Salvador-Carulla Luis, Bertelli Marco
WPA Section Psychiatry of Mental Retardation/Intellectual Disability, Jerez, Spain.
Psychopathology. 2008;41(1):10-6. doi: 10.1159/000109950. Epub 2007 Oct 18.
The term 'mental retardation' (MR) is outdated and has changed to 'intellectual disability' (ID). Unfortunately, this decision did not follow a nosology approach. The aim of this overview is twofold: (1) to provide a conceptual background and framing on the ID/MR field to other psychiatrists, and (2) to provide a nosology-based perspective to the debate on the name and concept of MR/ID.
This conceptual paper is based on a literature review and on an iterative process of debate within the WPA Section 'Psychiatry of Mental Retardation'.
ID may be regarded not as a disease or as a disability but as a syndrome grouping (metasyndrome) similar to the construct of dementia. It includes a heterogeneous group of clinical conditions, ranging from genetic to nutritional, infectious, metabolic or neurotoxic conditions. The ID metasyndrome is characterized by a deficit in cognitive functioning prior to the acquisition of skills through learning. The intensity of the deficit is such to interfere in a significant way with individual normal functioning as expressed in limitations in activities and restriction in participation (disabilities).
The name 'developmental cognitive impairment' is here suggested to coexist with ID for naming the metasyndrome previously called MR following a polysemic-polynomious approach.
“智力迟钝”（MR）这一术语已过时，现改为“智力残疾”（ID）。遗憾的是，这一决定并非遵循疾病分类学方法。本综述的目的有两个：（1）向其他精神科医生提供关于ID/MR领域的概念背景和框架；（2）为关于MR/ID名称和概念的辩论提供基于疾病分类学的视角。
本概念性论文基于文献综述以及世界精神病学协会（WPA）“智力迟钝精神病学”分会内部的反复辩论过程。
ID或许不应被视为一种疾病或残疾，而应被视为一种类似于痴呆症结构的综合征群组（元综合征）。它包括从遗传到营养、感染、代谢或神经毒性等多种临床情况。ID元综合征的特征是在通过学习获得技能之前认知功能存在缺陷。这种缺陷的严重程度足以显著干扰个体的正常功能，表现为活动受限和参与受限（残疾）。
建议采用一词多义 - 一词多式的方法，“发育性认知障碍”这一名称与ID共存，用于命名先前称为MR的元综合征。
