scholarly journals Pattern of psychiatric morbidity in children and adolescents attending Psychiatric OPD at a tertiary care hospital: A study from Midwestern Nepal

2018 ◽  
Vol 6 (1) ◽  
pp. 44-47
Author(s):  
TA Khan

Introduction: Mental health in child and adolescent is an essential component of overall health. Forty four percent of population in Nepal is under 19 years of age. Majority of lifetime psychiatric illnesses start during child and adolescent stage. Undetected poor mental health has wide range of adverse impact on individual's ability in various domains of achievement. This study is done with the objective to know the pattern of psychiatric morbidity in children and adolescents from a tertiary care hospital.Material and Method: This is a descriptive study comprised of all new cases i.e. 156 participants of child and adolescents visiting to psychiatric outpatients department of Nepalgunj Medical College, Nepalgunj, from January 2017 to June 2017. Socio-demographic data and clinical diagnosis based on International Classification of Disease- 10 diagnostic research criteria were collected and analyzed.Results: Out of 156 subjects studied, 2/3rd were female. The highest (57.06%) number of participants were from age group of 16 year to 18 years. Most common diagnosis was dissociative disorder in 24.35% followed by seizure disorder in 15.38% and mood disorder in 14.75% of participants.Conclusion: Adolescent female were most commonly affected population. Dissociative disorder was the most common psychiatric morbidity followed by seizure disorder and mood disorder.J Psychiatrists’ Association of Nepal Vol .6(1), 2017, p.44-47

Author(s):  
Sarada Prasanna Swain ◽  
Manoj Kumar Dash ◽  
Jigyansha Ipsita Pattnaik ◽  
Neelamadhab Rath

Background: The security personnel of our country including Army Personnel, C.I.S.F., Police and other security personnel bear a large amount of physical and psychological stress to maintain law and order situations at different corners of the country at different situations. To assess the Psychiatric Morbidity in C.I.S.F., the course of referrals of Para-military persons to a tertiary care hospital and to evaluate the Mental Health burden in the Para-military set up by virtue of their occupation. Methods: The study sample included all the consecutive patients referred by CISF Headquarters Hospital to the Mental Health Institute (MHI), S.C.B. Medical College, Cuttack, Odisha, from April 2015 to March 2016. The clinical information is collected from the patient and accompanying personnel from CISF or family members who accompanied the patient. The diagnosis is based on ICD-10 and the final opinion is given by the consultants of Psychiatry after final evaluation of all the reports. Results: Psychiatric assessment for job fitness (48%) was the dominant cause for referral of PMF staff to MHI. Substance abuse (alcohol) related disorders were the next common cause of referral (20%).Conclusions: Mental health burden in Para-military bases are substantial which should be taken care of in urgency basis. There is urgent need of posting of Psychiatrists with Clinical Psychologists and Psychiatric Social Worker or a team of the Mental Health Professionals should visit the paramilitary set ups regularly to look into improper diagnosis and review cases. 


2016 ◽  
Vol 07 (02) ◽  
pp. 238-243 ◽  
Author(s):  
Rajeev Ranjan ◽  
Manju Mehta ◽  
Rajesh Sagar ◽  
Siddharth Sarkar

ABSTRACT Background and Aims: Although it has been suggested that children and adolescents with dissociative disorder have some cognitive deficits, the association of these cognitive impairments with adjustment difficulties has not been evaluated. The present study aimed to assess the relationship between cognitive functioning and adjustment difficulties in children and adolescents with dissociative disorder. Methods: This cross-sectional, descriptive assessment was carried out in the outpatient setting of child and adolescent psychiatric service in a tertiary care hospital. Fifty newly diagnosed children and adolescents with dissociative disorder were included. The cognitive functions were assessed by varied neuropsychological tests, and Bell’s adjustment inventory was used for assessing various domains of adjustment. Results: The mean age of the sample which comprised 40% males was 13.0 (±2.4) years. The mean intelligence quotient (IQ) of the sample was 90.6. Impairment in cognitive test was maximum for verbal working memory followed by sustained attention, visual learning and memory, and verbal retention and recall. Adjustment difficulties were greatest in the domains of self, followed by domains of health, school, and family. Significant association was found between the IQ and adjustment in school; visual learning and memory and adjustments in school and overall adjustment; and sustained attention and adjustment of health. Conclusions: Dissociative children have poor cognitive ability which may be related to poor adjustment scores.


