中国七个地区精神残疾,智力残疾流行病学调查

目的了解９０年代我国精神残疾和智力残疾状况。方法于１９９３年在国内７个地区进行精神疾病流行病学调查，采用我国精神残疾与智力残疾评定工具，对确诊的未治愈患者进行残疾评定。结果在调查的总人口（２３３３３人）中残疾率为７．４６‰，其中精神残疾率为４．１６‰，智力残疾率为３．３０‰；在≥１５岁的１９２２３人中，精神残疾率为５．０５‰（９７例），多为精神分裂症所致；在≥７岁的２１８１５人中，智力残疾率为３．５３‰（７７例），多为精神发育迟滞所致。结论应重点防治精神分裂症和精神发育迟滞，并加强对患者病后的康复医疗     

慢性精神分裂症残因素分析

目的：探讨影响精神残疾的慢性精神分裂症相关因素。方法：采用1994年修订的精神残疾评定中精神残疾的定残程度。对110例住院慢性精神分裂症患者进行了评残定残。结果极重度精神残疾61例（55．5％），重度精神残疾16例（14．5％）中度精神残疾14例（12．7％），轻度精神残疾19例（17．3％），精神残疾等级与阴性症状，病程、婚姻等因素相关（P＜0．05），结论：本组病例精神残疾严重，致死因素复杂。     

中山市精神残疾、智力残疾流行病学调查

目的：了解中山市精神残疾和智力残疾流行病学情况；方法：采用WH0提供，1982年和1993年两次全国精神疾病流行学调查使用的方法，使用我国精神残疾与智力残疾评定工具，对确诊的未治愈患者进行残疾评定。结果：在调查人口中残疾率为17．20‰，其中精神残疾率为7．79‰，智力残疾为9．41‰；在≥15岁中，精神残疾率为9．97‰，多为精神分裂症所致；≥7岁中，智力残疾率为10．26‰，多为精神发育迟滞所致。结论：应加强对精神分裂症和精神发育迟滞的防治及其康复医疗。     

中国七个地区精神发育迟滞流行病学调查

目的了解９０年代精神发育迟滞患病率的变化。方法于１９９３年在７个地区进行流行病学调查。在１９８２年调查方法的基础上，增加儿童用韦克斯勒智力量表对７～１４岁患儿进行智商测查和适应行为判定；用成人智残评定量表评定≥１５岁患者的智力残疾。结果在≥１５岁人口（１９２２３人）中精神发育迟滞的患病率为２．８４‰（６２例），较１９８２年（３．３３‰）有降低趋势（Ｐ＞０．０５）；成人智力残疾平均分为１１．２７分，６２例均为中度及其以上智力残疾。结论精神发育迟滞应列为精神疾病防治重点之一。     

496例精神分裂症残疾评定分析

目的：了解精神分裂症致残情况。方法：收集我院1998年1月至2003年7月进行残疾评定的精神分裂症502例，采用中国实用残疾人评定标准评定精神残疾及等级。结果：502例中496例(98．8％)评定为精神残疾，其中Ⅰ级、Ⅱ级、Ⅲ级分别为12．1％、54．8％、33．1％。结论：精神分裂症致残率较高，其程度受性别、婚姻状况、药物依从性及社会支持系统的影响。     

精神分裂症患者社会技能训练研究的概述

精神分裂症是一种常见的、病因未明的精神疾病,且病程迁延,最终约有一半左右导致精神残疾,给社会及家庭带来严重的负担。据1987年全国残疾人抽样调查分析（北京分册）显示,精神分裂症导致的残疾占全部精神残疾的78．75％。长期以来,由于精神分裂症的高致残率和部分患者的高肇事肇祸率,     

