Erfassung kognitiver Defizite bei Patienten mit Intelligenzminderung und Epilepsie

[Cognition in Down's Syndrome: Development across the Life Span and Neuropsychological Assessment in Adults]

Das Down-Syndrom ist die häufigste genetische Ursache einer Intelligenzminderung. Da Menschen mit einem Down-Syndrom ein erhöhtes Risiko aufweisen, an einer Alzheimer-Demenz zu erkranken, ist eine umfassende Untersuchung der kognitiven Funktionen indiziert, sowohl im jungen Erwachsenenalter (zur Erhebung des kognitiven Ausgangsniveaus) als auch im Verlauf zur Demenzdiagnostik. Das weite Spektrum an kognitiver Leistungsfähigkeit bei Menschen mit einem Down-Syndrom stellt eine diagnostische Herausforderung dar. Wir möchten daher einen Überblick geben (1) über die kognitive Entwicklung über die Lebensspanne, (2) über verschiedene mögliche Ursachen kognitiver Veränderungen bei erwachsenen Menschen mit einem Down-Syndrom und (3) über neuropsychologische Diagnostik und entsprechende Verfahren für den Erwachsenenbereich. Schließlich geben wir, auf der Grundlage unserer Erfahrungen, (4) allgemeine Empfehlungen zur Untersuchung und Befundinterpretation bei Menschen mit Intelligenzminderung.

Gestural praxis in young adults with mild to moderate intellectual disabilities

BACKGROUND

Praxis functioning in the population with intellectual disabilities (ID) has been poorly studied. The goal of this research was to look for a starting point to study the praxic functioning in young adults with mild to moderate ID.

METHOD

Thirty young adults with ID and 30 young adults without ID, between the ages of 18 and 35 years, participated in this study. All participants completed tests that assessed gestural praxis.

RESULTS

It was possible to observe similar praxis behaviour in the group with ID in almost all domains studied, albeit showing statistical values lower than those of the group without ID.

DISCUSSIONS

Despite the high number of errors committed, the sample of participants with ID was able to reach the goal of praxic tasks performed; such errors may be associated with a deficit in the development of various brain functions and not only with praxis functioning, mainly related to a lower yield in terms of planning, monitoring and correcting intentional movement.

Mentally challenged patients in a forensic hospital: a feasibility study concerning the executive functions of forensic patients with organic brain disorder, learning disability, or mental retardation

The past years have seen an increasing number of patients of lower intelligence or with organic brain disorder being committed into our forensic psychiatry. Our clinic has an ongoing scientific project to investigate the possibilities of reducing costs while at the same time guaranteeing adequate treatment and enforcement practice in forensic hospitals. This current project did not take these kinds of patients into consideration initially. This feasibility study is intended to examine if and to what extent these patients can be part of the scientific project. All patients of forensic psychiatry in Rostock (Mecklenburg-Western-Pomerania) with an IQ<80 (learning disorder) or a primary or secondary organic brain dysfunction that have been committed to the clinic since 2009 are included. These patients went through an extensive battery of neuropsychological tests. Furthermore, the treating psychotherapists had to rate the prognoses for criminal re-offending at discharge. Patients affected by lower intelligence or an organic brain dysfunction achieve lower results in neuropsychological testing than other patients participating in the main project. Nevertheless, participation in neuropsychological testing does not appear to overtax them. Future examination of the patients will be conducted to investigate to what extent certain therapeutic methods have been of noticeable benefit to this problematic group.