Mental retardation( oligophrenia) - Causes, symptoms and treatment. MF.
What associations do you have when you hear the phrase "mental retardation"?Probably not very pleasant. The knowledge of most people about this disease is based on popular films and TV shows, where reality is often distorted for the sake of entertainment, as well as the stories of others. It is not often to see patients with severe mental retardation in our familiar surroundings - they are more often separated from society( although in Europe and the United States such people are built into the society and they are often found in everyday life, which sometimes creates a false impression of the allegedly greater prevalence of mental retardationin these countries).Many of us have faced mentally retarded people without knowing it, because with an easy degree of this disease, it is not easy to draw a line between a mentally retarded and healthy person.
From the physician's point of view, , the mental retardation of is a disease, the main condition of which is either a congenital or acquired( by a child under the age of 3) reduction of intelligence. At the same time, the ability to abstract thinking is basically reduced( it is the basis of mathematical abilities, logic and even creativity).The emotional sphere thus practically does not suffer - i.e.patients with mental retardation feel sympathy and dislike, joy and sorrow, sadness and fun, perhaps the emotions of mentally retarded people are not as multifaceted and complex as people with normal intelligence. It is important to note that mental retardation does not tend to progress - that is,the level of underdevelopment of the intellect is stable, and sometimes the intellect even rises with time under the influence of training, upbringing. This is one of the important differences between mental retardation and dementia, a condition characterized by a decrease in intelligence and appears as a complication in various diseases( strokes, head injuries, severe infections, alcoholism and drug addiction, severe mental illness) and in old age. In patients with dementia, the state of the intellect deteriorates with time.
Another name for mental retardation is oligophrenia( from the Latin "oligo" - little and "frenos" - the mind).
Causes of mental retardation
There are quite a few possible causes of mental retardation, not all of them have been sufficiently studied. It has been established that, with mental retardation, the decline in intelligence is due to organic brain damage, and, unfortunately, it is not always possible to say with certainty why this lesion arose in a particular patient. It is believed that the most common causes of mental retardation are hereditary predisposition, as well as harmful factors affecting the mother's body during pregnancy, for example, drugs( some antibiotics, birth control medications), alcohol and drugs, infections( especially viral, for example, rubella,flu).Some of the diseases that a woman had before pregnancy can provoke a child's mental retardation. These are infections( toxoplasmosis, syphilis, hepatitis), diabetes, heart disease.
Oligophrenia can be caused by severe toxicosis during pregnancy, Rh-conflict, placental pathology. The risk factor of mental retardation is prematurity, impetuous childbirth, birth trauma. That is why every woman should be examined by a doctor before planning a pregnancy, and in the period of expecting a child, she must be especially attentive to her health.
Yes, and men are also concerned - there are studies that prove that prolonged use of alcohol or drugs increases the chances of a man to become the father of a child-oligophrenia. In addition, the occupational hazards faced by future parents can also serve as a risk factor for the mental retardation of children. First of all, this refers to radioactive radiation and aggressive chemical reagents.
Symptoms of mental retardation
As you have already understood, the main symptom of mental retardation is a decrease in intelligence. Depending on the degree of decrease in the intellect, they give off a mild, moderate and severe form of mental retardation.
With mild degree of mental retardation( another name - debility) IQ patients is 50-69.Outwardly such patients practically do not differ from healthy people. Usually they experience difficulties in learning because of the reduced ability to concentrate. At the same time, their memory is quite good. Often patients with mild mental retardation have behavioral disorders. They are dependent on parents or educators, they are frightened by a change in the situation. Sometimes such patients become withdrawn( because they do not recognize the emotions of other people, therefore they experience difficulties in communication).And sometimes, on the contrary, they try to attract attention to themselves by various vivid actions, usually ridiculous, and sometimes anti-social. The suggestion of patients with mild degree of mental retardation can attract representatives of the criminal world to them, then they become either a victim of deception, a toy in the hands of criminals. Practically all patients of this group realize their difference from healthy people and try to hide their disease.
With , the average degree of mental retardation( or imbecility) of the IQ is 35-49.Such patients are able to experience attachments, to distinguish between praise and punishment, they can be taught basic skills of self-service, and sometimes reading, writing, simple account. However, they are not able to live independently and need constant monitoring and care.
The severe form of mental retardation or idiocy is characterized by IQ below 34. These patients are uneducable, they have no speech, their movements are clumsy and unfocused. Emotions are limited to the simplest manifestations of pleasure and displeasure. Such patients need constant supervision and are kept in special institutions.
IQ is an important, but not the only, criterion of mental retardation. In addition, there are cases when people with low IQ had no signs of mental retardation. In addition to the IQ, the doctor evaluates the patient's everyday habits, the general state of the psyche, the level of social adaptation, the diseases that have been transferred. And only on the basis of a complex of symptoms it is possible to diagnose mental retardation.
Oligophrenia in childhood, infantile years, may manifest as a delay in the development of the child, which can be identified with a timely visit to the pediatrician. In children's preschool institutions, a child with mental retardation usually has problems with the adaptation of other children in the team, it is difficult for him to observe the regime of the day, the activities carried out by the educator are often too complicated for such a child. At school-age parents should be alerted to a high degree of inattention and restlessness, fatigue, bad behavior and academic performance. It is necessary to maintain contact with teachers who can promptly recommend parents to contact a child psychoneurologist or psychologist. Also, with oligophrenia, neurological abnormalities - tics, partial paralysis of the limbs, convulsive seizures, headaches are also often encountered. Usually such displays do not remain without attention of parents and are the reason of the reference to the neuropathologist.
