Introduction: A variety of psychiatric manifestations can be seen in children and adolescents below the age of 19 years. This study aims to examine the socio-demographic, morbidity profiles, and clinical correlates of child and adolescent patients attending the psychiatry out-patient clinic of Lumbini Medical College and Teaching Hospital (LMCTH). Methods: It was an observational, cross-section study involving case record analysis of all children and adolescent patients attending the psychiatry out-patient clinic between December 1, 2018 to November 30, 2019 in LMCTH, Nepal. Socio-demographic and clinical data were entered into computer software and analysed. Results: One hundred and forty cases fulfilling inclusion criteria were included in the study. There were 96 (68.6%) females and 44 (31.4%) males. Majority of the patients were from 16-19 years age-group. Cases from urban areas predominated the picture. Most common psychiatric diagnosis was conversion disorder (29, 20.7%) followed by depressive disorder (25 or 17.9%) and anxiety disorder (14, 10%). Majority of females had conversion disorder (25 or 26%) followed by seizure disorder (23, 24%) and depressive disorder (15, 15.6%) whereas majority of males had equal count of depressive disorder and seizure disorder (10, 22.7%) followed by anxiety disorder (7, 15.9%). Conclusions: Psychiatric illness was most common in children and adolescents in the age group 16-19 years, followed by 11-15 years age-group. They were more common in female sex, and slightly higher in those from urban background. Common psychiatric diagnoses were conversion disorder followed by depressive disorder and anxiety disorder.
Introduction: Intentional self harm is a potentially self injurious action with a non-fatal outcome for which there is evidence, either explicit or implicit, that the individual intended to kill himself or herself. Suicide is a fatal act of self-injury (self harm) undertaken with more or less conscious self destructive intent. There has been an increase in the number of patients presenting with attempted suicide in the emergency settings of hospitals. This study aimed to explore socio-demographic characteristics, pattern of attempts, psychiatric diagnosis, psychosocial and personality factors among survivors of suicide attempt presenting to a tertiary care hospital. Methods: The study included 100 survivors of intentional self harm registered over a period of six months visiting a tertiary care hospital. The cases directly presented to Psychiatry department and were referred from medical and other departments for psychiatric evaluation. They underwent evaluation by consultant psychiatrist and received appropriate interventions. Results: Majority of the victims were female (73%), belonging to the age group of 20-40 years. The most common method of attempt was self poisoning with pesticides (65%) followed by hanging (16%) and overdose of drugs (7%). Most of the attempts (68%) were impulsive in nature. Mental illness was diagnosed in (65%) of the cases, mainly depressive disorder (51%), and personality disorder (10 %). Most of the attempts (67%) were triggered by psycho-social factors. Conclusion: The pattern shows predominance of female gender, young age group, a role of mental illness, impulsivity and psychosocial factors in intentional self harm.
Introduction: Mental health is state of wellbeing in which as individual realizes in his or her abilities, can cope with the normal stresses of life, can work productively and fruitfully, and is able to make a contribution to his or her community (WHO, 2004). Schizophrenia is a significantly disabling disease that affects social family psychological, vocational and occupational functioning (Lyngdoth, L. et al, 2016). Depressive disorders often start at a young age; they reduce people’s functioning and often are recurring (Marcus et al., 2012). Studies have shown decreased functioning ability in people having mental illness in Nepal. This study was done to explore the impact of mental illness in their daily functioning abilities. Material And Method: A cross-sectional survey was conducted among 120 people suffering from mental illness (psychosocial disabilities) for more than six months. Mental health social workers who were facilitating mental health self-help group of treatment seeking mental health patients in the health facilities were trained and supervised during data collection. Selected participants were informed about research objectives and received consent for the study. Nepali adopted WHO-DAS-2 (Thapa et al, 2005) was used to collect both demographic and functioning abilities of research participants. Data were analysed using SPSS 20th version mainly for descriptive statistics. Results: Participants' age ranged from 18-60 years with mean age 29.53 (SD±10.8), with gender distribution 58.3% female and 41.7% male. People with psychosocial disabilities experienced in an average 9.45 days difficulty, average 6.95 days they couldn't do daily work and minimized work for average 3.55 days in the month. Female with mental health problems experienced more difficulties in daily life functioning (S1-S12 items in WHO-DAS) where moderate to severe level difficulties observed than male with mental health problems. Emotional effect due to health problems, talking with unknown people, difficulties in friendship area and doing daily activities were affected significantly statistically (p=0.01, 0.05, 0.04 and 0.02). Ethnicity and gender is significantly correlated with total affected days (r=.221, -.180 p= 0.05, table 3). Gender and total affected working days is correlated but not significant statistically. Conclusion: Level of functioning is affected significantly in people having psychosocial disabilities; impairment is higher in female, people suffering with severe form of mental illness. Findings indicate need of awareness in mental health. Further research is necessary in larger and representative population including care-taker of mentally ill person.
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