OBJECTIVES: This study was designed to assess the present conditions of the mental retardation in a rural area by identifying the prevalence, socioeconomic characteristics and combined diseases of the subjects with mental retardation. METHODS: For this survey, four regions of a rural area with total population of 17,235 persons were chosen. The surveys were divided into 2 steps. After Key Informant Research(KIR) at first survey, one psychiatric specialist, two psychiatric residents and five clinical psychologists interviewed the high risk group who had been selected in KIR. By this two-step process, final diagnosis and degree of severity were confirmed. Diagnostic criteria of Mental Retardation by DSM-IV(Diagnostic and Statistical Manual of Mental Disorders-IV), K-WAIS, Social Maturation Scale were used as diagnositc tools. RESULTS: Prevalence of Mental Retardation in survey areas was 0.42%. The prevalences in male and female were 0.37% and 0.47%, respectively, which were of no significant statistical difference. The relative ratio of each degree of mental retardation-mild, moderate, severe and profound mental retardation-was 33:47:18:3 respectively. The prevalence of moderate mental retardation was higher than that of any other degrees. By age groups, the prevalence in twenties and thirties was 0.69%, which was the highest of all age groups. The prevalence in forties and over was 0.35%, which was the lower than that of twenties and thirties(x2-18.64, p=0.00002). CONCLUSIONS: Prevalence of mental retardation in survey areas was 0.42%, which was higher than any other previous studies in Korea. The prevalence of mild mental retardation was relatively lower than that of other previous studies, which means that the key informants may not have detected the subjects with mild mental retardations who were relatively socially adaptive in rural areas, because they might have focused on the ability of social adaptation as an important feature in detecting the mental retardations. The prevalence of moderate mental retardation was 0.20%, higher than any other groups, which resulted from low rate of failure in the detection of the moderate mental retardations because of their severe deficits in social adaptation and from the higher prevalence than severe and profound mental retardation in reality. The prevalence of severe and profound mental retardation was low rate because they used to be short-lived due to combined medical illnesses and congenital anomalies. The persons with mental reatardation were in low socioeconomic status and had poor supporting systems.
Diagnosis ; Epidemiologic Studies* ; Female ; Humans ; Intellectual Disability* ; Korea ; Male ; Prevalence ; Psychology ; Social Class ; Specialization

To study whether it is helped or not to medical diagnosis for children with normal and abnormal chromosomes from mental retardations, author performed and analyzed patterns of fingerprints, palmar prints creases on 99 mentally retarded children with normal chromosome and 16 mentally retarded children with Down syndrome and compared with healthy control group. In patterns of fingerprint, high frequency of ulnar loop showed significantly on fifth finger in mentally retarded children, while dominant whorl showed on first and fourth fingers in control group. High frequency of finger ridge count was appeared in Down syndrome, mentally retarded with normal chromosome (MRNC) and control group in order. Total ridge count TRC) was significantly decreased in Down syndrome, MRNC compared with control group. Total triradius count was significantly decreased in Down syndrome, however, no discrimination between control group and MRNC was found. a -b ridge count was not different among the groups. atd angle was wider in Down syndrome than in control group and MRNC. Interdigital pattern was high on ulnar loop of I3 in Down syndrome, in contrast, on ulnar loop of I4 in control group. In conclusion, detailed analysis of dermatoglyphics is able to contribute to study medical diagnosis on children with mentally retarded through above data.
Child ; Dermatoglyphics* ; Diagnosis ; Discrimination (Psychology) ; Down Syndrome ; Fingers ; Humans ; Intellectual Disability* ; Mentally Disabled Persons

OBJECTIVETo explore the impacts on the cognitive level of the children with mental retardation (MR) treated with JIN's three scalp needling therapy and the training for cognitive and perceptual disturbance so as to seek the more effective therapeutic method for the treatment of MR in children. Methods Sixty-six MR children were randomized into a head-point needle-retaining therapy + training group (group A) and a training after acupuncture group (group B). Seven cases and 12 cases were dropped in the two groups respectively. Twenty-six cases accomplished the treatment in the group A and 21 cases in the group B. In the group A, the points on the head were stimulated and the needles were retained (30 min after the general acupuncture, the needles on the body points were removed; and those on the head points were retained for 1 h, including Sishenzhen, Naosanzhen, Zhisanzhen and Niesanzhen). Simultaneously, the training for the cognitive perceptual disturbance was combined. In the group B, 1 h after needle retaining at the body points and head points, all the needles were removed; the training for the cognitive perceptual disturbance was followed. The treatment was given once a day, and the treatment for 3 months was required. Before and after treatment, the Wechsler intelligence scale for children (WISC) was used for evaluation and observation of verbal intelligence quotient (VIQ) , performance intelligence quotient (PIQ) and full-scale intelligence quotient (TFIQ) and score changes of 11 items such as information, picture vocabu; lary, arithmetic, picture generalization, comprehension, etc.

