Problems of Child Psychiatry in Low Income Countries

Abstract

Introduction:

Children and adolescents make up one third of the world's population. Neuropsychiatric disorders are the most prevalent cause of health burden in this age group and are estimated to effect 10 to 20 per cent of children worldwide. Little is known about the prevalence of child psychiatric morbidities and associated risk factors in countries like Pakistan.

Method:

This is a prospective cross sectional study of 300 participants aged 6 to 18 years. Participants were recruited from a general psychiatric outpatient department over 12 weeks in Lahore, Pakistan. Information was collected on presenting complaints, possible risk factors and mental health disorders using the strengths and difficulties (SDQ) questionnaire.

Results:

Our preliminary results show that frequently reported presenting complaint were fits and alterations in consciousness (54%), disturbed behaviour (14%) and depressive symptoms (8.3%). The most frequent mental health disorder on SDQ was hyperactivity, followed by conduct. Emotional problems were least commonly reported. Male participants scored higher for conduct disorder. A history of epilepsy was reported by 35.3% of participants. Low socio economic status, low educational achievement and nuclear family setup were associated with higher rates of illness.

Conclusion:

Our results show that fits and alterations in consciousness was the most frequently reported presenting complaint. Hyperactivity was most prevalent followed by conduct. The majority of child and adolescent patients attend general practitioners or general psychiatry out-patient departments. They are managed by practitioners who lack adequate training. Training these clinicians would help utilisation of limited resources.