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Neuropsychiatric consultation in mentally retarded patients: a clinical report

Published online by Cambridge University Press:  16 April 2020

WMA Verhoeven  and
S Tuinier
WMA Verhoeven
Affiliation:
Vincent van Gogh Institute for Psychiatry, Stationsweg 46, 5803 AC Venray, The Netherlands
S Tuinier
Affiliation:
Vincent van Gogh Institute for Psychiatry, Stationsweg 46, 5803 AC Venray, The Netherlands
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Summary

The present study describes the results of neuropsychiatric consultations in 70 institutionalized mentally retarded patients. On the basis of their major complaint, patients were assigned to eight overlapping categories. Diagnoses of a certain probability were established during multidisciplinary consensus meetings and classification was achieved according to ICD-10 criteria. In ten patients mental retardation was related to a specific syndrome; seizures or somatic comorbidity were present in 40 patients. The most frequent psychiatric diagnoses were: unspecified bipolar affective disorder (n = 14), depressive disorder (n = 6), impulse control disorder (n = 12), cycloid, transient, or schizoaffective psychotic disorder (n = 14), and (atypical) autism (n = 7). Recent history revealed a high occurrence of serious side effects of psychotropics or pharmacokinetic interactions. Appropriate pharmacological intervention resulted in an amelioration of the behavioural condition in about half of the patients. It is emphasized that psychiatric disorders frequently present with an atypical psychopathology and that stress- and anxiety-related disorders are most probably underdiagnosed.

Keywords

mental retardationneuropsychiatric diagnosisbipolar affective disordercycloid psychosis
Type
Original articles
Information
European Psychiatry , Volume 12 , Issue 5 , 1997 , pp. 242 - 248
Copyright
Copyright © European Psychiatric Association 1997

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References

Aman, AGAssessing psychopathology and behavoir problems in persons with mental retardation: a review of available instruments Rockville: US Dept of Health and Human Services, 1991Google Scholar
Brugger, C. Die erbbiologische Stellung der Propfschizophrenie. Z Neuro Psychiatr 1928; 113: 348–37810.1007/BF02884509CrossRefGoogle Scholar
Clarke, DJ. Prader-Willi syndrome and psychoses. Br J Psychiatry 1993; 163: 680–68410.1192/bjp.163.5.680CrossRefGoogle ScholarPubMed
Crews, WD, Bonaventura, S, Rowe, F. Dual diagnosis: prevalence of psychiatric disorders in a large state residential facility for individuals with mental retardation. Am J Ment Retard 1994; 98: 688–6731Google Scholar
Duncan, AG. Mental deficiency and manic-depressive insanity. J Ment Sc 1936; 82: 635–64710.1192/bjp.82.340.635CrossRefGoogle Scholar
Einfeld, SL, Aman, M. Issues in the taxonomy of psychopathology in mental retardation. J Autism Dev Disord 1995; 25: 143–14710.1007/BF02178501CrossRefGoogle ScholarPubMed
Glaus, A. Uber Propfschizophrenie und schizophrene Frühdemenz. Schweiz Arch Neurol Psychiatry 1936; 37: 238–252Google Scholar
Glue, P. Rapid cycling affective disorders in the mentally retarded. Biol Psychiatry 1989; 26: 250–25610.1016/0006-3223(89)90037-1CrossRefGoogle ScholarPubMed
Gordon, A. Psychoses in mental defects. Am J Insanity 1918; 75: 489–499Google Scholar
Jan, JE, Abroms, IF, Freeman, RD, Brown, GM, Espezel, H, Connolly, MB. Rapid cycling in severely multidisabled children: a form of bipolar affective disorder?. Pediatr Neurol 1994; 10: 34–3910.1016/0887-8994(94)90064-7CrossRefGoogle ScholarPubMed
King, BH. Self-injury by people with mental retardation: a compulsive behaviour hypothesis. Am J Ment Retard 1993; 98: 93–112Google ScholarPubMed
King, BH, Deantonio, C, McCracken, JT, Forness, SR, Ackerland, V. Psychiatric consultation in severe and profound mental retardation. Am J Psychiatry 1994; 151: 1802–1808Google ScholarPubMed
Lund, J. The prevalence of psychiatric morbidity in mentally retarded adults. Acta Psychiatr Scand 1985; 72: 563–57010.1111/j.1600-0447.1985.tb02655.xCrossRefGoogle ScholarPubMed
Medow, W. Atypische Psychosen bei Oligophrenic. Monatsschr Psychiatr Neurol 1925; 58: 222–28910.1159/000166364CrossRefGoogle Scholar
Meins, W. Symptoms of major depersssion in mentally retarded adults. J Intellectual Disabil Res 1995; 39: 41–4510.1111/j.1365-2788.1995.tb00912.xCrossRefGoogle ScholarPubMed
Neustadt, R. Uber Pfropfschizophrenie. Arch Psychiatr Nervenkr 1927; 82: 78–8410.1007/BF01828854CrossRefGoogle Scholar
Reid, AH. Psychoses in adult mental defectives. I. Manic depressive psychosis. Br J Psychiatry 1972; 120: 205–21210.1192/bjp.120.555.205CrossRefGoogle ScholarPubMed
Reid, AH. Psychoses in adult mental defectives. II. Schizophrenic and paranoid psychoses. Br J Psychiatry 1972; 120: 213–21810.1192/bjp.120.555.213CrossRefGoogle ScholarPubMed
Reid, AH. Psychiatry of mental handicap: a review. J R Soc Med 1983; 76: 587–59210.1177/014107688307600712CrossRefGoogle ScholarPubMed
Sartorius, N, Ustün, B, Korten, A, Cooper, JE, Van Drimmelen, J. Progress towards achieving a common language in psychiatry. II. Results from the international field trials of the ICD-10 diagnostic criteria for research for mental and behavioural disorders. Am J Psychiatry 1995; 152: 1427–1437Google Scholar
Singh, NN, Sood, A, Sonenklar, N, Ellis, CR. Assessment and diagnosis of mental illness in persons with mental retardation. Methods and measures. Behav Modif 1991; 15: 419–443CrossRefGoogle ScholarPubMed
Sovner, R, Hurley, A. Do the mentally retarded suffer from affective illness?. Arch Gen Psychiatry 1983; 40: 61–67CrossRefGoogle ScholarPubMed
Swift, RG, Sadler, DB, Swift, M. Psychiatric findings in Wolfram syndrome homozygotes. Lancet 1990; 336: 667–66910.1016/0140-6736(90)92157-DCrossRefGoogle ScholarPubMed
Trimble, ME. The schizophrenia-like psychosis of epilepsy. Neuropsychiatr Neuropsychol Behav Neurol 1992; 5: 103–107Google Scholar
Tuinier, S, Verhoeven, WMA. Pharmacological advances in mental retardation: a need for reconceptualization. Curr Opin Psychiatry 1994; 7: 380–38610.1097/00001504-199409000-00004CrossRefGoogle Scholar
Verhoeven, WMA, Tuinier, S. The effect of buspirone on challenging behaviour in mentally retarded patients; an open prospective multiple case study. J Intellectual Disabil Res 1996; 40: 502–508CrossRefGoogle ScholarPubMed
Wolf, P. Use of antiepileptic drugs in epileptology with respect to psychiatry. Neuropsychobiology 1993; 27: 127–13110.1159/000118967CrossRefGoogle ScholarPubMed
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