Audit of child and adolescent psychiatry in a teaching hospital in Nigeria: Prevalence, pattern and implication for improved services

Abstract

Objective . This study aimed to identify the socio-demographic characteristics, pattern of psychiatric disorders and management of children and adolescents before the setting up of a dedicated child and adolescent unit at the University of Ilorin Teaching Hospital, Ilorin, Nigeria.

Method . A retrospective study, carried out at the Department of Behavioural Sciences of the hospital.

Results . The age range of the 94 children seen was 7 - 19 years, with a mean of 16.38 years (standard deviation 2.49); 82% were aged 14 - 19 years and 17% 7 - 13 years, while only 1 child was under 7 years old. The majority of the children lived with their parents in monogamous families with 5 or more children. The majority of the parents were educated and gainfully employed. The major diagnoses were schizophrenia (50%), delirium (15%) and seizure disorders (9%). Of the patients 64% were managed as outpatients and 36% as inpatients. Drug therapy was involved in the majority of cases, and the most frequently prescribed medication was haloperidol, atypical antipsychotics such as risperidone being used in only 8% of cases. Most of the patients were referred from the primary care- associated departments of the hospital, i.e. the general outpatient department (40%) and the internal medicine and paediatrics departments (29%). Referrals from welfare, judicial and educational institutions were uncommon (3%).

Conclusion . The pattern of patient presentation and management had not changed to any great extent over the past two decades. The introduction of a child and adolescent psychiatric unit is expected to improve consultation/liaison psychiatry and also child psychiatric service delivery and research. Understanding of the prevalence and pattern of presentation of mental disorders and their management is also expected to help improve the strategic planning and organisation of the new clinic.