El infradiagnóstico del trastorno mental en la población con discapacidad intelectual: estudio de prevalencia en población con diferentes grados de discapacidad intelectual
Resumen
Introducción: Existen pocos estudios en la literatura que hayan analizado la prevalencia de enfermedades mentales en las personas con discapacidad intelectual (DI). Se presenta un estudio de identificación de enfermedad mental en población adulta sin trastorno mental previo conocido y con diferentes grados de DI.
Metodología: El presente estudio describe la comorbilidad psiquiátrica y médica de una muestra de 142 individuos con diferentes grados de DI. Para el estudio de enfermedad mental en la población con DI Leve/Moderada se utilizó la batería diagnóstica PAS-ADD, basada en criterios CIE-10 y DSM-IV TR y en la población con DI grave/severa la escala DASH-II
Resultados: El 29,57% de los participantes presentaron un trastorno psiquiátrico previamente no diagnosticado. En el grupo DI leve/moderada la patología más prevalente fue el trastorno depresivo mayor, en cambio en el grupo DI grave/profunda fue el trastorno de ansiedad. La comorbilidad médica más prevalente fue la epilepsia, con un 22,5% de la muestra global y un 39,2% en la población con discapacidad intelectual grave o severa.
Conclusión: Los trastornos psiquiátricos parecen ser más frecuentes en la población con DI que en población general, aumentando su prevalencia, así como su comorbilidad médica, en la DI severa/profunda.
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American Psychiatric Association. (2000). Diagnostic and statistical manual of mental disorders (4th ed).
American Psychiatric Association. (2014). Diagnostic and statistical manual of mental disorders (5a ed).
Amiet, C., Gourfinkel-An, I., Bouzamondo, A., Tordjman, S., Baulac, M., Lechat, P., … Cohen, D. (2008). Epilepsy in Autism is Associated with Intellectual Disability and Gender: Evidence from a Meta-Analysis. Biological Psychiatry, 64(7), 577–582. https://doi.org/10.1016/j.biopsych.2008.04.030
Blackwood, D. H. R., Thiagarajah, T., Malloy, P., Pickard, B. S., & Muir, W. J. (2008). Chromosome abnormalities, mental retardation and the search for genes in bipolar disorder and schizophrenia. Neurotoxicity Research. https://doi.org/10.1007/BF03033803
CIE 10 -Trastornos mentales y del comportamiento - Pautas diagnosticas. Criterios diagnósticos de investigación. (2014). Medvance S.L.
Cooper, S.-A., Smiley, E., Morrison, J., Williamson, A., & Allan, L. (2007). Mental ill-health in adults with intellectual disabilities: Prevalence and associated factors. The British Journal of Psychiatry, 190, 27–35. https://doi.org/10.1192/bjp.bp.106.022483
Deb, S., Thomas, M., & Bright, C. (2001). Mental disorder in adults with intellectual disability. 2: The rate of behaviour disorders among a community-based population aged between 16 and 64 years. Journal of Intellectual Disability Research?: JIDR, 45(Pt 6), 506–14. https://doi.org/10.1046/j.1365-2788.2001.00373.x
Emerson, E., Hatton, C., Thompson, T., & Parmenter, T. R. (2004). The International Handbook of Applied Research in Intellectual Disabilities. (E. Emerson, C. Hatton, T. Thompson, & T. R. Parmenter, Eds.)The International Handbook of Applied Research in Intellectual Disabilities. Chichester, UK: John Wiley & Sons Ltd. https://doi.org/10.1002/9780470713198
Espie, C. A., Watkins, J., Curtice, L., Espie, A., Duncan, R., Ryan, J. A., … Sterrick, M. (2003). Psychopathology in people with epilepsy and intellectual disability; an investigation of potential explanatory variables. Journal of Neurology, Neurosurgery, and Psychiatry, 74(11), 1485–92. https://doi.org/10.1136/jnnp.74.11.1485
Fatemi, S. H., & Folsom, T. D. (2011). The role of fragile X mental retardation protein in major mental disorders. Neuropharmacology, 60(7–8), 1221–6. https://doi.org/10.1016/j.neuropharm.2010.11.011
Fletcher, R., Loschen, E., Stavrakaki, C., & First, M. (2007). Diagnostic Manual - Intellectual Disability (DM-ID). Kingston, NY: NADD press.