2010 ◽  
Vol 30 (2) ◽  
pp. 79-84 ◽  
Author(s):  
Dhana Ratna Shakya

Background: Psychiatric morbidity is ubiquitous, affecting children, adolescents and adults. Age factorsplay a great role in pattern of morbidity profile. Psychiatric morbidity profile of children and adolescentsmay indicate different needs and priorities. Objective: This study aims to sort out referral pattern, attitudeabout psychiatric referral and morbidity profile among child and adolescent psychiatric out-patients in atertiary-care general hospital. Methodology: A total of 100 consecutive child and adolescent patientsin psychiatry OPD coming into contact with investigator psychiatrist were enrolled during the studyperiod. Diagnoses were made according to the ICD-10. Results: Fifty three of the subjects were female,majority of the cases (79) were of age between 13-18 years. Main ethnicity-caste groups seeking carewere Mongol, Brahmin, Chhetri and indigenous Terai tribes. People from semi-urban and urban settingspredominated in this study. Great majority (more than 80%) had reached this service in the 4th or in morethan the 4th step of their help seeking. Most of the subjects were comfortable and happy about psychiatricreferral. More than half had presented mainly with physical and somatic complaints. Major psychiatricdiagnoses encountered were mood (affective), anxiety, seizure, dissociative conversion disorders andmental retardation. Four percent of subjects had suicidal behaviours and 17% migraine headache.Conclusion: Common psychiatric diagnoses among these child and adolescent out-patients are mood,anxiety, seizure, dissociative conversion disorders and mental retardation.Key words: Attitude to psychiatric consultation; child and adolescent; out-patient; psychiatric morbidityDOI: 10.3126/jnps.v30i2.2604J. Nepal Paediatr. Soc. May-August, 2010 Vol 30(2) 79-84


2012 ◽  
Vol 8 (4) ◽  
pp. 375-381 ◽  
Author(s):  
A Risal ◽  
P P Sharma

Background A variety of psychiatric manifestations can be seen in children below the age of 18 years. Such cases rarely present directly to psychiatric care. Methods Retrospective study in Tertiary care hospital . The study population included all the patients of paediatric age group presenting to Psychiatry Outpatient Department of Dhulikhel Hospital directly or referred by a paediatrician or other specialists from October 2008 to October 2010. Results Among the paediatric population evaluated in the psychiatry clinic for two years from October 2008 to October 2010 (N=168), 66.7% were in the age group 15-18 years {mean = 14.77 (±2.99)}, 71.4% were female and 42.3% belonged to Brahmin cast. The highest number of (15%) patients was seen during the month of August 2010. Six months analysis of the psychiatric illnesses of the patients from April 2010 up to October 2010 (n=80) showed dissociative disorder (15%), and seizure disorder (15%) to be the most common diagnoses, followed by depressive disorder and intentional self harm (ISH) (13.8% each). 15% of patients were found to be treated by magico-religious means, with the majority of patients (66.7%) diagnosed as having dissociative disorder. Conclusion The majority of the paediatric population presenting to a psychiatry clinic were in the age group 15-18 years and of female sex. Dissociative disorder was the most common diagnosis followed by depressive disorders. The majority of patients with dissociative disorder had previously been treated by magico-religious means.http://dx.doi.org/10.3126/kumj.v8i4.6235 Kathmandu Univ Med J 2010;8(4):375-81


2016 ◽  
Vol 1 (1) ◽  
Author(s):  
S. K. Sharma ◽  
V. P. Shrotriya ◽  
D. Imtiaz ◽  
S. B. Gupta

<bold>Introduction:</bold> Perceived Health is a subjective assessment of the physical as well as mental health and includes so many aspects as mentioned in SF-36 form that are difficult to capture clinically such as incipient disease, physiological, psychological reserves and social functions. To assess the impact of Diabetes Mellitus, Hypertension and other socio-demographic factors on the Social Functioning component of mental health of the patients attending a tertiary care hospital in Bareilly. <bold>Material and Methods:</bold> Perceived health status of the patients was assessed by the Social Functioning dimension of the Mental Component Summary (MCS) using the SF-36 form. <bold>Results:</bold> The presence of both Diabetes Mellitus and Hypertension was associated with lower Social Functioning scores compared to those with diabetes (p = 0.013) and hypertension alone. Age was negatively related with Social Functioning scores (p<0.001) but male gender (p>0.000) and higher income (p<0.424) were all associated with higher Social Functioning scores. Rural subjects were found to have better SF score compared to urban. <bold>Conclusion:</bold> Age, gender and morbidity was found to have profound influence on Social Functioning scoring of the subjects. However, the results should be interpreted in terms of the study’s limitations.


