Psychopathology in institutionalised mentally retarded adults.

The clients in an institution for the mentally retarded were screened for signs of psychopathology with the Psychopathology Instrument for Mentally Retarded Adults (PIMRA). Of the 168 clients, 146 satisfied criteria for DSM-III axis I disorders, and 153 satisfied criteria for at least one disorder on either axis I or II. Multiple diagnoses were common, and a total of 288 diagnoses were found. No particular disorder was found to be more prevalent in those with organic brain dysfunction. The level of functioning was not found to predispose to any particular diagnosis. There was a positive relationship between the presence of a psychiatric disorder and the resources available to the clients and the activities offered. The prevalence of psychiatric disorders was extremely high in the population studied, with the exception of the affective disorders, of which no case was found. One possible reason for this high prevalence is that deinstitutionalisation leaves behind those with the more severe behavioural problems.

[Who is left in the institutions? Some problems in connection with the process of deinstitutionalization]. / Hvem er igjen i sentralinstitusjonene? Noen problemer knyttet til nedleggingen av HVPU.

The medical and psychiatric diagnoses of 168 clients aged 16 to 65 years in a Norwegian institution for the mentally retarded were registered together with medication, level of functioning, and types of problem behavior. Most of these clients (64.9%) were profoundly or deeply retarded, and only 6.5% were independent of continuous supervision or help. Medical diagnoses were found in 87.5%, psychiatric diagnoses in 89.1% (DSM-III, axis I). Daily use of medication was found in 81.0% of the clients, and 48.9% used psychotropic drugs on a daily schedule. 58.3% of the clients had exhibited violent behavior during the last year, defined as assaults on persons, self-mutilation or destructiveness. The article discusses the implications of these observations for primary health care, which is expected to supply the necessary service to these clients after 1991.