PREVALENCE AND CORRELATES OF MENTAL DISORDERS IN CHILDREN AND ADOLESCENTS IN MENDEFERA COMMUNITY, ERITREA

Abstract

Globally, the prevalence of mental disorders among children and adolescents is high, affecting one in five youth. There is currently no existing data on the prevalence, correlates or patterns of mental disorders in the Eritrean child and adolescent population. This pioneer descriptive cross-sectional community study in an Eritrean community was conducted to determine the prevalence, correlates and patterns of DSM-IV disorders in children and adolescents in Mendefera community, Eritrea. Methodology A two-stage design was used to assess the mental health of children and adolescents aged 4-17 years belonging to households recruited by a multistage random sampling method. In the first stage, parents or adult caregivers were required to complete the sociodemographic questionnaire and the parent version of the Strengths and Difficulties Questionnaire (SDQ) for all children. Adolescents aged 11-17 years were, in addition, administered the self-completed SDQ. All questionnaires were administered by interviewers. The School Health Questionnaire was completed by adolescents between 13 and 17 years of age to screen for suicidal ideation or attempt, alcohol abuse or substance abuse and bullying. Children and adolescents who screened positive for any of the SDQ abnormality subclasses and adolescents who reported either suicide ideations, attempt, alcohol abuse, substance abuse or experienced bullying were then interviewed using the Kiddie Schedule for Affective Disorders and Schizophrenia Lifetime version (K-SADS-PL) 2009 Working Draft, to diagnose specific DSM-IV psychiatric disorders. Data collected was entered into CSPro version 6.2 and then transported to and analysed using SPSS version 20 for windows. Results High prevalence of both SDQ abnormalities (15.9%) and DSM-IV psychiatric disorders (13.1%) were found. Prevalence rates by both instruments were found to be higher among males (21.3% by SDQ and 16.1% by K-SADS-PL, 2009) than among females (10.7% by SDQ and 10.1% by K-SADS-PL, 2009), and among adolescents aged 11-17 years (20.6% by SDQ and 18.3% by K-SADS-PL, 2009) than among children aged 4-10 years (12.6% by SDQ and 9.3% by K-SADS-PL, 2009). Behavioral disorders were found to be the commonest psychiatric disorders in this population of children and adolescents at a prevalence of 9.9%, followed by affective disorders (3.2%) and anxiety disorders (2.5%). ADHD was the commonest disorder at a prevalence of 4.5%, followed by conduct disorder (4.2%), and depression, GAD and ASD at a prevalence of 3.1% each. A high prevalence of comorbidity (29.3%) was found among these disorders. No substance abuse or alcohol abuse was found among participants in this study. The presence of chronic physical illness either in the child or in family members, unstable parental marital status, parental conflict, presence of psychopathology in the family, low level of maternal educational attainment, poor academic performance, grade repetition and having difficulties with teachers at school were found to significantly increase the risk of having any DSM-IV psychiatric disorders. Conclusion The high prevalence of DSM-IV disorders found in this study calls for making child and adolescent mental health services widely available in Eritrea. There is also the need for further research of wider scope. The sociodemographic characteristics identified by this study as having significant associations with high risk of mental disorders in children and adolescents may be important targets of intervention to reduce the high prevalence of these disorders in this community