Issues related to the diagnosis and assessment of mental deficiency, psychiatrists decide on the basis of all available data, clinical. Patopsihologicheskogo and paraclinical studies. The task of the pediatrician – as soon as possible to draw attention to deviations in the mental development of the child and send him to consult a specialist.
Kind of mouse smell coming from the urine and the body of the child with phenylketonuria,pronounced muscular hypotonia in the newborn with Prader-Willi syndrome.
The indications for psychiatric consultation is a distinct discrepancy between the level of mental development and passport age of the child. In the presence of malformations and minor congenital anomalies additionally necessary to consult a physician-geneticist.
Diagnostic criteria and rating scales in mental retardation
Although mental disorders accompanying mental retardation, often difficult to characterize, effective treatment is not possible without their clear identification. To evaluate the effectiveness of drug treatment is recommended to use rating scales, involving assessment of the behavior of the patient as a result of observing them. For example, to evaluate the effectiveness of the drug can be used evaluation scale misbehavior in negospitalizirovannyh patients (Aberrant Vehavior Checklist-Community Version – AVC-CV). Scale allows on the basis of information received from the attending persons to quantify the severity of major “status” symptoms. To assess the hyperactivity and attention disorders apply the scale Connors. For example, this scale was used to assess the effectiveness of methylphenidate attention deficit hyperactivity disorder in patients with mental retardation. Special difficulties are caused by assessment in patients with mental retardation of affective disorders, such as anxiety or depression. To do this, use special techniques, such as psychopathology scale for mentally retarded adults (Psychopathology Inventory for Mentally retarded adult – PIMRA), Short scale maladaptive behavior Reiss (Reiss Screen for Maladaptive strongehavior), Scale for the Assessment of emotional disorders (Emotional Disorders Rating Scale-DD).
When planning the treatment of patients with mental retardation are important identification and correction of associated psychiatric disorders – major depression, bipolar disorder, anxiety disorders, general disorders.
A. A significant reduction in intellectual function: when the intelligence test IQ value does not exceed 70 (in infants – a clinically apparent decline in intellectual function)
B. The combination of deficit or adjustment disorder (ie, matching of human behavior in this age norms cultural group) in at least two of the following areas: communication, self-care, ability to live in the home, social / interpersonal skills, use of community resources, self-contained goal-directed behavior, functional academic skills, work, leisure, health, safety.
Mental retardation without specifying severity: if there are sufficient grounds for the diagnosis of mental retardation, but in the absence of data in the standard intelligence test (for example, the impossibility of their conduct because of severity of the condition, the patient’s unwillingness or infant)