Mental retardation DSMIV

DSM-IV(6) provides a framework for multiaxial diagnosis with Axis II for personality disorders and mental retardation. Table 1 summarizes the DSM-IV criteria for mental retardation. The focus is not primarily one of aetiology but rather of quantifying the extent of mental retardation through defining the level of intellectual impairment and listing the range of possible adaptive functions that might be impaired. The definition makes explicit that the onset is in the developmental period and that mental retardation is the final common pathway of a number of potential aetiologies. Significant subaverage intellectual function is defined as an IQ of 70 or below (using standard IQ tests). The IQ is also used to help determine the level of mental retardation (mild, moderate, severe, or profound). Adaptive functioning has to be measured against what would be expected for a person of that age, and the social and cultural experience of the person has to be taken into account. The Wechsler Scales for IQ, and the Vineland Adaptive Behaviour Scales(7) or the revised Adaptive Behaviour Scales of the American Association for Mental Retardation (8) for characterizing functioning are established instruments for the measurements of these abilities and for which there are normative data for comparison.

Summary For Mental Retardation

Table 1 Summary of the diagnostic criteria for mental retardation (DSM-IV)

Fig 1 The use of such a multiaxial system recognizes the fact that mental retardation is a disorder of development, which is separate from other mental disorders, such as mental illness (Axis I), general medical conditions (Axis III), and which may be associated with particular psychosocial and environmental problems (Axis IV). Thus the process of formulation requires that all these broad domains be considered in arriving at an understanding of an individual's particular difficulties.

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