Mentally Impaired Research Articles

Parents’ Mental Illness and Its Impacts on Children: A Descriptive Study of the Perspectives of Youths (Case Study: Serekunda West, the Gambia)

Background Mental impairment is not only on the increase but it is a global problem. Although the precise number of the mentally impaired persons is not well documented more especially in developing countries, what is indisputable is they are in millions and is negatively impacting societies. Purpose The fundamental rationale for this study is to investigate into parents’ mental illness in the community and youths’ comprehension of its causes, negative impacts, support services needed by victims and their children; and its preventive methods with the ultimate objectives of sharing knowledge to spark and inspire processes that will usher rapid growth from all directions in the reduction of the phenomenon and its associated negative impacts. Methodology Hence the study was a descriptive survey meant to capture the youths’ perspectives on parents’ mental illness and its associated impacts especially on their children, questionnaires were administered to gauge the perspectives of hundred and twenty youths. Results The negative impacts of parents’ mental illness on their children are numerous and in addition to the general ones they include specific ones: social impacts, health impacts, psychological impacts, economic impacts; and educational impacts. To alleviate the impacts, access to medical treatment, basic needs, continuous prayers, counseling, financial assistance, regular visits from the helping profession, scholarships for children among other services are critical. To prevent the menace, general sensitization about mental impairment, sensitization on the use of illegal substance, counseling, helping single parents financially and morally; and the incorporation of mental health in the curriculum of secondary schools are some of the fundamental approaches. Conclusion In conclusion, the negative impacts of parents’ mental illness on their children can be simply pooled and catalogued into medical, social, psychological, educational; and economical.

Factors Influencing Children with Mental Impairment in Acquiring Quality Primary School Education in Singida Municipality, Tanzania

This study investigated the factors influencing children with mental impairment in acquiring quality primary education in Singida Municipality. Specific objectives were to determine the availability of specialist teachers to help pupils with mental impairment as to acquire quality primary education, to examine the availability of teaching and learning materials for teaching children with mental impairment, and to determine the perception of regular /ordinary teachers towards helping children with mental impairment in acquiring quality primary education. A descriptive type of research and a mixed research approach was used in this study. The study found that primary schools in the study area have specialised teachers for mentally impaired children, but they are not given training from time to time. It was further found that it is inadequate teaching and learning materials that hinder the provision of quality education for children with mental impairment. The study also revealed that the parents were not fully supporting children with mental impairment in acquiring quality education. The study however found that regular teachers were supporting in ensuring the provision of quality education for children with mental impairment in the study area. The study concluded that there is a problem with adequate teaching and learning materials for children with mental impairment in primary schools in the study area. This hinders the provision of quality education. Parents still lag behind in supporting children with mental impairment in primary schools to acquire quality education through failure to provide all the required learning materials and failure to make follow-ups on the academic progress of their children.

Turner Syndrome with Ring X Chromosome: Do They Have a Distinct Phenotype?

In contrast to classic Turner syndrome, Turner patients with ring X chromosome are associated with distinct dysmorphism and are likely to be mentally impaired. Four Turner patients with ring X chromosome were examined for phenotypic features of Turner syndrome and additional dysmorphism. Both patients 1 and 2 are twins with normal intelligence whereas patients 3 and 4 have mental impairment. With the exception of patient 4, the other three patients only have few Turner characteristics. None of the patients have the distinctive dysmorphism previously reported in Turner syndrome with ring X chromosome. Both twins developed spontaneous puberty. Patients 3 and 4 however had no spontaneous puberty. We postulate that this variation may be related to the ring size, the proportion of 45,X and ring X chromosome in cell lines of various body tissues as well as the ability of these rings to be inactivated as a result of lyonisation.

Importancia y sentido del coaching y la inteligencia emocional en itinerarios para el empleo de personas con discapacidad intelectual

