Psychiatric morbidity in children and young persons appearing in the Nairobi juvenile court

Abstract

This study was carried out among children and young persons 1Il difficult SOClOeconomic circumstances who had been brought to the Nairobi Juvenile Court. A total of 90 children and young persons between the age of 8 and 18 years were studied. Sixty of them were randomly selected from a similar group brought to the court by the police through the Probation department. All of the thirty children and young persons brought by their parents or other caregivers through the Children's department were interviewed. TIle main objective of this study was to establish the point prevalence of psychiatric morbidity and psychoactive substance use in such children and young persons. Socio-demographic and substance use data were collected using a questionnaire interview by the author. Screening for psychiatric morbidity was done using the Reporting Questiounaire for Chidren (RQC) and the potential cases were further subjected to a standard psychiatric interview; FolIow-up Interview for Children (FIC). lCD-lO diagnoses were then documented in all RQC positive cases. Results sbowed a crude psychiatric morbidity (CPM) in 40 out of the 90 children interviewed (44.4%). ICD-IO documented psychiatric disorders detected in those 40 with CPM were:- conduct disorders 18 (45%), mixed disorders of conduct and emotions 8 (20%), emotional disorders with onset specific to childhood 8 (20%), mood disorders 5 (12.5%) and hyperkinetic disorder 1 (2.5%). Out of the total sample studied, substance use was reported in 39 children (43.3%). TIle substances used were nicotine, volatile hydrocarbons, cannabis, alcohol, khat and sedatives in that order of decending frequencies. Multiple substance use was an associated factor. A wide spectrum of deviant behaviour was reported. 111is included leaving school before reaching secondary school; running away from home; begging; problems with parents, siblings, peers, teachers, police and administrative officers; stealing, thefts and robberies; possession and use of psychoactive substances; early unprotected sexual activity, sexual abuses and suicide attempts.

Rearing patterns and parenting were important factors in this study. Out of the total sample of 90, 23 (25.5%) were brought lip by the mother only and 3 (3.3%) by the father only. 15 (16.6%) reported 1I0t knowing their fathers and () (6.7%) reported not knowing their mothers. Of those brought up by the mother only, psychiatric morbidity was found in 7 (30.4%) and in 2 (66.7%) among those who had been brought up by father only. TIle relationship of family size and psychiatric morbidity was also assessed. A PM of about 27.6% was reported in families with an average of3 siblings. In this study it was found that 16 (17.7%) of the children and young person had appeared in the court more than once. Of these 6 (37.5%) had psychiatric morbidity. This study has confirmed the hypothesis that there is a significant psychiatric morbidity among children and young persons appealing ill the Nairobi Juvenile Court.