Neuropsychiatric consultation in mentally retarded patients: a clinical report

1997 ◽  
Vol 12 (5) ◽  
pp. 242-248 ◽  
Author(s):  
WMA Verhoeven ◽  
S Tuinier
Keyword(s):  
Impulse Control ◽  
Bipolar Affective Disorder ◽  
Mentally Retarded ◽  
Pharmacological Intervention ◽  
Clinical Report ◽  
Specific Syndrome ◽  
Somatic Comorbidity ◽  
Behavioural Condition ◽  
Icd 10 ◽  
Atypical Autism

SummaryThe 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.

scholarly journals Aripiprazole as a risk factor for impulse control disorders: a systematic review

BJPsych Open ◽  
2021 ◽  
Vol 7 (S1) ◽  
pp. S300-S301
Author(s):  
Benjamin Williams ◽  
Benjamin Williams ◽  
Kishen Neelam ◽  
Saumya Singh
Keyword(s):  
Systematic Review ◽  
Adverse Drug Reaction ◽  
Drug Reaction ◽  
Dopamine Agonist ◽  
Impulse Control ◽  
Bipolar Affective Disorder ◽  
Impulse Control Disorders ◽  
Risk Of Bias ◽  
Potential Association ◽  
Increased Risk

AimsAripiprazole is an anti-psychotic medication widely used for bipolar affective disorder and depression. It's primary mechanism of action is as a partial dopamine agonist. Aripiprazole's effect on dopamine signalling in the mesolimbic and mesocortical pathways may lead to impulse control disorders, as seen with other dopamine agonist medications. Aripiprazole is often chosen by prescribers because of its favourable side effect profile. There is a need to synthesise the available epidemiological literature on the potential association between aripiprazole use and impulse control disorders. This is needed to inform patients and prescribers of the best available evidence regarding this potential association. Our aim is to conduct a systematic review of the available non case-study evidence on the potential association between aripiprazole and impulse control disorders.MethodDatabases were searched using MEDLINE, PsychINFO, EMBASE, Cochrane Clinical Trials and Web of science. All studies from no earliest date to December 2020 were included; adult patients with a severe and enduring mental illness prescribed antipsychotic medication were included. Cinician diagnosis, structured interview diagnosis, and interviewer or self-completion questionnaires were used to measure prevalence. The study designs included were experimental designs, cohort study, cross-sectional survey and administrative databases. Exclusion criteria being those with traumatic brain injury, psychosis secondary to autoimmune, iatrogenic, chromosomal or metabolic disorder, those with Learning disability or Autistic Spectrum disorders. studies with majority of participants <18yrs. Those who were on other antipsychotic medications in addition to Aripiprazole, were excluded. To ensure quality assurance, we used ROBINS-I tool and GRADE assessment to measure the risk of bias.Result240 records were retrieved, 187 after duplicates were removed. 8 full text articles were assessed for eligibility, of which 4 were included in the qualitative synthesis. 2 studies were analyses of spontaneous adverse drug reaction reporting systems and 2 of health insurance claims databases. All 4 studies found aripiprazole to be associated with greater risk of impulse control disorders. The single study which compared directly with other antipsychotics had a much smaller effect size. Study heterogeneity precluded meta-analysis. All studies were at high risk of bias. The quality of evidence is very low.ConclusionThe available evidence is consistent with the existing warnings regarding increased risk of impulse control disorders in patients prescribed aripiprazole. Clinicians may wish to monitor for this adverse drug reaction. Further research which can account for potential confounders, examines specific impulse control disorders and which is less susceptible to detection and ascertainment biases is required.