Coaching e inteligencia emocional se presentan como dos potentes recursos a utilizar en los itinerarios para el empleo de personas con discapacidad intelectual. El artículo que nos ocupa ofrece, por un lado, una presentación de lo que es el coaching, pilares básicos y profesionales referentes, y cómo sus principios conectan -en el contexto de los itinerarios para el empleo de las personas con discapacidad intelectual-, con la planificación centrada en la persona, enfoque metodológico que las organizaciones del sector social vienen utilizando para la puesta en marcha del desarrollo del proyecto vital y empoderamiento personal de cada una de las personas de este colectivo. A su vez, se realiza un análisis del significado de inteligencia emocional y de la importancia de este constructo impartido en las acciones formativas de los itinerarios para el empleo, como elemento trampolín que forma y capacita para el autoconocimiento, la autorregulación, la toma de decisiones y la capacidad de relacionarse favorablemente con los otros, en todo tipo de entornos y en particular en los laborales. Con la necesidad de contextualizar lo anteriormente expuesto se lleva a cabo una presentación del concepto discapacidad intelectual y algunas de las leyes que amparan gran parte de los derechos del colectivo. Se explica qué es y en qué consiste un itinerario laboral para el empleo de personas con discapacidad intelectual, sus fases, contenidos y objetivos principales, tomando como referente el de una entidad social que trabaja en pro de la calidad de vida de las personas con discapacidad intelectual y sus familias.

Adverse Outcomes and Economic Burden of Congenital Adrenal Hyperplasia Late Diagnosis in the Newborn Screening Absence.

ObjectiveTo establish short- and long-term adverse outcome frequencies related to a late diagnosis of congenital adrenal hyperplasia (CAH) in the absence of newborn screening (NBS) and to determine respective treatment costs, which have never been reported.DesignA retrospective analysis of a CAH cohort diagnosed without NBS.MethodsWe evaluated medical record data concerning 195 patients (141 females) diagnosed with CAH through clinical suspicion and confirmed using hormonal and CYP21A2 analysis, who were followed from 1980 to 2016 at Sao Paulo University. We measured mortality, dehydration, mental impairment frequencies, and hospitalization length outcomes in the salt-wasting form; the frequency of genetic females raised as males in both forms, frequency of depot GnRh analog (GnRha) and GH therapies in the simple virilizing form, and related outcome costs were calculated.ResultsMortality rates and associated costs, varying from 10% to 26% and from $2,239,744.76 to $10,271,591.25, respectively, were calculated using the Brazilian yearly live-births rate, estimated productive life years, and gross domestic product. In the salt-wasting form, 76% of patients were hospitalized, 8.6% were mentally impaired, and 3% of females were raised as males (total cost, $86,230/salt-wasting patient). GnRha and growth hormone were used for 28% and 14% of simple virilizing patients, respectively, and 18% of females were raised as males (preventable cost, $4232.74/simple virilizing patient).ConclusionsA late CAH diagnosis leads to high mortality and morbidity rates, notably increasing public health costs, and may result in physical and psychological damage that is not easily measurable.

An Argument for Diminished Culpability Manslaughter: Responding to Gaps in Victorian Homicide Law

The complexity and diversity of unlawful killings — particularly those involving mentally impaired offenders — does not fit neatly across the binary distinction of offence/defence that structures criminal law. This is demonstrated in the Australian State of Victoria, where cognitively impaired homicide offenders who fail to meet the strict remit of the mental impairment defence have no (partial) defence or offence available to them which adequately captures their levels of criminal responsibility, moral agency and culpability. This makes the sentencing of such offenders not only particularly complex but means that the only stage in which both moral and legal culpability can be considered is in mitigation. This article argues that a progressive framework is needed to permit a small minority of (mentally impaired) homicide offenders to be simultaneously inculpated and (partially) exculpated. Accordingly, we propose introducing a model of diminished culpability manslaughter in Victoria, drawing from Loughnan’s seminal reconceptualisation of ‘diminished responsibility manslaughter’ as an offence-cum-defence, which renders the diminished accused differently liable. Informed by a study of all homicide cases (n=647) sentenced in Victoria between 1 January 2000 and 31 July 2017, we argue that this model would not revoke legal capacity and would instead enhance the legitimacy and coherence of criminal law procedures, allowing a wider range of more legitimate convictions and reflective sentencing dispositions.

