Abstract
BackgroundThere is dearth of data on the level of functional impairment and risk factors for psychiatric morbidity in children attending primary care services in developing countries like Nigeria. The risk factors for psychiatric morbidity and functional impairment in children attending the primary care unit of a teaching hospital in Ilorin, Nigeria was therefore investigated to obtain data that could be used in improving service provision by primary care physicians.MethodsA cross-sectional two-stage design was employed for the study. The first stage involved administration of the Child Behavior Questionnaire (CBQ) to 350 children while the children’s version of the schedule for affective disorders and schizophrenia was used for the second stage involving 157 children, all high scorers on CBQ (score of ≥ 7) and 30% of low scorers (score < 7). Diagnosis of psychiatric disorders was based on DSM-IV criteria.In addition, the Children Global Assessment Scale was used to assess the functional status of the children (score of ≤ 70 indicates functional impairment) while the mothers’ mental health status was assessed with the 12-item version of the General Health Questionnaire, a score of 3 or more on this instrument indicate presence of mental morbidity.ResultsIt was observed that 11.4% of the children had diagnosable psychiatric disorders and 7.1% were functionally impaired; and those with psychiatric disorders were more functionally impaired than those without. Thus, significant negative correlation was noted between CBQ scores and CGAS (r = 0.53; p < 0.001). Following logistic regression, younger age of children, frequent hospital attendance and maternal parenting distress independently predicted psychiatric morbidity while child psychopathology and maternal parenting distress predicted functional impairment.ConclusionsChild psychiatric disorders are prevalent in the primary care unit studied. Many of the risk factors identified in the study population are modifiable. Collaborative efforts between psychiatrists and primary care physicians could therefore help to reduce level of risk and functional impairment and psychiatric morbidity among children attending the primary care unit studied. It could also help improve referral rates of difficult cases to the child and adolescent psychiatric unit of the hospital.
Highlights
There is dearth of data on the level of functional impairment and risk factors for psychiatric morbidity in children attending primary care services in developing countries like Nigeria
Child psychiatric disorders are prevalent in primary care and undetected, and many of the affected children may be functionally impaired
Identification of risk factors of functional impairment and psychiatric morbidity in children would assist in formulating preventive strategies
Summary
There is dearth of data on the level of functional impairment and risk factors for psychiatric morbidity in children attending primary care services in developing countries like Nigeria. Risk factors increase the chances of onset of psychiatric disorders, and when already present, of its worsening and perpetuation or chronicity. Protective factors such as, high self esteem, problem-solving and social skills, positive thinking, good physical health, educational opportunities and positive parenting and availability of social support systems, as examples are capable of modifying individual response to psychosocial stress [1,2]. Knowing the most important risk factors may increase the frequency of detection at the clinic level but may serve preventive purpose in public health especially where they are modifiable [1]
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