Psychiatric profile of physically ill pediatric patients

Abstract

Background Mental health is an important component of overall health and mental disorders that can cause suffering, disability, and, rarely, even death. Pediatric-psychiatric liaison programs have evolved to enable the staff pediatricians to receive adequate training to assess emotional, behavioral, and family problems that may be an integral part of the patient's symptoms. Objectives The aim of the current study is to assess the prevalence of psychiatric symptoms among physically ill children ranging in age from 16 to 18 years attending the pediatric outpatient clinic in Beni Suef University Hospital and to compare the differences in psychiatric symptoms in relation to sex and the nature of physical illness among these patients. Participants and methods This survey study is a cross-sectional, observational, and comparative study. The study was carried out in the Pediatric outpatient clinic of Beni Suef University Hospital. A random sample of 300 Egyptian children with acute and chronic illness aged between 6 and 18 years, fulfilling the inclusion and exclusion criteria, participated in this study over an 8-month duration starting from May 2011 to December 2011. All participants of the study, both patients and informants, were subjected to a screening test using 'the Child Behavior Checklist for ages 6-18,' and intelligence quotient (IQ) was assessed for all sharing patients using the 'Stanford-Binet Intelligence Scale.' Results One hundred and seventy (56.7%) of the 300 selected patients were females and 130 (43.3%) were males; 260 of these patients attended regular schools. Out of the total number of patients, 155 (51.67%) presented with acute illness, whereas 145 (48.33%) had chronic illnesses. The mean IQ score was 79.8 ± 15.2 and only 22.3% of the sample (67 patients) had an 'average' IQ. Sex-based comparison of IQ results showed that female patients had significantly higher IQ scores (82.2 ± 13.6 with P = 0.035). However, Child Behavior Checklist 6-18 scores showed that 223 out of 300 patients had diagnosable Internalizing disorders with internalizing T -scores above 70; 118 (52.9%) of these were females compared with 105(47.1%) males, with a statistically significant difference ( P = 0.026). Meanwhile, 203 patients had diagnosable externalizing disorders with externalizing T -scores above 70; 104 (51.2%) of these were females. IQ scores differed significantly, being higher in acute illnesses (82.3 ± 13.6 vs. 77.8 ± 15.9 and P = 0.025). Another significant difference between patients with acute illnesses and those with chronic illnesses was clear in the internalizing T -score and the externalizing T- score (higher in acute illnesses, P = 0.028 and 0.034, respectively). Conclusion The current status of psychiatric problems in pediatric physically ill patients calls for mandatory cooperation in pediatric consultation-liaison services in the Beni Suef Governorate.