Overlooked Transport Participants – Mentally Impaired but Still Mobile

Providing an inclusive transport system is a global ambition. Whereas, mobility needs and mobility barriers of people suffering from a physical impairment have already been observed frequently, people suffering from mental impairments (due to e.g. anxiety disorders, obsessive-compulsive disorders, dementia or other degenerative diseases) are often overlooked. Numerous studies already suggest that the number of people with mental impairment will significantly increase due to the demographic change and is also shown by the prevalence of mental diseases. Whereby, not even the data collected do necessarily give the full picture of the actual situation. Thus, the importance of mobility needs and mobility problems of people with mental impairments will gain dramatically. Participating in the transport system is a basic need that furthermore requires the ability of adopting different roles (e.g. driver, pedestrian). Due to explanatory studies of the authors, it could be shown what kind of problems people with mental impairment are faced with while participating in the transport system or interacting in public space. Thus, these studies represent the first step that is needed to consider the specific needs of people with mental impairments in future planning. The identified problems of people who are suffering from mental impairment are various. Thereby it can be distinguished between problems triggered by structural (e.g. absence of emergency buttons, spacious stations), organisational (e.g. absence of security stuff, lacking information according time table of transit) or social conditions (e.g. crowed places or vehicles, stigmatisation). This paper presents an overall view of specific requirements of people with mental impairment and suggests possible solutions for planning and designing an inclusive transport system.

Sociocultural Factors Associated With Abuse of Mentally Impaired Persons in Imo State, Nigeria.

This study examined sociocultural factors associated with abuse of mentally impaired persons (MIP) in Imo state, Nigeria. A cross-sectional survey of 1,147 persons aged 10 years and above who had at least one MIP in their household was conducted. Six in-depth interviews and 21 focus group discussion (FGD) sessions with 160 study participants comprising adult male and female members of the communities, respectively, were conducted. The study established that a multitude of cultural and social factors shape the attitude of individuals toward mental impairment and MIPs. It was found that cultural perceptions of the cause of mental impairment as supernatural and evil forces were widespread within the study communities. Among those surveyed, 74.6% were aware that MIPs are victims of abuse. Perpetrators identified were mostly relatives and persons close to MIPs. The findings provide useful insights into gaps in conventional understanding of mental impairment and abuse of MIPs in Imo State.

Internal Fixation Compared with Total Hip Replacement for Displaced Femoral Neck Fractures

Prospective randomized studies comparing internal fixation and a cemented hip replacement in the treatment of displaced femoral neck fractures have shown favorable short-term results for prosthetic replacement. The present report compares the results after a minimum of fifteen years. From 1994 to 1998, 143 patients (146 hips) were randomized to closed reduction and internal fixation with two screws (n = 78) or a cemented total hip replacement (n = 68). The average age of the patients was eighty-four years (range, seventy-five to 101 years), and 38% were classified as mentally impaired. Failure after internal fixation was defined as early redisplacement, nonunion, symptomatic segmental collapse, or deep infection. In the arthroplasty group, failure was defined as two dislocations or more, implant loosening, deep infection, or a periprosthetic fracture. For the lucid patients, the failure rate was 55% after internal fixation compared with 5% after total hip replacement. For patients with mental impairment, it was 16% in both groups. Total hip replacement is superior to internal fixation in the treatment of a displaced femoral neck fracture.

Depressed but not legally mentally impaired

This article examines the mental impairment (insanity) defense in the Australian state of Victoria and argues that the defense is successful only when offenders suffer from psychotic mental illnesses. This raises the question about how non-psychotic offenders are dealt with by the courts when they claim ‘mental impairment’ for serious acts of violence such as homicide, particularly when a relatively large number of perpetrators involved in homicide suffer from non-psychotic illnesses like depression. The analysis shows that depressive illnesses do not reach the threshold for mental impairment (legal insanity) such that they mitigate violent criminal behavior, although they can, arguably, diminish culpability. This article draws upon existing literature, qualitative analysis of two court cases and semi-structured interviews with four legal representatives to make its conclusions.

Predictors of mental health in female teachers

Teaching profession is characterised by an above-average rate of psychosomatic and mental health impairment due to work-related stress. The aim of the study was to identify predictors of mental health in female teachers. A sample of 630 female teachers (average age 47 ± 7 years) participated in a screening diagnostic inventory. Mental health was surveyed with the General Health Questionnaire GHQ-12. The following parameters were measured: specific work conditions (teacher-specific occupational history), scales of the Effort-Reward-Imbalance (ERI) Questionnaire as well as cardiovascular risk factors, physical complaints (BFB) and personal factors such as inability to recover (FABA), sense of coherence (SOC) and health behaviour. First, mentally fit (MH(+)) and mentally impaired teachers (MH(-)) were differentiated based on the GHQ-12 sum score (MH(+): < 5; MH(-): ≥ 5); 18% of the teachers showed evidence of mental impairment. There were no differences concerning work-related and cardiovascular risk factors as well as health behaviour between MH(+) and MH(-). Binary logistic regressions identified 4 predictors that showed a significant effect on mental health. The effort-reward-ratio proved to be the most relevant predictor, while physical complaints as well as inability to recover and sense of coherence were identified as advanced predictors (explanation of variance: 23%). Contrary to the expectations, classic work-related factors can hardly contribute to the explanation of mental health. Additionally, cardiovascular risk factors and health behaviour have no relevant influence. However, effort-reward-ratio, physical complaints and personal factors are of considerable influence on mental health in teachers. These relevant predictors should become a part of preventive arrangements for the conservation of teachers' health in the future.

