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Nuhu F.T.,Child and Adolescent Psychiatry Unit
South African Journal of Psychiatry | Year: 2010

Background. The few studies on child abuse in Nigeria have focused on the child victims. However, little is known about characteristics of the parents who are the perpetrators of this abuse. Aim. To assess the opinions and attitudes of parents concerning child abuse and neglect, and the factors associated with the practice of child abuse. Method. We interviewed 260 randomly selected parents in the city of Ilorin, Nigeria, using a questionnaire to ascertain socio-demographic data and details about the understanding and practice of various forms of child abuse such as hawking, child labour, physical beating, sending children to work as house-helps, and sexual abuse. Results. Sixty per cent of the subjects were women, and 72.7% were less than 40 years old; 30.4% sent their children to hawk goods, 34.2% believed that a child must work before receiving food, 10.4% had sent or would send their children to work as house-helps, and 52.3% discipline their children by physical beating. Older age (40 years and over), being unmarried, being unemployed, having 3 or more children, and a low level of education were significantly associated with the tendency to abuse children. Conclusion. Child abuse is still practised in Ilorin, Nigeria. Socio-economic factors associated with child abuse were identified. We recommend that government should assist citizens financially and support programmes that educate parents about the dangers of child abuse.

Konofal E.,Pediatric Sleep Disorders Center | Konofal E.,Child and Adolescent Psychiatry Unit | Lecendreux M.,Pediatric Sleep Disorders Center | Cortese S.,University of Tours
Sleep Medicine | Year: 2010

This paper, intended to provide useful insights for the clinical management of sleep disturbances in attention-deficit/hyperactivity disorder (ADHD), presents a critical, updated overview of the most relevant studies on the prevalence, etiopathophysiology and treatment strategies of sleep problems associated with ADHD, including restless legs syndrome, periodic limb movements in sleep, sleep-onset delay, increased nocturnal motor activity, sleep-disordered breathing, deficit in alertness, and sleep alterations accounted for by comorbid psychiatric disorders or ADHD medications. We also discuss some possible avenues for future research in the field. © 2010 Elsevier B.V.

Psychoanalytic theory derives many or its concepts from psychic processes assumed to exist in babies and infants and further assumed to subsequently influence the adult psyche. The author contends that mother-infant psychoanalytic treatment (MIP) is a variant of general psychoanalysis and that many classic psychoanalytic concepts can and should be integrated into the theory pertaining to this form of treatment. For example, infant sexuality plays a major role in many mother-child disorders. Regardless of this, many mother-child therapists make little use of infant sexuality to explain such disturbances. If infant sexuality is to be of any clinical value, it must be clearly distinguished from attachment and understood in the context of the mother's «enigmatic messages» to her child, as proposed by Jean Laplanche. The author discusses two example cases. One is the video recording of a newborn chid and its parents, the other a clinical situation in which the analyses infant sexuality materialises in a comment addressed to a 3-month-old child.

Russell P.S.,Child and Adolescent Psychiatry Unit
Indian journal of pediatrics | Year: 2013

Anxiety Disorders (AD) have been known to have high prevalence of intra-AD and extra-AD co-morbidities. This study documents the prevalence and profile of intra and extra-AD co-morbidities, the effect of the presence and number of co-morbidities on the severity of anxiety symptoms and the influence of age as well as gender on the co-morbidity. In a prospective community survey of 500 adolescents, independent raters administered the Screen for Child Anxiety Related Emotional Disorders (SCARED) and Schedule for Affective Disorders and Schizophrenia for School-Age Children/Present and Lifetime Version (K-SADS-PL) to collect the required data. Descriptive statistics, independent t tests, one-way ANOVA and Chi-square tests were done to evaluate the prevalence and profile of co-morbidity presentation, compare the effect of co-morbidity on severity of anxiety symptoms as well as analyse the influence of age groups and gender on intra-AD co-morbidities. Among those with AD, 14.2% had a DSM-IV-TR intra-AD co-morbidity and 70% had SCARED based intra-AD co-morbidity. Adolescents with Separation Anxiety Disorder and Generalised Anxiety Disorder had the highest SCARED and DSM-IV-TR prevalence of intra-AD co-morbidity respectively. Also, 23.7% had overlapping extra-AD co-morbidity. Presence and number of intra-AD co-morbidity was significantly associated with severity of total anxiety score and subscale scores (all with P = 0.001). Age and gender of adolescents were not related to the co-morbidity. Intra and extra-AD co-morbidities are quite prevalent among adolescents with Anxiety Disorders in India. As such, co-morbidities increase the severity of anxiety symptoms, they should be identified and appropriate management should be established.

Screen for Child Anxiety Related Emotional Disorders (SCARED), a measure found useful in different settings and cultures has not been validated in the subcontinent. This study validated this measure for identifying Anxiety Disorder (AD) among adolescents in an Indian community context. Five hundred adolescents were assessed with SCARED and DSM-IV-TR reference standard for diagnosis of AD. The interviewers were experienced raters who were further trained to interview participants using Schedule for Affective Disorders and Schizophrenia for School-Age Children/Present and Lifetime Version (K-SADS-PL). Sensitivity, specificity, likelihood ratios and predictive values for various SCARED cut-off scores were calculated. Test-retest reliability and inter-rater reliability of SCARED were examined. The dichotomized SCARED score was correlated with the DSM-IV-TR clinical diagnosis of AD to establish the criterion validity of SCARED as a measure of AD. A SCARED total score of ≥21(Sn = 84.62%, Sp = 87.36%; AUC = 90%) is suggested for diagnostic use in Indian population. Specific threshold scores were identified for the Panic Disorder, Generalized Anxiety Disorder, Separation Anxiety Disorder and Social Anxiety Disorder subscales. The inter-rater reliability (ICC = 0.87) and test-retest reliability (ICC = 0.90) for SCARED is good. Besides the adequate face and content validity, SCARED demonstrates good internal consistency (Cronbach's α = 0.89) and item-total correlation. There is a high concordance rate with the reference standard, DSM-IV-TR diagnosis [81%; Cohen's κ = 0.42 (95% CI = 0.31 to 0.52); P = 0.001] in classifying AD. SCARED has adequate psychometric properties and is now available for clinical and research work in India.

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