Am J Psychiatry 1994; 151:1802-1808
Copyright © 1994 by American Psychiatric Association
Psychiatric consultation in severe and profound mental retardation
BH King, C DeAntonio, JT McCracken, SR Forness and V Ackerland
Department of Psychiatry and Biobehavioral Sciences, UCLA School of Medicine.
OBJECTIVE: This study was designed to examine the relationship between
reason for referral and subsequent DSM-III-R diagnosis in institutionalized
individuals with severe to profound mental retardation. A heavy emphasis
was placed on articulating how diagnostic criteria are applied in this
population. METHOD: The study population consisted of 251 patients
consecutively referred for initial psychiatric consultation from a large
series of institutionalized patients with predominately severe to profound
mental retardation. On the basis of the chief complaint, subjects could be
grouped into six overlapping categories: self-injury, aggression,
hyperactivity, agitation, medical questions, and miscellaneous behaviors.
Psychiatric diagnoses were made according to DSM-III-R criteria on the
basis of simultaneous clinical examination, staff interview, and medical
review. Relevant medical conditions were noted. RESULTS: The authors
demonstrate, as have others, that it is possible to make psychiatric
diagnoses in this population and that psychiatric disorder is common. The
most frequent diagnoses were impulse control disorders, anxiety disorders,
and mood disorders. Comorbid medical conditions, particularly seizure
disorders, are also common. CONCLUSIONS: These results are consistent with
the reported experience of others and underscore the importance of
psychiatric involvement in the multidisciplinary assessment and treatment
of individuals with retardation.
