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PubMedDate not supplied

A tongue stent for prevention of oral trauma in the comatose patient.

This paper presents the need for and offers a solution to the problem of factitial tongue and other intra-oral injuries in comatose and decerebrate patients. The neurophysiology of jaw movement in the comatose patient is the basis for the design of an intraoral prosthesis which in two patients has prevented discoordinate mandibular chewing movements and facilitated healing of preexisting factitial lesions. The authors delineate in detail the fabrication, insertion, and maintenance of this protective prosthesis and emphasize the need for joint effort between the intensive care, neurosurgical, and oral surgical teams.

Adult↗
PubMed1996

The effect of Danquah Communication System (DanCS) boards on maladaptive behaviours among individuals with severe intellectual impairment and non-verbal communication skills.

There is evidence that some individuals with severe intellectual impairment who are non-verbal may, out of frustration, display such inappropriate behaviour as aggression and self-injury as a means of communicating their needs to caregivers. The purpose of this study was to develop an inexpensive augmented communication device and to teach individuals with multiple impairment to use this method to communicate their needs in order to reduce their aggressive behaviours. The Dan Communication System (DanCS) symbol boards were therefore designed with computerized voice interface to help the individuals communicate to caregivers by means of audio and visual signs. A working DanCS board has been successfully developed and can now be mass produced by a manufacturer. The DanCS board is illustrated and described. A measurement device called the Goal Attainment Scale (GAS) that focused on three target behaviours; pressing of symbols, control of aggression, and social interaction with caregivers, was used to evaluate progress in the participating subjects (N = 30). Results showed that the multiply impaired individuals in the study significantly improved in all the targeted behaviours through the use of the DanCS. Details of the study are reported.

Adult↗
PubMed1991

Emergence of self-destructive phenomena in children and adolescents during fluoxetine treatment.

Self-injurious ideation or behavior appeared de novo or intensified during fluoxetine treatment of obsessive-compulsive disorder in six patients, age 10 to 17 years old, who were among 42 young patients receiving fluoxetine for obsessive-compulsive disorder at a university clinical research center. These symptoms required the hospitalization of four patients. Before receiving fluoxetine, four patients had major risk factors for self-destructive behavior including depression or prior suicidal ideation or self-injury. Three hypotheses concerning the apparent association between fluoxetine and these self-injurious phenomena are discussed: (1) coincidence; (2) disorganization of vulnerable individuals secondary to drug-induced activation; and (3) a specific serotonergic-mediated effect on the regulation of aggression.

Adolescent↗
PubMed1991

Self-harming behavior in incarcerated male delinquent adolescents.

This report describes self-harming behavior in males in a juvenile incarceration center. Three groups of adolescents were examined: self-harmers, those referred for a psychiatric examination, and the incarcerated general population. Compared to the general population, the youth in the two mental health groups were younger, had greater family needs, had more educational problems, were more likely to have escaped from a previous placement, and committed more rule violations. The self-harming group, when compared with the psychiatrically referred group, had a greater number of prior offenses, were more disruptive in school, performed worse on a problem-solving task, and committed more rule violations. Issues of psychopathology and treatment are discussed.

Adaptation, Psychological↗
PubMed1991

Reducing early childhood aggression: results of a primary prevention program.

Teacher-rated antisocial behavior in early elementary grades has been shown to be a precursor of adolescent delinquency and drug use. The combined effects of parent and teacher training on the teacher-rated antisocial behavior of a panel of subjects assigned to experimental and control classrooms at entry into the first grade was assessed at the end of the second grade. Lower rates of aggressiveness were found for white boys in the experimental classrooms and lower rates of self-destructive behavior were found for white girls in the experimental classrooms when compared with controls on the Teacher Form of the Child Behavior Checklist. No significant condition differences were found for black subjects. The interventions are described and limits and implications of the study are discussed.

Adolescent↗
PubMedDate not supplied

Self-inflicted burns.

Suicide by self-inflicted burns is uncommon in Western cultures. The majority of patients who attempt suicide in this manner have preexisting psychiatric illness, including a history of prior suicide attempts. A history of previous self-inflicted burn is rare, however, as are further suicide attempts in survivors. In this series of 33 patients, a cultural trend can be identified, with an increased incidence among Latin women.

Adolescent↗
PubMedDate not supplied

Self-inflicted burns: a ten-year retrospective study.

In this 10-year retrospective survey of 2216 admissions to a regional burn center, 15 patients (0.67%) had self-inflicted burn wounds. The burns were serious, with a mean abbreviated burn severity index of 11.2, and eight patients died of their injuries. Nine patients had a documented history of psychiatric problems, seven of whom had undergone a previous psychiatric hospitalization. A psychiatric assessment was obtained for 12 patients immediately after self-immolation, and all but one had a major psychiatric disorder. Seven patients had major depression and four had chronic paranoid schizophrenia. Motives were assessed, both by chart review and by interview of five available survivors and of relatives of nonsurvivors. Fewer than half actually intended to kill themselves; equally important was the theme of attempting to control internal psychotic states.

Adolescent↗
PubMedDate not supplied

Self-inflicted burns.

Over a 3-year period 17 people were admitted for intentionally self-inflicted burns. The mean total body surface area burn was 29.5%, and 59% of the patients sustained an inhalation injury. Two patients died from their injuries (one male and one female). The method most often used (59%) was a flammable liquid ignited by a flame. Of those patients, 50% used gasoline. Fifty-nine percent of the patients were current substance abusers, with alcohol (80%) being the favored drug. Aside from substance abuse, psychiatric abnormalities were present in 53% of the patients. Schizophrenia/schizoaffective disorders was the primary psychiatric diagnosis (44%), with most patients having undergone previous psychiatric treatment. All had diagnosed disorders (using the Diagnostic and Statistical Manual III--Revised) including substance abuse and/or other psychiatric disorders. Actual stated suicidal intent was present in 41% of the cases, and another 41% were irrational attempts to escape from or control emotional pain.

Adult↗
PubMed1983

Autism and the fragile X syndrome.

Ten patients with the fragile X syndrome were diagnosed at the Child Development Unit in 1982. Six of these patients are autistic and demonstrate similar profiles on three evaluations designed to measure the severity of autism. The similarities of these six autistic patients are described in depth.

Adolescent↗
PubMed1975

Utilization review and suicide attempts. Exploring discrepancies between experts' criteria and clinical practice.

The discrepancies between experts' criteria for hospitalization of suicide attempters with actual clinical practice were explored to develop utilization review criteria which reflect current clinical thinking and which could form guidelines for the assessment of clinical care. Experts' criteria predicted that a hospitalized group of suicide attempters did not require hospitalization and that a nonhospitalized group of suicide attempters required hospitalization. Examination of the discrepancies between clinical practice and experts' criteria not only revealed that incorporation of clinical measures of depressive symptomatology could improve the experts' criteria for hospitalization but also showed that clinicians did not hospitalize a group of markedly symptomatic and socially impaired white suicide attempters. Clinician and patient factors that may have contributed to this decision making and the application of these findings for utilization review are discussed.

Adolescent↗