PSYCHIATRIC-CONSULTATION IN SEVERE AND PROFOUND MENTAL-RETARDATION

Objective: This study was designed to examine the relationship between reason for referral and subsequent DSM-III-R diagnosis in institution alized individuals with severe to profound mental retardation. A heavy emphasis was placed on articulating how diagnostic criteria are appli ed in this population. Method: The study population consisted of 251 p atients consecutively referred for initial psychiatric consultation fr om a large series of institutionalized patients with predominately sev ere to profound mental retardation. On the basis of the chief complain t, subjects could be grouped into six overlapping categories: self-inj ury, aggression, hyperactivity, agitation, medical questions, and misc ellaneous behaviors. Psychiatric diagnoses were made according to DSM- III-R criteria on the basis of simultaneous clinical examination, staf f interview and medical review. Relevant medical conditions were noted . Results: The authors demonstrate, as have others, that it is possibl e to make psychiatric diagnoses in this population and that psychiatri c disorder is common. The most frequent diagnoses were impulse control disorders, anxiety disorders, and mood disorders. Comorbid medical co nditions, 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 multid isciplinary assessment and treatment of individuals with retardation.