Resumen

To the Editor,

Children with intellectual disability (ID) constitute a significant minority yet a heterogeneous population. They are commonly referred to child psychiatrists for behavioural decompensation. These children have the popular problem of diagnostic overshadowing, where ID masks comorbidities. Psychopathology, in contrast to upheld clinical lore, tends to be 3- to 6-fold overrepresented in this population—dual diagnosis. This, in turn, negatively impacts adaptive functioning, interferes with skills training, and adds further to caregivers’ distress. Contrariwise, some skewed practices are fraught with diagnostic slippage, a rather hasty ‘labelling’ approach where all agony for e.g. would translate ‘monothetically’ into depression. Besides, it remains difficult to conduct a routine MSE with these children. Diagnostic challenges in this population are protean and beleaguered by intellectual distortion, cognitive disintegration, baseline exaggerations and psychosocial masking. Diagnostic criteria in the current major classificatory systems (DSM-5 and ICD-11) are sorely developmentally insensitive—do not take into account the pathoplastic effect of ID on clinical presentation of varied diagnostic syndromes with ‘atypicalilty’ being the rule.

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2024-08-23   |   56 visitas   |   Evalua este artículo 0 valoraciones

Vol. 53 Núm.2. Abril-Junio 2024 Pags. 115-116 Rev Col Psiqui 2024; 53(2)