2021 ◽  
pp. 14-15
Author(s):  
Indira Ananthapadmanab asamy ◽  
V. Pavani Sai Mounika ◽  
K. Vijayakumar ◽  
C.H. Srinivasa Rao

INTRODUCTION: Staphylococcus aureus causes a wide range of infections including skin and soft tissue infections to life-threatening systemic infections like sepsis, endocarditis. This study ais to evaluate the antimicrobial susceptibility pattern of S.aurues among various clinical specimens. METHODS: The study included 326 S.aurues, isolated from various clinical specimens which were subjected to antimicrobial susceptibility testing as per CLSI guidelines. RESULTS: Among the 326 isolates, the highest were from pus specimens (47.85%), and was from Orthopaedics department (28.53%). Among the isolates, 219 (67.17%) were Methicilin resistant. All isolates were sensitive to Vancomycin, and all urine isolates were sensitive to Nitrofurantoin. The highest resistance was towards Penicillin (87.42%), Erythromycin (85.28), and Ciprooxacin (83.13%). CONCLUSION: The most effective way to prevent MRSA infection in every hospital is by performing continuous surveillance of antibiotic resistance and by following an effetive antibiotic policy.


1995 ◽  
Vol 29 (2) ◽  
pp. 230-237 ◽  
Author(s):  
Michael Gifford Sawyer ◽  
Robert John Kosky

Approximately 10% of children and adolescents experience mental health problems, however only a small proportion receive specialised help. Identifying approaches which can provide a balanced and effective service for the large number of children and adolescents with problems is currently a major challenge for child and adolescent mental health services in Australia. In South Australia, following a review in 1983, child and adolescent services were reorganised into two separate but closely related services. This paper draws on experience in South Australia over the last decade to identify approaches which can be employed in six key areas that significantly influence the effectiveness of child and adolescent mental health services. The paper also describes the specific features which were included in the South Australian child and adolescent mental health service to address these issues.


Author(s):  
Prakriti Goswami ◽  
Jyoti Bindal ◽  
Niketa Chug

Background: Maternal morbidity and mortality remains a major challenge to health systems worldwide. Referral services for identification and referral of high risk pregnancies are an integral part of maternal and child health services. Timeliness and appropriateness of referral are challenge to obstetricians, since delay in referral affects maternal outcome adversely, hence the identification of at risk patients and obstetric emergencies and their timely referral is of immense importance. The aim of this study was to review the pattern of obstetric cases referred to tertiary care centre, to identify their clinical course, mode of delivery and maternal outcomes.Methods: It was prospective observational study carried out from January 2015 to July 2016. Study population was all Obstetrics patients referred to Department of Obstetrics and Gynecology of Kamla Raja Hospital, G.R. Medical College, Gwalior, Madhya Pradesh, a tertiary care centre during the study period.Results: The total number of referred cases in above study period was 4085.The proportion of referred cases in the tertiary care hospital was 20.86%. Mode of transport used by the referred patients were hospital ambulances (38%) and private vehicles (62%). Most common diagnosis at the time of referral was anaemia (27.8%). Out of the total referred cases, 48% had vaginal delivery (either spontaneous or induced), 28% had caesarean section and 24% were managed conservatively. Hypertensive disorders (25.4%) constitutes the leading cause of maternal deaths amongst the referred cases.Conclusions: Peripheral health care system needs to be strengthened and practice of early referral needs to be implemented for better maternal outcome.


2020 ◽  
Vol 31 (2) ◽  
pp. 38-42
Author(s):  
Nasim Jahan ◽  
Mohammad Muntasir Maruf ◽  
Sharmin Kauser ◽  
Mekhala Sarkar ◽  
Md Masud Rana Sarker ◽  
...  

There is a dearth of studies related to consultation-liaison psychiatry in Bangladesh. The psychiatric referral rates in this country are very low, considering the higher rates of psychiatric morbidity in patients who attend various departments of a general hospital. This was a descriptive study consisting of all the cases referred for psychiatric consultation from inpatient units of various departments of BIRDEM General Hospital, Dhaka from July 2017 to June 2018. Patients of any age and of either gender were included. A total of 673 patients (1.97% of total admission) were referred from different departments of the hospital for psychiatric consultation within the study period. Majority of the respondents were female. The mean age of the respondents was 59.47 (±1.98) years. Among the referred, Generalized anxiety disorder (GAD) was the diagnosis in 24.96%, followed by Major depressive disorder (MDD) in 9.95% cases. Referral from the department of Medicine and allied was 92.86 %, followed by department of Surgery and allied (6.38%) & department of Obstetrics and Gynaecology (0.74%). Frequency of referral was the lowest in the months of November to January. There is a need to encourage multi-disciplinary interaction in the management of patients who attend general hospitals, so as to better identify the psychiatric morbidity. Bang J Psychiatry December 2017; 31(2): 38-42


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