Article Title: Pattern Of Child Psychiatric Emergencies And Consults In A Tertiary Care Hospital, Karachi
Author(s): Faheem Khan, Tayyab Arfeen, Mukesh Bhimani, Mohammad Zaman, Tania Nadeem
Institute(s): Department of Psychiatry, Aga Khan University Hospital Karachi
Journal: Journal of Pakistan Psychiatric Society, 2014, VOL. 11, No. 1, p. 21-23
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OBJECTIVE: To report patterns of referrals from Emergency Department (ED) and other departments for Child and Adolescents (C&A) mental health problems
DESIGN: Retrospective case review
PLACE AND DURATION OF STUDY: The study conducted at Aga Khan University Hospital, from June 2010 to December 2012
SUBJECTS AND METHODS: We did review of all the cases (<18 years of age) for whom psychiatric referral was generated for mental health problems from ED and/or other departments at Aga Khan University Hospital. Data was entered and analyzed using SPSS 16. Chi square was used for categorical variables and t-test was applied for continuous variables. P value of less than 0.05 was taken as statistically significant. Exemption from the AKU Research Ethics Review Committee was taken.
RESULTS: Among the 160 consults generated in this time period, 90 were girls. The majority presented with suicidal behavior (26%) followed by behavioral symptoms (16%). Out of 160 cases, 61 (38%) were diagnosed with mood disorders and 28 cases (17%) received the diagnosis of conversion and adjustment disorder. In 21% (n=33) of the consults there was no diagnosable mental illness. Family was found to be the main stressor. In 43% of cases no psychotropic was prescribed.
CONCLUSION: C&A with mental health problems can present in a general medical setup with varying issues and stressors. Physicians who are expected to assess them at ED and other departments should be trained to identify and address common mental health problems including suicidal behaviors. There is a huge need to develop effective consultation liaison services for C&A in hospitals.
KEYWORDS: Child mental health Pakistan, emergency child psychiatric disorders.