#3861 ·
Kevin Nguyen3 said:It is quite fascinating, isn't it? In cases involving mild intellectual disabilities—or indeed any type of cognitive impairment—the standardized tests used to establish these diagnoses often fail to explain *why* a person isn't providing the expected response.
There lies a massive, insurmountable hurdle right there.
Adults living with moderate intellectual disabilities require specialized, dedicated care to ensure they can achieve a decent quality of life.
I find it somewhat unusual that they assigned that specific F-code; here in the States, we don't typically link intellectual disability directly to schizophrenia in that manner. Usually, it is associated with schizophreniform psychoses. That is the standard clinical recommendation.
F20.5 refers to residual schizophrenia.
A schizophreniform disorder is remarkably similar to schizophrenia, but the duration is shorter—lasting less than six months.
That might be the actual reason for the moderate intellectual disability diagnosis (meaning an IQ somewhere between 35 and 50).
I believe it is incredibly difficult to predict the trajectory—whether things will stabilize or slide toward a more severe impairment. I would even venture to guess that symptoms might fluctuate, appearing milder at times before potentially heading toward full remission.
Residual schizophrenia represents the chronic phase of the disease's development (think psychomotor slowing, passivity, loss of initiative, avoiding eye contact or conversation, and so on).
The answer is complex and, unfortunately, rather inconsistent. It might happen, or it might not. But more often than not... yes, it can.
Medication is absolutely critical; in most instances, it improves the symptoms or manages them entirely for a period of time.
Since she is older (I assume), she will likely be on this medication protocol for the rest of her life.
She is truly ill; her first psychiatric treatment dates back to 1989. The initial diagnosis was paranoid schizophrenia. After about a year, around 1990, it was changed to schizoaffective disorder, which remained her diagnosis until roughly six months ago, when her psychiatrist adjusted it to residual schizophrenia. Her condition took a sharp downturn about a year ago when her cycles stopped—that is, when she entered menopause. She is quiet, withdrawn, almost vacant; she doesn't really look after herself or maintain hygiene, and honestly, she doesn't seem fully aware of how serious her illness is. She doesn't cry, and she can't even laugh. I recently tried teaching her how to smile; I would give anything just to see her smile once, but she simply doesn't know how. It is hard for outsiders to grasp, but she is very sick. It is heartbreaking because I remember her being such a different person, but sadly, that person is gone. I can't even reach her anymore, despite my best efforts. I try to engage her by recounting beautiful memories from the past, but she listens and then it's as if they vanish instantly from her mind, or she just offers a hollow "uh-huh," or says she can't remember. We aren't expecting much improvement; we just hope things don't get worse. Following her hospital stay, we were advised to contact Social Services to arrange for a legal guardian, either one of us or someone appointed by the state.
