Medical and genetic issues

The availability of a thorough medical assessment is a necessary component of the psychiatric assessment of children with mental retardation to both establish the cause of the mental retardation and define the presence of any associated medical condition that might contribute to, or complicate, the emotional and behavioural problems. Young people with mental retardation have an increased risk of medical problems particularly those that involve the brain, such as epilepsy and cerebral palsy. Specific medical complications are associated with known causes of mental retardation such as cardiac and bowel problems that occur in Down syndrome and hearing impairment associated with rubella embryopathy.

Epilepsy is the single most common neurological handicap that is associated with mental retardation, and together they constitute the two largest neurological impairments of childhood/25ยป For example about 20 per cent of children with autism have epilepsy.(20) Some older studies suggest that rates of psychopathology are higher in persons with mental retardation who have epilepsy, (26> but more recent studies suggest that rates are not increased except perhaps in those with poor seizure control.(27> The site and growth of neurocutaneous lesions in the central nervous system that are a feature of tuberous sclerosis are implicated in the development of epilepsy and a range of psychopathological disorders including tic disorder, autism, and psychosis. (28>

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