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Query: UMLS:C0025362 (mental retardation)
 15,878 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

This study was conducted to compare DSM-II and DSM-III in the diagnosis of childhood and adolescent psychiatric disorders. Twenty psychiatrist-raters completed standardized diagnostic questionnaires for 24 actual case histories. This report, the first of four, presents the rater agreement with the "expected diagnosis," ie, the diagnosis that we considered most appropriate for each case. The average rater agreement with the expected diagnosis was less than 50%. It was highest in cases of mental retardation, psychosis, hyperactivity, and conduct disorder. In only five cases did the most common diagnosis of the raters differ from the expected diagnosis. Analyses of these cases and those we selected to present specific diagnostic problems to the raters have produced suggestions to improve the reliability of DSM-III.
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PMID:A comparison of DSM-II and DSM-III in the diagnosis of childhood psychiatric disorders. I. Agreement with expected diagnosis. 48 78

A case-history format was utilized to compare interrater agreement on childhood and adolescent psychiatric disorders, using DSM-II and DSM-III. The average interrater agreement was 57% for DSM-II and 54% for axis I (clinical psychiatric syndrome) of DSM-III. There was high agreement in both systems on cases of psychosis, conduct disorder, hyperactivity, and mental retardation, with DSM-III appearing slightly better. There was noteworthy interrater disagreement in both systems for "anxiety" disorders, complex cases, and in the subtyping of depression. Overall, the reliability of DSM-III appears to be good and is comparable with that of DSM-II and other classification systems of childhood psychiatric disorders.
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PMID:A comparison of DSM-II and DSM-III in the diagnosis of childhood psychiatric disorders. II. Interrater agreement. 48 79

The psychiatric community seems determined to ground its medical legitimacy on principles that confuse diagnoses with disease. If mental illnesses are diseases of the CNS, they are diseases of the brain, not the mind. If mental illnesses are the names of (mis)behaviour, they are forms of behaviour, not diseases. Psychiatric metaphors have the same role in medicine as religious metaphors have in theology. Religion is, among other things, the institutionalised denial of a finite life. Psychiatry is, among other things, the institutionalised denial of the tragic nature of life: individuals who want to reject the reality of free will and responsibility can medicalise life, and entrust its management to health professionals. Psychiatrists have succeeded in persuading the scientific community, the courts, the media, and the general public that the conditions they call mental disorders are diseases, that is, phenomena independent of motivation or will. The more firmly psychiatrically based ideas take hold of the collective American mind, the more foolishness and injustice they generate. Long ago, the law makers agreed to let psychiatrists literalise the metaphor of mental illnesses. Thus, the Americans With Disabilities Act (AWDA), scheduled to be fully implemented by July 1992, covers claustrophobia, personality problems, and mental retardation, though unlike DSM-III-R it excludes kleptomania, pyromania, compulsive gambling, and transvestism. The literal language of psychiatry allows motivated actions to be called 'disease'. Other examples of behaviour for which psychiatrists have disease names, and which AWDA implicitly accepts as genuine diseases, include dysmorphophobia, multiple personality disorder, frotteurism, hypoactive sexual desire disorder, and fractitious disorder with physical symptoms.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Diagnoses are not diseases. 142 20

Three cases of fragile X (fra X) have been identified in a systematic survey of 30 boys, aged 3 to 14, with infantile autism or psychotic disorders, associated with mental retardation. Only one of these children exhibited a dysmorphy characterizing the Martin-Bell syndrome. Two fra X cases fulfilled the DSM III criteria for autism; none corresponded to the Kanner's description of infantile autism. The prevalence of fra X among children with psychotic disorders (6%) is much higher than in the general population; however it is close to the prevalence observed in non psychotic mentally retarded patients. Given the inconsistency of the somatic phenotype, the screening should benefit from the recent discovery of abnormal methylation of DNA.
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PMID:[Fragile X chromosome in autism and psychotic disorders in children]. 158 Jul 45

Although traditional diagnostic criteria are accepted for use with mentally retarded persons, diagnosis of psychiatric disorders in this population is often complicated by clinicians' ignoring or underestimating such disorders and by patients' communication problems. The revision of DSM-III and changes in policies of third-party payers have sensitized clinicians to the presence of psychopathology among mentally retarded persons. The authors discuss the relationship between mental illness and mental retardation and review recent research on the diagnosis of specific psychiatric disorders in these patients. Some problems, such as behavioral disruptiveness, psychoses, and phobias, are more prevalent among mentally retarded persons than among other populations, whereas other problems, such as alcoholism and suicide, may be less common.
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PMID:Mental retardation and psychiatric illness. 158 14