精神分裂症残疾评定及相关因素调查

目的 评定精神分裂症的精神残疾现状及其相关因素.方法 采用自制一般人口学资料调查问卷及WHO残疾评定量表(WHO-DASⅡ),对来源于河北省精神卫生中心2009年4月～2010年9月进行精神疾病残疾鉴定的210例精神分裂症患者进行评定.结果 精神残疾等级评定以中度(44.8％),轻度(34.3％)为主.中度及以上残疾组在年龄及病程上高于轻度残疾组(P＜0.05).中度及以上残疾组在WHO- DASⅡ总分及各因子分之间比较均高于轻度残疾组(P＜0.05).以残疾等级评定结果为因变量,行多因素线性回归分析显示,只有病程与残疾程度独立相关(P＜0.05).结论 精神分裂症的精神残疾以轻、中度为主,病程越长,残疾程度越重.     

528例精神残疾评定分析

作者于1998年在山东德州市进行精神残疾鉴定。1对象和方法 按国务院批准的《中国残疾标准》和检查方法[1]进行评定,共送检626名,评定精神残疾和智力残疾528名,致残率84％,其中一级6人,二级98人,三级192人,四级232人。 精神疾病按中国精神疾病分类方案与诊断标准第2版     

长期住院精神分裂症患者精神残疾状况的调查分析

长期住院精神分裂症患者精神残疾状况的调查分析河北省精神卫生中心（０７１０００）陈立成，王凤英，余莎莎，李翠领河北省荣军医院刘晓温精神分裂症是一种致残率很高的精神疾病。本文对长期住院的８１例男性精神分裂症患者进行了社会功能状况的调查和分析，现将结果报告...     

九江市精神疾病及其残疾流行病学调查

目的：了解九江市各类精神障碍患病率及精神残疾和智力残疾状况。方法：采用中国精神障碍分类与诊断标准第3版、精神残疾与智力残疾评定工具，对九江市11个抽样地区进行流行病学调查。结果：共调查市辖区55户，市辖县550户，共调查2636人。在≥15岁人口中，各类精神障碍的时点患病率为24．33‰，终生患病率为27．80‰，精神残疾率为8．94‰，智力残疾率为4．97‰。在≥7岁人口中，精神发育迟滞的时点患病率为3．31‰。在调查的总人口中，精神残疾率为6．83‰，智力残疾率为3．79‰。结论：心境障碍患病率居首位，精神分裂症和精神发育迟滞居2、3位，酒依赖患病率升高，均应列为防治和研究重点。     

Assessment of terms to describe mental retardation

There is currently debate among professionals in the area of mental retardation/developmental disabilities regarding the use of, and a possible replacement for, the term mental retardation. Using the semantic differential technique, 284 participants drawn from various Midwestern populations completed assessments of several terms used to describe the condition known as mental retardation (e.g., intellectual disability) as well as the person with the condition (e.g., mentally challenged) and other disabilities (e.g., physically disabled). Assessments were made on three factors: evaluation, activity, and potency. Results indicated that although all of the terms were generally assessed neutrally, the term Mentally Challenged emerged as the most positive particularly compared to evaluations of the other investigated terms. Moreover, mentally challenged was evaluated as significantly more positive compared to the term physically disabled but was similarly evaluated as the term visually disabled. Implications of the results are discussed.     

青海高原精神残疾抽样调查及阳性病例的12年随访

目的 了解青海高原地区精神残疾情况及阳性病例的转归。方法 按照国务院、民政部的全国残疾人抽样调查方案,青海省于1987年4月1日零时对精神疾病进行逐家庭户抽样调查,共调查了15105人,并于12年后进行了阳性病例的随访。结果①青海省精神疾病患病率、残疾率较低;②精神分裂症为首要病因,其次为情感性精神病、脑外伤及精神发育不全;⑧女性患病率高于男性;④汉族患病率高于少数民族;⑤12年随访结果表明,由于治疗的严重滞后导致残疾率升高,症状明显者比例较大。结论青海高原地区的精神残疾有其自身特点,阳性病例的预后较差。 810007 青海省人民医院     

