Presentation and Follow-up Patterns of Child and Adolescent Patients attending a Teaching Hospital Psychiatric Clinic in Lagos, Nigeria.

Abstract

Background: Child and Adolescent Mental Health is a fast developing subspeciality of psychiatry in low income countries. Units in tertiary hospital settings are well positioned to be useful referral centres for young patients from other areas of medicine in such hospitals. Aim: The authors aimed at describing the ways in which the children/ adolescents presented at the psychiatric out patient clinics and their follow up attendance patterns. Method: The study was retrospective in nature, with data gathered basically from the case file records. All the records of patients that were aged below 16 years old at first presentation and were registered between January 1993 and December 2008 were included. Results: A total of 106 cases were included in the study. Mean age was 8.84 + / - 3.5) years and 60.4% were male and 39.6 female. For majority of them, the key informant at presentation was the mother (55.3%), followed by the father (19.4%) and in some cases both parents (15.1)%. It was seen from this study that more than half (55.6%)of the patients seen in the unit were referred from the paediatric neurology clinic within the teaching hospital, while another quarter (25.5%) were from child guidance centres in the community; only 15.1% walked in from the community on their own initiative. Abnormal behaviours , seizures and restlessness were the commonest reasons for presenting. Over 88% had stopped attending the clinic over the years while about 11% were still attending regularly. The average total number of clinic visits was 7.65 + - total 8.5). Conclusion: Child and Adolescent units are relevant referral units for patients with developmental or neurological problems identified from other hospital units and community child service providers. Default rates in clinic attendance is however high. Key Words: Child, Adolescent, Psychiatry, Africa, Hospital