DSM-IV substance use disorders, major psychiatric disorders and anxiety disorders were prevalent and co-morbid. However, anxiety disorders were hardly diagnosed and therefore not managed. Suicidal symptoms were common. These results call for more inclusive clinical diagnostic practice. Standardized clinical practice using a diagnostic tool on routine basis will go a long way in ensuring that no DSM-IV diagnosis is missed. This will improve clinical management of patients and documentation.

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 childhood 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.

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DSM-IV Axis I and II comorbidities and the pattern of Axis II diagnoses in patients admitted at Mathari (Psychiatric) Hospital, Nairobi, Kenya are unknown. To determine DSM-IV Axis I and II comorbidities and patterns of Axis II diagnoses in patients admitted at Mathari Hospital. Cross-sectional study on 148 randomly sampled patients. Twenty percent of the patients were confirmed for an Axis II diagnosis. Eighty-seven percent of the Axis II disorders were Cluster B Personality Disorders of various types. Using chi2 tests, significant associations were found between Axis I and II diagnoses and substance use/dependence (p < 0.001; 66.7%), mood disorder (p = 0.002; 46.7%) and schizophrenia (p < 0.001; 23.3%). The prevalence of personality disorders was lower than that reported in psychiatric patients in USA and Europe. The results are likely to be a true reflection of the actual epidemiological situation, but cannot be generalized to outpatient or general populations.

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