A retrospective review of pre-schoolers referred for psychiatric services at the Charlotte Maxeke Johannesburg Academic Hospital

Abstract

The study is a retrospective review of pre-schoolers 6 years old and younger who were referred to the Charlotte Maxeke Johannesburg Academic Hospital Child, Family and Adolescent Unit, Johannesburg for psychiatric intervention between 1 January 2006 and 31 December 2010. The study described and analysed demographics and the various characteristics of children 6 years old and under who were referred to the unit for psychiatric intervention. The several psychiatric conditions and interventions were also evaluated. One hundred and forty nine (149) pre-schoolers who were 6 years old and under presented to the Unit and the majority were male (77.2%;N=115). The mean age of presentation was 54 months (SD=12.59) and the majority of the pre-schoolers were referred to the Unit by medical professionals. Attention-Deficit/ Hyperactivity Disorder (ADHD) was the most common presenting condition. Girls were more likely to present with Anxiety disorders (44.1%;15/34) and Reactive Attachment Disorder (35.3%;12/34) and boys were more likely to present with Autism Spectrum Disorders (26%;30/115). There were no statistical differences in the rates of Attention-Deficit/ Hyperactivity Disorder between girls (38.2%;13/34) and boys (43.6%;65/115) with ADHD (x2=2.705; df=1; p=0.1001). A psychological assessment was conducted in 68.5 % (102/149) of referrals. Almost half the children (46.3%; N=69) received pharmacological intervention. The defaulting rate after the initial assessment was high. The study highlights the frequency of psychiatric illness in pre-schoolers and necessitates the need to conduct further research in this vulnerable age group at other clinical sites.