Forensic Assessment
Louis B. Schlesinger in Sexual Murder, 2021
The defendant did not have a great deal of formal education, but he always worked, was a well-respected employee, raised two children, and frequently traveled abroad. The defense expert evaluated the defendant and found he had an IQ of 56; he concluded that the defendant was mentally retarded (intellectually disabled) and, as a result, was unable to waive his Miranda rights. The psychologist based the diagnosis of mental retardation solely on an IQ score. However, an IQ score is not a diagnosis and is never sufficient for a diagnosis of intellectual disability. An IQ score alone—which represents an averaging of skills—can be easily affected by many factors such as attention, concentration, culture, psychopathological disorders, physical handicaps, and the subject’s motivation. As a result, an IQ score can be quite misleading. According to criteria established by the American Association on Intellectual and Developmental Disabilities, the Diagnostic and Statistical Manual of Mental Disorders, and the Wechsler Intelligence Scales, an individual’s ability to adapt to the demands of daily life is considered to be a more reliable diagnostic guideline than IQ scores alone. Therefore, a diagnosis of intellectual disability can be properly made if an IQ is below 70 (in the intellectually disabled range), or even above 70, as long as there is an impairment in two areas of adaptive functioning. But if an IQ score is below 70, and there is no impairment in adaptive functioning, there is no basis for a diagnosis of intellectual disability.
Neurology and neurosurgery
Jagdish M. Gupta, John Beveridge in MCQs in Paediatrics, 2020
12.21. Which of the following statements is/are true in relation to mental retardation?Mental retardation occurs in more than 1% of the population.The majority of mildly retarded individuals are at the upper end of socioeconomic scale.Dietary modification may prevent some forms of mental retardation.Pregnant women with no immunity against rubella should be immunized as soon as they find out that they are pregnant.Early treatment of congenital hypothyroidism may not prevent the associated mental retardation.
Contraindications to breastfeeding
Amy Brown, Wendy Jones in A Guide to Supporting Breastfeeding for the Medical Profession, 2019
Galactosaemia occurs in about 1 in 45,000 births (Walter et al. 1999). It is a deficiency of enzyme galactose-1-phosphate uridyl transferase transmitted as an autosomal-recessive trait. The liver enzyme that converts galactose to glucose is absent, so the baby is unable to metabolise lactose. The infants appear normal at birth but often have feeding difficulties, with jaundice, enlarged liver, lethargy, irritability, vomiting and poor weight gain (Walker 2006). Without treatment mental retardation develops. Galactosaemia is one of the few instances where breastfeeding needs to stop immediately to be replaced by galactose-free formula milk. Approximately one in every 19,000 infants born in Ireland may have this condition. However, it is particularly common among infants born to Traveller parents, in whom the incidence is approximately 1 in 450 births. Babies of the Traveller community are offered the Beutler test on day 1 of life and are fed galactose-free feed (soya-based) formula and not breastfed until the result of the test is available. This protects the infant if he/she has the condition (UCD School of Public Health and Population 2010).
Genome-wide association studies on Northern Italy isolated populations provide further support concerning genetic susceptibility for major depressive disorder
Published in The World Journal of Biological Psychiatry, 2023
Vincenzo Dattilo, Sheila Ulivi, Alessandra Minelli, Martina La Bianca, Edoardo Giacopuzzi, Marco Bortolomasi, Stefano Bignotti, Massimo Gennarelli, Paolo Gasparini, Maria Pina Concas
The replication cohort has been made of 463 MDD patients and 339 controls. Patients with at least moderate to severe depression, who met the Diagnostic and Statistical Manual of Mental Disorders-IV (DSM-IV) classification system criteria, were voluntarily enrolled in the study. All of them had been referred to Villa S. Chiara Psychiatric Hospital in Verona or the Psychiatry Rehabilitation Unit of IRCCS Centro Fatebenefratelli ‘S. Giovanni di Dio’ in Brescia. Diagnosis of unipolar depression was confirmed using the Structured Clinical Interview for DSM-IV Axis I Disorders (SCID-I) diagnostic scale. The exclusion criteria were as follows: (a) mental retardation or cognitive disorder; (b) a lifetime history of schizophrenic, schizoaffective, or bipolar disorder; (c) personality disorder, substance abuse, alcohol abuse or dependency, obsessive-compulsive disorder, or post-traumatic stress disorder as the primary diagnosis; and (d) comorbidity with an eating disorder.
The effect of Dual-Task balance exercises on cognitive functions among children with mild and borderline mental retardation: a randomized controlled trial
Published in European Journal of Physiotherapy, 2022
Ebrar Atak, Farzin Hajebrahimi, Z. Candan Algun
There are different theories about how DTBT can improve an individual’s cognitive and motor performance, of which, the most convincing claim is that automating a single task reduces attentional needs for the task, which helps in concentrating on another simultaneous task being performed, thereby stimulating both the components [28]. Comparable results have been obtained for other neurological conditions when treated with DTT [7,21]. Many studies have examined the effects of DTBT on cognitive functions; however, the present study was a novel attempt to use the MOXO attention and the WISC-R intelligence tests, and the results so obtained will contribute to substantiating the efficacy of DTT. The main reason for selecting attention as a primary outcome was that it influences both motor and cognitive aspects, particularly working memory, and information processing speed. Moreover, individuals with mental retardation have difficulties related to attention that may interfere with their fine motor tasks.
Trichobezoar presenting as an acute abdominal obstruction in a 17-year-old girl
Published in Paediatrics and International Child Health, 2022
Zuhal Bayramoglu, Rana Gunoz Comert, Basak Erginel, Abdulkadir Baziki
Bezoar obstruction of the small intestine and giant bezoar in the stomach are rare causes of vomiting in adolescents and young adults and require surgical removal. Foreign bodies swallowed by pre-school-age children include toys, while adolescents may repeatedly ingest organic foreign bodies. Mental retardation or psychiatric disorders are usually the basis of these behavioural disorders [7]. Bezoars may require admission to hospital owing to non-specific findings such as an inability to gain weight, growth retardation, anaemia, vomiting and abdominal tenderness. In the presence of dyspeptic symptoms such as vomiting and regurgitation, if there is an enlarged stomach on imaging, bezoars in the gastric lumen should be considered; other causes include pyloric stenosis and superior mesenteric artery syndrome. Since bezoars are formed from indigestible food residue, they are of soft tissue density on radiography, but contrast with the air surrounding the bezoar in the enlarged intestinal lumen may provide a clue to the diagnosis [8]. Children with iron deficiency should be carefully evaluated as the deficiency may progress owing to mucosal irritation. Bezoars can also be caused by pica [9]. In this case, significant anaemia (<8 g/dL) did not develop, despite the large size of the trichobezoar.
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