A study on the administrative management for mentally retarded persons in the social welfare center for disability of Yokohama City


Akiko Yoshida, Tomoko Sugano, Takeshi Matsuishi, Keiko Endo, Tetsuaki Yamaguchi, Yoshiteru Yamada

Abstract
A survey was carried out to assess the administrative management of people with mental retardation, the results of medical diagnosis, psychological testing and testing of working capacity from October, 1987 to March, 1989 in the social welfare center for disabilities of Yokohama city. The total number of cases with mental retardation in this survey was 377. Male : female ratio of mental retardation was 1.73 : 1, The average IQ was 39.0. The percentage of mildly mentally retarded was 20.8, 30,0% for moderate, 25.1% for severe and 20.2% for profound. These result shows that the rate for severely retarded is more than that previously presented.
The most prevalent complication was epilepsy with 28% of cases being affected. Using antiepleptics their condition was generally controlled. The prevalence rate of epilepsy was proportional to the degree of mental retardation.
Male : female ratio of mentally retarded with autistic disorder was 7.7 : 1. The percentage of autistic disorder in the total group was 16%. The average IQ of this group was 42.4. Generally speaking, the more severe the degree of mental retardation, the higher the prevalence of autistic disorder.
Those with mild mental retardation showed maladjustment at a higher rate.
As for the administrative management on the basis of these result, the group of profound and severe mentally retarded tended to be institutionalized and the group of moderate and mild mentally retarded attended a vocational aid center.
The shortage of facilities is a serious problem in Yokohama city. Considering of higher rate of severely mentally retarded, construction of institutions is urgent. In addition to that, we emphasize the need for special consideration for those with autistic disorder.
(Kanagawa Seishinigaku kaishi, Journal of Kanagawa Psychiatric Association, 47: 59-66,1997)

An epidemiological study on the cause of mental retardation in Yokohama City

Akiko Yoshida, Tomoko Sugano, Takeshi Matsuishi, Keiko Endo, Yoshiteru Yamada

We investigated the cause of mental retardation in 337 cases. This survey was carried out from October 1987 to March 1989. The total number of participants in the survey was 337 mentally retarded people residing in Yokohama City and consisted of 207 male, 130 female. Age ranged from 14 years to 58 years with an average age of 22 years. IQ was evaluated using Tanaka-Binet test,the Japanese version of the Binet test. The sample population was classified into two groups. The first group was made up of cases with severe mental retardation with IQ scores of 50 or less. The second group had mild mental retardation with IQ scores of over 50. This classification is in accordance with the international standard. The number of cases in the first group was 262 and in the second group was 75. Physical and neurological examination was performed in all cases in an attempt to ascertain the causes of the mental retardation. Where it was deemed necessary electroencephalogram, cranial CT scan and chromosome test were carried out in cases where parental consent was granted.
The time of insult was categorized into four groups; prenatal, perinatal, postnatal and unclear. In the severely mentally retarded group, group one, the time of insult occurred in the prenatal period in 25.6% of cases, in the perinatal period in 9.2% of cases, in the postnatal period in 8.0% of cases and was unclear in 57.2% of cases. In the second group a prenatal insult occured in 14.7% of cases, perinatal was 8.0%, postnatal was 12.0% and was unclear in 65.3%. In the first group gene or chromosomal abnormalities accounted for 68.6% of cases with mental retardation occurring in the prenatal period. In the second group a familial relationship was recognised in 26.9% of cases. The cause of mental retardation in the second group was in many cases difficult to specify.
A comparison performed between this study and a similar study carried out in Finland revealed similar patterns. The above findings suggest a need for prenatal diagnosis and genetic counseling in certain cases.
(Kanagawa Seishinigaku kaishi, Journal of Kanagawa Psychiatric Association, 48:15-21,1998)