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The Psychiatric Clinics of North America Jun 1992Mental retardation is defined using two criteria: intelligence quotient and adaptive functioning. Subclassification based on IQ is helpful in predicting outcome and... (Review)
Review
Mental retardation is defined using two criteria: intelligence quotient and adaptive functioning. Subclassification based on IQ is helpful in predicting outcome and determining educational program. Advances continue to be made in identifying specific medical causes of intellectual deficits. As the natural history of conditions such as fragile-X becomes better understood, treatment approaches based on medical diagnosis will likely evolve. Clinicians working with mentally retarded patients should pursue vigorously medical diagnosis because of its implications for genetic counseling, family management, and full recognition of other handicapping conditions which may affect the patient. Psychopathology in the mentally retarded resembles that in nonretarded individuals, but occurs more frequently. Treatment of psychiatric disorders must be individualized. Mildly and some moderately retarded persons can benefit from psychotherapy. Behavioral approaches, particularly applied behavior analysis, are the most effective treatment for specific aberrant behaviors. Pharmacotherapy should be based on psychiatric diagnosis. Medications may be used, together with behavioral interventions, to treat specific destructive behaviors, but the scientific support for such use is new and somewhat limited.
Topics: Adolescent; Adult; Aged; Attention Deficit Disorder with Hyperactivity; Child; Child, Preschool; Female; Humans; Infant; Intellectual Disability; Male; Middle Aged; Psychiatric Status Rating Scales
PubMed: 1603737
DOI: No ID Found -
The British Journal of Psychiatry : the... Jun 1994Individuals affected by mental retardation are a clinically and aetiologically heterogeneous group. This heterogeneity is particularly highlighted when we consider the... (Review)
Review
Individuals affected by mental retardation are a clinically and aetiologically heterogeneous group. This heterogeneity is particularly highlighted when we consider the genetics of mental retardation. Recent advances in molecular genetic techniques have enabled us to understand more about the molecular basis of several genetic syndromes associated with mental retardation. In contrast, where there is no discrete cause, the interplay of genetic and environmental influences remains poorly understood.
Topics: Humans; Intellectual Disability; Phenotype; Risk Factors; Social Environment; Syndrome
PubMed: 7952981
DOI: 10.1192/bjp.164.6.747 -
Journal of Medical Genetics Jun 1991
Review
Topics: Genetic Linkage; Humans; Intellectual Disability; X Chromosome
PubMed: 1870092
DOI: 10.1136/jmg.28.6.361 -
Pathologie-biologie Oct 2010Mental retardation affects nearly 3 % of the population. The causes of these disorders are various and are often not identified. Recent advances focused on the molecular... (Review)
Review
Mental retardation affects nearly 3 % of the population. The causes of these disorders are various and are often not identified. Recent advances focused on the molecular basis of mental retardation. Nearly half of mental retardation syndromes have a genetic origin and the description of molecular, cytogenetic and metabolic alterations in these disorders led to the development of diagnostic tools. Indeed, identifying the precise origin of the mental retardation allows to improve patient care and to refine the prognosis. Moreover, these molecular tools will help the geneticist to evaluate the recurrence risk in the family in the genetic counseling step. On a fundamental point of view, the knowledge of molecular basis of mental retardation will help to understand the biological pathway which constitutes the first step before therapeutic strategies. Every patient with mental retardation should be investigated for causal origin of the disease. We will detail the diagnostic methods necessary to investigate a patient presenting with mental retardation. Then different examples of syndromes including a mental retardation will be chosen to illustrate different clinical situations.
Topics: Abnormalities, Multiple; Child; Chromosome Deletion; Chromosome Disorders; Cytogenetic Analysis; Female; Genetic Counseling; Humans; Intellectual Disability; Male; Metabolism, Inborn Errors; Mutation; Phenotype; Prevalence; Syndrome
PubMed: 19942372
DOI: 10.1016/j.patbio.2009.09.013 -
Psychopathology 2008The term 'mental retardation' (MR) is outdated and has changed to 'intellectual disability' (ID). Unfortunately, this decision did not follow a nosology approach. The... (Review)
Review
BACKGROUND
The term 'mental retardation' (MR) is outdated and has changed to 'intellectual disability' (ID). Unfortunately, this decision did not follow a nosology approach. The aim of this overview is twofold: (1) to provide a conceptual background and framing on the ID/MR field to other psychiatrists, and (2) to provide a nosology-based perspective to the debate on the name and concept of MR/ID.
METHOD
This conceptual paper is based on a literature review and on an iterative process of debate within the WPA Section 'Psychiatry of Mental Retardation'.
RESULTS
ID may be regarded not as a disease or as a disability but as a syndrome grouping (metasyndrome) similar to the construct of dementia. It includes a heterogeneous group of clinical conditions, ranging from genetic to nutritional, infectious, metabolic or neurotoxic conditions. The ID metasyndrome is characterized by a deficit in cognitive functioning prior to the acquisition of skills through learning. The intensity of the deficit is such to interfere in a significant way with individual normal functioning as expressed in limitations in activities and restriction in participation (disabilities).
CONCLUSIONS
The name 'developmental cognitive impairment' is here suggested to coexist with ID for naming the metasyndrome previously called MR following a polysemic-polynomious approach.
