementia in adults with mental retardation: assessment at a single point in time.

Dementia status of 273 adults with mental retardation was rated based upon two extensive evaluations conducted 18 months apart. Overall, 184 individuals did not have dementia, 33 had possible or definite dementia, and 66 had findings suggesting uncertain or questionable status. These ratings were compared to binary classifications (dementia vs. no dementia) generated from the Dementia Questionnaire for Persons With Mental Retardation (Evenhuis, 1995) and the IBR Mental Status Examination (Wisniewski & Hill, 1985). When performance was referenced to IQs (established earlier in adulthood), quantitative criteria effectively distinguished between individuals with and without dementia based upon assessment at a single point in time. Findings suggest that procedures of this type could soon contribute to more accurate and rapid diagnoses of dementia.

Adult↗
PubMed1991

[A study of dental status and its contributing factors in mentally retarded persons institutionalized in welfare facilities].

Two hundred and forty-one mentally retarded persons, institutionalized in three private welfare facilities in Oita Prefecture, were assessed for dental status and tooth brushing ability. Information on their life style was also obtained by a questionnaire completed by their supervisors in the facilities. 1) Dental status of mentally retarded subjects was found to be inferior compared to the general Japanese population studied in the survey of dental disease in 1987 by the Ministry of Health and Welfare. Inferior dental status was characterized by a low score for filled teeth and a high score for missing teeth. 2) Both low tooth brushing ability and low intelligence quotient were associated with their poor dental status. 3) Discrepancy between supervisor assessment of tooth brushing ability and actual ability was observed. 4) Periodontitis was observed in young epileptics taking antiepileptic medication at a high rate. However there was no association between the taking of antiepileptic medication and missing teeth score. These results indicate a necessity for more active dental services including the teaching of tooth brushing and early treatment by dentists and supervisors.

Adolescent↗
PubMed2001

Move of adults with mental retardation from institutions to community-based living: changes in the oral microbiological flora.

In the Western world, the policy of deinstitutionalization and integration of individuals with mental retardation is generally accepted. We tested the hypothesis that de-institutionalization may lead to changes of habits with a potential to influence oral health. When 57 adults with mental retardation moved from an institution to community-based living, their oral hygiene habits, gingival bleeding, and a three-day food record were registered one month before and 9 and 21 months after the move. Mutans streptococci and lactobacilli in saliva, P. intermedia/P. nigrescens, P. gingivalis, and A. actinomycetemcomitans in supragingival plaque, and C. albicans on mucous membranes were analyzed. After 21 months of community-based living, fewer persons showed high classes of mutans streptococci, growth of P. intermedia/P. nigrescens, and high frequency of sucrose intake, and more subjects showed growth of C. albicans. In a short perspective, the indicators of oral diseases suggest an unchanged or lower risk of oral diseases after the de-institutionalization of individuals with moderate or severe mental retardation.

Adult↗
PubMed1976

[A clinical and cytogenetic investigation carried out in a special institution for mentally retarded patients: preliminary results concerning 82 cases of oligophrenia (author's transl)].

A clinical and cytogenetic investigation carried out in a special institution for mentally retarded patients revealed 82 cases of oligophrenia, amongst whom were found 56 normal karyotypes (68.3%). Out of 25 karyotypes with chromosome anomalies or variants there were 18 cases of trisomy 21 and 7 others: one case of mosaicism with balanced translocation, 46,XX/46,XX,6p+,17q-; one case of partial trisomy, 46,XX,11q+; one case of pericentric inversion, 46,XY,inv(1) (p13,q21); one case with 8% chromosome breaks; three cases of marker chromosomes, of which one was of karyotype 46,XX,1qh+, and two (oligophrenic sisters) 46,XX,21p+. Moreover, there was an interesting case of testicular feminisation in a 9-year-old girl with karyotype 46,XY. The authors' results corroborate those obtained in several important previous studies based on much larger numbers of patients. Amongst the 56 cases where the karyotype was shown to be normal, there were 15 for whom a probably exogenic cause of the oligophrenia could be established, occurring mainly during the perinatal period. The authors were also able to confirm that the genetic factor plays an important role in the incidence of mental retardation, since in 22 examined patients, i.e. 26.8% of all cases, the condition was of familial type. Some interesting observations of idiopathic oligophrenia are reported, as well as several cases with well-known syndromes (Crouzon's and Cornelia de Lange's syndromes, hypothyroidism). Two cases of incest between father and daughter, which had produced children with serious oligophrenia associated, in one case, with deaf-mutism, microphthalmia, microcephaly and sclerocornea, are also discussed. The data show that mental retardation can frequently have a genetic cause, either of mendelian, chromosomal or multifactorial origin.

