Diagnosis of mental retardation

Questions related to the diagnosis and evaluation of the degree of intellectual underdevelopment are resolved by psychiatrists based on all available clinical data. Pathopsychological and paraclinical research. The pediatrician's task is to pay attention to deviations in the child's mental development as early as possible and send it to a specialist for consultation. Anxiety signs of mental retardation in children up to the year:

• features of the structure of the head, face and body;
• congenital malformations:
• a peculiar murky odor emanating from the urine and the body of the child in phenylketonuria;
• pronounced muscular hypotension in the newborn with Prader-Willi syndrome.

Indications for consultation of a psychiatrist is a distinct discrepancy between the level of mental development and the child's passport age. In the presence of malformations and small congenital anomalies, an additional consultation with a geneticist is necessary.

Criteria for diagnosis and evaluation scales for mental retardation

Although mental disorders accompanying mental retardation are often difficult to characterize, effective treatment is impossible without their clear identification. To assess the effectiveness of drug treatment, it is recommended to use rating scales, which presume an assessment of the patient's behavior based on the results of monitoring him. For example, to evaluate the effectiveness of a medicinal product, you can use the Aberrant Behavior Checklist-Community Version (ABC-CV) Scale of Invalid Behavior Assessment. The scale allows, based on information received from observing patients, to quantify the severity of the underlying "status" symptoms. To assess hyperactivity and attention disorders, the Connors scale is used. For example, this scale was used to assess the effectiveness of methylphenidate in attention deficit hyperactivity in patients with mental retardation. Particular difficulties arise from the evaluation in patients with mental retardation of affective disorders, such as anxiety or depression. For this, special techniques are used, for example, the Psychopathology Inventory for Mentally Retarded Adult (PIMRA), the Reiss Screen for Maladaptive Strongehavior, the Emotional Disorders Rating Scale (DD) .

When planning the treatment of patients with mental retardation, the identification and correction of concomitant mental disorders - major depression, bipolar disorder, anxiety disorders, general disorder - are of great importance.

Diagnostic criteria of mental retardation

• A. Significant decrease in intellectual functions: when performing tests for intelligence, the value of IQ does not exceed 70 (in children of early age, a clinically apparent decrease in intellectual functions)
• B. The combination of a deficit or violation of adaptation (that is, the correspondence of human behavior to age standards in a given cultural group) in at least two of the following areas: communication, self-care, livelihoods at home, social / interpersonal skills, use of public resources, autonomous purposeful behavior, functional academic skills, work, leisure, health, safety
• B. Start at the age of 18 years

The code depends on the degree of severity that reflects the level of intellectual disorders:

• Easy mental retardation - IQ from 50-55 to about 70
• Moderate mental, backwardness - IQ from 35-40 to 50-55
• Severe mental retardation - IQ from 20-25 to 30-35
• Deep mental retardation - IQ below 20-25

Mental retardation without clarifying the severity: if there are sufficient grounds for diagnosing mental retardation, but in the absence of these standard tests for intelligence (for example, if they can not be carried out because of the severity of the condition, unwillingness of the patient or infantile age)

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