[Changes in the concept of minimal brain dysfunction in modern diagnostic classification and its manifestation in our...

The purpose of the investigation was to give an account of changes in the concept of minimal brain dysfunction and deduce certain recommendations for professional and social practice. The authors describe the development of consensus regarding the problem of impaired activities and behaviour during childhood based on probable damage of the central nervous system. Analysis of the 8th, 9th and 10th decennial revision of the International Classification of Diseases and DSM III revealed a trend of increasing specification of clinical entities included in the complex of minimal brain dysfunctions. Diagnostic systems are focused on syndromological classification according to specific functions, reduced or impaired by the disorder. Contemporary diagnosis is to an increasing extent based on behavioural signs disorders. The analogous development in Czechoslovak practice is demonstrated on frequency analysis of articles in professional periodicals. It is apparent that social needs emphasize in particular early diagnosis of disorders of school skills. The result of the analysis is evidence of continuous overlapping of specific diagnostic units based on common symptoms (such as mental retardation, developmental disorders, hyperkinetic disorders and behavioural disorders). The authors discuss the problem of comorbidity of the complex of minimal brain dysfunctions and recommend provisions in diagnostic practice. Hypothetically pathogenetic models of the outcome of actual forms of different brain dysfunctions into specific risks or disorders in adult age are proposed.