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


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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    • "There are two meta-analytic studies reported from India on the prevalence of psychiatric disorders in adults [24,25], but no meta-analysis has been reported for the child and adolescent psychiatric epidemiology. Only one review has been reported for the child and adolescent psychiatric epidemiology in India, which was more than a decade ago [26]. As meta-analysis involves systematic analysis and synthesis of results from several studies done on a subject, it was felt that an attempt should be made to combine the results of various epidemiological studies done so far to calculate the overall and the best estimate of prevalence of psychiatric disorders in children and adolescent in India. "
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    ABSTRACT: The importance of epidemiological studies lies in recognition of cases that do not come to treatment settings. The increasing focus on child adolescent mental health in India points to the necessity of epidemiological studies on children. Although there are a few such studies done in different parts of India in different socio-cultural settings, data from those cannot be generalized to the entire country. This need can be served by meta-analysis. There has been no meta-analysis reported from India for the child and adolescent psychiatric epidemiology. To review and do the meta-analysis of epidemiological studies on child and adolescent psychiatric disorder from India. Sixteen community based studies on 14594 children and adolescents; and seven school based studies on 5687 children and adolescents, reporting prevalence of child and adolescent psychiatric disorder were analyzed and overall prevalence was calculated. The prevalence rate of child and adolescent psychiatric disorders in the community has been found to be 6.46% (95% confidence interval 6.08% - 6.88%) and in the school it has been found to be 23.33% (95% confidence interval 22.25% - 24.45%). This is the first meta-analysis determining the epidemiology of child and adolescent psychiatric disorders in India. It has been found that the reporting systems of psychiatric disorders in children are inadequate.
    Full-text · Article · Jul 2014 · Child and Adolescent Psychiatry and Mental Health
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    • "The reasons for low prevalence of MD need to be explored in the context of the increasing evidence of suicidal behavior in young Indian population. The present study might have underestimated psychiatric morbidity among adolescents, and particularly among adolescent girls whose vulnerability to emotional or internalizing disorders is well documented.[18] "
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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.
    Full-text · Article · Apr 2013 · Journal of Family Medicine and Primary Care
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    • "In this sample the prevalence of CMD was 7.87 % which is less than the prevalence reported in other studies on youth studies outside of India [32–39] but it does fall within prevalence rates among young and adult samples reported in India [20, 24, 30]. National reports and systematic reviews produced in India commonly show a varied prevalence of mental disorders across India in the adult populations and a low prevalence compared to studies globally [20, 22, 40, 41]. "
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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.
    Preview · Article · Oct 2012 · Social Psychiatry
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