Psychiatric disorders in children and adolescents with mental retardation and developmental disabilities

Children and adolescents with mental retardation and developmental disabilities are thriving in their communities owing to special education programs that provide full inclusion in school and community life. Many youngsters, however, do not reach their full potential because of the limitations imposed by untreated psychiatric disorders. Although striking behavioral symptoms may be present, care providers often mistake them for typical aberrant behavior associated with developmental disabilities. When this occurs, these children do not receive proper psychiatric care and may suffer restrictive behavioral programming and exclusion from community living. On the other hand, children and adolescents with mental retardation and developmental disabilities frequently present with unusual symptoms associated with psychotic disorders, leading to misdiagnosis and inappropriate treatment with antipsychotic agents. The problems due to stress on these children and their families, long-terms costs in loss of educational and vocational opportunities, and the development of serious adult psychiatric disorders are enormous. By exploring the risk factors for psychiatric diagnosis in this population and presenting illustrative cases, awareness of the indicators for pediatric practice with this population is provided in this review.