Topics: Humans; Intellectual Disability; Phenotype; Psychiatry; Terminology as Topic
PubMed: 17952016
DOI: 10.1159/000109950 -
Journal of Medical Genetics Mar 1998Despite improvements in diagnostic techniques and progress made in mapping genes associated with syndromal mental handicap, the estimation of recurrence risks in... (Review)
Review
Despite improvements in diagnostic techniques and progress made in mapping genes associated with syndromal mental handicap, the estimation of recurrence risks in non-syndromal mental retardation is still dependent on empirical data. Unfortunately, few studies are available to guide the clinician and their results differ significantly. For example, recurrence risks to all sibs of a male index patient with severe mental retardation vary between 3.5% and 14% in commonly quoted series. The present review highlights the problems involved in interpreting the previous work in this area and discusses the definition of mental retardation according to the degree of severity, phenotype, and its pattern of inheritance. In planning future studies, an appreciation of these issues should allow us to derive accurate and comparable risk figures for use in counselling affected subjects and their families.
Topics: Female; Fragile X Syndrome; Genetic Counseling; Genetic Linkage; Humans; Intellectual Disability; Male; Phenotype; Prevalence; Risk Factors; Sex Factors; X Chromosome
PubMed: 9541099
DOI: 10.1136/jmg.35.3.177 -
Indian Journal of Pediatrics Feb 2003Mental retardation (MR) occurs in 2-3% of the general population. Prevalence of milder MR is seven to ten times more than severe MR. Cause of severe MR can be determined...
Mental retardation (MR) occurs in 2-3% of the general population. Prevalence of milder MR is seven to ten times more than severe MR. Cause of severe MR can be determined in 60-70% of cases, as compared to mild MR where 35-55% remain idiopathic. The diagnostic process is aided considerably if the timing of a developmental insult can be determined: prenatal, periatal, postnatal (not mutually exclusive). History plays a pivotal role in approaching a diagnosis. After clinical evaluation one should be able to assess whether the disorder is static or progressive; approximate developmental quotient; possible timing of insult and possible underlying genetic etiology. Investigations should be based on history and physical examination. The important category of tests include: thyroid function tests, cytogenetic studies, metabolic work-up, fragile-X screening, radiological investigations, electrophysiological studies and specific tests according to the suspected diagnosis. Having an etiological explanation aids in the development of a specific treatment plan; helps families understand prognosis and recurrence risk and on the community level assists in the development of preventive strategies.
Topics: Child; Down Syndrome; Fragile X Syndrome; Humans; Intellectual Disability; Physical Examination
PubMed: 12661811
DOI: 10.1007/BF02723745 -
Journal of the International... Mar 1996This critical review examines mental retardation (MR) from a neuropsychological perspective. Competing definitions of MR are discussed and the prevalence is estimated.... (Review)
Review
This critical review examines mental retardation (MR) from a neuropsychological perspective. Competing definitions of MR are discussed and the prevalence is estimated. Descriptions are given of idiopathic MR and the five major identifiable prenatal causes of MR: fetal alcohol syndrome, Down's syndrome, fragile X syndrome, Prader-Willi syndrome, and Angelman syndrome. Similarities and differences among syndromes are examined. Cognitive deficits common to all disorders were in attention, short-term memory, and sequential information processing, whereas language and visuospatial abilities were varied. Neuroanatomical abnormalities common to all disorders were in the hippocampus and cerebellum; individual disorders typically showed a unique pattern of other neurological abnormalities. Both knowledge of individual MR-related disorders and comparative research between disorders are important for researchers and clinicians. Further research is called for in both areas.
Topics: Diagnosis, Differential; Humans; Intellectual Disability; Neuropsychological Tests
PubMed: 9375201
DOI: 10.1017/s1355617700001016 -
Jornal de Pediatria Apr 2004This paper describes recent advances in the neurobiology of mental retardation, emphasizing new diagnostic resources provided by cytogenetics, molecular testing, and... (Review)
Review
OBJECTIVE
This paper describes recent advances in the neurobiology of mental retardation, emphasizing new diagnostic resources provided by cytogenetics, molecular testing, and neuroimaging.
SOURCES OF DATA
MEDLINE (January 2000 through October 2003), using the following key words: mental retardation, developmental disability, child, and adolescent. Search of the Pediatrics and New England Journal of Medicine websites using the key word mental retardation. The Online Mendelian Inheritance in Man (OMIM) database was searched for information on clinical genetics.
SUMMARY OF THE FINDINGS
In October 2003, the number of genetic syndromes associated with mental retardation reached 1,149. Considering the genetic or environmental and congenital or acquired causes of mental retardation, current diagnostic investigation is able to detect the etiology in 50 to 70% of cases.
CONCLUSION
Diagnostic evaluation should follow a stepwise approach in order to make rational use of the expensive tools of cytogenetics, molecular biology, and neuroimaging.
Topics: Adolescent; Child; Facies; Female; Humans; Intellectual Disability; Male
PubMed: 15154075
DOI: No ID Found -
European Child & Adolescent Psychiatry 2000This is a review of pharmacotherapy in children and adolescents with mental retardation from the perspective of DSM and ICD disorders. The existing research is reviewed... (Review)
Review
This is a review of pharmacotherapy in children and adolescents with mental retardation from the perspective of DSM and ICD disorders. The existing research is reviewed in young people with mental retardation but, when data are lacking, we examined the literature from adults with mental retardation and from typically-developing children. The literature is discussed for each of the following disorders: ADHD, anxiety disorders, bipolar disorder, conduct disorder, depression, enuresis, schizophrenia, self injury, and tics and movement disorders. With the possible exception of ADHD, there is a woeful lack of empirical data on most of these disorders in young people with mental retardation. Clinicians will often be forced to extrapolate from data on adults having mental retardation and from typically-developing children. The best policy is probably to treat such patients cautiously, while gathering data on the effects of such therapy in the hopes of beginning a data base.
Topics: Adolescent; Child; Child, Preschool; Female; Humans; Intellectual Disability; Male; Mental Disorders; Movement Disorders
PubMed: 11140785
DOI: 10.1007/s007870070023