Imran Nazish, Bodla Zubair Hassan, Asif Aftab, Shoukat Rabia, Azeem M Waqar
Prof. Dr. Nazish Imran, MBBS, FRCPsych (London), MRCPsych (London), MHPE, Department of Child & Family Psychiatry, King Edward Medical University, Mayo Hospital, Lahore, Pakistan.
Dr. Zubair Hassan Bodla, MBBS, Medical Officer, Department of Child and Family Psychiatry, King Edward Medical University, Mayo Hospital, Lahore, Pakistan.
Pak J Med Sci. 2021 Mar-Apr;37(2):305-311. doi: 10.12669/pjms.37.2.2611.
BACKGROUND & OBJECTIVE: Child & adolescent mental health needs to be considered as an integral component of overall health, however significant gaps exist in service provision especially inpatient services in Pakistan. The paper presents the characteristics of admitted youths and response to treatment in Pakistan's first dedicated child & adolescent psychiatry inpatient unit in Lahore over a period of first seven years. The aim of this study was to better understand the various characteristics of children and youth admitted to this inpatient unit and response to treatment over a seven years' period since the inception of the unit.
Inpatient medical records of children & adolescents admitted to dedicated Child & Adolescent Inpatient Unit at King Edward Medical University, Lahore were reviewed. Data was extracted regarding referral patterns, sociodemographic factors and diagnosis for the first seven years, from 2012 to 2019. Patients' scores on Strengths and Difficulties Questionnaire and Clinical Global Impressions Scales administered during intake were also reviewed.
Six hundred and thirty-four (634) patients, 56% (355) being females were admitted to the unit during seven years with mean age of 12.3 ± 2.3. Mean duration of admission was 15.60 ± 6.3 days. Most predominant ICD-10 Axis-I psychiatric diagnosis were neurotic, stress related and somatoform disorders (262); mood disorders (78); schizophrenia, schizotypal & delusional disorders (77) and behavioral and emotional disorders with onset usually occurring in childhood and adolescence (44). One hundred and fifty-nine (25%) children had comorbid diagnosis of intellectual disability on Axis-III. Strengths and difficulties questionnaire scores were in abnormal range for significant proportion (>50 %) of patients. CGI mean scores showed marked improvement at discharge.
Neurotic, stress related and somatoform disorders are the most common diagnosis in youth needing inpatient treatment in Pakistani setup. Study results indicate that there is a clear need for specialized inpatient child and adolescent services such as ours in low- & middle-income countries.
儿童及青少年心理健康应被视为整体健康的一个重要组成部分，然而在巴基斯坦，尤其是住院服务方面，服务提供存在显著差距。本文介绍了巴基斯坦拉合尔首个专门的儿童及青少年精神病住院单元在最初七年期间收治的青少年的特征及治疗反应。本研究的目的是更好地了解自该住院单元成立七年来收治的儿童和青少年的各种特征及治疗反应。
回顾了拉合尔爱德华国王医科大学专门的儿童及青少年住院单元收治的儿童及青少年的住院病历。提取了2012年至2019年最初七年的转诊模式、社会人口学因素及诊断数据。还回顾了患者入院时填写的优势与困难问卷及临床总体印象量表的得分。
七年间，该单元共收治634名患者，其中56%（355名）为女性，平均年龄为12.3±2.3岁。平均住院时间为15.60±6.3天。国际疾病分类第十版（ICD - 10）轴I精神障碍中最主要的诊断为神经症、应激相关及躯体形式障碍（262例）；心境障碍（78例）；精神分裂症、分裂型及妄想性障碍（77例）以及通常起病于儿童期和青少年期的行为和情绪障碍（44例）。159名（25%）儿童在轴III上合并智力障碍诊断。相当比例（>50%）的患者优势与困难问卷得分处于异常范围。临床总体印象量表平均得分在出院时显示有显著改善。
在巴基斯坦的医疗环境中，神经症、应激相关及躯体形式障碍是需要住院治疗的青少年中最常见的诊断。研究结果表明，在低收入和中等收入国家，明显需要像我们这样专门的儿童及青少年住院服务。
