RESUMO
Longitudinal follow-ups of the cessation of long-term Naltrexone administration (1 year of drug therapy) were conducted with a young woman (in her early 30s) with profound mental retardation who had previously displayed dramatic decreases in her self-injurious behaviors (SIB) both during, and for a period of at least 6 months following termination of drug treatment. After 2 and 4 years, post-Naltrexone therapy, the subject continued to exhibit near-zero rates of SIB episodes despite significant turnovers in her direct care staff by the 2-year follow-up, and changes in her physical/living environment and fellow residents by 4-year follow-up. These findings provide further support to the idea that long-term Naltrexone administration may result in highly durable reductions in SIB long after treatment ends and argue against certain aspects of the subject's environment affecting her rates of SIB significantly. These results are discussed in light of the endogenous opiate system theories of SIB. A functional analysis and discussion of the effectiveness of behavioral treatments for her few remaining SIB episodes are also provided.
Assuntos
Naloxona/uso terapêutico , Antagonistas de Entorpecentes/uso terapêutico , Comportamento Autodestrutivo/tratamento farmacológico , Adulto , Feminino , Seguimentos , Humanos , Fatores de Tempo , Resultado do TratamentoAssuntos
Auxiliares de Comunicação para Pessoas com Deficiência , Métodos de Comunicação Total , Deficiência Intelectual/reabilitação , Transtornos do Desenvolvimento da Linguagem/reabilitação , Adulto , Atenção , Paralisia Cerebral/psicologia , Paralisia Cerebral/reabilitação , Feminino , Humanos , Deficiência Intelectual/psicologia , Inteligência , Transtornos do Desenvolvimento da Linguagem/psicologia , Masculino , Pessoa de Meia-IdadeRESUMO
The prevalence of psychiatric disorders in a large residential population (N = 1,273) of individuals with mental retardation was examined. We found that the point prevalence rate for dual diagnoses based on DSM-III-R criteria was 15.55% (n = 198). Rates for specific psychiatric disorders were also provided by level of retardation and sex. Results were compared to similar epidemiological studies and discussed in light of factors hypothesized to affect diagnosis of psychiatric disorders among individuals with mental retardation.
Assuntos
Deficiência Intelectual/epidemiologia , Transtornos Mentais/epidemiologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Criança , Comorbidade , Estudos Transversais , Diagnóstico Duplo (Psiquiatria) , Feminino , Humanos , Incidência , Deficiência Intelectual/diagnóstico , Deficiência Intelectual/psicologia , Masculino , Transtornos Mentais/diagnóstico , Transtornos Mentais/psicologia , Pessoa de Meia-Idade , Escalas de Graduação Psiquiátrica , Instituições Residenciais/estatística & dados numéricos , Virginia/epidemiologiaRESUMO
The cessation of long-term Naltrexone administration was investigated through a double-blind, placebo-controlled, withdrawal design in a 28-year-old, profoundly mentally retarded woman with a history of severe self-injurious behavior (SIB). The subject had previously exhibited a dramatic decrease in SIB subsequent to Naltrexone administration. At the end of 1 year of continuous drug treatment, the subject displayed a near-zero rate of SIB episodes. This near-zero rate continued through placebo and no-drug phases of the study and at 6-month (no-drug) follow-up. This trend suggests not only that Naltrexone may be effective in reducing SIB, but that long-term administration may produce durable results after treatment cessation. Findings are discussed in relation to the endogenous opioid system theories of SIB.
Assuntos
Naltrexona/efeitos adversos , Comportamento Autodestrutivo/tratamento farmacológico , Síndrome de Abstinência a Substâncias/psicologia , Adulto , Feminino , Seguimentos , Humanos , Deficiência Intelectual/complicações , Deficiência Intelectual/psicologia , Assistência de Longa Duração , Naltrexona/administração & dosagem , Comportamento Autodestrutivo/psicologia , Comportamento SocialRESUMO
There have been limited reports on the incidence of Gilles de la Tourette disorder among individuals with mental retardation. Only three cases have been reported in people with severe or profound mental retardation. In this paper three additional case reports of people with severe or profound mental retardation and Tourette disorder were presented. Issues related to the diagnosis of Tourette disorder in this population were discussed.