Sociodemographic and Clinical Profile of Pediatric Patients at the Out-Patient Department of a Psychiatric Facility in Southern Philippines

Research Article

J Psychiatry Mental Disord. 2023; 8(2): 1069.

Sociodemographic and Clinical Profile of Pediatric Patients at the Out-Patient Department of a Psychiatric Facility in Southern Philippines

Toledo CB*; Sayon-Gonzalez DM

Department of Psychiatry, Southern Philippines Medical Center, Davao City, Philippines

*Corresponding author: Toledo CB Department of Psychiatry, Southern Philippines Medical Center, JP Laurel Street, Barangay 30-C, Poblacion District, Davao City, 8000, Philippines. Tel: (+63)9171344106; (082)324 1804 Email: camtoledo99@gmail.com

Received: April 19, 2023 Accepted: May 20, 2023 Published: May 27, 2023

Abstract

Objective: This study aimed to describe the sociodemographic and clinical profile of pediatric patients who consulted at the Out-Patient Department of a psychiatric facility in Davao City, ie. Southern Philippines Medical Center Institute of Psychiatry and Behavioral Medicine and provide baseline data for future research and program development.

Methodology: This is a descriptive chart review that used a purposive sampling method to determine the sociodemographic and clinical profile of patients below nineteen (19) years old, seen at the Out-Patient Department of a psychiatric facility from January 2015 to December 2019.

Results: A total of 427 charts were reviewed in this study. Majority (30.2%) of the study population had their first consult in 2019, female (56%), belonged to the 12-18 age groups (64%), and had high school education (43%). Most came from Davao Region (89%) with class D social classification (64%). The clinical profile showed that majority consulted due to forensic reasons (54%), with referrals coming from WCPU, courts, or police stations (54%). Sexual abuse (43.9%) was the most common cause for forensic consult. The most common diagnosis was clustered under Adverse Childhood Experiences (30%). Most were advised referral to the psychology unit (59%) and were discharged as Out-patient (97%).

Conclusion: The number of child and adolescent consults in the Out-Patient Department of a psychiatric facility steadily increased within the span of five years. Majority of the patients came in for forensic reasons, with sexual abuse as the highest. A third of the consults were diagnosed to have Adverse Childhood Experience.

Keywords: Adverse childhood experience; Clinical profile; Pediatric patients; Psychiatric facility; Sociodemographic profile; Southern philippines

Abbreviations: AMC: Another Medical Condition; CARAGA: Caraga Administrative Region; CICL: Child in Conflict with the Law; Contd: Continued; DOH-CERC: Department of Health Cluster Ethics Review Committee; DSWD: Department of Social Welfare and Development; HAMA: Home Against Medical Advise; IPBM: Institute of Psychiatry and Behavioral Medicine; OPD: Outpatient Department; SOCCSKSARGEN: South Cotabato, Cotabato, Sultan Kudarat, Sarangani and General Santos City; SPMC: Southern Philippines Medical Center; UNICEF: United Nations Children’s Fund; VAWC: Violence Against Women and Children; WCPU: Women and Children Protection Unit; WHO: World Health Organization

Introduction

The World Health Organization (WHO) reported that disorders in mental health are one of the leading causes of diseases worldwide [1]. Studies have found that most mental disorders begin in childhood and adolescence [2] where half of the mental illness commenced by fourteen (14) years of age [3,4]. Thus, understanding the degree, risk factors, and progression of such illness in this population should be highlighted [5].

Children’s mental disorders can be varied and present as grave changes in how children learn, behave, or regulate their affect that can cause distress in their daily activities [6]. Approximately 10-20% of children and adolescents have mental disorders [4], or an estimated 15 million, and can presently be diagnosed with a mental health disorder, including depression, anxiety, and conduct disorder [7]. A more significant number of children could be at risk of developing mental disorders due to factors in genetics, families, schools, and communities. Data showed an alarming number of children who have mental health problems had not received appropriate interventions compared to the 7% who do [8].

There has been little research on the mental health of children and adolescents in the Philippines compared to other developing countries [9]. WHO reported that 16% of children in the Philippines suffer from mental disorders [10]. The recent passage of the Republic Act 11036 or the Mental Health Act in the Philippines signaled that mental health is gaining importance among Filipinos. However, except for mental health promotions in schools, little was included for children and adolescents in this law [11] which showed the need for additional development of child and adolescent mental health policy.

In many countries, including the Philippines, most of the funding for mental health services is dedicated to adult services. This made it difficult to the development of appropriate child and adolescent mental health services. Specific funding arrangements and policies should be facilitated for child and adolescent mental health services and should be regarded as separate health care [4]. The Out-Patient Department of the Southern Philippines Medical Center Institute of Psychiatry and Behavioral Medicine (SPMC-IPBM) also caters to children who are brought in for a psychiatric consult. Still, this population is seen in the same setting as their adult counterparts who could hinder proper intervention for this vulnerable population.

Children are the nation's most important asset, and proper promotion of their welfare should be implemented. The results of this study will serve as baseline data for the sociodemographic and clinical profiles of pediatric patients in the study area. This could be used in improving the services and establishing specialty training in the institution for enhanced service delivery specific to this population. This will benefit other researchers as a reference for further studies. Thus, this study aims to determine the socio-demographic (age, sex, address, social classification, educational attainment) and clinical profile (reasons for consult, diagnosis, outcome, referral to other services) of pediatric patients examined in the Out-Patient Department of SPMC-IPBM from 2015-2019.

Methodology

This study utilized a descriptive retrospective chart review design. A purposive sampling method was conducted, wherein all charts of patients who were below 19 years old and who consulted at the Outpatient Department from 2015-2019 were included in the study. Only the initial consult was included for uniformity. The computed sample size at 95% confidence interval was 353.

The research protocol was presented to the department for approval and was then submitted to the Department of Health Cluster Ethics Review Committee (DOH-CERC). An expedited review of the protocol was done by DOH-CERC and was approved last August 10, 2021. Letters were then sent to the Department Chairman and Head of the Records Section to allow access to the charts for review. Data collection was then conducted. The charts were assigned a control number to ensure anonymity. To ensure privacy, the patients and their families were not contacted by any means (i.e. mail, electronic mail, phone, or social media) throughout the duration and even after the end of this study. A data-gathering form was utilized for the chart review.

The sociodemographic and clinical profiles of the study population were analyzed using descriptive statistics. Mean and standard deviation for continuous data such as the case of age and other relevant parameters measured using a standardized unit of measure. For categorical data such as the case of sex, type of management, and or procedure, frequency and the percentage were used to express the variables and data were summarized using frequency distribution table. Data analysis was encoded using Microsoft Excel software. Data analysis was done using Epi Info version 7. This software was favored over the other software because this is freeware and shareware software which is available at https://www.cdc.gov/epiinfo/index.html.

Results

A total of 427 charts were reviewed for this study, which was 20% more than the computed sample size of 353 at 95% confidence interval. The majority of the study population had their first consult in 2018 and 2019 with 24.4% and 30.2% respectively (Table 1). The least number of child and adolescent patients were those seen in 2015 with a frequency of 12.2%.