Types of Mental Disorders in People with Intellectual Disability

2020 ◽  
pp. 55-60
Author(s):  
Sally-Ann Cooper
Keyword(s):  
Intellectual Disability ◽  
General Population ◽  
Mental Disorders ◽  
Mental Disorder ◽  
Bipolar Affective Disorder ◽  
Hyperactivity Disorder ◽  
Dsm 5 ◽  
Icd 10 ◽  
Physical Disorders ◽  
Challenging Behaviours

Mental disorders are common in people with intellectual disability, with a reported point prevalence of 36% in children and young people (including challenging behaviours), and 40.9% in adults (or 28.3% excluding challenging behaviours). People with intellectual disability experience all types of mental disorders, some more commonly than the general population, e.g. autism, attention-deficit hyperactivity disorder, schizophrenia, bipolar affective disorder, and dementia. Challenging behaviours are also common, and have no clear general population equivalent. Multi-morbidity of mental and physical disorders is typical. Mental disorder assessments are complex due to multi-morbidity and polypharmacy, in addition to impairments in communication, understanding, vision, and hearing, and the need to work with family and paid carers as well as the person with intellectual disability. Mental disorder classificatory systems have been developed for people with intellectual disability, in view of under-reporting when using general population manuals: DC-LD was designed to complement ICD-10, and DM-ID 2 to interpret DSM-5.

scholarly journals Study of psychiatric disorders among nepalese patients working abroad and their family members

2012 ◽  
Vol 6 (4) ◽  
pp. 1-6
Author(s):  
B Yengkokpam ◽  
SK Shah ◽  
GR Bhantana
Keyword(s):  
Psychiatric Disorders ◽  
Psychotic Disorders ◽  
Somatoform Disorders ◽  
Bipolar Affective Disorder ◽  
Family Members ◽  
International Classification Of Diseases ◽  
Obsessive Compulsive ◽  
Compulsive Disorder ◽  
Classification Of Diseases ◽  
Icd 10

This study was carried out among the patients working abroad and their family members, having various psychiatric disorders. 80 patients attending psychiatry OPD between the age of 15 to 65 years both male and female in the period of July 2009 to July 2010 were included. The results were tabulated as per the diagnostic criteria of International Classification of Diseases (ICD-10). Out of total 80 patients, 41 were males and 39 were females, whose husbands were working abroad. 30 cases were of depression,out of which 16 were males and 14 were females.18 cases were having anxiety disorders out of which 5 were males and 13 were females. 12 cases were suffering from psychotic disorders out of which 10 were males and 2 were females.7 cases were having dissociative disorders with 1 male and 6 females.4 cases were having somatoform disorders with 2 males and 2 females.1 male and 1 female were suffering from mania.1 male and 1 female were suffering from bipolar affective disorder. 2 males were alcohol dependent and 2 males were having obsessive compulsive disorder. 1 male was having organic psychosis. Journal of College of Medical Sciences-Nepal,2011,Vol-6,No-4, 1-6 DOI: http://dx.doi.org/10.3126/jcmsn.v6i4.6718

Clinical issues in the use of carbamazepine in psychiatry: a review

1989 ◽  
Vol 19 (3) ◽  
pp. 591-604 ◽  
Author(s):  
Martin Elphick
Keyword(s):  
Adverse Effects ◽  
Impulse Control ◽  
Acute Treatment ◽  
Bipolar Affective Disorder ◽  
Disease Entity ◽  
Diagnostic Categories ◽  
Frequent Monitoring ◽  
Drug Plasma ◽  
Psychiatric Conditions ◽  
Line Drug

SynopsisEvidence is presented here in support of the efficacy of carbamazepine (CBZ) in a variety of different psychiatric conditions. While there is now considerable evidence to support the use of CBZ in the acute treatment of mania and in the prophylaxis of bipolar affective disorder, particularly as a second-line drug, its usefulness in other conditions is less well documented. Overactivity, aggression and poor impulse control appear to improve in a variety of different diagnostic categories, and it may possibly be more appropriately prescribed to control or prevent these symptoms than as a treatment for a particular disease entity. The use of CBZ as an antidepressant is not well proven. Most of the adverse effects reported are due to rapid initial escalation of dosage, which can be avoided, or are reversible such as drug rashes. Severe adverse effects have been reported but are rare. Frequent monitoring of drug plasma concentration is not required. Some reports of synergism with lithium have appeared and combination therapy may be a useful strategy. Drug interactions, the need for clinical monitoring, and the possible pharmacological mode of action of CBZ are also discussed.

