Psychiatric ills neglected in mentally impaired

NEW YORK, Oct 26: Four out of 10 children with mental retardation also have severe emotional and behavioral problems, which often persist into adulthood, according to results of a long-term study conducted in Australia.

However, according to the study findings, reported in the Journal of the American Medical Association, few of these children with psychological problems receive any mental health therapy.

The psychopathology that often affects people with intellectual disability limits their ability to live in the community, participate in social activities or gain employment, Dr Stewart L Einfeld and his colleagues note. Even so, little research, particularly long-term studies, has been devoted to children with both intellectual and psychiatric disorders.

The Australian Child to Adult Development Study included 507 children between 5 and 19.5 years old when they were evaluated at study entry - ''wave 1'' (1991-1992). The subjects were re-examined at wave 2 (1995-1996), wave 3 (1999) and wave 4 (2002-2003).

The participants were assessed with the Developmental Behavior Checklist, a 96-item questionnaire with a total possible score of 190. A score of 46 or higher is indicative of a definite psychiatric disorder.

The results showed that 41 per cent of subjects at wave 1 met criteria for major psychopathology; the prevalence decreased to 31 per cent by wave 4. However, 12 per cent of the subjects had scores worsened over time.

The overall severity of psychopathology was similar among children with mild-to-severe intellectual disabilities, the authors note. Nevertheless, distinct differences were seen on the subscales of the Developmental Behavior Checklist.

Subjects with mild intellectual disability scored significantly higher for disruptive behavior and communication disturbance, while those with severe or profound intellectual disability had highest scores for self-absorbed behavior and social maladjustment.

Despite the high prevalence of severe psychological and behavioral disorders, the survey results showed that only about 10 per cent of those with severe psychopathology received any mental health attention by a specialist.

These findings reflect ''the need for effective mental health interventions,'' the investigators note. ''This should include support, education, and skills training for their parents.'' ''Without effective interventions...this sizable and neglected public health problem will also continue to be a burden on families, communities, and governments,'' Einfeld and his co-authors conclude.

REUTERS