tailieunhanh - Case files psychiatry - part 10

khách quan tình báo kiểm tra, cũng như năng lực thích ứng Giảm cho tioning func trong môi trường nhiều (xem Bảng 56-2 cho độ chậm tảng tinh thần). Các nguyên nhân gây chậm phát triển tâm thần là Nhiều, như là các phương pháp điều trị. Nguyên nhân chung bao gồm các vấn đề di truyền trước khi sinh như vậy | 416 CASE FILES PSYCHIATRY objective intelligence test as well as a diminished capacity for adaptive functioning in multiple environments see Table 56-2 for degrees of mental retardation . The causes of mental retardation are numerous as are the treatments. General causes include genetic prenatal problems such as chromosomal abnormalities or mutations prenatal causes related to an external source such as toxins or infections and postnatal causes such as anoxia infection or deprivation experienced by an infant after birth. Differential Diagnosis Specific communication or learning disorders must be differentiated from mental retardation which is associated with greater global functional impairment. Table 56-2 DEGREES OF MENTAL RETARDATION AND FUNCTION SEVERITY OF INTELLIGENCE RETARDATION QUOTIENT CHARACTERISTICS FUNCTION Mild 50-55 to about 70 Usually not detected until child attends school individual usually completes a high level of elementary school Can often live and work independently with social support Moderate 35-40 to 50-55 Social isolation in elementary school Can be competent at occupational tasks in supportive setting need a high level of supervision Severe 20-25 to 35-40 Minimal speech poor motor development May accomplish some degree of selt -care needs extensive supervision not independent Profound Below 20-25 Absenl to minimal speech poor to absent motor skills Needs constant supervision nursing care needed throughout life CLINICAL CASES 417 Patients with pervasive development disorder frequently have uneven areas of deficit particularly in regard to social interaction skills. Onset must be before the age of 18. If the impairment is noted after the age of 18 years dementia and its various causes should be considered. Therapeutic Approach There are several principles behind the treatment of mental retardation. The first is the concept of prevention. Whenever possible potential causes of mental retardation should be minimized Women should abstain from .