Profile of mental and behavioral disorders among preschoolers in a tertiary care hospital in Oman: a retrospective study

Objectives: Early diagnosis and prompt treatment of mental and behavioral disorders in preschoolers is critical for a better prognosis, ultimately leading to improved quality of life for both the child and the family. Our study investigated the clinical profile of mental and behavioral disorders in children < 7 years of age, seeking consultation at Sultan Qaboos University Hospital, Muscat, Oman, between 1 June 2006 and 31 December 2010. The objective was to explore demographic variables, intervention types, and annual Trends

Methods: this retrospective, descriptive study was conducted by reviewing the electronic records of preschoolers seeking consultation on mental and behavioral disorders at the Department of Behavioral Medicine. The diagnosis was based on the Diagnostic and Statistical Manual of Mental Disorders [DSM-IV] criteria

Results: the total number of cases was 466, the majority [77.9%] being boys. The cumulative frequencies and annual hospital-based prevalence rates were estimated for each category of mental and behavioral disorders. Our findings showed increased service utilization among preschoolers, as reflected in the annual trend and case-specific prevalence rates. While comorbidity was common, the most frequent disorders encountered were attention deficit hyperactivity disorder [70.8%], developmental language disorder [23.6%], autism spectrum disorders [20.2%], and disruptive behavior disorders [11.6%]. The most commonly prescribed drugs/supplementation were risperidone [18.7%], atomoxetine [9.7%], omega-3 [8.8%], and methylphenidate [6.2%]

Conclusions: consultations for mental and behavioral disorders are being sought for Omani preschoolers. Beside pharmacotherapy, other interventions, which are an integral part of a much desired multidisciplinary approach should be introduced. Readdressing the missing needs is essential for a comprehensive approach to managing mental and behavioral disorders

Profile of child and adolescent psychiatry in Oman

To find the common behavioral problems in youth, their co-morbidity, treatment, and other variables in Oman. All patients who attended the child psychiatric clinic in Sultan Qaboos University Hospital [SQUH], Muscat, [the only child psychiatry clinic in Sultanate of Oman] for a 3-month period were investigated for behavioral problems, particularly hyperactivity [by Conners' Questionnaire]. The diagnosis was based on the Diagnostic and Statistical Manual of Mental Disorders, 4th edition. Of the total 212 cases, Omani nationals constituted 89% and the rest were expatriates. Sixty five% were boys, 57% were of school age, 26% were adolescents, 9% were preschoolers and 5% were toddlers. Consanguinity among their parents was high at 52%. The majority [60%] of the patients exhibited hyperactivity. Aggression was found in 49%, while stealing and lying were found in 25% and 22%. Approximately one-third suffered from headache and abdominal pain. The majority [62%] were of below-normal intelligence. Anxiety affected 14%, depression 4%, and conduct disorders 8%. One-third of the patients were taking psychostimulants and another one-third were taking tricyclics. The results were compared with those from other developing countries. Behavioral problems among children and adolescents are high in Oman, same as other developing countries, though the type of disorders is different here. This calls for the attention of the health policy makers for diagnosing and treating such disorders in Oman as well as in the other developing countries

strange type of Pica

Pica, where the patient eats non-food items such as mud, clay, varnish etc., is a common behavioural problem seen in children, pregnant women and the mentally retarded. However sponge pica is a very rare variation. We report a case of a 5-year-old Omani girl, who presented with sponge pica since the age of two years, with recent abdominal pain. Investigations showed anaemia, elevated liver enzymes and normal intelligence. There was no evidence of obsessive-compulsive disorder. Both clinical and laboratory findings showed complete recovery after a few weeks of oral iron therapy. Her appetite improved, and she started to gain weight. No recurrence was observed when followed up after two years. Awareness is necessary to detect and treat pica as early as possible to prevent its complications. Keywords: pica, anemia, sponge pica, abdominal pain, Oman

Growth pattern of primary schoolchildren in Benghazi, Libya

To fi nd the growth trends in a sample of schoolchildren in Benghazi [Libya], and to compare it with international and other local growth charts, as a step for setting the national curves. From 25th February to 31st October 1993, a sample of 2,022 pupils [1,160 boys and 862 girls] were randomly selected from three public primary schools in three different socio-economic areas in Benghazi. A questionnaire consisting of social and scholastic items was distributed to teachers a few days before the examination. The height and weight of all the pupils were measured according to the standards of Jellife, Gorstein, WHO, and de Onis. Data were analyzed and compared with both the reference standard of the United States National Center for Health Statistics [NCHS-USA], and the local standards of Tripoli-1986. The boys and girls in the lowest age-group had a pattern similar to that of the reference population for both height/age and weight/age, but it dropped sharply from mid-school years. The Benghazi curves were consistently higher than those of Tripoli, particularly for height/age. The nutritional status of these children, which was good before the beginning of schooling, was negatively affected during the school years. This could be attributed either to births in the family and consequent neglect, or to the school-s negative effects on the child, such as lack of appetite created by anxiety or other factors. Further studies from dif ferent regions of the country are needed to set national growth curves

Behavioral problems among pupils

To find the prevalence of some behavioral problems among Libyan public primary school children in Benghazi. This cross-sectional study was conducted between 25th February and the end of October 1993, by selecting randomly three public primary schools in different socio-economic areas, from which a sample of 2088 pupils from 1st -6th classes were included. A questionnaire concerning social, psychological and behavioral aspects was completed by teachers, social workers, parents and researchers. The pupils who got >/= 15 Conner's Scale were considered as hyperactives, meanwhile the success mark was considered as 50%, any mark below that in one subject or more in the final examination was considered a failure. This study shows that 26% of the sample had failed once or more, 8.1% had aggressive, and 9.2% had stealing and lying behaviors, while 5.3% of the sample manifested hyperactivity, and finally 7.3% were left handed. This paper stresses the importance of behavioral problems among school children, and that they deserve more attention and consideration to solve them and to prevent their sequelae in the further