Adolescent↗
PubMed1998

Functioning in activities of daily living of psychiatric inpatients with mental retardation.

Functioning in activities of daily living of 40 psychiatric inpatients with mental retardation was compared with that of nonhospitalized control subjects matched for sex, age, and level of intellectual impairment. After excluding data for six quadriplegic control subjects from the analyses, the only difference between the groups was that the inpatients were less impaired in seeing. The findings indicate that even a major psychiatric disorder does not necessarily impair functioning in activities of daily living among individuals with mental retardation. Thus normal functioning adjusted for intellectual impairment does not necessarily indicate the absence of a major psychiatric disorder.

Activities of Daily Living↗
PubMed1998

Characterisation of an inverted X chromosome (p11.2q21.3) associated with mental retardation using FISH.

We report on a patient with a pericentric inversion of the X chromosome, 46,Y,inv(X) (p11.2q21.3), who was referred for cytogenetic analysis because of mild mental retardation, short stature, prepubescent macro-orchidism, and submucous cleft palate. The same chromosomal abnormality was found in the proband's mother. The inverted X chromosome was late replicating in all the mother's lymphocytes studied, indicative of a likely unbalanced inversion. We show, by fluorescence in situ hybridisation (FISH) using a panel of ordered yeast artificial chromosome (YAC) clones, that the Xp breakpoint is localised in Xp11.23 between DXS146 and DXS255 and that the Xq breakpoint is assigned to the X-Y homologous region in Xq21.3. YACs crossing the Xp and Xq breakpoints have been identified. One of these two breakpoints could be linked to the mental retardation in this patient as many non-specific mental retardation (MRX) loci have previously been located in the pericentromeric region of the X chromosome. Morever, the elucidation at the molecular level of this rearrangement will also indicate if cleft palate or prepubescent macro-orchidism, or both, in this boy are related to one of the two X breakpoints.

Azure Stains↗
PubMed1988

Hepatitis B virus infection in an institution for the mentally retarded.

A cross-sectional survey on the prevalence of hepatitis B serologic markers and hepatitis B virus DNA was performed in a population of 493 mentally handicapped males. Special interest was focused on age-related variables such as age at entry into the institution and on duration of residency. Furthermore, the differences with regard to the prevalence of hepatitis B markers found in Down's syndrome residents and other mentally retarded persons were analyzed. In a longitudinal study, the impact of the presence of hepatitis B virus DNA in serum was studied. Overall, 62.1 per cent of residents had serologic evidence of infection with hepatitis B virus, while 16.7 per cent of those residents with markers of infection were positive for hepatitis B surface antigen (HBsAg). Hepatitis B virus DNA was found in 24 per cent of HBsAg carriers (all positive for hepatitis B e antigen (HBeAg). In residents whose age at entry was less than 15 years, those with Down's syndrome were more often carriers of HBsAg than other mentally retarded residents. In addition, Down's syndrome residents more often had serum hepatitis B virus DNA compared with residents with other forms of mental retardation. A young age at entry was recognized as an important factor with regard to the prevalence of hepatitis B markers. From the longitudinal studies, it appeared that loss of hepatitis B virus DNA from serum indicated imminent loss of HBeAg and normalization of alanine aminotransferase values. Knowledge of the hepatitis B virus DNA status of HBsAg carriers in these institutions may therefore provide a valuable tool in attempts to reduce the transmission of this infection.

