Emotional illness in a paediatric population in Nigeria

Abstract

In a survey of 500 children aged between 5-15 years in a small rural community in Nigeria, 15.0% were found to suffer from mental morbidity. Disturbances of emotion and conduct disorder constituted 66.7% of total morbidity detected. Children from disrupted families (due to divorce, separation and widowhood) were found to be significantly more likely to suffer from psychiatric morbidity. The need to train primary health care worker and for them to work closely with families and school teachers in the provision of community mental health care services for children in the rural communities of developing countries was emphasized.

PIP: 500 children aged between 5 and 15 years were randomly screened from all the compounds in Esie, a small rural community in Nigeria during a survey of the adult population. A 2-stage design was employed for the assessment of psychiatric morbidity. The 1st stage involved the use of the Reporting Questionnaire for children (containing 10 items) which was developed during the WHO study on strategies for extending mental health care in developing countries. The questionnaire was administered by 4 research assistants who also collected basic sociodemographic information on each child (age, sex, education, marital status, and occupation of parents/guardians). The Rutter's Teacher scale (containing 26 items and widely used in previous studies in Africa) was later distributed to the various schools for completion by 200 respondents who were interviewed by the research psychiatrist using the Follow-up Interview for Children (FIC), a semistructured interview schedule developed during the WHO study. Based on this assessment, diagnoses were assigned in accordance with the International Classification of Disease (ICD-9) criteria. 274 (54.8%) of the children screened were aged 5-10 years, while the remaining 226 (45.2%) were aged 11-15 years. There were 277 (55.4%) females and 223 (44.6%) males. 440 (88.0%) children were enrolled in various educational institutions. 358 (71.6%) of the children lived with their parents, while 142 (28.4%) lived with other relatives. Most of the parents/guardians were married (89.4%), while 53 (10.6%) were either widowed, separated, or divorced. The overall prevalence of psychiatric morbidity was found to be 15.0%. The psychiatric diagnoses of the 30 cases identified were described. Emotional and behavioral disorders constituted 66.7% of identified psychiatric cases. It was ascertained that significantly more of the children with psychiatric morbidity (56.7%) came from families disrupted by separation, divorce, or widowhood (p 0.05).