Terapia cu ajutorul calului ca metodă sportivă în afecțiunile psihomotorii: Un studiu controlat pretest-posttest

2017 ◽  
Vol 8 (1-2) ◽  
pp. 87-116
Author(s):  
Anca Nicoleta Bîlbă
Keyword(s):  
Pervasive Developmental Disorders ◽  
Developmental Disorders ◽  
Alternative Therapy ◽  
Assessment System ◽  
Control Group ◽  
Psychomotor Disorders ◽  
Icd 10 ◽  
Adaptive Behavior Assessment System ◽  
Group A ◽  
Atypical Autism

Pervasive developmental disorders are a series of illnesses characterized by delays in the development of some basic functions, such as the ability to communicate and socialize, but also through a small number of interests or activities, and according to ICD-10 (1996), in this category can include childhood autism, where deficiencies at these levels are identified, being identified until the age of three years or atypical autism - common in people with mental retardation or with responsive language disorders. A form of alternative therapy focused on these dimensions is horse-therapy therapy, a rapidly expanding approach in recent years, both with the aim of empirical substantiation and implementation of its different application centers to alleviate psychomotor deficiencies and emotional. This study aims to analyze the results obtained from horse-assisted therapy on psychomotor disorders in children with autistic spectrum disorders, epilepsy, ADHD or cerebral palsy. A group of 64 children aged between 2 and 14 years, biological age, participated in the study. 41 children were part of the study group, 23 constituting the control group. A controlled research model with pretest-posttest measurements was used. The effect of horse therapy on adaptive skills was evaluated. The ABAS II Adaptive Behavior Assessment System was used to measure these skills. The results indicate that hypothyroid therapy is effective in increasing the adaptability of children with psychomotor disorders.

Electrodermal Activity (EDA) and Suicidal Behavior

Crisis ◽  
1996 ◽  
Vol 17 (2) ◽  
pp. 69-77 ◽  
Author(s):  
Manfred Wolfersdorf ◽  
Roland Straub ◽  
Thomas Barg
Keyword(s):  
Personality Disorders ◽  
Suicidal Behavior ◽  
Impulse Control ◽  
Suicide Attempts ◽  
Electrodermal Activity ◽  
Female Patients ◽  
Icd 10 ◽  
Depressive Patients

There may be a connection between suicidal tendencies, electrodermal activity (EDA), disorders of impulse control, and neurobiochemistry (in the sense of a “psychobiology of suicidal tendencies”). The EDA values obtained during a psychobiological habituation experiment involving 11 female patients with personality disorders (PA; ICD-10) and histories of suicide attempts were compared with those of age-paralleled nonsuicidal depressive patients and depressive patients with histories of suicide attempts. They were also compared with EDA values in female schizophrenics with and without histories of suicide attempts. The PA group showed significant differences in all EDA values compared with nonsuicidal depressives, but no significant differences compared with other groups.

Psychiatry

2016 ◽  
pp. 312-409
Author(s):  
Andrew Baldwin ◽  
Nina Hjelde ◽  
Charlotte Goumalatsou ◽  
Gil Myers
Keyword(s):  
Mental Health ◽  
Psychiatric Symptoms ◽  
Psychological Treatment ◽  
Bipolar Affective Disorder ◽  
Behavioural Therapy ◽  
Child And Adolescent Psychiatry ◽  
Liaison Psychiatry ◽  
Supportive Psychotherapy ◽  
Icd 10 ◽  
Systemic Family Therapy

