Evaluation of school based teachers training intervention for common child mental health problems in Pakistan

The main aim of this present study is to provide teachers with skills needed to recognize and manage children with mental health problems through school-based training. Pre and post training analysis. This study was conducted in various schools of Karachi, Pakistan from July 2010 to July 2011. This study will involve the development and evaluation of a two-day workshop [10-12 hours] for 89 teachers of primary school children to provide them with an understanding of mental health, and train them in skills needed to meet the needs of children. Post training analysis suggested an improvement in the teachers' knowledge, about common child behavioral and emotional difficulties. In low-income developing country like Pakistan teachers should be trained in early intervention programmes for identification and school based management of emotional and behavioral problems

Prevalence of mental health disorders amongst 5-11 year old primary school children in Karachi, Pakistan

The main purpose of this study was to estimate the prevalence of common psychiatric disorders among Pakistani primary school children. Two-stage cross sectional survey. The two-stage study was conducted in private, government and community primary schools in Karachi Pakistan during January 2006 to June 2007. A two-phase cross sectional survey of 5-11 year-old primary school children in Karachi was carried out. In the first screening phase, broad morbidity rates were measured using the Strength and Difficulties Questionnaire [SDQ]. A total of 968 parents and 793 teachers participated in the study. In the second phase, 100 children were randomly selected for a diagnostic interview using the Urdu version of Kiddie Schedule of Affective Disorders and Schizophrenia for School-Age Children. Results indicated a weighted prevalence of 17% common child psychiatric disorder among primary school children in Pakistan, with a preponderance of behavioural disorders, followed by anxiety and mood disorders. This exploratory study suggests estimates of child psychiatric disorders in Pakistan are slightly higher than other countries, and highlights the necessity of establishing service networks to meet children's mental health needs

Comparison of urdu version of strengths and difficulties questionnaire [SDQ] and the child behaviour check list [CBCL] amongst primary school children in Karachi

To compare CBCL [Child Behaviour Check Llist] Urdu, with the validated Urdu version of Strengths and Difficulties Questionnaire [SDQ] used as "gold standard" among school children in Karachi, Pakistan, and to develop local cutoffs for CBCL using SDQ as a gold standard. A cross-sectional study. Schools of Karachi metropolitan area from January to December 2006. The Strengths and Difficulties Questionnaire [SDQ] and Child Behaviour Check List [CBCL] was completed by parents of 5-11 years old primary school children in Karachi. Appropriate cutoff points for total problem, internalizing and externalizing scales were obtained for CBCL. A total of 556 parents filled out both the SDQ Urdu version as well as CBCL. Scores from the parent rated total SDQ scores were highly correlated with the total CBCL scores [r=0.589]. The local cutoffs derived for CBCL were considerably lower than USA norms. Slightly higher cutoff for males was found as compared to females for the total CBCL scores. Like the original English version, the Urdu version of CBCL and SDQ are both equally valid assessment tools to be used for both clinical and research purpose in Pakistani settings, where Urdu is widely spoken and understood

Psychiatric morbidity in children reporting at a tertiary care hospital

The study is designed to assess the psychiatric morbidity in children reporting at psychiatry OPD, of National Institute of Child Health [NICH], Karachi. Simple descriptive study. This study was conducted during the period of two years from January 2005 to January 2007 at National Institute of Child Health [NICH] Karachi. All consecutive patients who reported in child psychiatry clinic were enrolled in this study if they fulfilled the inclusion criteria having age of 3 years to 15 years of either sex. Cases excluded in the study were psychiatric presentation associated with physical illness and symptoms related to drug side effects. The facility received direct referrals from other professional colleagues, and from parents, school teachers who have been sensitized to child psychiatric issues. Semi-structured interview based on DSM-IV along with an open ended slot of question were used for evaluation. Data regarding demographic characteristics, referral source, reasons for referral and diagnostics based on clinical judgment were collected. Five hundred and seventy new cases were inducted in this study over a period of two years. Males outnumbered females with the ratio of 1.7:1. Majority [42.28%] of children were in the age range from 11-15 years. Standard deviation of age was 6.8 years for male and 3.5 years for female children. Most [69.6%] of the referrals were made from professionals working in pediatric medicine. The most common reason for referral was disruptive behaviour [26.32%], followed by behavioural problem with fits [15.79%] and physical over activity [7.89%]. Other presenting complaints [reasons for referral] included slow learner, self injurious behaviour, aggression, speech delay, unexplained physical symptoms, bed wetting, emotional problems poor attention and tics etc. Mental retardation with behavioural problem was the most frequent [36.14%] provisional diagnosis. About 16.14% of cases related to seizure disorder with behavioural problem while 10.53% were attention deficit hyperactivity disorder [ADHD]. Other diagnoses made were depressive illness, conversion disorder, functional enuresis and autism. After mental retardation, one third of cases comprised of seizure disorder with behavioral problem, attention deficit hyperactivity disorder [ADHD], and depressive illness. It is therefore recommended that professionals at primary health care level should be trained to identify psychiatric illness in children so that early intervention, proper referral and effective management may be possible