Read S
Br J Psychiatry. 1998 May;172:381-4. doi: 10.1192/bjp.172.5.381.
Psychiatry in severe and profound learning disability is essentially behavioural psychiatry. Some clinical and research observations of disorders of behaviour in this group are summarised in this study.
After inspection of the literature, I postulated a clinical syndrome of violence and self-injury in the severely learning disabled. A check-list of behavioural symptoms was developed and used in a community survey.
Behaviour, assessed by the check-list, supported the existence of organic behaviour disorder, as did small-scale psychophysiological testing.
Self-injury is strongly associated with violence, and with severe and profound learning disability. Pathophysiology of violence and self-injury may include high levels of psychophysiological arousal demonstrated by unstable EEGs. Reduction of arousal by antipsychotic medication is associated with clinical improvement in violent and self-injurious behaviours.
重度和极重度学习障碍患者的精神病学本质上是行为精神病学。本研究总结了该群体行为障碍的一些临床和研究观察结果。
查阅文献后，我提出了重度学习障碍患者暴力和自我伤害的临床综合征。制定了一份行为症状清单并用于社区调查。
通过清单评估的行为支持了器质性行为障碍的存在，小规模心理生理学测试也支持这一点。
自我伤害与暴力以及重度和极重度学习障碍密切相关。暴力和自我伤害的病理生理学可能包括脑电图不稳定所显示的高水平心理生理唤醒。抗精神病药物降低唤醒水平与暴力和自我伤害行为的临床改善相关。