Mental retardation examination
Most of the cases of mental retardation can be recognized at an early age. Mental retardation, due to genetic causes, can be identified even during pregnancy( eg, Down's disease).To do this, a screening examination of a pregnant woman is carried out in a women's consultation at an early date, which makes it possible to decide whether to maintain or terminate the pregnancy. In the maternity home for the early diagnosis of certain hereditary diseases that lead to mental retardation, screening examinations are also used.
Some forms of mental retardation arise from the underdevelopment of a particular enzyme system in a child. The most common disease in this group is phenylketonuria. At birth, children with phenylketonuria are no different from healthy ones, but in the first months of life they are characterized by lethargy, frequent vomiting, skin rashes, excessive sweating with a specific unpleasant odor. In the treatment, begun before 2-3 months of age, it is possible to preserve the intellect of children. Therefore, it is important to observe the pediatrician during the period of newborn and early childhood.
The pediatrician, when examining a child with suspected oligophrenia, will prescribe a neurologist's consultation, blood and urine tests, possibly an encephalogram. A survey of older children includes a consultation with a psychologist, a child psychoneurologist or a psychiatrist.
With the timely start of treatment in the vast majority of cases, it is possible to achieve a good adaptation of the child to the subsequent independent life. But self-treatment and self-diagnosis can lead to sad consequences - time will be missed, which is so expensive when it comes to treating children. In addition, under the mask of mental retardation, other diseases can also be hidden - for example, hypothyroidism, epilepsy, various mental illnesses.
The lag in the development of a child under 1 year of age necessarily requires the attention of specialists - at least a pediatrician and a neurologist. Of course, not always a child, developing slower than his peers, is mentally retarded. Studies show that approximately 10% of children who seriously lagged behind their peers in development did not subsequently have mental retardation.
Treatment of mental retardation
Today, there are many drugs for the treatment of mental retardation and the best doctor can choose the most suitable drug. Depending on the cause of the disease, it can be iodine preparations or hormones( if oligophrenia is caused by a disease of the thyroid gland).In the case of phenylketonuria, there is enough special diet that the pediatrician will appoint.
Doctors often use nootropics for correction of mental retardation - all known pyracetam, as well as aminalon, encephabol, pantogam. The purpose of using nootropic drugs is to improve metabolic processes in the brain tissue. With the same purpose in the treatment of mental retardation, B vitamins and amino acids are used, which are necessary for the normal functioning of the brain( glutamic and succinic acids, cerebrolysin).These drugs are sold without a doctor's prescription, but the expediency of their intake should be determined by a specialist.
Sometimes in patients with mental retardation there are behavioral disorders, then a psychiatrist can pick up a drug from the group of neuroleptics or tranquilizers .
The key to successful treatment of mental retardation is a complex impact, i.e.the use not only of medicines, but also an individual approach to training, classes with psychologists and speech therapists - all this is necessary for a more successful adaptation in society. It is necessary to comply with the dosage prescribed by the doctor, and when new symptoms appear, immediately go to the reception. For example, in the treatment with nootropics, there may be increased excitability and headaches, in which case it is necessary to consult a doctor to decide whether to replace the drug or change the dose.
In folk medicine instead of nootropic drugs apply medicinal plants that have an activating effect on the nervous system. This is ginseng, Chinese magnolia vine, aloe. It should be remembered that the use of stimulants with mental retardation can provoke psychoses and gross violations of behavior, so before using traditional medicine it is better to consult a doctor.
Social rehabilitation is an essential component of helping patients with mental retardation. First of all, rehabilitation programs are aimed at providing job placement for patients with mild mental retardation. For this, there are specialized educational institutions, where it is possible to study the adapted school curriculum, and then to master simple occupations, for example, such building specialties as painter, plasterer, carpenter, etc.
With timely and correct treatment of mild degree of mental retardation, it is possible to achieve good results - many patients with mental retardation are mildly independent, have a profession and their family. At the same time, in the absence of proper upbringing, rehabilitation measures and medical care, oligophrenics become asocial personalities - they abuse alcohol, are involved in criminal histories, can represent a public danger. As for the average and severe form of mental retardation, the tasks of medical and social assistance for such patients are providing care and supervision, and, if necessary, monitoring the state of health.
Prevention of Mental Retardation
Prevention of mental retardation is based on a serious approach to their health and the health of future generations. Before planning a pregnancy, the spouses are advised to undergo specialist examinations to identify infectious and chronic diseases, sometimes a geneticist consultation is required. A pregnant woman should remember the responsibility for the health of her unborn child. It is necessary to lead a correct way of life, avoid the influence of harmful factors, regularly visit the women's consultation and follow the recommendations of the gynecologist. After the birth of the child, parents should establish contact with the pediatrician, perform all the prescribed examinations. If there is a suspicion of mental retardation, the child should promptly consult a specialist and begin treatment. Some parents are at the mercy of prejudices towards psychoneurologists and psychiatrists, and try to avoid visiting these specialists even with serious testimony, thereby causing irreparable harm to the health and future of their child. Fortunately, recently there has been a tendency to increase the medical literacy of the population and such situations are rare.
Doctor psychiatrist Bochkareva OS