Use of the atypical antipsychotics Olanzapine and Risperidone in adults with intellectual disability

The present study was designed to monitor the use of atypical antipsychotics in adults with intellectual disability and to evaluate the clinical effectiveness of these drugs. Twenty‐one patients were commenced on an atypical antipsychotic: 12 on Olanzapine and nine on Risperidone. The ICD‐10 diagnoses of the subjects were mild (13 cases) or moderate (8 cases) mental retardation, and psychiatric disorders (17 cases) with significant impairment of behaviour in 10 cases. Tolerability was good for 15 patients experiencing minimum or no side‐effects, and medication was only stopped as a result of side‐effects in one case. Clinical global outcome was rated as minimally improved or better for 16 cases. The present findings suggest that the atypical antipsychotics Olanzapine and Risperidone are well tolerated by patients with intellectual disability and psychiatric disorders, and are broadly effective against target symptoms.     

Continuum of intellectual disability: demographic evidence for the "forgotten generation"

Demographic features of Americans with mild intellectual disabilities were estimated in an analysis of the National Health Interview Survey. The cohort was compared to the population of the United States, persons with specific learning disabilities, and persons with mental retardation. Comparison on basic indices of adaptive functioning and SES suggest a large cohort of Americans who share many support needs and social and economic vulnerabilities with those labeled "mentally retarded." The combined prevalence of intellectual disability/mental retardation was estimated to be 1.27%. Implications are discussed in terms of the "forgotten generation" report of the 1999 President's Committee on Mental Retardation and evolving conceptions of mental retardation.     

精神发育迟滞患者性防卫能力评定的相关因素分析

目的探讨影响精神发育迟滞患者的性防卫能力评定的相关因素及社会功能水平对性防卫能力的影响。方法对性侵害案中139例符合CCMD-3精神发育迟滞诊断的性受害者采用自编法医精神病学鉴定案例登记表收集-般资料,使用韦氏智力测试量表（WAIS—RC）测定智商,使用成人智残评定量表和功能大体量表（C．AF）进行社会功能的评定。结果单因素分析有统计学意义9因子中只有文化程度、性知识、索要财物、成人智残量表和GAF评分进入回归方程,且它们影响力大小依次为成人智残量表评分（OR=4．3705）,GAF评分（OR=3．4742）,索要财物（OR=2．1607）,性知识（OR=1．5213）,文化（OR=1．3423）。结论性防卫能力受诸多因素的影响,在性自我防卫能力评定时除充分考虑社会学、法学因素外,尤其要考虑其社会功能的水平。     

Asperger's Disorder,Criminal Responsibility and Criminal Culpability

In the seminal 2002 case of Atkins v. Virginia, the United States Supreme Court held that executing the mentally retarded violates the Eighth Amendment's ban on cruel and unusual punishment. The Court did not set forth guidelines for defining mentally retarded and instead left it to the states to define the issue individually. State definitions for mental retardation or intellectual disability were examined, including documentation of procedures for Atkins claims. Results indicated significant differences between states in definitions and procedures. Not all states had a statutory ban on executing the mentally retarded, and while most states subscribed to a three-pronged definition modeled after clinical psychiatric definitions, most failed to operationalize the prongs. Additionally, states differed on the burden of proof required to show mental retardation, which party bears that burden, the timing of the showing, who makes the determination of mental retardation, and the standard used to review the determination. In addition to documenting definitions of mental retardation and criminal procedures for Atkins claims in states with the death penalty, this study sought to identify an ideal definition for intellectual disability in capital cases. While aspirational, a single definition would better satisfy the mandate of the Atkins decision by providing consistent protection to criminal defendants across states.     

