Abstract :
Background Psychosocial issues and interventions
play a very important role in the aetiology,
course and prognosis of several child psychiatric disorders.
Psychosocial problems in a child and adolescent
psychiatric clinic population in Nigeria were documented
as a preliminary step towards the planning and
development of this new facility. Methods A standardised
assessment procedure was integrated into the routine
at the clinic when services commenced. Psychosocial
stressors and life events were measured using the
interview method so that in-depth information could be
obtained. Results Over the 3-year period of study, 79
(62.2%) of the 127 new referrals to the clinic had significant
psychosocial stressors in the year preceding presentation.
Problems with primary support, such as separation
from parents to live with relatives, disruption of
the family, abandonment by mother, psychiatric illness
in a parent and sexual/physical abuse, occurred in 50
(39.4%) of the subjects. Problems with social environment
occurred in 11 (8.7 %), 39 (30.7 %) had educational
problems, 5 (3.9%) had economic problems and 15
(11.8%) of the children had ‘other’ psychosocial stressors.
Significantly more children and adolescents with
disruptive behaviour disorders and disorders like
enuresis, separation anxiety and suicidal behaviour had
psychosocial stressors when compared to children with
psychotic conditions, autistic disorder and epilepsy
(χ2=9.6; p=0.048). Conclusions The importance of the
psychosocial diagnostic dimension in routine practice is
illustrated in this study. Some psychosocial factors identified
are cultural practices. The effects of these practices
on child mental health require further study.