Sahoo Manoj K, Biswas Haritha, Padhy Susanta Kumar
Department of Psychiatry, Tata Main Hospital, Jamshedpur, Jharkhand, India.
Department of Psychiatry, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
J Family Med Prim Care. 2015 Jan-Mar;4(1):21-5. doi: 10.4103/2249-4863.152243.
Children under 19 years of age constitute over 40% of India's population and information about their mental health needs is a national imperative. Children with specific learning disorders (SLDs) exhibit academic difficulties disproportionate to their intellectual capacities. Prevalence of SLD ranges from 2% to 10%. Dyslexia (developmental reading disorder) is the most common type, affecting 80% of all SLD. About 30% of learning disabled children have behavioral and emotional problems, which range from attention deficit hyperactivity disorder (most common) to depression, anxiety, suicide etc., to substance abuse (least common). Co-occurrence of such problems with SLD further adds to the academic difficulty. In such instances, diagnosis is difficult and tricky; improvement in academics demands comprehensive holistic treatment approach. SLD remains a large public health problem because of under-recognition, inadequate treatment and therefore merits greater effort to understand the co-morbidities, especially in the Indian population. As the literature is scarce regarding co-morbid conditions in learning disability in Indian scenario, the present study has tried to focus on Indian population. The educational concessions (recent most) given to such children by Central Board of Secondary Education, New Delhi are referred to. The issues to be addressed by the family physicians are: Low level of awareness among families and teachers, improper dissemination of accurate information about psychological problems, available help seeking avenues, need to develop service delivery models in rural and urban areas and focus on the integration of mental health and primary care keeping such co-morbidity in mind.
19岁以下儿童占印度人口的40%以上,了解他们的心理健康需求是一项国家要务。患有特定学习障碍(SLD)的儿童表现出与其智力水平不相称的学业困难。SLD的患病率在2%至10%之间。诵读困难(发育性阅读障碍)是最常见的类型,占所有SLD的80%。约30%的学习障碍儿童存在行为和情绪问题,范围从注意力缺陷多动障碍(最常见)到抑郁、焦虑、自杀等,再到药物滥用(最不常见)。这些问题与SLD同时出现会进一步增加学业困难。在这种情况下,诊断困难且棘手;学业的改善需要全面的整体治疗方法。由于认识不足、治疗不充分,SLD仍然是一个重大的公共卫生问题,因此需要付出更大努力来了解共病情况,尤其是在印度人群中。鉴于印度关于学习障碍中共病情况的文献稀缺,本研究试图聚焦于印度人群。文中提及了新德里中央中等教育委员会最近给予此类儿童的教育优惠。家庭医生需要解决的问题包括:家庭和教师的认识水平低、关于心理问题的准确信息传播不当、可用的求助途径、需要在农村和城市地区开发服务提供模式,以及在考虑到这种共病情况的前提下关注心理健康与初级保健的整合。