There is much evidence in the literature suggesting that children with congenital blindness can also present autistic like features. The aetiopathogenetic and clinical significance of this association is still unclear. Given the central role played by vision in development, we set out to establish the significance of autistic‐like behaviours in children with early‐onset severe visual impairment. Our sample comprised 24 children (13 males, 11 females; mean age 5y 2mo; range 2‐11y) affected by Leber's congenital amaurosis (LCA). The results of our administration of a modified Childhood Austism Rating Scale ‐ excluding item VII (Visual Responsiveness) ‐ showed that only four of the children gave an overall score indicating the presence of autism (moreover, of mild/moderate degree). Hardly any of the children in our LCA sample presented major dysfunctions in their relationships with other people or in their social and emotional responsiveness, thus allowing us to exclude a genuine comorbidity with a picture of autism. Indeed, the risk facing the visually impaired child seems to concern their early interactive experiences, which may be affected by their inability to connect with others, and may be prevented through the development of specific strategies of intervention.
The concept of Quality of Life (QoL) has gradually acquired importance and interest. In its application and development it was able to represent an important and valuable conclusion for many a clinical trials. However, until now little research has been conducted toward evaluating QoL results in Intellectual Developmental Disorders (IDD). Pharmacotherapy in IDD is mainly directed towards managing behavioral symptoms and psychiatric disorders, with limited relevance to QoL. Objective: The purpose of this paper is to provide a critical review of the literature on the QoL as a new outcome measure on pharmacological research in IDD. Materials and methods: A review of the literature from the last 15 years was carried out and an article search was conducted using search engines available on Medline, EBSCO, Web of Science, Medmatrix, NHS Evidence and Cochrane Library. The main keywords that were used in the searches included the following: intellectual developmental disorders, autism, autism spectrum disorders, pervasive developmental disorders, mental retardation, intellectual disability, learning disability, developmental disorder, developmental disability, quality of life, psychopharmacology and psychopharmacotherapy. Afterwards the authors went through all of the articles to produce organisational criteria and comments. Conclusion: A QoL measure on IDD certainly has clinical utility. Given that individuals with IDD are a highly vulnerable population and that the medications used to treat them could have serious side effects and important repercussions on daily practice, it seems imperative that their use be directed by empirically supported research that considers new person-centered outcome measures such as QoL.
IntroductionAlthough pharmacological treatment is indicated by international guidelines not to be considered the first choice intervention for the management of problem behavior in Intellectual Developmental Disorders (IDD), around 60% of prescriptions are still for this purpose, while reliability with psychiatric diagnosis is often uncertain. Antipsychotics represent the most frequently prescribed class, followed by mood stabilisers, benzodiazepines, and antidepressants.Several empirical studies support the use of these compounds, although some other publications are more sceptical of the quality of the evidence to date. Special attention is given to their side-effects on cognitive skills.In the last years clinicians have shown increasing interest for Very New Generation Antipsychotics (VNGA) having a better tolerability profile, like aripiprazole, asenapine, quetiapine, ziprasidone, and paliperidone.AimThe purpose of this paper is to provide an overview on the use of VNGA in adults with IDD.MethodsSystematic mapping of the literature. Systematic mapping varies from a systematic review in the breadth of the topic area and questions, and the limits of data extracted.ResultsEvidence on these compounds is lacking, but clinical experiences and the few trials conducted in the last years allow to make some distinctions within the group.Current psychopharmacology tends to evaluate the usefulness of pharmacological treatments in terms of effectiveness rather than in terms of efficacy on target symptoms and safety. This new measure, which focus on prevention of discontinuation seems to be strictly related to patient's perception of treatment adequacy and usefulness to their own life overall.
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