Idiocy (profound mental retardation)

Idiocy is the most severe form of mental retardation (previously in psychiatry the term “oligophrenia” was used to describe this pathology). This disease is caused by a serious mental disorder due to congenital defects or neurological pathologies suffered in childhood. A decrease in intellectual and cognitive functions makes it impossible to fully communicate in society, learn, and even perform everyday, routine duties. Children with this diagnosis require constant assistance. The disease is practically, however, the doctors of the mental health center “Leto” are ready to provide the patient with qualified care from medical personnel on the basis of our inpatient department, and will provide psychological support to the patient’s relatives.

Etiology of the disease

Idiocy occurs under the influence of both external and endogenous factors, and the exact cause of underdevelopment of intellectual function is often simply impossible to determine, despite a thorough examination. The disease may be associated with:

• Pathologies of early intrauterine development. Today, about 400 pathological factors are known that can lead to defects in fetal maturation, especially since nervous tissue is most sensitive to their action. This is intoxication with alcohol, drugs, nicotine, some medications and other poisons. Not the least important role is played by environmental factors such as viral or bacterial diseases suffered by a woman during pregnancy (in particular, rubella), disturbances in the blood supply to the placenta, and deficiency of vitamins and other nutrients.
• Pathologies in the perinatal and postnatal period: hypoxia, traumatic brain injury, neuroinfections, severe illnesses in early (especially infancy) ages. Often, organic brain damage occurs when the fetus is not positioned correctly, the umbilical cord is entangled, or labor is prolonged or too rapid.
• Genetic defects (connections with hereditary factors are noted in almost 90% of cases). Idiocy is associated with gene mutations on the X chromosome, so the disorder is more common in boys.

Causes of idiocy

The reasons that caused idiocy can be different:

- accidental damage to the head of a newborn;

- an infectious disease complicated by inflammation of the brain;

- genetic predisposition to mental and nervous diseases;

- drunkenness during conception;

- illnesses or moral shocks of the expectant mother during pregnancy;

- parental relationship;

- hereditary syphilis;

- delayed embryonic brain development;

- poor hygienic conditions, insufficient nutrition, excessive head wrapping;

- the use of vodka and opium in lulling a child.

Clinical signs

Symptoms of the disease appear at an early age .
The child does not react to what is happening around him (including loud sounds, bright lights and other irritants), there is no completely normal animation when he sees his father or mother, or interest in new, bright toys. As you grow older, the situation practically does not change. The patient does not recognize family members or parents, does not speak, only sometimes makes inarticulate sounds reminiscent of a growl, and cannot perform basic everyday activities (wash, eat on his own, brush his teeth, etc.). There is no control over the urge to urinate and defecate. Also characteristic is a decrease in tactile sensitivity (but the patient distinguishes between hot and cold), deterioration of hearing and vision.

Emotional reactions are primitive. Children diagnosed with idiocy do not know how to be happy, upset, or cry. More often they show anger, aggression, and irritability. The patients' movements are scanty, inexpressive, chaotic, and uncoordinated. A child may sway his whole body for a long time, shift monotonously from foot to foot, and stomp in one place.

When visiting a doctor at an early stage of the disease and starting correctional work before the age of 3, it is possible to learn basic self-care skills and simple speech patterns. But in the future, patients are not capable of any work, education, or social contacts.

As a rule, intellectual deficit is accompanied by somatic symptoms. Possible:

• seizures;
• acute pain in the abdomen and chest;
• arthralgia and myalgia;
• arrhythmia, hypertension;
• renal and/or liver failure, etc.

If idiocy is caused by gene mutations, already at an early age they pay attention to the structural features of the skull (elongated face, rounded, convex forehead), excessive mobility in the joints.

Idiocy (profound mental retardation)

Manifestations of pathology begin to be noticeable already in the first six months of a child’s life. The earliest signs of idiocy are the absence or weakness of reactions to the environment, the absence of a differential smile, and a complex of animation when relatives approach. There is an inability to distinguish loved ones from strangers; there is no reaction to the mother, interest in toys, expressive facial activity - all this is a characteristic clinical manifestation of congenital dementia. The child has an inexpressive look, a smile appears late, there is no object-manipulative activity and an initial understanding of addressed speech. The degree of lag in motor development begins to manifest itself more and more clearly over time.

