Mental retardation

Description:

Mental retardation (maloumy, oligophrenia; other - Greek  — unique + φρήν — mind, reason) — "a resistant, irreversible underdevelopment of level mental, first of all intellectual activity, connected with inborn or the organic pathology of a brain acquired (dementia). Along with intellectual insufficiency the underdevelopment of the emotional and strong-willed sphere, the speech, motility and all personality in general always takes place".

The term "oligophrenia" was offered by Emil Krepelin.

The oligophrenia (maloumy) as a syndrome of inborn mental defect is distinguished from the acquired weak-mindedness, or dementia (German by de — the prefix meaning decrease, decrease, the movement down + is mute. mens — mind, reason). The acquired weak-mindedness — decrease in intelligence from the normal level (corresponding I will increase), and at an oligophrenia intelligence of the adult physically of the person in the development does not reach normal level.

"Exact assessment of prevalence of oligophrenias is complicated in connection with distinctions in diagnostic approaches, in degree of tolerance of society to mental anomalies, in degree of availability of medical care. In the majority of industrially developed countries the frequency of oligophrenias reaches 1% of the population, however an overwhelming part (85%) of patients have easy mental retardation. The share of average, heavy and deep mental retardation makes respectively 10, 4 and 1%. The ratio of men and women fluctuates from 1,5:1 to 2:1.

Mental retardation — not progressing process, and a consequence of the postponed disease. Degree of intellectual insufficiency is estimated quantitatively by means of intellectual coefficient on standard psychological tests.

Sometimes the oligophrenic person is defined as "… the individual incapable of independent social adaptation".

Symptoms of Mental retardation:

General diagnostic instructions F7X.X:

    * A. Mental retardation — a condition of the detainee or ateliosis of mentality which first of all is characterized by disturbance of the abilities which are shown during maturing and providing the general I.Q. that is cognitive, speech, motor and special abilities.
    * B. Backwardness can develop with any other mental or somatic disorder or arise without it.
    * C. The adaptive behavior is always broken, but in the protected social conditions where support is provided, these disturbances at patients with easy degree of mental retardation can not have explicit character at all.
    * D. Measurement of coefficients of intellectual development has to be taken taking into account cross-cultural features.
    * E. The fourth sign is used for definition of expressiveness of behavioural disturbances if they are not caused by the accompanying (mental) frustration.

Instructions on behavior disorders:

    *.0 — absence or weak expressiveness of behavior disorders
    *.1 — with the considerable behavior disorders demanding leaving and treatment
    *.8 — with other behavior disorders
    *.9 — without instruction on behavior disorders.

E. I. Bogdanova's classification (ROKPND State Healthcare Institution, Ryazan, 2010):
    *.1 — Decrease in intelligence
    *.2 — General system underdevelopment of the speech
    *.3 — Disturbance of attention (instability, difficulty of distribution, pereklyuchayemost)
    *.4 — Perception disturbance (slowness, fragmentariness, decrease in volume of perception)
    *.5 — Concreteness, noncriticality of thinking
    *.6 — Low-productivity of memory
    *.7 — Underdevelopment of cognitive interests
    *.8 — Disturbance of the emotional and strong-willed sphere (low-differentiation, instability of emotions, their inadequacy)

Difficulties in diagnosis of mental retardation can early arise in need of an otgranicheniye from the begun schizophrenia. Unlike oligophrenic persons, at patients with schizophrenia the arrest of development has the partial, dissociated character; along with it in a clinical picture a number of manifestations inherent to endogenous process — autism, pathological imagination, catatonic symptoms is found.

Mental retardation is distinguished also from dementia — the acquired weak-mindedness at which elements of the being available knowledge, a bigger variety of emotional manifestations, rather rich lexicon, the remained tendency to abstract constructions, as a rule, come to light.

Reasons of Mental retardation:

    * Genetic reasons of mental retardation;
    * Pre-natal defeat of a fruit neurotoxic factors physical (ionizing radiation), chemical or infectious (cytomegalovirus, syphilis, etc.) nature;
    * Considerable prematurity.
    * Disturbances in the course of childbirth (asphyxia, a birth trauma);
    * Head injuries, a hypoxia of a brain, an infection with damage of the central nervous system.
    * Pedagogical neglect in the first years of life at children from dysfunctional families.
    * Mental retardation of not clear etiology.

Genetic reasons of mental retardation.

Mental retardation is one of the main reasons for the address to genetic consultation. By the genetic reasons it is caused to a half of cases of heavy intellectual insufficiency. The main types of the genetic disorders leading to intellectual insufficiency include:

    * The chromosomal anomalies breaking dose balance of genes such as aneuploidy, deletions, duplications.

        Chromosome trisomy 21 (Down syndrome);
        Partial deletion of a short limb 4;
        Microdeletion of the site of a chromosome 7q11.23 (Williams's syndrome), etc.

    * Deregulation of an imprinting owing to deletions, a one-parent disomy of chromosomes or sites of chromosomes.

        Angelman's syndrome;
        Pradera-Willie's syndrome.

    * Dysfunction of separate genes. The number of genes in which mutations cause this or that degree of mental retardation exceeds 1000. Enter their number, for example, NLGN4 gene which is on a chromosome of X in which mutations are found in some patients suffering from autism; FMR1 gene linked to a chromosome of X which deregulation of an expression causes a syndrome of brittle X-chromosome; MECP2 gene which is also on a chromosome of X in which mutations cause Rhett's syndrome in girls.

Treatment of Mental retardation:

Specific therapy is carried out at some types of mental retardation with the established reason (inborn syphilis, a toxoplasmosis, etc.); at the mental retardation connected with metabolism disturbances (a fenilketonuriya, etc.), appoint a dietotherapy; at endocrinopathies, a myxedema) — hormonal treatment. Medicines appoint also for correction of affective lability and suppression of the perverted inclinations (neuleptil, Phenazepamum, сонапакс). Medical and educational actions, labor training and professional adaptation are of great importance for compensation of oligofrenichesky defect. In rehabilitation and social adaptation of oligophrenic persons along with bodies of health care auxiliary schools, boarding schools, specialized technical training colleges, workshops for mentally retarded, etc. play a role.