Child and adolescent psychiatric epidemiology in India.

POORNIMA BHOLA, Ph.D. (Clinical Psychology), Junior Research Fellow, National Institute of Mental Health and Neum Sciences, Bangalore. 502E. Ranks. Corner Apartments, I" Main. Cambridge Layout, Ulsoor, Bangalore-560 008. .
Indian Journal of Psychiatry 10/2003; 45(4):208-17.
Source: PubMed

ABSTRACT The increasing focus on child mental health in developing countries like India points to the importance of epidemiological data in developing training, service and research paradigms.This review attempts to synthesise and evaluate the available research on the prevalence of child and adolescent psychiatric disorders in India and highlight significant conceptual and methodological trends. It identified 55 epidemiological studies conducted between 1964 and 2002 in the community and school settings. Despite considerable progress, various methodological lacunae continue to limit the value of the epidemiological surveys. These include issues related to sampling, case definition methods, tools, multi-informant data and data analysis. The importance of a socio-culturally relevant research framework has been highlighted. The review suggests directions for future research to guide planning of services that meet the mental health needs of vulnerable children and adolescents.

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    ABSTRACT: There is increasing concern about suicide rates in the vulnerable developmental stage of adolescence. The experiences and expressions of suicidality among adolescents are often “hidden” and occur due to complex and cumulative interactions of multiple factors. A cross-sectional survey assessed self-reported suicidal ideation, suicide attempts and helpseeking behaviour among adolescents attending a pre-university college in Bangalore, India. This formed part of a 2-year teacher training project for Adolescent Mental Health and Suicide Prevention in the college. 1087 male and female adolescents aged 16–18 years, completed the Columbia Teen Screen which assessed self-reported suicide attempt/s (lifetime, past 3 months) as well as suicidal ideation (current, past 3 months) and associated intensity, severity and duration. Adolescents’ perceptions about the need for help and mental health consultation were also assessed. Emotional and behavioural difficulties were reported on the Strengths and Difficulties Questionnaire. The results indicated that 25.4% of the adolescents reported suicidal ideation (past 3 months) and 12.9% of the total sample expressed their need for seeking help. The rate of suicide attempt was 12.9% (lifetime) and 6% (past 3 months). Logistic Regression analysis identified factors associated with recent suicidal ideation and attempt. Females had higher rates of suicide ideation and attempts than males (Ideation OR = 1.4, CI = 1.04–1.9; Attempt OR = 2.2, CI = 1.0–4.5) and adolescents with abnormal emotional and behavioural problems were at higher risk for suicidal ideation (emotional difficulties OR = 4.6, CI = 3.2–6.6; hyperactivity/inattention OR = 2.1, CI = 1.3–3.2). The findings add to the limited database on youth suicidality in India and have implications for prevention and intervention.
    Asian Journal of Psychiatry 01/2013;
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    ABSTRACT: Study of the prevalence of common psychiatric disorders in children aged 5 to 14 years in a health post area of an urban slum. (1) To study frequency of specific psychiatric disorders in the study population, (2) To study the relationship between sociodemographic variables and psychiatric morbidity. The present study was conducted in one of the five health posts of an urban slum, which is a field practice area of the teaching medical institute. It was a cross-sectional study. Sample size was estimated by using 20% as a prevalence of psychiatric morbidity which was obtained from previous studies done in developing countries. Household was used as a sampling unit and systematic random sampling method was used for selecting household. Total 257 children aged 5 to 14 years were included in the study. A pre-designed, semi-structured diagnostic interview schedule based on DSM-IV criteria was used for data collection. The tests of significance used were Chi-square and Logistic regression analysis. The prevalence of psychiatric morbidity in this study was 14.8%. Non-organic enuresis, Attention deficit hyperactivity disorder, Conduct disorder, and Mental retardation were identified as the common mental health problems. Factors like nuclear family, parents not living together, large family size, and positive family history of psychiatric disorder were associated with psychiatric morbidity in children.
    Journal of family medicine and primary care. 04/2013; 2(2):164-8.
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    ABSTRACT: PURPOSE: There is a paucity of known correlates of common mental disorders (CMDs) among the youth age group in India. This analysis aims to determine risk factors associated with a probable diagnosis of CMD in a youth sample in India. METHODS: This is a secondary analysis of data collected via a door-to-door (community) survey of 3,662 youth (aged 16-24 years) in selected urban and rural areas in Goa. The urban and rural areas were selected based on their engagement with a Goan-based mental health charity organisation, Sangath. Point prevalence of CMD was estimated using the general health questionnaire-12 (GHQ-12). Multivariate logistic regression analyses determined factors associated with CMD and associations were stratified by gender. RESULTS: In total, 3,649 (1,796 urban; 1,853 rural) youth were assessed for probable diagnosis of CMD. There was an almost equal ratio of males (49 %) to females (51 %) in the sample. During the time of the survey, 91 % of the sample was residing with parents, with 83 % being between the ages of 22 and 24 years living with parents. A small proportion of the sample never attended school (1.1 %) with the rest either educated, employed or unemployed. The point prevalence of probable CMD in the sample was 7.87 %; 95 % CI 7.01-8.80 %. Those living in urban areas had a higher prevalence of CMD (9.12 %; 95 % CI 7.90-10.52 %) compared to those living in rural areas (6.60 %; 95 % CI 5.50-7.82 %). After adjusting for a range of potential confounders, independent risk factors for CMD were being older, i.e., between 22- and 24-years old, (OR 1.60; 95 % CI 1.10-2.24; p = 0.015), residing in urban areas (OR 1.51; 95 % CI 1.12-2.04; p = 0.007), physical abuse (beaten in the last 3 months) by parents, teachers or others (OR 3.10; 95 % CI 2.11-4.51; p < 0.001), sexual harassment (OR 2.01; 95 % CI 1.30-3.20; p = 0.003) and sexual abuse (OR 2.54; 95 % CI 1.94-3.33; p < 0.001). Being able to talk about personal problems (OR 0.52; 95 % CI 0.34-0.80; p = 0.003) was a protective factor. After stratifying by gender, sexual harassment, physical and sexual abuse were associated with a likely CMD diagnosis in females and males. CONCLUSIONS: Sexual and recent physical abuses were independent risk factors for CMD in both genders. In addition, being older and being able to discuss problems were associated with CMD diagnosis in females but not in males.
    Social Psychiatry 10/2012; · 2.05 Impact Factor

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