PSYCHIATRIC MORBIDITY AMONG SEXUALLY ABUSED CHILDREN AND ADOLESCENTS

Objectives: To describe the social demographic profile and identify psychiatric morbidity in sexually abused children and adolescents.Design: A Cross-sectional descriptive survey.Setting: Nairobi WomenÕs Hospital (NWH) Gender Violence Recovery Centre (GVRC),Hurlingham, Nairobi- Kenya.Subjects: A sample of 61 sexually abused children and adolescents aged 7-17 years.Results: Eighty two percent of the survivors were sexually abused by acquaintances such as neighbours, caregivers and parents. Ninety percent of the sampled group were females. Abuse occurred in both single and both parent families and regardless of the guardian/ parental economic status. Sixty six percent of the survivorsÕ parents were abusing psychoactive substances. Sexual abuse variables and most of the social demographic variables did not predict either presence or absence of psychiatricmorbidity. Only 66% of the abuse came to the notice of the childÕs caregiver within the first 48 hours. On the socio demographic profile, the only factor that showed a statistical significant difference in predicting presence or absence of psychiatric morbidity was the familyÕs way of sorting out their disagreements (p = 0.045). The prevalence of psychiatric morbidity among the subjects studied as measured by the Diagnostic Statistical Manual Text Revision (DSM IV-TR) was found to be 69%. Eight different types of DSM IV- TR diagnoses were made. Twenty nine percent of the AXISI DSMIV-TR diagnoses were co-morbidities (Multiple DSM IV- TR diagnoses).Conclusions: The psychiatric morbidity prevalence is comparable to that found in other studies. Sexual abuse occurred regardless of the social demographic variables. FamilyÕs way of sorting out disagreement predicted presence or absence of psychiatric morbidity among the study subjects. Majority (82%) of the sexual abusers were acquaintances to the study subjects.Recommendations: It is recommended that all children and adolescents who have been sexually abused be evaluated for psychiatric morbidity regardless of their social demographic and abuse profiles and that all parents and care givers, be sensitised on childhood sexual abuse and the fact that majority of the perpetrators are acquaintances to the subjects. Families need to be sensitised on their role on prevention and reductionof psychiatric morbidity among children and adolescents in general

PSYCHIATRIC MORBIDITY AMONG CHILDREN AND YOUNG PERSONS APPEARING IN THE NAIROBI JUVENILE COURT, KENYA

ABSTRACTObjectives: To estimate the prevalence and pattern of psychiatric disorders amongchildren and young persons appearing in the Nairobi juvenile court, Kenya.Design: A point prevalence survey.Setting: The Nairobi Juvenile Court, Kenya.Subjects: Ninety (sixty-four males and twenty-six females) children and young personsaged 8 to 18 years classified as criminal offenders, group I (60), and those for protectionand discipline, group II (30), were selected.Method: A socio-demographic questionnaire, reporting questionnaire for children (RQC),follow-up interview for children (FIC), present state examination (PSE) and clinicalinterview were administered to the subjects. International Classification of Diseases, 10thEdition (ICD-10) diagnostic criteria were used.Results: The crude psychiatric morbidity (CPM) rate was 44.4%. ICD-10 documentedpsychiatric disorders detected in those with CPM were conduct disorders 45%, mixeddisorders of conduct and emotion 20%, emotional disorders with onset specific tochildhood 20%, mood disorders 12.5% and hyperkinetic disorders 2.5%.Conclusion: This study has shown a high presence of psychiatric morbidity in childrenand young persons appearing in the Nairobi Juvenile Court. These juveniles need andwould benefit from mental treatment as recommended in section 18 of Cap 141 of thelaws of Kenya; The Children’s and Young Persons Act

PREVALENCE OF TARDIVE DYSKINESIA AMONG PSYCHIATRIC IN-PATIENTS AT MATHARI HOSPITAL, NAIROBI

Objective: To determine the prevalence of tardive dyskinesia among psychiatricin-patients.Design: A cross-sectional survey.Setting: Mathari Hospital, Nairobi, the main psychiatric referral hospital in Kenya.Subjects: Two hundred and two randomly selected in-patients seen in the hospitalbetween January and April 2000.Results: The prevalence of tardive dyskinesia was 11.9%. Neither the psychiatricdiagnosis nor the sex was significantly associated with tardive dyskinesia. The antipsychoticdosage was also not associated with tardive dyskinesia but an increase in age wassignificantly associated with the abnormal movements.Conclusion: The prevalence rate of tardive dyskinesia among patients at MathariHospital is much lower than that found in western countries but similar to that fromAsian studies. These findings indicate the possibility of racial differences in the aetiologyof TD. Prospective cross- racial studies are necessary to confirm these findings

Psychiatric morbidity among children and young persons appearing in the Nairobi Juvenile Court, Kenya

Objectives: To estimate the prevalence and pattern of psychiatric disorders among children and young persons appearing in the Nairobi juvenile court, Kenya. Design: A point prevalence survey. Setting: The Nairobi Juvenile Court, Kenya. Subjects: Ninety (sixty-four males and twenty-six females) children and young persons aged 8 to 18 years classified as criminal offenders, group I (60), and those for protection and discipline, group II (30), were selected. Method: A socio-demographic questionnaire, reporting questionnaire for children (RQC), follow-up interview for children (FIC), present state examination (PSE) and clinical interview were administered to the subjects. International Classification of Diseases, 10th Edition (ICD-10) diagnostic criteria were used. Results: The crude psychiatric morbidity (CPM) rate was 44.4%. ICD-10 documented psychiatric disorders detected in those with CPM were conduct disorders 45%, mixed disorders of conduct and emotion 20%, emotional disorders with onset specific to childhod 20%, mood disorders 12.5% and hyperkinetic disorders 2.5%. Conclusion: This study has shown a high presence of psychiatric morbidity in children and young persons appearing in the Nairobi Juvenile Court. These juveniles need and would benefit from mental treatment as recommended in section 18 of Cap 141 of the laws of Kenya; The Children\'s and Young Persons Act. (East African Medical Journal: 2003 80(6): 282-288