Adolescent↗
PubMed1980

Developmental dyspraxia in a family with X-linked mental retardation (Renpenning syndrome).

This paper describes the existence of severe developmental speech dyspraxia in a member of a family that is typical of other reports of X-linked mental retardation without physical abnormality (Renpenning syndrome). Other family members have evidence of motor or speech dyspraxia. Other reports of X-linked mental retardation have mentioned "verbal disability", which suggests that developmental dyspraxia may be quite common in these families. Developmental dyspraxia of speech is amenable to specific types of intervention: after two years of such intervention our patient's adaptive skills reflect his normal non-verbal intellectual ability, despite persistent speech deficits. This functional improvement shows how important it is to identify dyspraxia in young children, who may otherwise be labelled mentally retarded.

Apraxias↗
PubMed2003

Reliability and validity of an assessment instrument for anxiety, depression, and mood among individuals with mental retardation.

A review of the literature revealed that there was no adequate assessment instrument available that screens comprehensively for anxiety and depression in persons with mental retardation. The purpose of this research was to develop the Anxiety, Depression, and Mood Scale (ADAMS), an instrument intended to fill this gap. We developed a preliminary rating scale that included 55 symptom items. We examined the factor structure of these items by an exploratory factor analysis of behavior ratings on 265 individuals. A five-factor solution emerged that was both statistically sound and clinically meaningful. These factors were labeled "Manic/Hyperactive Behavior," "Depressed Mood," "Social Avoidance," "General Anxiety" and "Compulsive Behavior." We validated this solution by conducting a confirmatory factor analysis on ratings of 268 additional individuals. Model fit was acceptable. Internal consistency of the subscales and retest reliability for both the total scale and the subscales was high. Interrater reliability was satisfactory. The validity of the ADAMS was assessed with a clinical sample of 129 individuals with mental retardation who were seen in a psychiatric clinic; this provided additional support for the subscales. The ADAMS appears to be a psychometrically sound instrument for screening anxiety, depression and mood disorders among individuals with mental retardation.

Adolescent↗
PubMed1993

Confusing the terms "guilty" and "not guilty": implications for alleged offenders with mental retardation.

Evaluations of competency to stand trial of 45 alleged offenders with mental retardation were inspected to examine their understanding of "guilty" and "not guilty." Seven defendants (16%) had virtually no knowledge of "guilty" and were judged not competent after a thorough evaluation. None received a jail sentence. Although the criminal justice system served well this group with mental retardation, questions remain about the fate of those not identified. Are some pleading guilty when actually meaning "I did not do it" and being surprised by an unexpected jail sentence?

Adult↗
PubMedDate not supplied

Aggression and psychopathology in persons with severe or profound mental retardation.

We examined aggression and psychopathology in persons with severe or profound mental retardation. Most aggressive episodes were directed toward other clients, and ratings of aggression were positively correlated with self-injury, stereotypic behavior, and being ambulatory. In a linear regression analysis of psychopathological correlates, aggression was most consistently predicted by dependent personality and psychosis. To better describe the construct of aggression, we also developed an Aggression-psychopathology scale. Persons with mental retardation and aggression were more likely to be impulsive, attention-seeking, dependent, socially inadequate, and anxious. Intensive efforts to modify the psychopathological correlates of aggression may improve treatment planning and outcome.

Adolescent↗
PubMed1998

Mental retardation in amaurosis congenita of Leber.

A group of 229 patients with Leber's congenital amaurosis (ACL) was investigated for associated defects. We especially looked for the occurrence of mental retardation because the literature gives varying frequencies for this association. A percentage of 19.8% was found. This finding has consequences for genetic counseling. Special attention was given to how frequently sibling pairs occurred in which one patient was mentally retarded whereas the other functioned normally. We found 11 sibling pairs that were discordant with regard to their mental state. This observation proves that mental retardation could be one variable expression of ACL.

