Imbecility (Moderate mental retardation)

Classification

There are three types of oligophrenia.

1. Moronism. Is the easiest degree. This condition can only be diagnosed after 10 years. Observed:

• lack of perception of complex concepts and ways of explaining them;
• the child cannot think abstractly;
• there is isolation, fear of a new environment;
• sudden changes in character;
• the baby becomes distracted;
• inappropriate behavior is observed.

1. Imbecility. Is average. Characteristic:

• lack of initiative;
• The child’s thinking is primitive;
• the baby is easily suggestible;
• such a child can understand basic speech;
• able to learn to count, write, and read;
• the child reproduces short phrases;
• they react sharply to praise and scolding.

Such children need constant care and supervision.

1. Idiocy. This condition is a severe form of oligophrenia:

• the child is unable to speak;
• emotionally limited;
• cannot master simple skills;
• There are no productive activities.

These babies need continuous care.

To date, this classification is not in demand. Now the disease is divided according to ICD 10. The basis is an intellectual indicator, which is the main criterion for determining the stage of development of the disease.

Oligophrenia is divided into:

• differential - when it is possible to find out the cause of the disease;
• non-differential - when the etiology is unclear.

Depending on the progression of the disease, the following types are distinguished:

• mild degree – from 50 to 70 intelligence points;
• moderate degree – from 35 to 50;
• heavy – from 25 to 30;
• deep degree - intelligence below 20 points.

There is a classification according to Pevzner. Distinguishes the following types:

• uncomplicated;
• there are neurodynamic disturbances;
• deviations in the operation of analyzers;
• complicated, with a psychopathic form of behavior;
• mental deficiency.

Considering the etiology, oligophrenia is distinguished:

• hereditary factor;
• consequences of intrauterine damage to the child;
• birth injuries;
• developmental deviations.

Moronism

Debility is the mildest degree of dementia. Morons are capable of learning, can acquire simple work skills and, to a certain extent, adapt to social life. Morons have a rather developed speech, in which empty phrases and imitative features are expressed. In behavior they are more adequate, they can disguise their own weakness of thinking and seem at first glance to be quite healthy people. Their dementia is revealed more in abstract thinking; the transition from simple abstract generalizations to more complex ones is difficult. Morons can teach in a regular school, but the difficulty will be in inertia, slowness, lack of independence and initiative. Morons cannot master theory, but they can master specific knowledge, which at an older age can help them become independent people.

See also: Symptoms of manic-depressive psychosis

Causes

Chromosomal abnormalities most often cause the development of oligophrenia

1. Heredity (70% of all cases), chromosomal disorders, gene abnormalities: Patau, Wolf-Hirschhorn, Down syndrome, fragile chromosome, Prader-Willi, cat cry, Alfie.

These conditions are characterized by structural damage to the brain subsequent to chromosomal mutations.

This also includes:

• hereditary disorders of metabolic processes in the body;
• phenylalanine metabolism disorder;
• neonatal thyrotoxicosis, which develops due to iodine deficiency;
• hyperargininemia.

1. Antenatal reasons:

• toxic poisoning with phenol or lead;
• hypoxia in intrauterine development;
• infections during pregnancy;
• placental insufficiency;
• premature birth;
• alcoholism;
• taking antibiotics and certain medications, in particular aspirin, during pregnancy;
• influence of radiation;
• preeclampsia.

1. Postnatal causes:

• asphyxia at the time of birth;
• TBI during labor due to forceps;
• immune incompatibility of the child with the mother (Rh factor);
• tumor in the brain;
• meningitis at birth or encephalitis;
• skull injury;
• a complication of scarlet fever or measles suffered before the age of three.

Useful products for oligophrenia

To stimulate brain metabolism, patients with oligophrenia need to eat more foods containing vitamin B. Focus on vegetables and fruits, various dishes made from them (juices, purees, jelly).
Pregnant women need proper nutrition with the intake of all necessary macro- and microelements, mineral salts, proteins, carbohydrates and vitamins. Proper nutrition will help eliminate the possibility of having a baby prematurely and, thanks to good immunity, reduce the risk of infections entering the body.