Idiocy and Madness in Princely European Families

Idiocy and Madness in Princely European Families

Constitutional Haploinsufficiency of Tumor Suppressor Genes in Mentally Retarded Patients With Microdeletions in 17p13.1

Chromosome microdeletions or duplications are detected in 10–20% of patients with mental impairment and normal karyotypes. A few cases have been reported of mental impairment with microdeletions comprising tumor suppressor genes. By array-CGH we detected 4 mentally impaired individuals carrying de novo microdeletions sharing an overlapping segment of ∼180 kb in 17p13.1. This segment encompasses 18 genes, including 3 involved in cancer, namely KCTD11/REN, DLG4/PSD95, and GPS2. Furthermore, in 2 of the patients, the deletions also included TP53, the most frequently inactivated gene in human cancers. The 3 tumor suppressor genes KCTD11, DLG4, and GPS2, in addition to the GABARAP gene, have a known or suspected function in neuronal development and are candidates for causing mental impairment in our patients. Among our 4 patients with deletions in 17p13.1, 3 were part of a Brazilian cohort of 300 mentally retarded individuals, suggesting that this segment may be particularly prone to rearrangements and appears to be an important cause (∼1%) of mental retardation. Further, the constitutive deletion of tumor suppressor genes in these patients, particularly TP53, probably confers a significantly increased lifetime risk for cancer and warrants careful oncological surveillance of these patients. Constitutional chromosome deletions containing tumor suppressor genes in patients with mental impairment or congenital abnormalities may represent an important mechanism linking abnormal phenotypes with increased risks of cancer.

Common Law Sentencing of Mentally Impaired Offenders in Australian Courts: A Call for Coherence and Consistency

This article discusses the common law sentencing of mentally impaired offenders in Australian courts. In Part A, the author discusses the significant correlation between mental impairment and crime. In Part B the author considers how courts have used different sentencing purposes (incapacitation, rehabilitation, deterrence, and proportionate retribution) in determining appropriate sentences for this class of offender. The author highlights the inconsistencies that have developed within and between jurisdictions. In Part C the author argues that the inconsistencies have arisen as a result of the theoretically incoherent use of general deterrence, rather than proportionality, as a site for the consideration of diminished offender culpability.

Drug Use and the Defence of Mental Impairment: Some Conceptual and Explanatory Issues

Recent work has highlighted the problem of amphetamine use in Queensland. In particular, concern has been expressed in relation to what has been described as a ‘disturbing trend’ towards the provision of exculpatory defences based on findings of ‘amphetamine‐induced psychosis’. While the subject of a spate of cases before the then Queensland Mental Health Tribunal, instances of drug induced psychosis are not restricted to Queensland. Similar issues have arisen in the context of the Victorian Law Reform Commission’s recent analysis of people with mentally impaired functioning who kill. What has become apparent in both case law and reform proposals dealing with this area is the interconnectedness of issues of principle and policy. The present article endeavours to clarify the thicket of conceptual and explanatory issues underlying voluntary drug use and the subsequent raising of a defence of non‐responsibility. This article is available in Bond Law Review: http://epublications.bond.edu.au/blr/vol18/iss2/6 165 DRUG USE AND THE DEFENCE OF MENTAL IMPAIRMENT: SOME CONCEPTUAL AND EXPLANATORY ISSUES

Lawyers: A Role to Play in the Detection of Mental Impairment?

Mental impairment can be considered at three temporally distinct stages of the South Australian criminal justice system. Present literature gives modest support for the routine consideration of mental impairment by lawyers, but fails to clarify whether consideration occurs in practice. The current study sought to establish the frequency with which South Australian lawyers consider mental impairment, using 'detection' as a benchmark. The relevance of high prevalence rates of mentally impaired offenders was also considered. Results established that for a population of defendants with high rates of mental impairment, lawyers frequently considered impairment, but were unable to specify type of impairment. The implications of these results are discussed.

