A review of the literature revealed that there was no adequate assessment instrument available that screens comprehensively for anxiety and depression in persons with mental retardation. The purpose of this research was to develop the Anxiety, Depression, and Mood Scale (ADAMS), an instrument intended to fill this gap. We developed a preliminary rating scale that included 55 symptom items. We examined the factor structure of these items by an exploratory factor analysis of behavior ratings on 265 individuals. A five-factor solution emerged that was both statistically sound and clinically meaningful. These factors were labeled "Manic/Hyperactive Behavior," "Depressed Mood," "Social Avoidance," "General Anxiety" and "Compulsive Behavior." We validated this solution by conducting a confirmatory factor analysis on ratings of 268 additional individuals. Model fit was acceptable. Internal consistency of the subscales and retest reliability for both the total scale and the subscales was high. Interrater reliability was satisfactory. The validity of the ADAMS was assessed with a clinical sample of 129 individuals with mental retardation who were seen in a psychiatric clinic; this provided additional support for the subscales. The ADAMS appears to be a psychometrically sound instrument for screening anxiety, depression and mood disorders among individuals with mental retardation.

The present study was an attempt to cross-validate discrimination rules derived from a previous study on the Luria-Nebraska Neuropsychological Battery for use in predicting ventricular enlargement and to replicate the correlations found between the Luria-Nebraska scales and ventricular brain ratio. Forty-three chronic schizophrenic patients between the ages of 20 and 39 were given a computed tomography (CT) scan and the Luria-Nebraska Battery. Ventricular brain ratio was calculated, and the Luria-Nebraska rules previously suggested were applied to predict the absence or presence of ventricular enlargement. All 15 of the patients with ventricular enlargement were correctly classified by the Luria-Nebraska. Of 28 patients with normal ventricles, the Luria-Nebraska classified 18 as normal and 10 as brain damaged, for a combined hit rate of 33 out of 43, or 77%. The multiple correlation between the Luria-Nebraska scales and ventricular brain ratio was .76, comparable to the results of the previous study. Differences between the studies and the implications of objective CT scan measurement for detecting cerebral atrophy are discussed..

The aim of the present study was to evaluate the efficacy of divalproex sodium treatment in adults with intellectual disability, and aggressive or self-injurious behaviour. Twenty-eight adults aged between 20 and 63 years of age with severe, long-lasting behavioural problems were treated with divalproex sodium (dosage 500-4000 mg day(-1)). Clinical changes were assessed at 2-73 months into the pharmacological treatment utilizing the Clinical Global Impression Severity (CGI-S) scale, and monthly behavioural counts of aggressive and self-injurious acts. Seventy-one percent of subjects demonstrated a moderate or marked improvement on the CGI-S; another 21% demonstrated mild benefits. Among the patients for whom objective prospective behavioural counts were available, 88% showed a significant reduction in aggression and self-injurious behaviour, 46% had other psychotropic medications discontinued, and another 39% had psychotropic medications decreased. One patient had serious thrombocytopenia which required the discontinuation of divalproex sodium, and one other had vomiting and worsened aggression. The present preliminary, uncontrolled study suggests that adults with intellectual disability, and aggressive or self-injurious behaviour may respond to divalproex sodium, and that this drug is well-tolerated in the majority of subjects.