정신과 병동에 입원한 정신지체아에 대한 임상적 고찰

Clinical Study on the Mentally Retarded Children and Adolescents Admitted to Psychiatric Ward

This is a retrospective study on clinical features of 37 mentally retarded children and adolescents, excluding those with convulsive disorder, who were admitted to child psychiatric ward in Seoul National Mental Hospital druing the period from Jan. 1982 to June, 1989. The results, were as follows ; 1) Boys were more common than girls at the ratio of 1.3 to 1. On admission, the mean age was 14.4土 2.6 years. As to the education level, 18 subjects (48.7%) were above the middle school. 2) The chief problems were psychotic symptom(59.5%), aggressive and destructive behavior (56.8%), antisocial behavior(24.3%), hyperactivity(21.6%), self m utilation(l3.5% ), anxiety(l3.5% ), stereotypy(10.8%), sexual problem (8.1%), compulsive behavior(5.4%). 3) As to the associated psychiatric disorders, 11(29.7%), subjects were associated with schizophrenia, 11(29.7%) with psychosis, 7(19.0%) with conduct disorder, 2(5.4% ) with conduct disorder and attention deficit disorder with hyperactivity, 2(5.4% ) with pervasive developmental disorder, and 4 subjects(l0.8%) were not diagnosed with other psychiatric disorder. 4) The mean age of onset of associated psychiatric disorders was as follows •• 14.1±2.5 years in schizophrenia, 13.0土 3.0 years in psychosis, 9.9土 4.6 years in conduct disorder, conduct disorder and attention deficit disorder with hyperactivity, and there was a significant difference among the three groups(P〈0.05). 5) The precipitating stressor was known in 10 subjects. The most frequent precipitating stressor was admission to middle and high school. 6) 15 subjects (40.5 땄) of the total were tested for intellectual level. The most frequent degree of mental retardation was mild. 7) 19 subjects(51.3%) of the total received EEG. The most frequent EEG finding was normal. 8) The mean maximum dosage of antipsychotics was as follows : 1161.8土 1230.8mg in schizophrenia, 481.8± 202.8mg in psychosis, 286.1± 204.3mg in conduct disorder, conduct disorder and attention deficit disorder with hyperactivity, and there was a significant difference among the three groups(P〈0.05). 9) The extrapyramidal symptom was noted in 24 subjects(64.990. The most frequent extrapyramidal symptom was parkinsonism. The mean minimum dosage of antipsychotics at the time extrapyramidal symptom occurred was 335.4士 280.6mg. 10) The mean duration of admission was 121.6+69.3 days, and there was no significant difference in mean duration of admission according to sex and associated psychiatric disorders