Ojha Saroj Prasad, Ma Jasmin, Chapagain Manisha, Tulachan Pratiksha
Department of Psychiatry and Mental Health, Maharajgunj Medical Campus, Tribhubhan University Teaching Hospital, Kathmandu, Nepal.
JNMA J Nepal Med Assoc. 2013 Jul-Sep;52(191):457-61.
Homelessness in children is a serious problem in the society. Factors leading to homelessness in Nepalese children are poverty, unemployment, multiple children, exposure to violence, caste based social discrimination etc. Children living out of their homes have problems in attachment, temperament, social skills, cognitive ability, and language development. Few non-governmental organizations that have started to look after these children but the mental health need is neglected. The study attempted to investigate the emotional and behavioural problems in homeless children in one of the shelters in Kathmandu.
All the children (n=126) in the SAATHI Organization were included in the study. They were administered Child Behaviour Check List 6-18. Children with T-score ≥65 on externalising or internalising dimension were further evaluated in the Child Guidance Clinic for the final diagnosis based on DSM IV.
The prevalence of emotional and behavioural problem among the participants was 36 (28.57%) [15 (26.31%) in boys and 21 (30.43%) in girls] based on CBCL/6-18 years and 29 (23.01%) [12 (21.05%) in boys and 17 (24.63%) in girls] based on final diagnosis. The conduct problems was the most common among the male children 5 (8.77%), followed by ODD 3 (5.26%), ADHD 2 (3.5%), Anxiety 2 (3.50%) whereas Anxiety is most common in female children 9 (13.04 %), followed by depression 5 (7.24%), conduct 3 (4.34%).
The rate of emotional and behavioral disorder in homeless children in the study is similar to the school aged non homeless children in previous studies, which may be because of the protection provided by the shelters. This study highlighted the need for methodologically better studies in the field.
儿童无家可归是社会中的一个严重问题。导致尼泊尔儿童无家可归的因素包括贫困、失业、子女众多、遭受暴力、基于种姓的社会歧视等。无家可归的儿童在依恋、气质、社交技能、认知能力和语言发展方面存在问题。少数非政府组织已开始照料这些儿童，但心理健康需求却被忽视。本研究试图调查加德满都一家收容所中无家可归儿童的情绪和行为问题。
SAATHI组织中的所有儿童（n = 126）均纳入本研究。对他们进行了儿童行为检查表（6 - 18岁版）测试。在外显或内化维度上T分数≥65的儿童在儿童指导诊所根据《精神疾病诊断与统计手册》第四版进行进一步评估以做出最终诊断。
根据儿童行为检查表（6 - 18岁版），参与者中情绪和行为问题的患病率为36（28.57%）[男孩15（26.31%），女孩21（30.43%）]；根据最终诊断，患病率为29（23.01%）[男孩12（21.05%），女孩17（24.63%）]。品行问题在男性儿童中最为常见，有5例（8.77%），其次是对立违抗性障碍3例（5.26%）、注意力缺陷多动障碍2例（3.5%）、焦虑症2例（3.50%）；而焦虑症在女性儿童中最为常见，有9例（13.04%），其次是抑郁症5例（7.24%）、品行问题3例（4.34%）。
本研究中无家可归儿童的情绪和行为障碍发生率与先前研究中处于学龄期的非无家可归儿童相似，这可能是由于收容所提供的保护。本研究强调了该领域在方法上需要开展更好的研究。
