Mental retardation

Definition

 * aka. Intellectual disability, oligophrenia, Intellectual disability disorder (IDD) (name in the DSM-V)
 * It is a neurodevelopmental disorder, affects intellectual abilities
 * characterized by a decrease of cognitive skill, adaptive function (need help)

Etiology

 * genetic screening (only if you would terminate), part of a syndrome (fraglie X, down, cri du chat), acquired (cretinism, lead, alcohol)

Epidemiology

 * Prevalence: 1% of gen. population

Classification

 * mild mental retardation: IQ: 50-70, 6th grade, weak, need help
 * moderate mental retardation: IQ: 35-49: 3rd grade, must live supervised
 * severe mental retardation: IQ: 20-34: pre-school, must live in a nursing home
 * profound mental retardation: IQ: < 20: infant, total care

DX

 * IQ Testing (e.g. Hamburg-Wechsler IQ-test)
 * Screen for secondary causes: genetic testing, PKU, imaging methods, CBC, glucose...

Management (long-term)

 * Severity according to loss of adaptive function (not intelligence)
 * Psychotherapy ( CBT, family-oriented therapy)
 * Special education programs
 * Control psychiatric symptoms if concurrent: e.g. SSRIs

DDx

 * Specific learning disorder
 * e.g. just problems with reading (dyslexia), math (dyscalculia), spelling, writing...
 * are much more prevalent
 * should be present for more than 6 months
 * Hearing impairment, vision impairment, language impairment (e.g. English parallel)
 * Dementia: principal difference is that mental retardation is a neurodevelopmental disorder, in dementia a previously neurodevelopmentally healthy person deteriorates