Traditional medicine for oligophrenia

For oligophrenia, the necessary treatment is prescribed by medical professionals based on the diagnostic results and the causes of the disease. Nootropics, tranquilizers, neuroleptics, drugs containing iodine or hormones (if mental retardation is associated with malfunctions in the thyroid gland) can be prescribed, or only diet therapy can be prescribed for phenylpyruvic oligophrenia.

Instead of nootropic drugs, traditional medicine provides for the use of decoctions of lemongrass, ginseng and aloe juice. Before you start taking them, you should definitely consult your doctor. Otherwise, if the dose and use are incorrect, the patient may experience psychosis or develop aggression and anger. This is due to the fact that these plants activate brain activity.

Dangerous and harmful products for mental retardation

In case of phenylpyruvic oligophrenia (phenylalanine metabolism is impaired), patients are excluded from the diet of natural protein (this includes products of animal origin: fish, seafood, meat, including milk).
This is because these products contain phenylalanine. This diet must be followed at least until adolescence. For any type of mental retardation, it is necessary to exclude the consumption of all non-living food. It negatively affects all body functions, which makes parenting even more difficult and causes unnecessary health problems. The additives found in unhealthy foods slow down all metabolic processes, thicken the blood, which causes blood clots and impairs blood circulation (this is especially dangerous for blood flow to and from the brain).

Attention!

The administration is not responsible for any attempt to use the information provided, and does not guarantee that it will not harm you personally. The materials cannot be used to prescribe treatment or make a diagnosis. Always consult a specialized doctor!

Tatyana Eliseeva chief editor of the Food+ project

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Symptoms

Signs of oligophrenia in children may vary at different age periods.

The most striking manifestations are observed at the age of six. The fact is that some signs can be observed at an earlier age, but parents may mistake them for character traits. It is also worth considering that how severe the disease will be depends on the area of ​​brain damage. Therefore, signs of oligophrenia can occur even in the first months of a baby’s life.

1. The following symptoms are typical for newborns:

• increased irritability;
• tendency to seizures;
• muscle weakness;
• incorrect proportions;
• large skull;
• visual defects of the face (for example, a cleft lip or a flat nose).

1. For infants it is typical:

• lack of any interest in everything around;
• no desire to communicate with peers;
• difficulty understanding adult conversations;
• difficulty reproducing words;
• the child is not able to repeat the action he saw.

1. Children in preschool age are characterized by:

• difficulty performing simple tasks, such as modeling;
• monotonous actions are observed.

1. For schoolchildren:

• impaired ability to recognize objects and their properties;
• children have chaotic activity;
• the information received is distorted;
• speech skills are impaired;
• memory decreases;
• there may be a complete lack of imaginative thinking;
• there is no feeling of empathy.

Diagnosis of deviation

Diagnosis is not difficult. The task of identifying pathology falls on the shoulders of the psychiatrist. Also, in the future, the participation of a neurologist, speech pathologist, or speech therapist may be required. First of all, it is necessary to establish whether the defect is a consequence of organic defects: an inflammatory process, a tumor, a cyst.

Shown:

• MRI of the brain,
• electroencephalography,
• Dopplerography of cerebral vessels.

If there is no evidence of structural changes of this kind, a basic psychopathological study is carried out:

1. An oral survey in order to establish the range of interests, general erudition, the ability to think logically, draw conclusions, build a narrative thread, and competently conduct a dialogue. In children, this technique is impossible; therefore, observation of behavioral reactions to stimuli (smile, touch, etc.) is practiced.
2. Tests. Special studies within the framework of questionnaires and tests to determine IQ. In some cases, it gives false information, especially such an old method as Eysenck’s IQ studies. A group of techniques is required. Tests according to Vanderlik, Raven.
3. Assessment of abilities to read, write, count. Retell and analyze text, think figuratively, understand metaphors.
4. Memory test based on visual material: special cards. There is also an opportunity to simultaneously test your ability to verbalize what you see and tell a coherent story. It is proposed to compose a story based on cards with a visual description of some situations, then tell it coherently and clearly.

For obvious reasons, the patient will have impaired almost all criteria of a healthy psyche: from behavior to memory, the ability to generalize. Complicated oligophrenia, severe and advanced forms of it put an end to the possibility of establishing contact. However, there are no problems with making a diagnosis.

