The relationship between client demographics, DSM III diagnoses, and the Psychopathology Instrument for Mentally Retarded Adults.

Abstract

Psychiatric disorders in the mentally retarded are often, misdiagnosed and under reported, resulting in a lack of appropriate treatment and services for the mentally retarded/mentally ill client. Misdiagnosis also results in erroneous prevalence figures which are used in planning services. The main purpose of this study was to stabilize and clarify the diagnosis of psychological disorders in a community-based mentally retarded population. The study also evaluated specific demographic data to determine the extent of their relationship to a dual diagnosis of mental retardation/mental illness. The type and frequency of psychopathology in this population was also examined. Clients referred to a community mental health project serving dually diagnosed clients during a two-year period were surveyed to determine the extent of agreement between psychiatric diagnoses based on the Diagnostic and Statistical Manual of Mental Disorders (Third Edition) and the test score obtained on a psychopathology assessment device (Psychopathology Instrument for Mentally Retarded Adults). The major findings of the study revealed that at least 27% of the 160 clients surveyed had a psychiatric diagnosis on the DSM III while 46% of the clients had high ratings of psychopathology on the PIMRA. The most prevalent disorder was schizophrenia (11%). The analysis of demographic/assessment variables using Chi Square correlational analyses indicated that a significant relationship emerged on both the DSM III and PIMRA with psychotropic medication only indicating that clients with a psychiatric diagnosis were more likely to receive medication. A significant relationship between level of retardation and psychiatric rating was noted on the PIMRA only. A significant relationship was found between DSM III psychiatric diagnoses and PIMRA subscale scores on two important diagnostic groupings--anxiety and schizophrenia. The findings suggest that some subscales of the PIMRA may be more useful than others in targeting psychiatric problems. Suggested revisions for increasing the scale's utility were made. Continued research in assessment devices, particularly with the lower levels of retardation is indicated.