Axis III intellectual level

The categories are no mental retardation (IQ 70 or over), mild mental retardation (IQ 50-69), moderate mental retardation (IQ 35-49), severe mental retardation (IQ 20-34), and profound mental retardation (IQ under 20). In DSM-IV personality disorders are also included on the axis.

Subtyping mental retardation gives a good example of substantial differences which arise when categories are imposed on top of a dimensional construct. If all children with an IQ below 50 are taken together (often together also called 'severe'), and compared with those with IQ 50 to 70 ('mild'), major differences emerge on independent validating criteria, as shown in T§ble.,2;

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Table 2 Characteristics of children with severe and mild mental retardation

From the table it will be seen that there are major differences between the categories on fronts as varied as brain pathology and life expectancy. There is no particular psychiatric pattern arising in children with mental retardation, rather the incidence of all disorders is raised, so that in those with IQ under 50, fully one-half have a psychiatric disorder/20' In this group precise characterization of mental state is difficult, and validity less certain. (21>

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