[Attention deficit hyperactivity disorder and mental retardation].
BACKGROUND
Attention deficit hyperactivity disorder (ADHD) is a common condition in children with mental retardation (MR), with a prevalence rate of between 4 and 15%. It is therefore necessary to examine the epidemiological characteristics of neurodevelopmental disorders in patients with MR, evaluate diagnostic protocols and especially update the pharmacological treatment of ADHD in children with MR.


METHODS
The study of ADHD in patients with mild mental retardation is no different to that carried out in children without MR. No neuropsychological instruments are available to measure the executive functions properly in patients with severe mental retardation. Neuroleptic and psychostimulant agents are the two groups of drugs that are most commonly used to treat behavioural problems in children with MR. Methylphenidate is effective in three quarters of the children with MR at preschool ages. It has proved to be effective in the clinical profiles and in psychometric studies. Other forms of treatment, such as clonidine or fenfluramine, have also proved to be effective to a certain extent in patients with MR, especially in the clinical setting.


CONCLUSIONS
ADHD is more frequent in patients with MR than in the general population. The diagnostic methodology is usually the same as that used in patients without MR. Stimulation treatment is the most specifically indicated for the treatment of attentional and behavioural problems in these children.
Servicio de Neuropediatría, Hospital La Zarzuela, Madrid, España. aferjaen@telefonica.net
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Fernandez-Jaen
D001289:Attention Deficit Disorder with Hyperactivity / Q000150:complications* / Q000175:diagnosis / Q000628:therapy; D002648:Child; D006801:Humans; D008607:Intellectual Disability / Q000150:complications*