ABSTRACT
The change from "mental retardation" to "intellectual disability" (ID) in the new version of the DSM-5 aims not only to eliminate stigmatization but also to modify diagnostic criteria. The IQ is no longer preeminent for defining ID or its severity, relying instead on broader clinical criteria and neuropsychological evaluation. More relevance is given to the evaluation of the individuals performance on daily life. This perspective addresses the concerns raised since the 1990s by organizations representing professionals and patients and their families. To better understand these changes we reviewed the definitions and criteria of previous DSM editions. The adoption of the alternative denomination of the "intellectual developmental disorder" is compatible with the ICD-11 to be released in 2015. This guideline was based on the recommendation of the working group for the classification of the intellectual disabilities.
Subject(s)
Intellectual Disability , Intellectual Disability/diagnosis , Humans , Diagnostic and Statistical Manual of Mental Disorders , Terminology as TopicABSTRACT
Los trastornos del desarrollo intelectual (TDI) son un grupo de alteraciones del desarrollo caracterizadas por una notable limitación de las funciones cognitivas, trastornos del aprendizaje y de las habilidades y conductas adaptativas. Anteriormente agrupados bajo el término discapacidad intelectual, constituyen un problema poco estudiado y cuantificado en América Latina. Los afectados están ausentes en las políticas públicas y no se benefician de las estrategias gubernamentales de desarrollo social y reducción de la pobreza. En este artículo se aporta una visión crítica de los TDI y se describe una nueva taxonomía. Además, se propone reconocerlos como problema de salud pública, promover la profesionalización de la atención, y sugerir una agenda de investigación y acción regional. En América Latina no hay consenso sobre los criterios diagnósticos de los TDI. Pocos programas de rehabilitación cubren una proporción importante de las personas que los padecen, no se ofrecen servicios basados en la evidencia científica y las directrices de atención no se han evaluado. Los manuales de diagnóstico psiquiátrico conceden más importancia a la identificación de los TDI graves, favorecen su subregistro y clasificaciones erróneas. Su estudio no se ha priorizado desde las perspectivas jurídica, de las ciencias sociales y de la salud pública. Por ello escasean las pruebas científicas sobre estos trastornos. Faltan competencias específicas y profesionalización para el cuidado de estas personas y es indispensable realizar intervenciones de prevención, rehabilitación, integración comunitaria e inclusión laboral.
Intellectual development disorders (IDDs) are a set of development disorders characterized by significantly limited cognitive functioning, learning disorders, and disorders related to adaptive skills and behavior. Previously grouped under the term "intellectual disability," this problem has not been widely studied or quantified in Latin America. Those affected are absent from public policy and do not benefit from government social development and poverty reduction strategies. This article offers a critical look at IDDs and describes a new taxonomy; it also proposes recognizing IDDs as a public health issue and promoting the professionalization of care, and suggests an agenda for research and regional action. In Latin America there is no consensus on the diagnostic criteria for IDDs. A small number of rehabilitation programs cover a significant proportion of the people who suffer from IDDs, evidence-based services are not offered, and health care guidelines have not been evaluated. Manuals on psychiatric diagnosis focus heavily on identifying serious IDDs and contribute to underreporting and erroneous classification. The study of these disorders has not been a legal, social science, or public health priority, resulting in a dearth of scientific evidence on them. Specific competencies and professionalization of care for these persons are needed, and interventions must be carried out with a view to prevention, rehabilitation, community integration, and inclusion in the work force.