RESULTSAfter treatment, FIQ, VIQ and PIQ scores were different significantly as compared with those before treatment (all P<0. 01). In the group A, the results of picture vocabulary, animal egg laying, maze, block design and geometric figure were all improved significantly (all P<0. 05). In the group B, the results of information, comprehension, block design and geometric figure were all improved significantly (all P<0. 05). After treatment, concerning the value difference in FIQ and PIQ of the two groups; the changes in the group A were more significant (both P<0. 01). After treatment, the results of picture vocabulary and maze were improved significantly in the group A as compared with the group B (both P<. 01). The IQ categories changed apparently after treatment in the two groups, toward the higher level in tendency generally, but without significant difference (both P>0. 05).

CONCLUSIONThe simultaneous treatment with head point retaining of JIN's three needling therapy and the training for cognitive and perceptual disturbance obviously improves children patients' verbal comprehension, expression ability, hand-eye coordination ability, attention, logical reasoning ability and visual perception. The efficacy is better than that in the treatment of the training after acupuncture.

Acupuncture Therapy ; Child ; Child, Preschool ; Cognition ; Female ; Humans ; Intellectual Disability ; psychology ; therapy ; Intelligence Tests ; Male ; Perception ; Scalp ; Treatment Outcome

OBJECTIVE: To explore the application of Diminished Criminal Responsibility Rating Scale (DCRRS) to mental retardation offenders. METHODS: The DCRRS was used to 121 cases of mental retardation offenders who were divided into three groups according to the degree of their diminished criminal responsibility. RESULTS: There were significant differences in rating score among the three groups (mild group 22.12+/-4.69, moderate group 25.50+/-5.48, major group 27.59+/-5.69), and 17 items had good correlation with the total score of the scale with the correlation coefficient from 0.289 to 0.665. Six factors were extracted by the factor analysis, and 69.392% variation could be explained. CONCLUSION The DCRRS has rational items, its total score could show the difference among the three degree diminished criminal responsibility of mental retardation offenders.
Adolescent ; Adult ; Aged ; Analysis of Variance ; Crime/psychology* ; Female ; Forensic Psychiatry/methods* ; Humans ; Intellectual Disability ; Liability, Legal ; Male ; Mental Competency/psychology* ; Middle Aged ; Psychiatric Status Rating Scales ; Young Adult

OBJECTIVE: To investigate the different kinds of controversial cases of mental disability after brain damage, to analysis the problems in the first appraisal, and to explore solutions of the problems. METHODS: The reappraisals of mental disorders after traumatic brain damage were collected from 2007-2011 in Shanghai forensic center, and the first appraisal and reappraisal cases were analyzed and compared. RESULTS: The changes of conclusion in reappraisal cases showed the following major reasons: inappropriate appraisal time, not comprehensive and object investigation of mental state of patients in first appraisal, misunderstanding the standards, etc. CONCLUSION The quality improvement of appraisal should adopt the following measures: regulating the practice, improvement of the professional skills of experts, choosing appropriate appraisal time, improvement of appraisal standards, etc.
Accidents, Traffic ; Activities of Daily Living ; Adolescent ; Adult ; Aged ; Brain Concussion/diagnosis* ; Brain Injuries/complications* ; Child ; Disability Evaluation ; Female ; Forensic Psychiatry ; Humans ; Intellectual Disability/psychology* ; Male ; Mental Disorders/psychology* ; Middle Aged ; Retrospective Studies ; Severity of Illness Index ; Time Factors ; Young Adult