This chapter discusses psychiatry. It outlines psychiatric history skills (principles, mental state exam, risk assessment, confidentiality, and physical ecamination), assessment of psychiatric symptoms (descriptive psychopathology, classification of disorders (ICD-10, DSM-V)), community psychiatry (community care, schizophrenia, depression, bipolar affective disorder, anxiety, OCD, and PTSD, and the withdrawal of psychotropics), emergency department psychiatry (suicide and suicidal ideation, deliberate self-harm, crisis intervention, urgent psychiatry situations, and managing violence), liaison psychiatry and organix illness (delirium and dementia), child and adolescent psychiatry (depression, psychosis, behavioural difficulties, sleep disorders, ASD, and ADHD), psychiatric subspecialties (substance and alcohol misuse, intellectual disability, personality disorders, eating disorders, psychosexual disorders, and perinatal disorders), psychological treatment and psychotherapy (cognitive therapy, behavioural therapy, dynamic psychotherapy, systemic/family therapy, counselling and supportive psychotherapy, group psychotherapy, play and art therapy), and mental health and the law (compulsory hospitalisation, consent, capacity, and the Mental Health Act).

Autism and the pervasive developmental disorders

2012 ◽  
pp. 1633-1643
Author(s):  
Fred R. Volkmar ◽  
Ami Klin
Keyword(s):  
Pervasive Developmental Disorders ◽  
Developmental Disorders ◽  
Treatment And Prevention ◽  
Communicative Development ◽  
Icd 10 ◽  
Stereotyped Movement ◽  
Dsm Iv ◽  
Social Communicative ◽  
Rett’S Syndrome ◽  
Atypical Autism

The pervasive developmental disorders (PDDs) are characterized by patterns of deviance and delay in social-communicative development in the first years of life, which are associated with restricted patterns of interest or behaviour. The prototypic PDD is childhood autism; other conditions included in the PDD class in ICD-10 include Rett's syndrome, childhood disintegrative disorder, Asperger's syndrome, and atypical autism. Except for one additional category in ICD-10 (hyperkinetic stereotyped movement disorder), the disorders included in ICD-10 and DSM-IV are essentially identical. In this chapter each of these conditions will be reviewed in terms of their clinical features, definition, epidemiology, course, and aetiology; final sections of the chapter address aspects of treatment and prevention for the group of disorders as a whole (Box 9.2.3.1).

scholarly journals The prevalence of mental retardation by gender, age, and age of diagnosis at Nobel Medical College, Biratnagar

2012 ◽  
Vol 1 (2) ◽  
pp. 77-81
Author(s):  
Naba Raj Koirala ◽  
Ajoy Kumar Das ◽  
Santosh Kumar Bhagat
Keyword(s):  
Mental Retardation ◽  
Rural Areas ◽  
Mentally Retarded ◽  
Medical Problems ◽  
Medical College ◽  
Icd 10 ◽  
Age Of Diagnosis ◽  
Iq Scores ◽  
Mentally Retarded Children ◽  
One Year

Objectives: To evaluate the prevalence of mental retardation by gender and age of diagnosis at Nobel Medical College, Biratnagar. Methods: The data of all mentally retarded children recorded within a period of one year from 01st May 2011 to 30th April 2012 is analyzed retrospectively. Age, gender, IQ scores, the age of diagnosis, and their living place were evaluated. Results and conclusion: A total number 103 children attended the Psychiatric Out-patient Department of Nobel medical College and Teaching Hospital over the study period of one year. Out of all those 103 children, 67 children were with normal IQ scores, 7 with coexistence of epilepsy and other medical problems, and 3 children with incomplete case records, thus they were excluded from the study, and the subjects for further study was constituted by just 26 cases, who fulfilled the diagnostic criteria for Mental Retardation according to ICD-10. The overall prevalence of mental retardation in our study was 25% and the distribution of mental retardation amongst all those 26 cases were as follows: 2 cases (8%) were profound, 3 severe (12%), 7 (27%) were moderate and 9 (35%) mild, and 5 (19%) were borderline. Out of all those 26 mentally retarded children 11 were male (42%) and 15 (58%) were female, and of these cases, 07 were living in urban, and 19 in rural areas. Most of our cases were diagnosed between 6-10 years of age.DOI: http://dx.doi.org/10.3126/jonmc.v1i2.7304 Journal of Nobel Medical College (2012), Vol.1 No.2 p.77-81

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