At older ages, the main clinical manifestations of the disease are lack of speech and underdevelopment of other mental functions. It is difficult to come into contact with patients, since they do not perceive speech addressed to them, the reaction to the environment either does not arise at all, or is of a perverted, inadequate nature. Attention is unstable or completely absent. In such patients, motor and static functions are completely undeveloped; they are not able to take care of themselves and do not have even the simplest self-care skills, and therefore need constant supervision and care.

Patients have access to only the most basic mental operations, and their mental life is at the level of unconditional reflex (a conditioned reflex can only be formed for feeding). Basic mental functions are either completely absent or underdeveloped. Emotions are not differentiated and are represented only by two opposite reactions - pleasure and dissatisfaction. Patients are gluttonous, putting absolutely everything into their mouths - edible or inedible.

There are two main clinical forms of idiocy - torpid and excitable. In the torpid version, patients are left to their own devices and remain motionless; when excitable, they are in a constant state of unfocused and often stereotypical psychomotor agitation (clapping their hands, swaying and making other movements).

Quite often, a severe form of mental retardation is combined with anomalies and defects of physical development. They can be represented by various dysplasias: developmental defects of the upper and lower extremities, six-fingered or fused fingers, congenital joint contractures, spina bifida and cerebral hernias; Diastemas, underdevelopment or defects of the outer ear are also quite common. Malformations of internal organs are also common: congenital heart defects, dysgenesis of the gastrointestinal tract, malformations of the genitourinary system.

Diagnostic methods

In diagnosing the disease, the assessment of the degree of intelligence development is of primary importance. A generally accepted indicator of cognitive functions is IQ, which is determined using the Wechsler scale (for idiocy, it does not exceed 20). For testing, we use a special version adapted for early childhood. However, such a technique cannot be considered universal, since intellectual development is also influenced by many other factors: characteristics of upbringing, social environment, etc. Therefore, when making a diagnosis, doctors also evaluate memory, attention, ability to adapt, communicate and learn.

In addition to psychological testing, for an objective assessment of the patient’s condition, data from laboratory and instrumental studies (EEG, tomography, radiography, Dopplerography, cytogenetic and general clinical tests) are required. In addition, if the suspected cause of idiocy is intrauterine pathologies, damage to other internal organs cannot be ruled out, which requires careful diagnosis and selection of symptomatic therapy.

Idiocy - symptoms

Idiocy is a disease characterized by the following symptoms

• Violation of the structure of internal organs;
• Lack of meaningfulness of actions;
• Underdevelopment of the speech apparatus.

Patients with idiocy (it is correct to use the word “idiots,” but it has become commonplace and has lost its original medical meaning) are unable to remember anything, including distinguishing one person from another. They do not even have the simplest skills - for example, such patients are not able to feed themselves, take care of themselves, and constantly need care and supervision. In idiocy, thought processes stop completely, and the reaction to all types of stimuli decreases (inhibits). Quite quickly, all reactions begin to be divided into “like/dislike”, and then simply into “yes/no”.

Idiocy makes a person's instincts more important than reason. For example, patients often become gluttonous - they try to eat “everything that is not nailed down.” Sexual desire can increase to an equally extreme degree - the patient, like an animal, begins to rush at everyone, performing or imitating sexual intercourse, as well as openly masturbating.

A frequent symptom of the disease is focal neurological symptoms. It manifests itself in different ways. Some patients are characterized by outbursts of rage and aggression, while others are characterized by depression and apathy

. People with idiocy are placed in special institutions for the mentally retarded. They are not capable of learning anything.

Idiocy, as a rule, shows its signs from the very birth of the patient. Human development occurs slowly - the child does not hold his head well, learns to sit and walk late. Even having learned basic motor skills, children with idiocy are awkward, poorly coordinate their actions and orient themselves in space. Their facial expression most often does not express any emotion, although sometimes one can notice rudimentary manifestations of complacency or anger on it.

The maximum that patients with idiocy in speech are capable of is the repetition of inarticulate sounds or individual syllables. True, it is worth recognizing that they can do this for a long time. Other unconscious manifestations of motor skills may also be observed - for example, pendulum movements of the head and torso. It is pointless to look for the reason for the manifestation of aggression and impulsiveness, because “idiots” are not motivated by anything. And in the case of particularly severe manifestations of idiocy, even pain sensitivity decreases and the person ceases to be bothered by the temperature, size and humidity of objects.

