title: [Waiting-for-Instruction behavior as depressive symptom in mentally retarded autistic children and adolescents and its treatment].
abstract: We have seen 9 moderately to severely mentally-retarded autistic children and adolescents who waited for small-step instructions to perform previously acquired daily life activities (called "waiting-for-instruction" behavior). None of these patients were capable of expressing their depressive mood. All cases were considered to meet the criteria for major depressive episode described in DSM-IN. The "waiting-for-instruction" behavior was suggested to be a diagnostic key for depressive state in mentally retarded children and adolescents. GAF scales for depressive symptoms including the "waiting-for-instruction" behavior improved in 7 of these 9 cases with fluvoxamine. Risperidone and valproate sodium were useful for these symptoms in patients who were not responsive to fluvoxamine. Therefore, there is a possibility that they met the criteria for bipolar II disorder in DSM-IV.
authors.affiliation: Division of Clinical Nursing, Yamagata University School of Nursing, Yamagata.
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Yokoyama
authors.forename: Mieko
authors.initials: M
authors.lastname: Hirose
authors.forename: Chieko
authors.initials: C
authors.lastname: Nara
authors.forename: Keisuke
authors.initials: K
authors.lastname: Wakusawa
authors.forename: Yuki
authors.initials: Y
authors.lastname: Kubota
authors.forename: Kazuhiro
authors.initials: K
authors.lastname: Haginoya
authors.forename: Shigeru
authors.initials: S
authors.lastname: Tsuchiya
authors.forename: Kazuie
authors.initials: K
authors.lastname: Iinuma
mesh_terms: D000293:Adolescent; D001321:Autistic Disorder / Q000175:diagnosis / Q000523:psychology*; D003863:Depression / Q000175:diagnosis; D006801:Humans; D008607:Intellectual Disability / Q000523:psychology*; D008297:Male