Article Type: Research
Presenting complaints and comorbid diagnoses in children with mental disabilities presented to a child psychiatry outpatient clinic
Asiye Arıcı, Hatice Altun, Feyza Hatice Sevgen
Objective: In this study, WE aimed to determine sociodemographic characteristics, presenting complaints and comorbid diagnoses as well as effectiveness and adverse effects of medical treatments employed in patients presented to our Child and Adolescent Psychiatry Outpatient Clinic with mental disability.

Material and method: We reviewed medical records of 112 patients aged 0–17 years who presented to Child and Adolescent Psychiatry outpatient clinic of Kahramanmaras Sutcu Imam University, Medicine School between January 1st, 2016 and January 1st, 2017. Age, gender, IQ, presenting complaints, comorbid physical and psychiatric disorders, medications and adverse effects, and status of special education were assessed in all patients. Patients with incomplete data were excluded.

Results: There were 112 patients including 76 girls (67.9% and 36 boys (32.1%). Most patients (74, 66.1%) were in age group of 6–11 years. Mean age was 9.47±2.92 years in girls while 9.42±3.32 years in boys. Most common presenting complaint was hyperactivity (47.3%); followed by irritability (42.0%), academic failure (36.6%); harming to surroundings (29.5%), self-harming behavior (27.7%); inattention (25.0%; apathy to surroundings (13.4%), delayed speech (11.6%), forgetfulness (11.6), masturbating-playing with genitalia (6.3%), and other complaints (17.0%) including enuresis, anxiety, loss of joy, being anxious, repetitive questions, and not willing to speak in crowd. The most common presenting complaints were speech retardation and excessive mobility in the age group of 0–5 years while hyperactivity, academic failure, self-harming behavior and harming to surroundings in the age group of 6-12 years and harming to surroundings, academic failure, self-harming behavior and inattention in the age group of 12–18 years. Mental retardation was mild in 56.3%, moderate in 32.1% and severe in 7.1% of patients; in addition, overall developmental delay was present in 7.1%. The most commonly encountered psychiatric comorbid diagnosis was conduct disorder (23.2%) and attention-deficit/hyperactivity disorder (ADHD) (20.5%). The most common psychiatric comorbidity was ADHD in the age groups of 0–5 years and 6–11 years while conduct disorder in the age group of 12–18 years. There was physical comorbidity in 41.4% of patients as epilepsy being most common disorder. Of the patients, 9.8% were not using any psychotropic agents. Most commonly used agents were risperidone (46.4%) and short-acting methylphenidate (33.9%). It was seen that 88.4% of patients benefited from medical therapy and that girls responded to medical therapy better than boys. The rate of multi-drug use was 79.9%. It was seen that psychotropic agents were associated to adverse effects in 14.3% of patients as sedation, palpitation, and loss of appetite being most common adverse effects. Of the patients, 70.5% were attending to special education program.

Conclusions: Given the findings that most frequent mental disability was mild mental retardation, that most frequent psychiatric comorbid diagnoses were conduct disorder and ADHD and that most comorbid physical comorbid diagnosis was epilepsy, our results were consistent with the literature. To our knowledge, there is paucity in studies about mental disability in Turkey. We think that establishing demographic characteristics, presenting complaints, psychiatric comorbid diagnoses and psychotropic agents in children with mental disability will contribute to our knowledge in this field in child psychiatry.

Key words: presenting complain, children, ADHD, comorbid diagnosis, mental disability
Journal of Mood Disorders (JMOOD) 2017;7(4):199-204
Online ISSN: 2146 -2380
Print ISSN: 2146-1473
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