DSM-III diagnoses compared with factor structure of the psychopathology instrument for mentally retarded adults (PIMRA), in an institutionalized, mostly severely retarded population.

Researchers gave the PIMRA checklist to the adults living in a state institution. Most residents had severe or profound intellectual disability.

They compared each person’s PIMRA scores with the official DSM-III psychiatric diagnosis. A computer looked for patterns in the answers.

Nine clear groups of symptoms showed up in the numbers. The PIMRA matched the DSM label 69 % of the time. Agreement was moderate (kappa = 0.62).

Freeman et al. (2015) later found the same moderate agreement when they compared Mini-PASADD and BSI. Both studies show informant screens catch most cases but miss some.

Weiss et al. (2001) and Rojahn et al. (2012) moved the field toward shorter tools. Their BPI-01 and BPI-S focus on behavior, not mental illness, and give even stronger numbers.

Sappok et al. (2013) tested autism tools in the same ID adults. They saw mixed results, reminding us one size does not fit all diagnoses.

You can use the PIMRA as a quick first pass when you suspect psychiatric illness in non-verbal adults. It will flag about seven out of ten true cases. Always follow a positive screen with a full clinical interview, because three out of ten will still need deeper checking.