OBJECTIVE: To analyze the types of mental disorders caused by traumatic brain injury and the optimal time for forensic psychiatric appraisal. To explore the relationship between the degree of traumatic brain injury, the time of appraisal and the grade of intellectual deficiency. METHODS: Five hundred and thirty-four forensic psychiatric cases of mental disorders caused by traumatic brain injury were retrospectively analyzed. RESULTS: In the types of mental disorders caused by traumatic brain injury, the most cases were diagnosed as organic mood disorders (51.1%), following organic neurosis-like syndrome (24.0%) and organic intellectual deficiency (18.0%). For the disability grades, the most cases were the level VIII and IX disability grades, 219 cases (41.0%) and 177 cases (33.1%), respectively. The degree of brain injury and the degree of intelligence defection according to WAIS-RC were higher in intellectual deficiency group compared with non-intellectual deficiency group (P < 0.05). The grade of disability correlated with the degree of brain injury, the result of WAIS-RC, the result of cerebral CT scanning, and the grade of brain electrical activity mapping (BEAM) abnormality (P < 0.05). Nevertheless, the degree of intellectual deficiency did not correlate with appraisal time and the degree of brain injury (P > 0.05). CONCLUSION The factors influencing intellectual deficiency are complex. The findings of objective examination including cerebral CT scanning, BEAM, WAIS-RC and others should be considered as important indexes for disability evaluation.
Adolescent ; Adult ; Aged ; Brain Injuries/diagnosis* ; Diagnosis, Differential ; Disability Evaluation ; Female ; Forensic Psychiatry ; Humans ; Intellectual Disability/psychology* ; Male ; Mental Disorders/psychology* ; Middle Aged ; Retrospective Studies ; Severity of Illness Index ; Time Factors ; Wechsler Scales ; Young Adult

OBJECTIVE: To discuss the causes for changes of opinions in reappraisals of mental disabilities due to traffic accidents. METHODS: Fifty-one reappraisals of mental disorders due to traffic accidents from October 2009 to October 2011 in the Institute of Forensic Science, Shaoxing Seventh People's Hospital, were retrospectively analyzed. RESULTS: In the reappraisals, the opinions about disability grade changed in 30 cases (58.82%), including 8 cases increased and 22 cases decreased. According to the causes of changing the opinions, there were 8, 10 and 2 cases related to different understandings of appraisers in the severities of mental disorders, subjective judgements and certain psychiatric symptoms, respectively. Also, there were 10 cases related to different appraisal time. CONCLUSION Appraisals of mental disabilities should grasp the appraisal time, decrease the changes of opinions due to the differences of appraisers and correctly understand the orders of rules and clauses.
Accidents, Traffic ; Adult ; Aged ; Brain Injuries/psychology* ; Disability Evaluation ; Female ; Forensic Psychiatry ; Humans ; Intellectual Disability ; Intelligence ; Male ; Mental Disorders/psychology* ; Middle Aged ; Retrospective Studies ; Severity of Illness Index ; Time Factors ; Young Adult

Atypical absence is less understood than typical absence. Several conditions that produce atypical absence are known including Lennox-Gastaut syndrome, myoclonic astatic epilpsy and epileptic encephalopathy with continuous spike and waves in slow wave sleep. A 17-year-old girl with mental retardation had developed frequent loss of consciousness and occasional falling attack with traumatic facial injury for 2 years. The interictal EEG showed 2 Hz slow spike-and-wave complex with maximum over right frontotemporal area and the brain MRI was normal. Carbamazepin was prescribed initially but the drug seemed to worsen the seizures. Long term video-EEG monitoring showed very frequent atypical absence seizures consisting of sudden hypotonia of head and oral automatism with or without secondary generalization. Generalized 2 to 2.5 Hz slow spike-and-wave complexes with duration of 10 to 40 seconds were seen during ictal period. About 10% to 20% of the non REM sleep was occupied with generalized slow spike-and-wave complex and/or polyspikes or polyspikes-and-wave complex with duration of within 1 second. Valprorate monotherapy had failed, then lamotrigin was added. In spite of polytherapy, the seizure was intractable. We think this intractable atypical absence might be associated with juvenile onset Lennox-Gastaut syndrome.
Adolescent ; Automatism ; Brain ; Electroencephalography ; Epilepsy, Absence ; Facial Injuries ; Female ; Generalization (Psychology) ; Head ; Humans ; Intellectual Disability ; Magnetic Resonance Imaging ; Muscle Hypotonia ; Seizures ; Sleep, REM ; Unconsciousness

