Epidemiological Characterization of Patients in the Outpatient Clinic of the Department of Child and Adolescent Psychiatry of a University Hospital in Paraguay: A Three-Year Study
DOI:
https://doi.org/10.18004/mem.iics/1812-9528/2024.e22162401Keywords:
Mental disorders, epidemiology, children, adolescents, ParaguayAbstract
he topic of mental health in children and adolescents requires increased attention. Therefore, this study aimed to determine the characteristics of outpatient clinic patients at a specialized center within a Paraguayan University Hospital. This study employed a retrospective, non-probabilistic series of consecutive cases. The medical records of patients of both sexes, aged between 2 and 17 years, who sought consultation at the Department of Child and Adolescent Psychiatry of the Hospital de Clínicas between July 2021 and July 2023, and were diagnosed with a mental disorder according to the ICD-10, were examined. Demographic and clinical data were collected from 447 patients, representing 1278 consultations. The majority of the patients were female (57.7%), with a mean age of 13 ± 3 years. Most patients (57.3%) were from the Central Department, 61.5% were from rural areas, and 72% did not have medical insurance. The most frequent diagnoses were depressive episodes (F32), other anxiety disorders (F41), conduct disorders (F91), and specific personality disorders (F60). The findings of this study provide crucial information on child and adolescent mental health, which is essential for informing mental health policies, allocating resources, and training healthcare professionals tasked with caring for this patient group.
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References
García-Carrión R, Villarejo-Carballido B, Villardón-Gallego L. Children and Adolescents Mental Health: A Systematic Review of Interaction-Based Interventions in Schools and Communities. Front Psychol. 2019; 10: 918. doi: 10.3389/fpsyg.2019.00918.
Colizzi M, Lasalvia A, Ruggeri M. Prevention and early intervention in youth mental health: is it time for a multidisciplinary and trans-diagnostic model for care? Int J Ment Health Syst. 2020; 14: 23. doi: 10.1186/s13033-020-00356-9.
Schlack R, Peerenboom N, Neuperdt L, Junker S, Beyer AK. The effects of mental health problems in childhood and adolescence in young adults: Results of the KiGGS cohort. J Health Monit. 2021;6(4):3-19. doi: 10.25646/8863.
Otto C, Reiss F, Voss C, Wüstner A, Meyrose AK, Hölling H, et al. Mental health and well-being from childhood to adulthood: design, methods and results of the 11-year follow-up of the BELLA study. Eur Child Adolesc Psychiatry. 2021; 30(10): 1559-1577. doi: 10.1007/s00787-020-01630-4.
Stein DJ, Shoptaw SJ, Vigo DV, Lund C, Cuijpers P, Bantjes J, et al. Psychiatric diagnosis and treatment in the 21st century: paradigm shifts versus incremental integration. World Psychiatry. 2022; 21(3): 393-414. doi: 10.1002/wps.20998.
Fusar-Poli P. Integrated Mental Health Services for the Developmental Period (0 to 25 Years): A Critical Review of the Evidence. Front Psychiatry. 2019; 10: 355. doi: 10.3389/fpsyt.2019.00355.
Patel V, Chisholm D, Dua T, Laxminarayan R, Medina-Mora ME. Mental, Neurological, and Substance Use Disorders: Disease Control Priorities, Third Edition (Volume 4). Washington (DC): The International Bank for Reconstruction and Development / The World Bank; 2016.
Loidl V, Hamacher K, Lang M, Laub O, Schwettmann L, Grill E. Impact of a pediatric primary care health-coaching program on change in health-related quality of life in children with mental health problems: results of the PrimA-QuO cohort study. BMC Prim Care. 2023; 24(1): 182. doi: 10.1186/s12875-023-02119-0.
Kegelaers J, Baetens I, Soyez V, Van Heel M, Van Hove L, Wylleman P. Strengthening Mental Health and Resilience Through Schools: Protocol for a Participatory Design Project. JMIR Res Protoc. 2023; 12: e49670. doi: 10.2196/49670.
Erskine HE, Baxter AJ, Patton G, Moffitt TE, Patel V, Whiteford HA, et al. The global coverage of prevalence data for mental disorders in children and adolescents. Epidemiol Psychiatr Sci. 2017; 26(4): 395-402. doi: 10.1017/S2045796015001158.
Argimón Pallás JM, Jiménez Villa J. Métodos de investigación clínica y epidemiológica. Barcelona: Elsevier España; 2010.
Torales J, Barrios I. Diseño de investigaciones: algoritmo de clasificación y características esenciales. Med Clínica Soc. 2023; 7(3): 210-35. doi: 10.52379/mcs.v7i3.349.
World Health Organization. The ICD-10 classification of mental and behavioural disorders [Internet]. 2019 [citado el 14 de noviembre de 2023]. Disponible en: Disponible en: https://icd.who.int/browse10/2019/en
Hernández Sampieri R. Metodología de la Investigación. 6ª ed. McGraw Hill: México; 2014.
Yoon Y, Eisenstadt M, Lereya ST, Deighton J. Gender difference in the change of adolescents' mental health and subjective wellbeing trajectories. Eur Child Adolesc Psychiatry. 2023; 32(9): 1569-1578. doi: 10.1007/s00787-022-01961-4.
