PREVALENCE AND CORRELATES OF CHILD AND ADOLESCENT MENTAL DISORDERS IN GUNJUR, THE WESTERN DIVISION OF THE GAMBIA

Abstract

Background According to the World Health Organization (WHO), globally 10-20 % of children and adolescents suffer mental disorders and 50% of adult mental disorders start before 14 years of age. Unfortunately, in many developing regions of the world, such as in The Gambia, due to a dearth of resources, the mental health needs of children and adolescents are neglected thereby causing several who would have benefitted from care to suffer lifelong disabilities. There are no studies in The Gambia on the prevalence and correlates of mental disorders in children and adolescents. The only trained mental health professionals working in The Gambia presently are two contract adult psychiatrists from Cuba. As a first step towards rectifying the treatment gap for mental disorders in children and adolescents, this descriptive cross-sectional study determines the prevalence, pattern and correlates of child and adolescent mental disorders in Gunjur, Western Division of The Gambia. Methodology This was a two-stage cross-sectional community based study to assess the mental health problems of children and adolescents’ aged 4-16years living in Gunjur, Western Division of The Gambia. A stratified random sampling technique was employed to select participants from households. In the first stage the parents or caregiver completed the socio-demographic questionnaire and the parent version of the Strengths and Difficulties Questionnaire (SDQ) and adolescents aged 11-16 years completed the self-administered SDQ. Children and adolescents who screened above the abnormal range of the SDQ subclasses or total difficulties score and adolescents with suicide ideations, attempt, alcohol abuse, substance abuse or who reported that they experienced bullying were interviewed using the Kiddie Schedule for Affective Disordersand Schizophrenia Lifetime version (K-SADS-PL) 2009 Working Draft, to diagnose specific DSM-IV mental disorders in the second stage of this study. Data collected was entered into SPSS version 20 for analysis. Overall prevalence, prevalence according to gender and age, specific mental disorders and their patterns were presented in frequencies and percentages. The association of mental disorders with selected socio-demographic characteristics was subjected to Chi-square tests at a significance of 5%. All significant associations were subjected to logistic regression at significance level of 5% and 95% confidence interval. Results A total of 270 children and adolescents participated in the study. There were 141(52.2%) females and 129(47.8%) males. The prevalence of mental disorders in the sample based on SDQ abnormalities and KSADS assessment was 24.1% and 23.7% respectively. The prevalence mental disorders in males and females was 34.1% and 14.2% respectively according to KSADS assessment DSM-IV. Children aged 4-10years had prevalence of mental disorders 23.9% while adolescents aged 11-16years had a prevalence of 23.4%. Behavioural disorders occurred in 17.8% and affective disorders were found in 4.1%. ADHD was found in 11.5% of the sample conduct disorder 5.6%, depression in 4.1%. Gender, repeated hospital visits, parental conflicts, repeating a grade , reporting difficulties with teachers and the experience of being bullied were found to be significantly associated(p<0.05) with DSM-IV disorders.Males were 6 times more likely to have mental disorders than females. [OR=6.050;95% Cl;3.770-9.710)] Conclusion This study reveals that 1 in 4 children and adolescents in Gunjur, Western Division of The Gambia have a mental disorder. This high prevalence substantiates the need for child and adolescent mental health policies and services in The Gambia.Health workers should be trained to identify and address mental health problems in children and adolescents. Awareness campaigns on child mental health and disorders should also be conducted across the country