García González-Gordon, R. (2002). Adaptación espa-ola de la entrevista PAS-ADD. Una entrevista estandarizada. (R. García González-Gordon, Ed.) (1st ed.). Cadiz: UNIVERSIDAD DE CADIZ, S.PUBLICACIONES.
Haro, J. M., Palacín, C., Vilagut, G., Martínez, M., Bernal, M., Luque, I., … Grupo ESEMeD-Espa-a. (2006). [Prevalence of mental disorders and associated factors: results from the ESEMeD-Spain study]. Medicina Clínica, 126(12), 445–51. https://doi.org/10.1157/13086324
Jokiranta, E., Sourander, A., Suominen, A., Timonen-Soivio, L., Brown, A. S., & Sillanpää, M. (2014). Epilepsy among children and adolescents with autism spectrum disorders: a population-based study. Journal of Autism and Developmental Disorders, 44(10), 2547–57. https://doi.org/10.1007/s10803-014-2126-6
Koskentausta, T., Iivanainen, M., & Almqvist, F. (2007). Risk factors for psychiatric disturbance in children with intellectual disability. Journal of Intellectual Disability Research?: JIDR, 51(Pt 1), 43–53. https://doi.org/10.1111/j.1365-2788.2006.00871.x
Kozlowski, A. M., Matson, J. L., Sipes, M., Hattier, M. A., & Bamburg, J. W. (2011). The relationship between psychopathology symptom clusters and the presence of comorbid psychopathology in individuals with severe to profound intellectual disability. Research in Developmental Disabilities, 32(5), 1610–1614. https://doi.org/10.1016/j.ridd.2011.02.004
Matson, J. L., Gardner, W. I., Coe, D. A., & Sovner, R. (1991). A scale for evaluating emotional disorders in severely and profoundly mentally retarded persons. Development of the Diagnostic Assessment for the Severely Handicapped (DASH) scale. The British Journal of Psychiatry?: The Journal of Mental Science, 159, 404–9. https://doi.org/10.1192/bjp.159.3.404
Matsuura, M., Adachi, N., Muramatsu, R., Kato, M., Onuma, T., Okubo, Y., … Hara, T. (2005). Intellectual disability and psychotic disorders of adult epilepsy. Epilepsia, 46 Suppl 1, 11–4. https://doi.org/10.1111/j.0013-9580.2005.461004.x
Moss, S., Ibbotson, B., Prosser, H., Goldberg, D., Patel, P., & Simpson, N. (1997). Validity of the PAS-ADD for detecting psychiatric symptoms in adults with learning disability (mental retardation). Social Psychiatry and Psychiatric Epidemiology, 32(6), 344–54. https://doi.org/10.1007/BF00805440
Petry, K., Maes, B., & Vlaskamp, C. (2009). Measuring the quality of life of people with profound multiple disabilities using the QOL-PMD: First results. Research in Developmental Disabilities, 30(6), 1394–1405. https://doi.org/10.1016/j.ridd.2009.06.007
Psychiatrics, R. C. of. (2001). DC-LD. Diagnostic criteria for psychiatric disorders for usewith adults with learning disabilities/mental retardation. (The royal colleges of psychiatrics, Ed.) (1st ed.). London: Bristish Library Cataloguing-in-Publication Data.
Reiss, S., & Valenti-Hein, D. (1994). Development of a psychopathology rating scale for children with mental retardation. Journal of Consulting and Clinical Psychology, 62(1), 28–33. https://doi.org/10.1037/0022-006X.62.1.28
Rojahn, J., Matson, J. L., Naglieri, J. A., & Mayville, E. (2004). Relationships Between Psychiatric Conditions and Behavior Problems Among Adults With Mental Retardation. American Journal on Mental Retardation, 109(1), 21–33. https://doi.org/10.1352/0895-8017(2004)109<21:RBPCAB>2.0.CO;2
Rush, A. J., & Frances, A. (2000). Expert Consensus Guideline Series: Treatment of psychiatric and behavioral problems in mental retardation. American Journal of Mental Retardation AJMR, 105(3), 159–226.