Characteristics of Seizures in a Population-Based Series of Mentally Retarded Children with Active Epilepsy

Summary: Purpose: The characteristics of seizures were analysed in a population-based study of active epilepsy in 6-to 13-year-old mentally retarded children. Methods: The search procedure included diagnostic registers, EEG registers, and registers of the Education of the Subnormal. Medical files were scrutinized, and clinical examinations and interviews with parents or caretakers or both were performed. Results: The median age of seizure onset was 1·3 years, 3·1 for children with mild retardation and 0·8 for children with severe retardation. Among the 98 children identified, current seizure groups were partial in 20, generalized in 59, and mixed in 19. The prevailing seizure types were tonic-clonic, myoclonic, atypical absences, and partial complex seizures, present in 42, 33, 23, and 23 children, respectively. A total of 46 children had more than one seizure type. Seizures every day/week occurred in 44 children. There was a constancy between seizure type at onset and later seizure type. Neonatal seizures (n = 25), infantile spasms (n = 12), and status epilepticus (n = 37) occurred independent of one another. Prognostic factors for poor neurologic outcome were early onset of epilepsy, infantile spasms as onset type, and prior neonatal seizures. Children with only partial seizures less frequently had severe mental retardation, cerebral palsy, and visual impairment than those with only generalized seizures. Conclusions: Epilepsies in children with mental retardation are characterized by severe seizure manifestations. The brain damage giving rise to mental retardation and epilepsy is probably the main factor in terms of seizure outcome.     

Phenylketonuria is still a major cause of mental retardation in Tunisia despite the possibility of treatment

Background and objective

Accumulation of phenylalanine following a deficiency of phenylalanine hydroxylase activity generates a brain damage with mental retardation: phenylketonuria (PKU).In the developing countries, where PKU systematic neonatal screening program is not established yet, the management of PKU handicap is not properly carried out.The aim of this study was to estimate the frequency of the PKU diagnosed following clinical features anomalies, to provide information about the untreated PKU patients profile in Tunisia not covered by neonatal screening. Also it is stressed that treated patients have a normal development.

Patients and methods

This is a retrospective study of 156 cases of PKU detected in Tunisia over 20 years following symptoms suggestive of inherited metabolic disease. Phenylalaninemia level was performed by fluorometric method. Among them 9 patients were treated.

Results

The PKU estimated frequency was 1/7631. The diagnosis mean age was 4 years. The phenylalaninemia mean was 1680 μmol/L; the classical PKU form accounted for 85.3% of cases and the dominant clinical symptoms were: mental retardation (88.2%), motor delays (87.7%), speech difficulties (83.2%) and pigmentation anomalies (61.7%). The treated patients responded to treatment and showed a normal development.

Conclusion

The establishment of neonatal screening should be a priority to avoid cases of mentally retardation.     

精神发育迟滞患者犯罪行为的相关因素分析

目的：研究精神发育迟滞患者犯罪行为的主要相关因素。方法：对１７５例精神发育迟滞患者分为犯罪组和对照组,进行比较分析。结果：犯罪组较对照组在家庭监护能力,是否自感受歧视,临床表现,辨认能力,是否伴 有精神病性症状及既往有无违法史等因素两组均有显著差异。结论：精神发育迟滞患者的犯罪行为与若干因素有关,可依此提出犯罪行为的预防措施。     

以躯体症状与以精神症状为主的抑郁症社会功能损害的对比分析

目的 比较以躯体症状与以精神症状为主的两种抑郁症患者出院后社会功能损害状况及其影响因素。方法 收集符合CCMD-2-R诊断标准的抑郁症患者67例，按不同的主诉分成两组，用病史问卷及汉密尔顿抑郁量表(HAMD)进行调查与评定；出院后1年随访时，再次进行HAMD评分，同时采用SDSS评定患者的社会功能损害，以及对其影响因素进行相关分析。结果 1年后随访发现，两组的社会功能存在极显著差异；患者的社会功能与随访时的HAMD评分、复发次数、迟滞因子分和阳性家族史等因素相关。结论 以躯体症状为主的抑郁症患者治疗后能保持较好的社会功能，关键在于早期识别与治疗。