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- Title
P-766 - Coexistent mental retardation is a complicating factor in the diagnosis of psychiatric illness. a case study of a mentally impaired OCD patient wrongly diagnosed as schizophrenic
- Authors
Charatsidou, I.; Chatziioannidis, S.; Nikolaidis, N.; Garyfallos, G.; Giouzepas, I.
- Abstract
Introduction: Mental retardation is a condition characterized by limitations in intellectual and adaptive functioning. Impairments in cognitive and verbal skills may undermine the ability of a patient to clearly express the symptoms of his or her illness. Thus, when a psychiatric disorder coexists, the limited capacity of the individual to describe his or her internal state may lead to an erroneous diagnostic hypothesis. Objectives and method: A clinical case was followed and reviewed to illustrate the difficulties concerning the diagnosis of mental illness in patients with lower intelligence. Results: A 31 year old male was admitted in our acute psychiatric department with predominant auditory hallucinations. Prior to his admission, based on the assumption that he suffered from paranoid type schizophrenia, the patient had been treated by his private physician with heavy doses of antipsychotic medication, showing no clinical response. During his psychodiagnostic evaluation he underwent intelligence and personality testing, the former indicating mild mental retardation and the latter revealing no signs of psychotic symptoms. Careful clinical interviewing proved that his auditory hallucinations were in fact obsessive thoughts which he could not understand and describe as such due to his limited cognitive skills. Upon these, further investigation revealed typical obsessive compulsive behaviours which led us to a diagnosis of OCD. Following a proper adjustment in his medication and the initiation of psychotherapy, the patient showed marked improvement in his symptomatology. Conclusions: Deficits in receptive and expressive language skills in people with mental retardation may obscure the diagnostic indicators of psychiatric disorders. Clinicians should be vigilant to adequatelly explore this area in their standard evaluation and modify the diagnostic assessment accordingly.
- Subjects
INTELLECTUAL disabilities; PSYCHIATRIC diagnosis; PEOPLE with mental illness; OBSESSIVE-compulsive disorder; DIAGNOSTIC errors; DIAGNOSIS of schizophrenia
- Publication
European Psychiatry, 2012, Vol 27, p1
- ISSN
0924-9338
- Publication type
Abstract
- DOI
10.1016/S0924-9338(12)74933-7