An unquiet mind in the workplace: mental illness and the Disability Discrimination Act 1995

New Labour's recent ‘Welfare to Work’ policies encourage people with disabilities, where possible, to enter and participate in the workplace. The current policy of ‘inclusion’ is supported by the Disability Discrimination Act 1995 (DDA), which came into force in December 1996 providing those who are discriminated against on the grounds of their disability with an action against their employer. Drawing upon recently decided case law, this paper considers what the DDA offers those who are discriminated against because of a mental illness. I argue that policy-makers, courts and tribunals, because the relationship between physical and mental impairments is often misunderstood, fail to reflect the varied nature of or understand the stigma associated with, mental ill health. The law is thus at present incapable of providing adequate protection for mentally impaired individuals who attempt to participate or remain in the labour market, and new approaches, which are sensitive to the diverse nature of disability, need to be considered.

An e-mail programme for mentally impaired persons

The ALDICT project (1998-2001) from TIDE programme (Access of Persons with Learning Disabilities to Information and Communication Technologies) had as primary goal to create and develop an e-mail programme for people with mental impairment (MI) using different graphic signs communication systems. Simplified e-mail software was developed, using graphic symbols to enable MI persons to communicate with people using different graphic sign systems or the Roman alphabet without having to perform complex tasks required by regular e-mail software. Moreover, the e-mail allows MI users to communicate with people from different countries without knowing their native language (the programme allows the automatic translation of the words written with the roman alphabet that normally follows the sign graphic symbols as well as the change between the different graphic sign systems used). As a general conclusion we can say that the e-mail programme developed may be regarded as a good tool to teach MI students to communicate with graphic signs and to increase their communication skills and social networks. However, some improvements are still required.

Dystrophin deletions and cognitive impairment in Duchenne/Becker muscular dystrophy

Analyses of deletions in the dystrophin gene and of cognitive status were performed on patients with Duchenne (DMD) or Becker (BMD) muscular dystrophy in order to find a correlation between both features. Molecular study by multiplex and simplex PCR of dystrophin exons led to the identification of 51 deletions in 126 unrelated patients. Most of them were frameshift, in full agreement with severe clinical symptoms, three patients with a BMD-like phenotype had in-frame mutations. Deletions were localized with reference to the different dystrophin isoform sequences and were clustered in two main areas, 5′ and central + 3′ end of the gene. Cognitive abilities were tested in 47 out of 51 patients with identified mutations, 23 of them being mentally impaired. Comparison of molecular and neuropsychological features showed that deletions localized in central and 3′ parts of the gene (18 out of 23) are preferentially associated with mental impairment. Fourteen of them were found in the regulatory and coding sequences for the three CNS specific carboxy terminal isoforms. Therefore, though mutations with variable locations may lead to cognitive impairment, our results show that deletions in the distal portion of the gene are basically related to mental retardation.

The influence of expanded unmethylated alleles for FRAXA/FRAXE loci in the intellectual performance among Brazilian mentally impaired males

Both fragile X (FRAXA) syndrome and fragile XE (FRAXE) disorder are caused by an expansion of a polymorphic trinucleotide repeat and are associated with mental impairment. Based on the size and methylation status of the expansion, individuals are classified as having normal, intermediate, premutation or full mutation alleles. Unlike individuals with full mutations, carriers of intermediate and premutated alleles should not exhibit obvious clinical symptoms, since the FMR1 (FRAXA) or FMR2 (FRAXE) genes are not transcriptionally silenced. However, there are data suggesting a phenotype consequence of the FRAXA premutation alleles. We have investigated a population consisted of 276 males with idiopathic mental retardation or learning disability and a control sample of 207 non-affected boys in order to determine if there was a possible phenotype consequence of the expanded unmethylated alleles for FRAXA/FRAXE loci. Direct molecular diagnosis for the FRAXA/FRAXE loci were performed in both populations by using PCR technique and sizing of the amplification products by electrophoresis in denaturing polyacrilamide gels. No FRAXA/FRAXE premutations or FRAXE mutated alleles were observed. The 25 FRAXA full mutations alleles detected were confirmed by Southern blot analysis. We found an excess of intermediate alleles for both FRAXA and FRAXE in the target population, but it did not reach statistically significant difference. This suggests that relatively large unmethylated repeats may not be associated with an abnormal cognitive and/or behavioral phenotype. However, recent evidence that FRAXA premutation alleles in males have increased FMR1 message levels emphasizes the need of more studies using large sample sizes and proper control population to resolve this contradictory observation.