Abnormalities, Multiple↗
PubMed1991

An outbreak of El Tor cholera in an institution for the mentally retarded in Nonthaburi, June-July 1987.

In June and July 1987, an outbreak of cholera caused by V.cholerae O1, biotype El Tor, serotype Inaba, occurred in an institution for the mentally retarded in Nonthaburi. Of the 447 retarded inmates, 74 were found to be infected and one died. Epidemiological investigation revealed that the inmates with severe mental retardation who ate food in their own sleeping-room were significantly (p less than 0.001) more likely to be infected than those taking food in the dining-room. We hypothesize that the liquid diet commonly served to the more severely mentally retarded may have increased the risk of infection by more rapid gastric emptying. The long average period of time for meal consumption among these individuals may have allowed the organisms to multiply to a level capable of causing disease. Contamination of food with cholera might have occurred during food handling in the kitchen or within the sleeping-room where overcrowded conditions and poor personal hygiene facilitated person-to-person spread of infection. Prompt implementation of control measures effectively terminated cholera transmission in the outbreak.

Adolescent↗
PubMed1994

Reliability and acquiescence in the measurement of locus of control with adolescents and adults with mental retardation.

The locus of control construct has been useful for explaining individual and group variability in motivation, personality, and achievement. Despite a general agreement that people with mental retardation generally lack control in their lives, the construct has not been used to any meaningful extent to explain less than optimal life outcomes experienced by this group. One reason that this circumstance exists is that people with mental retardation often answer questions in an acquiescent manner, thereby jeopardizing the reliability and validity of the measure. The present study examined the reliability of one measure of locus of control, the Adult version of the Nowicki-Strickland Internal-External Scale, for 491 adults and adolescents with mental retardation and, using alternative forms of this scale, assessed the extent to which acquiescence contributes to externality in this population. Results from repeated-measures analysis of variance suggest that the acquiescence contributes nominally to measurement error with this population. Suggestions are made to improve reliability with the scale.

Adolescent↗
PubMed1993

Mental health services for people with mental retardation: a framework for the future.

The mental health needs of mentally retarded people cannot be met satisfactorily with generic mental health services. Specialized services are required. A number of different service models have evolved which require evaluation. They include subregional units, community-based services with a small admission facility, integrated services and specialist teams. Staff working in specialist mental health services must be appropriately trained.

Combined Modality Therapy↗
PubMed2005

Shoplifting in the mentally ill: the role of bipolar affective disorder and mental retardation.

This study explores shoplifting behaviour in mentally ill patients, and evaluates the association between shoplifting and different mental illnesses in a local Chinese population. A comparison is made between shoplifting offenders and a matched control group of non-offenders among the psychiatric patients registered at a university department of psychiatry. Major depression, bipolar affective disorder (BAD) and mental retardation (MR) are the most common diagnoses among mentally ill shoplifters, while patients with a diagnosis of BAD or MR are at higher risk of committing an offence than patients with other diagnoses. Bipolar affective disorder has not been described as a risk factor for shoplifting behaviour in the psychiatric literature. Such a possibility should be seriously considered in the psychiatric assessment of shoplifting cases.

Adolescent↗
PubMed1995

Mixed sclerosing bone dysplasia, small stature, seizure disorder, and mental retardation: a syndrome?

We present a 40-year-old man with mental retardation, short stature, minor anomalies, and seizures, who was found to have osteopoikilosis with melorheostosis (mixed sclerosing bone dysplasia, MSBD). Cytogenetic findings of a low level trisomy 8 mosaicism were not confirmed by fluorescence in situ hybridization (FISH) of fibroblast cells. To our knowledge, the association of MSBD and mental retardation has not been previously reported.

Adult↗