Salvador-Carulla, L., & Novell-Alsina, R. (2002). Guía práctica de la evaluación psiquiátrica en el retraso mental (1st ed.). Madrid: Aula Medica ediciones.
Schalock, Robert L., Verdugo Alonso, M. A. (2002). Handbook on quality of life for human service practitioners. (D. L. Braddock, Ed.) (1st ed.). Washington DC: American Asociation on mental retardation.
Schmitz, B. (2005). Depression and mania in patients with epilepsy. Epilepsia, 46 Suppl 4, 45–9. https://doi.org/10.1111/j.1528-1167.2005.463009.x
Smith, K., Shah, A., Wright, K., & Lewis, G. (1995). The prevalence and costs of psychiatric disorders and learning disabilities. The British Journal of Psychiatry?: The Journal of Mental Science, 166(1), 9–18. https://doi.org/10.1192/bjp.166.1.9
Sperli, F., Rentsch, D., Despland, P. A., Foletti, G., Jallon, P., Picard, F., … Seeck, M. (2009). Psychiatric comorbidity in patients evaluated for chronic epilepsy: a differential role of the right hemisphere? European Neurology, 61(6), 350–7. https://doi.org/10.1159/000210547
Turygin, N., Matson, J. L., & Adams, H. (2014). Prevalence of co-occurring disorders in a sample of adults with mild and moderate intellectual disabilities who reside in a residential treatment setting. Research in Developmental Disabilities, 35(7), 1802–1808. https://doi.org/10.1016/j.ridd.2014.01.027
Vargas-Vargas, C., Rafanell, A., Montalvo, D., Estarlich, M., Pomarol-Clotet, E., & Sarró, S. (2014). Validity and reliability of the Spanish version of the diagnostic assessment for the severely handicapped (DASH-II). Research in Developmental Disabilities, 36C, 537–542.
Whitaker, S., & Read, S. (2006). The prevalence of psychiatric disorders among people with intellectual disabilities: An analysis of the literature. Journal of Applied Research in Intellectual Disabilities, 19(4), 330–345. https://doi.org/10.1111/j.1468-3148.2006.00293.x
World Health Organisation. (2004). ICD-10 guide for mental retardation. Mental Retardation, 82.
American Psychiatric Association. (2014). Diagnostic and statistical manual of mental disorders (5a ed).
Amiet, C., Gourfinkel-An, I., Bouzamondo, A., Tordjman, S., Baulac, M., Lechat, P., … Cohen, D. (2008). Epilepsy in Autism is Associated with Intellectual Disability and Gender: Evidence from a Meta-Analysis. Biological Psychiatry, 64(7), 577–582. https://doi.org/10.1016/j.biopsych.2008.04.030
Blackwood, D. H. R., Thiagarajah, T., Malloy, P., Pickard, B. S., & Muir, W. J. (2008). Chromosome abnormalities, mental retardation and the search for genes in bipolar disorder and schizophrenia. Neurotoxicity Research. https://doi.org/10.1007/BF03033803
CIE 10 -Trastornos mentales y del comportamiento - Pautas diagnosticas. Criterios diagnósticos de investigación. (2014). Medvance S.L.