Diagnostics

To accurately establish the presence of oligophrenia, it is necessary to conduct special tests (psychological). The doctor will evaluate the child’s mental and speech development, vocabulary, note how others perceive him, and the presence of abstract thinking. It is important that this technique is suitable only for children starting from 3 years old. If the disease is suspected in a younger child, the following research methods are used:

• MRI of the brain;
• karyotype study;
• genetic tests;
• assessment of the baby's memory;
• blood screening for phenylketonuria and hypothyroidism;
• encephalography;
• congenital infection samples;
• comprehensive examination.

On the issue of differentiating the diagnoses “oligophrenia”, “dementia” and “mental retardation”

Terminological confusion in the concepts of “oligophrenia”, “dementia”, “mental retardation” leads to difficulties in unambiguously determining the diagnosis in some cases. So, for example, problems with intellectual activity develop against the background of multiple sclerosis. Especially in the later stages. Should such a defect be considered oligophrenia? As a rule, none of the doctors consider it as such, because there is a different origin, there is a clear origin of the problem. We are talking about a symptom, a syndrome within the framework of a specific diagnosis. As for oligophrenia, it is a diagnosis in itself.

The same thing with dementia: Alzheimer's, schizophrenic type, senile, parkinsonian and others. The difference between oligophrenia and dementia is made by: clinical picture (against the background of dementia, the defect increases and deepens), origin (the pathogenesis of oligophrenia is congenital or acquired in early years under the influence of general underdevelopment of the brain).

The question is complex, you need the help of a doctor and differential diagnosis of the pathological process.

Treatment

It is not possible to completely rid a child of mental retardation. However, parents and doctors can correct this condition if the disease is detected in a timely manner.

Classes with specialists play an important role:

• defectologist, speech therapist;
• psychiatrist;
• neurologist;
• orthopedist;
• physiotherapist;
• social service workers.

Symptomatic therapy may be prescribed:

• tranquilizers, sedatives, in particular Diazepam or Phenazepam;
• neuroleptics, antipsychotic drugs, for example, Relatin or Nootropil;
• hormonal agents, for example, Thyroidin or Hypophysin;
• taking medications to normalize the activity of the central nervous system, for example, Piracetam or Phezam;
• vitamin therapy, in particular group B;
• glutamic acid, which is taken in a course to reduce the symptoms of mental retardation;
• psychotherapy, psychocorrection, classes with a speech therapist;
• physical therapy and massage;
• psychomotor gymnastics.

MedGlav.com

OLIGOPHRENIA (from the Greek olfgos - small and phren - mind), dementia - various forms of mental underdevelopment, congenital and early acquired. Signs that unite the entire group of mental retardation are the presence of mental retardation and the absence of progression of the disease.

Etiology.

The causes of Oligphrenia are varied. In most cases, mental retardation is caused by exposure to external hazards that damage the reproductive cells (eggs, sperm) of the parents or disrupt the development of the central nervous system of the fetus in utero or the child in infancy. Only in a small part of cases of oligophrepenia is it caused by pathological heredity.

• The most common external factors that cause mental retardation include infections ( influenza, pneumonia, dysentery, rubella, meningitis and encephalitis, syphilis, etc.) suffered by the mother during pregnancy or by the child in the first years of life,
• intoxication of the pregnant
• injuries to the child during childbirth and infancy,
• exposure to radiation energy,
• long fasting.
• Two forms of oligophrenia of infectious origin were studied oligophrenia, caused by the mother's illness in the first months of pregnancy with rubella and manifested by severe dementia of the child, visual defects (cataracts) and hearing (deafness) in combination with heart defects;

• Mental retardation caused by toxoplasmosis and often combined with eye damage, cephalic dropsy and epileptic seizures. The parasite, the microorganism Toxoplasma, penetrates from the body of a healthy mother into the fetus through the placenta.

Various manifestations of mental retardation also depend on the time of exposure to harmful effects: harmful effects on the embryo or fetus in the early period of pregnancy can cause severe malformations of the brain; Damage to the fetus in the last months of pregnancy or illness of the child in the first years of life result in less profound developmental defects.

