Degrees of oligophrenia: general and specific features

Anomalies of mental development belong to the category of pathologies which, when detected, require establishing the level of the patient's cognitive abilities and determining the state of his psyche. For this purpose, psychiatry uses a gradation of feeblemindedness and the degree of oligophrenia, determined by the general and specific features of the varieties of this pathological condition.

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Degrees of severity of oligophrenia

How are the degrees of mental retardation determined? Based on examination: testing the development of intelligence (including thinking, memory and speech), assessing the level and characteristics of motor activity (coordination of movements, range of fine motor skills), studying the patient's emotional and volitional characteristics and related behavioral reactions, etc.

These examinations allow us to make preliminary conclusions about the localization of damage to brain structures. For example, in case of speech disorders in right-handed people, the defect may be in the left hemisphere (in the lower frontal, lower parietal lobe or thalamus). Measurement of brain activity (encephalography) and computed tomography of the brain help to confirm or refute the assumption.

In addition to speech underdevelopment (limited vocabulary and inability to explain the meaning of simple words), oligophrenia to the degree of debility or oligophrenia of the 1st degree is manifested by:

• delayed physical development (compared to age norms);
• disorder of abstract thinking and imagination (patients have a concrete and descriptive type of thinking);
• low ability to remember and instability of attention;
• fragmentation of the general perception of the environment;
• suggestibility, lack of purposefulness and various disorders in the expression of emotions.

This is the mildest degree of oligophrenia, in which the average IQ (level of intellectual development) is from 50 to 69 points.

Next comes oligophrenia of the 2nd degree (moderate or moderate severity), defined in psychiatry as oligophrenia in the degree of imbecility. At this degree of mental retardation, the following are noted:

• severe retardation in intellectual development (IQ at the level of 20-49);
• speech underdevelopment (short simple phrases or lack of phrasal speech, use of gestures);
• understanding of speech that is simple in content;
• significant memory impairment, complete lack of cognitive interests;
• significant delay in physical development (children start walking late, coordination of movements is impaired);
• difficulties in self-care and performing simple actions;
• absence or weakening of will;
• underdevelopment or absence of higher emotions;
• emotional instability, affective disorders, psychosis.

Oligophrenia to the degree of idiocy, according to the classical systematization of this pathology, which is rarely used today, is oligophrenia of the 3rd degree, in which disturbances in the development of the brain and central nervous system are total and are expressed by:

• in the absence of conscious thinking and rational speech;
• in complete detachment from the surrounding world (inability to recognize objects and people, including their relatives); in absolute lag of children in physical development;
• in difficulties or complete inability to perform purposeful actions (hold a spoon, cup, etc.), lack of coordination of movements, disordered reflexive gesticulation (or complete immobility).

Idiocy is the most severe degree of oligophrenia, caused by gross defects of many structures of the brain. Intelligence is developed within 0-20, and patients are not able to exist without constant care.

It should be noted that, regardless of the severity of oligophrenia, the diagnosis of oligophrenia is never formulated at birth, even in the case of Down syndrome. This is done upon reaching 18 months. If there are alarming signs of mental retardation (for example, changes in the size and proportions of the body, body functions, sluggish reflexes, etc.), then the doctor indicates the presence of perinatal encephalopathy in the medical history.