Kay S R
Department of Psychiatry, Albert Einstein College of Medicine/Montefiore Medical Center, Bronx, NY 10461.
Res Dev Disabil. 1989;10(3):251-60. doi: 10.1016/0891-4222(89)90014-0.
Because of their severe cognitive and social deficits, seriously impaired and regressed psychotics are often misdiagnosed as mentally retarded. This diagnostic confusion, which carries dire consequences for treatment, has prevailed due to the lack of objective tests directed at this problem. Procedures are needed to specifically measure and differentiate the hallmarks of the intellectual dysfunction in both conditions (i.e., cognitive abnormality [psychosis] and subnormality [mental retardation]). Such methods also must be adapted to the particular problems and limitations of these populations. We propose here the use of three long established tests and a new developmentally rooted Cognitive Diagnostic Battery, one that assesses conceptual, perceptual-motor, and social maturity. Empirical study supported the validity of this Battery for differential diagnosis between mentally and functionally retarded psychotics matched for IQ, 97% of the developmentally disabled group exhibiting deficits on all three tests of conceptual development vs. 27% in the functionally mentally retarded group.
由于存在严重的认知和社交缺陷，严重受损且病情倒退的精神病患者常常被误诊为智力迟钝。这种诊断上的混淆对治疗产生了可怕的后果，由于缺乏针对这一问题的客观测试，它一直存在。需要有程序来专门测量和区分这两种情况（即认知异常[精神病]和智力低下[智力迟钝]）中智力功能障碍的特征。这些方法还必须适应这些人群的特殊问题和局限性。我们在此提议使用三项长期确立的测试以及一种新的基于发展的认知诊断组合测试，该测试评估概念、感知运动和社会成熟度。实证研究支持了该组合测试对于智商匹配的精神性和功能性智力迟钝精神病患者进行鉴别诊断的有效性，发育障碍组中97%的患者在所有三项概念发展测试中都表现出缺陷，而功能性智力迟钝组中这一比例为27%。