People with idiocy are physically unable to live in society, so they are placed in special institutions.

Cost of services

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Treatment of idiocy and mental retardation

It is worth noting right away that it is impossible to completely recover from idiocy and mental retardation at this stage of medical development. However, you can fight its symptoms. Treatment depends on the cause of the disease. If it is necessary to improve cell metabolism, special medications are prescribed and a course of vitamins is given. If you need to reduce the pressure inside the skull, use glycerin and magnesium. In cases of severe inhibition, stimulants are used, and in cases of agitation, sedatives are used. Anticonvulsant medications work well against seizures.

Classification

Debility has different stages, types and forms, which depend on the factors discussed below.

Stages of debility

Degrees of debility are distinguished depending on the degree of mental impairment. To assess intellectual capabilities, the IQ coefficient is used.

In this case, the violation can be represented in three forms:

• mild form with IQ = 65-69;
• moderate form with IQ = 60-64;
• deep form with IQ = 50-59.

The level of intelligence is assessed using special psychological methods, including tests of logic, spatial thinking, etc.

Types

Types of debility differ depending on the degree of violation of volitional processes. So they distinguish:

• hypodynamic type - general inhibition of mental processes;
• hyperdynamic type - motor restlessness, disinhibition, motiveless affects.

If you organize life and work rules correctly for children suffering from debility, they will be able to master simple professions and serve themselves independently. To do this, they need guidance and support.

Forms

There are also forms of debility.

Highlight:

• The sthenic form, which is characterized by the patient’s good nature, balanced temperament, and activity.
• Asthenic form, which is characterized by emotional instability and fatigue.
• Atonic form, characterized by the patient’s inability to exhibit motivated behavior.
• Dysphoric form. The rarest form, which has severe emotional distress, aggressive behavior and self-destructive tendencies.

Treatment of oligophrenia

Psychoneurologists or psychiatrists are involved in the treatment of oligophrenia. Additionally, patients undergo therapy from psychologists, defectologists, and speech therapists. Treatment of oligophrenia is possible only if the disease appears against the background of fermentopathy or mucopolysaccharidosis.

In other cases, therapy is only symptomatic. Drug treatment of mental retardation in children is carried out with the help of nootropic drugs (Aminalon, Piracetam, Pantogam), antioxidants, vitamins (Cerebrolysin, glutamic and succinic acid), antihypoxants. If overexcitation is observed, then sedatives are recommended; in case of lethargy, mild stimulants are recommended.

If dementia occurs due to a malfunction of the thyroid gland, iodine-containing or hormonal drugs are prescribed. Treatment of mild mental retardation requires more than just the use of medications. Such people can live in society, which means they need to be prepared for this and helped to get used to it. This is not only contacts with relatives, conversations with psychologists, neurologists, classes with speech therapists are necessary. Correction is carried out not only with children, but also with their parents.

Particular attention is paid to joining any team (school, school, etc.)

Additionally, self-care classes are provided. Adults help not only choose a specialty, but also acquire the necessary professional skills. In this case, the degree of dementia, features of physical development, mental state, and the absence of other disorders must be taken into account.

Disease prognosis

If oligophrenia is diagnosed, the prognosis of the disease depends on the stage of retardation, timely diagnosis and initiation of treatment. In many cases, the pathology is eliminated even before the child is born. With a mild degree of dementia, patients can develop normally, but with increased attention, and over time, independently solve everyday situations and solve simple life problems.

In the stage of imbecility, people can get professions and exist normally in society. However, solving complex issues requires outside support and assistance. With moderate to severe mental retardation, patients can learn simple actions. However, specially equipped places are needed to employ such patients.

However, with imbecility, proper training and care can significantly improve adaptation in society. There are special programs for homeschooling for this purpose. In severe dementia, patients require round-the-clock care and are incapacitated.

Oligophrenia is not a temporary disease, but for life. Some adapt to an inferior life, others remain disabled. In any case, such patients require constant monitoring.

With the help of modern medicine, the onset of pathology can be identified in the initial stages and dementia can be prevented in the womb or pregnancy can be terminated. This is what screening tests are for.