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A Study Of Co Morbidity In Mental Retardation

1433 words - 6 pages

Abstract : Mental retardation (MR) is a condition of arrested or incomplete development of the mind, characterized by impairment of skills (cognitive, language, motor and social) manifested during the developmental period, which contribute to overall level of intelligence. Intellectual Disability is a more precise term (used in DSM-V). MR is an etiological factor for development of various co-morbidities, which account for substantial burden of the disease. However, the extent of this co-occurrence varies substantially between reports.

Aim: To study the prevalence of psychiatric and medical comorbidity, among different degrees of Mental Retardation.

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Keywords : Mental retardation, psychiatric co-morbidity, medical co-morbidity

Introduction
There is evidence of recognition and treatment of intellectual disability that dates back to Hippocrates, Galen & the Middle Ages. The modern history for the field of intellectual disability begins in the late 18th century 1. The term co-morbidity indicates co-existence of an index disease with another clinical entity. It is increasingly recognized that co-morbidity is more common among people with intellectual disabilities than among the general population. It has now been clearly documented that the mentally retarded are at a greater risk of developing psychiatric disorders (Borthwick- Duffy & Eyman, 1990) 2 and medical illness. Dual diagnosis refers to the joint occurrence of mental retardation and psychiatric disorders. The rates of dual diagnosis have varied from 31% to 100% across various studies (Jacobson, 1982) 3. Indian review of results of previous studies on co-morbidities stressed on mood disorder (8%), hyperkinetic disorder (14%), autism (11%), psychosis (11%), conduct disorder (2%) enuresis (2%) and unspecified emotional and behavioral disorder (26 %)4, mostly not based on any scale but rather the examiners expertise and the ICD-10 & DSM-IV diagnostic guidelines. A Taiwan study using a structured questionnaire indicated that nearly half (47.7%) of the subjects with MR had an associated co-morbid medical or psychiatric illness. A population-based study using a Learning Disability Register in the UK reported that the prevalence of epilepsy was 26% in adults with intellectual disabilities. In view of the common interface of medical and mental-health problems in mentally retarded, initiatives should be taken to enhance their healthcare following a multidisciplinary approach, laying emphasis on dual diagnosis and diagnostic overshadowing. Since there is inconsistency among various reports of occurrence of comorbidities in MR, this study has been conducted.

Aims & Objectives:
To study the prevalence of psychiatric and medical comorbidity, in persons with different degrees of mental retardation.

Materials and Methods:
This is a cross-sectional, single-centered study conducted in the Psychiatry Out-Patient Department of a tertiary care General Hospital, from February 2013 to May 2013. Sixty three persons, who came for disability certification, were taken into the study after obtaining the informed consent from the concerned. The data was recorded in a semistructured proforma and included socio-demographic profile, primary assessment including case history, complete physical and mental status examination. All subjects included in this study were between 5 years and 60 years. Diagnosis of mental retardation was made as per ICD-10 classification. The degree of retardation was assessed based on the intelligence quotient and social quotient by using the following tests:- Developmental Screening Test5 : It was developed by Bharath Raj...

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