Cooper, S.-A., Smiley, E., Morrison, J., Williamson, A., & Allan, L. (2007). Mental ill-health in adults with intellectual disabilities: Prevalence and associated factors. The British Journal of Psychiatry, 190, 27–35. https://doi.org/10.1192/bjp.bp.106.022483
Deb, S., Thomas, M., & Bright, C. (2001). Mental disorder in adults with intellectual disability. 2: The rate of behaviour disorders among a community-based population aged between 16 and 64 years. Journal of Intellectual Disability Research?: JIDR, 45(Pt 6), 506–14. https://doi.org/10.1046/j.1365-2788.2001.00373.x
Emerson, E., Hatton, C., Thompson, T., & Parmenter, T. R. (2004). The International Handbook of Applied Research in Intellectual Disabilities. (E. Emerson, C. Hatton, T. Thompson, & T. R. Parmenter, Eds.)The International Handbook of Applied Research in Intellectual Disabilities. Chichester, UK: John Wiley & Sons Ltd. https://doi.org/10.1002/9780470713198
Espie, C. A., Watkins, J., Curtice, L., Espie, A., Duncan, R., Ryan, J. A., … Sterrick, M. (2003). Psychopathology in people with epilepsy and intellectual disability; an investigation of potential explanatory variables. Journal of Neurology, Neurosurgery, and Psychiatry, 74(11), 1485–92. https://doi.org/10.1136/jnnp.74.11.1485
Fatemi, S. H., & Folsom, T. D. (2011). The role of fragile X mental retardation protein in major mental disorders. Neuropharmacology, 60(7–8), 1221–6. https://doi.org/10.1016/j.neuropharm.2010.11.011
Fletcher, R., Loschen, E., Stavrakaki, C., & First, M. (2007). Diagnostic Manual - Intellectual Disability (DM-ID). Kingston, NY: NADD press.
García González-Gordon, R. (2002). Adaptación espa-ola de la entrevista PAS-ADD. Una entrevista estandarizada. (R. García González-Gordon, Ed.) (1st ed.). Cadiz: UNIVERSIDAD DE CADIZ, S.PUBLICACIONES.
Haro, J. M., Palacín, C., Vilagut, G., Martínez, M., Bernal, M., Luque, I., … Grupo ESEMeD-Espa-a. (2006). [Prevalence of mental disorders and associated factors: results from the ESEMeD-Spain study]. Medicina Clínica, 126(12), 445–51. https://doi.org/10.1157/13086324
Jokiranta, E., Sourander, A., Suominen, A., Timonen-Soivio, L., Brown, A. S., & Sillanpää, M. (2014). Epilepsy among children and adolescents with autism spectrum disorders: a population-based study. Journal of Autism and Developmental Disorders, 44(10), 2547–57. https://doi.org/10.1007/s10803-014-2126-6
Koskentausta, T., Iivanainen, M., & Almqvist, F. (2007). Risk factors for psychiatric disturbance in children with intellectual disability. Journal of Intellectual Disability Research?: JIDR, 51(Pt 1), 43–53. https://doi.org/10.1111/j.1365-2788.2006.00871.x
Kozlowski, A. M., Matson, J. L., Sipes, M., Hattier, M. A., & Bamburg, J. W. (2011). The relationship between psychopathology symptom clusters and the presence of comorbid psychopathology in individuals with severe to profound intellectual disability. Research in Developmental Disabilities, 32(5), 1610–1614. https://doi.org/10.1016/j.ridd.2011.02.004
Matson, J. L., Gardner, W. I., Coe, D. A., & Sovner, R. (1991). A scale for evaluating emotional disorders in severely and profoundly mentally retarded persons. Development of the Diagnostic Assessment for the Severely Handicapped (DASH) scale. The British Journal of Psychiatry?: The Journal of Mental Science, 159, 404–9. https://doi.org/10.1192/bjp.159.3.404
Matsuura, M., Adachi, N., Muramatsu, R., Kato, M., Onuma, T., Okubo, Y., … Hara, T. (2005). Intellectual disability and psychotic disorders of adult epilepsy. Epilepsia, 46 Suppl 1, 11–4. https://doi.org/10.1111/j.0013-9580.2005.461004.x
Moss, S., Ibbotson, B., Prosser, H., Goldberg, D., Patel, P., & Simpson, N. (1997). Validity of the PAS-ADD for detecting psychiatric symptoms in adults with learning disability (mental retardation). Social Psychiatry and Psychiatric Epidemiology, 32(6), 344–54. https://doi.org/10.1007/BF00805440
Petry, K., Maes, B., & Vlaskamp, C. (2009). Measuring the quality of life of people with profound multiple disabilities using the QOL-PMD: First results. Research in Developmental Disabilities, 30(6), 1394–1405. https://doi.org/10.1016/j.ridd.2009.06.007
Psychiatrics, R. C. of. (2001). DC-LD. Diagnostic criteria for psychiatric disorders for usewith adults with learning disabilities/mental retardation. (The royal colleges of psychiatrics, Ed.) (1st ed.). London: Bristish Library Cataloguing-in-Publication Data.
