Abstract
Objective:Association between Intellectual disability (ID) and psychiatric disorders in children & adolescents is well established but there is a paucity of published studies from Pakistan on this topic. The main aim of the study was to assess the frequency of ICD-10 psychiatric diagnosis in the hospital outpatient sample of children with ID in Lahore, Pakistan as well as to find out which challenging behaviors, caregivers find difficult to manage in this setup.Methods:Socio-demographic information was collected, Wechsler Intelligence Scale for Children-Revised & ICD-10 diagnostic criteria was used to assess children (age range 6 – 16 years) with suspected ID along with identification of behaviors found to be difficult to manage by caregivers.Results:150 children were assessed with mean age of 10.7 years (males 70 %). Majority (72%) had mild ID while 18.7% and 9.3% had moderate and severe ID respectively. Thirty percent of children met the criteria for any psychiatric diagnosis, the most common being Oppositional Defiant Disorder (14%) and Hyperkinetic Disorders (10%). Verbal and physical aggression, school difficulties, socialization problems, inappropriate behaviors (e.g. disinhibition), sleep & feeding difficulties were the significant areas identified by the caregivers as a cause of major concern.Conclusions:Significantly high prevalence of ICD-10 psychiatric diagnosis in children with ID was found in Lahore, Pakistan. Support services for these children should be responsive not only to the needs of the child, but also to the needs of the family.
Highlights
Children & Adolescents with Intellectual Disability (ID) have high rates of mental health problems and behavioral difficulties
The study showed a high proportion of psychiatric diagnosis (30%) in our sample of children with ID, the results being consistent with previous literature reporting variable but consistently higher prevalence of psychopathology in this group.[1,12,13,14,15]
Overall studies have concluded that children with ID have at least three fold increased risk of significant psychopathology in comparison to children without ID.[14]
Summary
Children & Adolescents with Intellectual Disability (ID) have high rates of mental health problems and behavioral difficulties. Sensory disabilities, epilepsy, physical illness, medications, limited coping strategies have been identified as some of the predisposing factors for mental health problems in this group.[7] These children with various accompanying diagnosis poses many diagnostic and therapeutic challenges as the needs for adequate mental health services for these children largely remains unmet. These psychiatric disorders can further lead to deterioration in the functioning capacity of these children
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