As a developmental disorder, autism presents as a combination of unusually delayed maturational stages constrained by neuropathology that also produces many atypical behaviors. This process was labeled atypical ontogeny. To understand the development of autistic symptoms, it is necessary to consider each behavior in the context of what is normal for the child's nonverbal mental age and then the extent to which the behavior is delayed or atypical, given factors such as degree of delay, function, and frequency of expression. Many symptoms of autism are not unique to autism, and many reflect at least in part the underlying degree of mental retardation present in a large proportion of autistic individuals. Given this, it is important to rate autistic symptoms in the context of the child's mental development in areas of intelligence not specifically affected by the autism (i.e., nonverbal intelligence) in order to be sure that the symptom is characteristic of autism and not just reflective of the degree of mental retardation. In order to do this, the clinician must have a good understanding of the normal milestones in development in each of the areas in which autistic children develop symptoms. Developmental examples of both normal and atypical milestones, as well as a reliable indicator of nonverbal level of development, would help a user of the DSM-IV criteria for autistic disorder make more accurate decisions in reaching a diagnosis. The DSM-III-R criteria for autistic disorder have many other problems, such as lack of certain kinds of reliability and validity, poor specificity, and redundancy. Discussion of these problems is beyond the scope of this article but is presented elsewhere. What have been presented here are recommendations for revising DSM-III-R diagnostic criteria for autistic disorder insofar as there are implications for putting developmental psychopathology into a developmental context.
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PMID:Toward DSM-IV: a developmental approach to autistic disorder. 204 32

The purpose of the investigation was to give an account of changes in the concept of minimal brain dysfunction and deduce certain recommendations for professional and social practice. The authors describe the development of consensus regarding the problem of impaired activities and behaviour during childhood based on probable damage of the central nervous system. Analysis of the 8th, 9th and 10th decennial revision of the International Classification of Diseases and DSM III revealed a trend of increasing specification of clinical entities included in the complex of minimal brain dysfunctions. Diagnostic systems are focused on syndromological classification according to specific functions, reduced or impaired by the disorder. Contemporary diagnosis is to an increasing extent based on behavioural signs disorders. The analogous development in Czechoslovak practice is demonstrated on frequency analysis of articles in professional periodicals. It is apparent that social needs emphasize in particular early diagnosis of disorders of school skills. The result of the analysis is evidence of continuous overlapping of specific diagnostic units based on common symptoms (such as mental retardation, developmental disorders, hyperkinetic disorders and behavioural disorders). The authors discuss the problem of comorbidity of the complex of minimal brain dysfunctions and recommend provisions in diagnostic practice. Hypothetically pathogenetic models of the outcome of actual forms of different brain dysfunctions into specific risks or disorders in adult age are proposed.
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PMID:[Changes in the concept of minimal brain dysfunction in modern diagnostic classification and its manifestation in our theory and practice]. 234 89

A review is presented of the diagnosis and drug treatment of the more common psychiatric and developmental disorders in the pediatric population. Where applicable, DSM III (Diagnostic and Statistical Manual of Psychiatric Disorders, III) criteria are utilized to describe the behavioral syndromes. The indications for usage and appropriate dosages of antipsychotics, antidepressants, anxiolytics, stimulants, and lithium are described. Those disorders discussed are attention deficit disorder, conduct disorders, anxiety disorders, sleep disorders, schizophrenia, autism, Tourette's syndrome, mental retardation, depressive illness, manic depressive illness, eating disorders, and enuresis.
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PMID:Pharmacologic treatment of psychiatric and neurodevelopmental disorders in children and adolescents (Part 1). 241 73

This paper presents a summary and critical review of the DSM-III diagnostic system for childhood psychiatric disorders with particular reference to developmental disorders. The rational for a multiaxial system, explicit diagnostic criteria, and a phenomenological approach are outlined. Criteria for mental retardation, infantile autism, and specific developmental disorders are reviewed. While this system is an advance over previous schemes many problems are also evident. These include a lack of specificity of the criteria, inconsistencies in criteria, and placement on the axes of mental disorders.
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PMID:A critical review of DSM-III in the developmental disorder of childhood. 243 Jan 29

Schizophrenic patients in long-term care programs may not have been carefully diagnosed according to current criteria. As part of a clinical reassessment program at a state hospital, the author randomly assessed 72 patients who carried a diagnosis of schizophrenia. The diagnosis of schizophrenia by DSM-III-R criteria was confirmed in 45 patients. Various organic disorders were diagnosed in seven patients. Four patients had bipolar affective disorder, manic; one patient had schizoaffective disorder, depressed; one patient had a substance use disorder; and two had primary mental retardation or pervasive developmental disorder. Twelve patients had unclear or atypical syndromes.
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PMID:Reassessment of state hospital patients diagnosed with schizophrenia. 252 Oct 89


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