Herrmann L, Reiss F, Becker-Hebly I, Baldus C, Gilbert M, Stadler G, et al. Systematic Review of Gender-Specific Child and Adolescent Mental Health Care. Child Psychiatry Hum Dev. 2023. doi: 10.1007/s10578-023-01506-z. Epub ahead of print.
Alegria M, Vallas M, Pumariega AJ. Racial and ethnic disparities in pediatric mental health. Child Adolesc Psychiatr Clin N Am. 2010; 19(4): 759-74. doi: 10.1016/j.chc.2010.07.001.
Torales J, Villalba-Arias J, Ruiz-Díaz C, Chávez E, Riego V. The right to health in Paraguay. Int Rev Psychiatry. 2014; 26(4): 524-9. doi: 10.3109/09540261.2014.926866.
Islam MR, Rahman MS, Qusar MS. Community-based decentralized mental health services are essential to prevent the epidemic turn of post-Covid mental disorders in Bangladesh: A call to action. Health Sci Rep. 2022; 5(4): e734. doi: 10.1002/hsr2.734.
Última Hora. 2007 [citado el 14 de noviembre de 2023]. Paraguay tiene apenas 7 psiquiatras infantiles. Disponible en: Disponible en: https://www.ultimahora.com/paraguay-tiene-apenas-7-psiquiatras-infantiles-n63413
Toure DM, Kumar G, Walker C, Turman Jr JE, Su D. Barriers to Pediatric Mental Healthcare Access: Qualitative Insights from Caregivers. Journal of Social Service Research 2022; 48(4): 485-495. doi: 10.1080/01488376.2022.2088949.
Grover S, Sahoo S, Aggarwal S, Dhiman S, Chakrabarti S, Avasthi A. Reasons for referral and diagnostic concordance between physicians/surgeons and the consultation-liaison psychiatry team: An exploratory study from a tertiary care hospital in India. Indian J Psychiatry. 2017; 59(2): 170-175. doi: 10.4103/psychiatry.IndianJPsychiatry_305_16.
Burgić-Radmanović M, Burgić S. Comorbidity in children and adolescent psychiatry. Psychiatr Danub. 2010; 22(2): 298-300.
Mesman E, Vreeker A, Hillegers M. Resilience and mental health in children and adolescents: an update of the recent literature and future directions. Curr Opin Psychiatry. 2021; 34(6): 586-592. doi: 10.1097/YCO.0000000000000741.
Li F, Cui Y, Li Y, Guo L, Ke X, Liu J, et al. Prevalence of mental disorders in school children and adolescents in China: diagnostic data from detailed clinical assessments of 17,524 individuals. J Child Psychol Psychiatry. 2022;63(1):34-46. doi: 10.1111/jcpp.13445.
Ghandour RM, Sherman LJ, Vladutiu CJ, Ali MM, Lynch SE, Bitsko RH, et al. Prevalence and Treatment of Depression, Anxiety, and Conduct Problems in US Children. J Pediatr. 2019; 206: 256-267.e3. doi: 10.1016/j.jpeds.2018.09.021.
Bitsko RH, Claussen AH, Lichstein J, Black LI, Jones SE, Danielson ML, et al. Mental Health Surveillance Among Children - United States, 2013-2019. MMWR Suppl. 2022; 71(2): 1-42. doi: 10.15585/mmwr.su7102a1.
Hossain MM, Nesa F, Das J, Aggad R, Tasnim S, Bairwa M, et al. Global burden of mental health problems among children and adolescents during COVID-19 pandemic: An umbrella review. Psychiatry Res. 2022; 317: 114814. doi: 10.1016/j.psychres.2022.114814.
Durukan İ, Karaman D, Kara K, Türker T, Tufan A, Yalcin O, et al. Diagnoses of patients referring to a child and adolescent psychiatry outpatient clinic. Dusunen Adam. 2011; 24: 113-120. doi: 10.5350/DAJPN2011240204
Giasuddin N, Diba S. Pattern of child and adolescent patients attending psychiatric outpatient department of the mental hospital in Bangladesh. Faridpur Med. Coll. J. 2013;7(2):67-70. doi: 10.3329/fmcj.v7i2.13501
Kölch M, Klein M, Knebusch V, Deister A, Heuft G, Sauter D, et al. Individual and needs-based: the platform-model for personnel allocation in child and adolescent psychiatry and psychotherapy. Z. Kinder. Jugendpsychiatr. Psychother. 2021;49(2): 124-133. doi: 10.1024/1422-4917/a000780
Kowalenko N, Hagali M, Hoadley B. Building capacity for child and adolescent mental health and psychiatry in Papua New Guinea. Australas. Psychiatry. 2019; 28(1): 51-54. doi: 10.1177/1039856219871883
Jarbin H, Ivarsson T, Andersson M, Skarphedinsson G. Screening efficiency of the mood and feelings questionnaire (MFQ) and short mood and feelings questionnaire (SMFQ) in Swedish help seeking outpatients. Plos One 2020; 15(3): e0230623. doi: 10.1371/journal.pone.0230623
Ford J, Gagnon K, Connor D, Pearson G. History of interpersonal violence, abuse, and nonvictimization trauma and severity of psychiatric symptoms among children in outpatient psychiatric treatment. J. Interpers. Violence. 2011; 26(16): 3316-3337. doi: 10.1177/0886260510393009