Clinical symptoms.

Oligophrenia is manifested not only by mental, but also by physical underdevelopment: retardation in growth, disproportions in physique, abnormal structure of the skull, delayed or, conversely, premature sexual development. Frequent signs of mental retardation are speech disturbances, movement disorders, and sensory organ defects. Some features are also noted in the behavior of some patients with mental retardation - restlessness, mood instability, increased irritability, inability to control their desires; in others, on the contrary, lethargy and lethargy predominate. Depending on the degree of intellect deficiency in mental retardation, three groups are distinguished:

• The most severe is Idiocy (from the Greek idiot eia - in a figurative sense: rudeness, ignorance),
• Less severe— Imbecility (from the Latin imbecillus—weak, infirm),
• Relatively mild - Debilitation (from Latin debilis - weak).

This division is of practical importance, since patients in each of these groups require different methods of training, education and care.

With Idiocy, speech is absent or limited to only individual words, comprehension of the environment is inaccessible, the simplest service skills are absent or very poorly developed. These profoundly demented patients require constant supervision and care.

Imbeciles master the elements of speech, but the vocabulary is small, and the speech is incorrect in the sense of articulation. Thinking is poorly developed; possessing a certain stock of ideas and individual specific concepts, they are incapable of generalization and abstract (abstract) thinking. Teaching them to read, write and count is very difficult even in a special school: knowing the letters, they have difficulty putting them into words, and abstract counting is inaccessible to them. With proper upbringing, they manage to instill basic labor skills; however, their ability to independently adapt to life is limited and they need care.

Morons can speak, motor disorders are observed less frequently and are easier to correct. They are more focused and can learn to read and write within grades 4-5; but the higher forms of cognitive activity and the ability for abstract thinking are underdeveloped. Therefore, they must be trained according to an appropriate program and using special methods in a special (auxiliary) school. Morons can master a simple profession, adapt to living conditions and lead a living existence.

Prevention. Due to the fact that most cases of Oligophrenia are associated with harmful effects on the embryo and fetus, as well as on young children, the most effective way of prevention is a system of measures to protect pregnant women, nursing mothers, and children in infancy from injuries, infections and toxic diseases. It is very important to establish special monitoring of children exposed to harm in the prenatal period, during childbirth and in the first years of life. An important preventive task is the early recognition of mental retardation, timely initiation of treatment and medical and pedagogical work with sick children.

TREATMENT. Treatment is most effective in cases where the cause of underdevelopment is known (syphilis, toxoplasmosis, intrasecretory disorders, etc.).

• In all cases of mental retardation, therapy is used to stimulate the development of the child’s intelligence and speech ( glutamic acid, lipocerebrin, vitamins ).
• If there is motor restlessness, sedatives ( bromine, valerian, calcium ) are used.
• In some forms of mental retardation (patients with pathological behavior, disinhibition of gross impulses), treatment with aminazine is indicated.
• In all cases of oligophrenia, it is necessary to carry out therapeutic and pedagogical measures, special methods of training, education and employment.

Upbringing

These children need care and attention.

The characteristics of children with mental retardation are such that there is an urgent need for constant care and concern for them.

If the situation is unfavorable, the child’s condition will only worsen, and at a fairly rapid pace. Aggression, hatred of the outside world may arise, and even with rehabilitation, its effectiveness will significantly decrease.

Parents with such a child must know a number of rules and strictly follow them:

• constant supervision of the baby;
• a friendly attitude towards the baby;
• providing psychological assistance;
• basic skills training;
• presence of positive motivation;
• visiting specialized institutions;
• classes with specialists;
• compliance with all recommendations.

Possibilities for patient correction and adaptation

Imbecility, like any congenital form of dementia, cannot be cured. All that can be done for such patients is to treat not the disease, but the symptoms. Drug treatment is divided into specific and symptomatic.