Sagittal synostosis with related functional aspects of elevated ICP, hydrocephalus, mental retardation and visual abnormalities, or with multiple suture synostosis, surgical correction is imperative. But, craniofacial surgery may impose a threat to an infant or small child. The blood volume in these patients is small and a minor hemorrhage may induce proportionately greater blood loss, resulting in a greater stress to the patient's system. Mortality resulting from craniofacial surgery is uncommon, mostly from operative hemorrhage and infections. Releasing the stenosis and reshaping the cranial vault is the primary operative goal. Authors sought to minimize surgical stress on the child and attain control of cranial vault reshaping by gradual distraction osteogenesis in treating children with sagittal suture synostosis. Three sagittal synostosis patients, aged from 11 months to 3 years old were treated. One of the patients had multiple suture synostosis. Patient follow-up ranged from 3 months to 3 years. Biparietal bone flap was elevated and external distraction devices were inserted. Distraction rate varied from 0.5 to 1mm/day, without a latency period. After a consolidation period of 2-3weeks, the devices were removed. Functional aspects of ICP and mental retardation subsided post surgery. Radiological follow-up showed cessation of enhancement of bone deposition at the frontal and occipital sutures. Excellent aesthetic results were accounted for in all three of the patients. Application of distraction osteogenesis in correcting sagittal craniosynostosis is very effective; surgical stress on the patients is minimal and controlled cranial vault reshaping is possible.
Blood Volume ; Child ; Child, Preschool ; Constriction, Pathologic ; Craniosynostoses* ; Follow-Up Studies ; Hemorrhage ; Humans ; Hydrocephalus ; Infant ; Intellectual Disability ; Latency Period (Psychology) ; Mortality ; Osteogenesis, Distraction* ; Sutures ; Synostosis

OBJECTIVETo observe the impacts of acupuncture on intelligent structure, social adaptability and fMRI brain function in children mental retardation (MR).

METHODSSixty cases of MR in compliance with the diagnostic standard were randomized into an acupuncture group and a medication group, 30 cases in each one. In the acupuncture group, Sishenzhen [four points, 1.5 cun anterior, posterior and bilateral to Baihui (GV 20)], Zhisanzhen [Shenting (GV 24), bilateral Benshen (GB 13)], Niesanzhen (the point 2 cun directly above the ear a-pex, the two points 1 cun bilateral the first point) and Naosanzhan [Naohu (GV 17) and bilateral Naohu (GB 19)] were selected as the main points. In the medication group, piracetam tablets were prescribed for oral administration. One course of treatment was 4 months in the two groups. The comprehensive efficacy was compared between the two groups at the end of treatment course. China-Wechsler Intelligence Scale for Children (C-WISC) was used to assess the intelligent improvements. Infant-Junior School Student Social Life Ability Scale was adopted to assess the improvements of social adaptability. Five cases were selected from the acupuncture group and fMRI was adopted to compare the brain function imaging changes before and after acupuncture treatment.

METHODSIn the acupuncture group, the final intelligence quotient (FIQ) and social adaptability score after treatment were higher than those before treatment (P<0.05), of which, the performance intelligence quotient (PIQ) was improved significantly, indicating the statistically significant difference (P<0.05). But the verbal intelligence quotient (VIQ) did not change apparently (P>0.05). In the medication group, the changes in all the indices were not apparent before and after treatment (P>0.05). In comparison of the changes after treatment between the two groups, FIQ, PIQ and social adaptability score in the acupuncture group were improved more significantly as compared with the medication group (P<0.05). The fMRI brain function images did not change apparently before and after treatment in those 5 cases of the acupuncture group.

CONCLUSIONAcupuncture promotes the intelligent recovery of MR children and improves their social adaptability. It indicates the satisfactory clinical efficacy. But, the fMRI brain function images do not change apparently before and after treatment.

Acupuncture Points ; Acupuncture Therapy ; Adolescent ; Child ; Child, Preschool ; Female ; Humans ; Intellectual Disability ; psychology ; therapy ; Intelligence Tests ; Male ; Social Adjustment ; Treatment Outcome