Reiss, S., & Valenti-Hein, D. (1994). Development of a psychopathology rating scale for children with mental retardation. Journal of Consulting and Clinical Psychology, 62(1), 28–33. https://doi.org/10.1037/0022-006X.62.1.28
Rojahn, J., Matson, J. L., Naglieri, J. A., & Mayville, E. (2004). Relationships Between Psychiatric Conditions and Behavior Problems Among Adults With Mental Retardation. American Journal on Mental Retardation, 109(1), 21–33. https://doi.org/10.1352/0895-8017(2004)109<21:RBPCAB>2.0.CO;2
Rush, A. J., & Frances, A. (2000). Expert Consensus Guideline Series: Treatment of psychiatric and behavioral problems in mental retardation. American Journal of Mental Retardation AJMR, 105(3), 159–226.
Salvador-Carulla, L., & Novell-Alsina, R. (2002). Guía práctica de la evaluación psiquiátrica en el retraso mental (1st ed.). Madrid: Aula Medica ediciones.
Schalock, Robert L., Verdugo Alonso, M. A. (2002). Handbook on quality of life for human service practitioners. (D. L. Braddock, Ed.) (1st ed.). Washington DC: American Asociation on mental retardation.
Schmitz, B. (2005). Depression and mania in patients with epilepsy. Epilepsia, 46 Suppl 4, 45–9. https://doi.org/10.1111/j.1528-1167.2005.463009.x
Smith, K., Shah, A., Wright, K., & Lewis, G. (1995). The prevalence and costs of psychiatric disorders and learning disabilities. The British Journal of Psychiatry?: The Journal of Mental Science, 166(1), 9–18. https://doi.org/10.1192/bjp.166.1.9
Sperli, F., Rentsch, D., Despland, P. A., Foletti, G., Jallon, P., Picard, F., … Seeck, M. (2009). Psychiatric comorbidity in patients evaluated for chronic epilepsy: a differential role of the right hemisphere? European Neurology, 61(6), 350–7. https://doi.org/10.1159/000210547
Turygin, N., Matson, J. L., & Adams, H. (2014). Prevalence of co-occurring disorders in a sample of adults with mild and moderate intellectual disabilities who reside in a residential treatment setting. Research in Developmental Disabilities, 35(7), 1802–1808. https://doi.org/10.1016/j.ridd.2014.01.027
Vargas-Vargas, C., Rafanell, A., Montalvo, D., Estarlich, M., Pomarol-Clotet, E., & Sarró, S. (2014). Validity and reliability of the Spanish version of the diagnostic assessment for the severely handicapped (DASH-II). Research in Developmental Disabilities, 36C, 537–542.
Whitaker, S., & Read, S. (2006). The prevalence of psychiatric disorders among people with intellectual disabilities: An analysis of the literature. Journal of Applied Research in Intellectual Disabilities, 19(4), 330–345. https://doi.org/10.1111/j.1468-3148.2006.00293.x
World Health Organisation. (2004). ICD-10 guide for mental retardation. Mental Retardation, 82.
Peña Salazar, C., Arrufat Nebot, F., Fontanet, A., García-León, N., Más, S., Roura-Poch, P., & Santos López, J. M. (2017). El infradiagnóstico del trastorno mental en la población con discapacidad intelectual: estudio de prevalencia en población con diferentes grados de discapacidad intelectual. Siglo Cero, 48(3), 27–39. https://doi.org/10.14201/scero20174832739
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