Patients with metabolic disorders and enzyme defects receive specific treatment:

1. In case of hypothyroidism, a lack of thyroid hormones is treated with their synthesized substitute - Levothyroxine. The endocrinologist selects an individual dosage regimen, determines the initial dose and its subsequent increase.
2. Phenylketonuria is treated with a strict diet. Products high in protein, that is, phenylanine, are excluded. The body does not produce the enzyme that should convert phenylanine into tyrosine. Namely, tyrosine is responsible for the normal course of many hormonal processes. In addition to diet, patients need to take Carnitine, which inhibits the excessive production of thyroid hormones.
3. Toxoplasmosis responds well to treatment with antibiotics, Diraprim, Chloridine, and arsenic preparations.
4. Brain infections (encephalitis, meningitis) are treated with antibiotics in combination with sulfonamides (Biseptol, Sulfatone, Bakterial).

Symptomatic treatment consists of prescribing drugs that stimulate brain activity. These include:

1. Psychostimulants . Medicines that increase the level of mental and physical activity (Caffeine, Sidnocarb, Ritalin, amphetamines).
2. Biostimulants . Herbal infusions and herbs that accelerate metabolism (aloe extract, ginseng, mumiyo, propolis, plantain)
3. Diuretics . Agents that remove excess water from the body (Furosemide, Diacarb, Mannitol). They are indicated for hydrocephalus.
4. Anticonvulsants (Phenobarbital, Phenytoin, Carbamazepine) are prescribed for those prone to epileptic seizures.
5. Psychotropic drugs from the group of tranquilizers (Phenazepam, Elzepam, Sibazon) and neuroleptics (Aminazin, Haloperidol, Tizercin) are used to reduce excitability and unmotivated outbursts of aggression.

Patients with severe speech defects work with a speech therapist. All patients should be under the supervision of a psychiatrist. Remembering that imbeciles are not ahead of seven-year-old children in terms of development, the main treatment comes down to education, care and vigilant control.

If there is no control over patients, they easily fall under the influence of asocial elements and become accomplices in crimes. Such people are dangerous and need to be placed in a psychiatric clinic where they are treated with antipsychotics.

Forecast

With proper and timely therapy, the child can have an almost normal future.

A favorable prognosis can only be discussed with early diagnosis of mental retardation and timely treatment. This also applies to mild degrees of the disease. In such children, the disease can be stopped, and they will have the opportunity to master certain professions.

An unfavorable prognosis will be in advanced or severe disease:

• disability;
• inferior intelligence;
• mental disorders.

Prevention

Prevention of oligophrenia in a child is aimed at ensuring that the expectant mother follows all the rules

Precautionary measures should be directed at a pregnant woman when she is carrying her child.

1. Timely registration order.
2. Regular visits to antenatal clinics.
3. Perform all necessary tests.
4. Walk daily for at least two hours.
5. Correct daily routine.
6. Healthy sleep.
7. Refusal of bad habits and food.
8. Balanced diet.
9. During childbirth, the use of forceps is prohibited.

The diagnosis of oligophrenia really sounds very scary. Parents should understand that timely changes in the child’s body will allow the disease to be diagnosed in time and its treatment to begin. Of course, you will not be able to completely get rid of this condition. However, you can make your child's life much easier.

Treatment methods

Is full recovery possible?

Full recovery is usually not possible. Not counting forms associated with the formation of excess ketones. The key task of treatment is the patient’s adaptation to society. As much as possible.

Which doctor should I contact?

A whole group of specialists is working on the patient’s recovery. Neurologist, psychiatrist, pediatrician, defectologist, speech therapist. The drugs are used as an auxiliary measure.

Nootropic drugs are prescribed to speed up metabolism in the brain, cerebrovascular. To restore blood flow, vitamin and mineral complexes. If necessary, also tranquilizers (there are cases of increased aggressiveness), neuroleptics in short courses.

Otherwise, treatment of mental retardation involves assistance in understanding people’s emotions and expressing one’s thoughts as much as possible. Individual work with a psychotherapist and group sessions are carried out.

A big role is given to working with parents and close relatives. It is necessary to ensure a normal microclimate at home to improve forecasts. If there is an inadequate reaction to the patient, the child, teenager or adult will withdraw even more.

Modern methods aimed at expressing the emotional state and relieving stress are a good help in therapy. This includes pet therapy (communication with animals: horses, dogs, cats), art therapy (artistic self-expression, usually we are talking about visual methods, drawing).