International Journal of Innovative Research and Development

Abstract

Background-Developmental delay (DD) is one of the commonest conditions seen by paediatrician with many preventable factors contributing to it and affecting its long term prognosis.

Aim-To study the factors associated with severity of developmental delay and its co-morbidities.

Methods-162 patients attending the child guidance clinic who fulfilled the inclusion criteria were selected for study by purposive sampling from a tertiary referral centre. Detailed physical and psychological evaluation was done for the patients. Developmental quotient (DQ) was assessed by the clinical psychologist using Denver’s developmental screening test. Comorbidities were assessed. Data, thus obtained was statistically evaluated.

Results and discussion- Of the 162 patients studied, the diagnosis was mild DD in 50.61%; moderate DD in 27.8%; severe DD in 17.9% and profound DD in 4.3%. Majority was less than 20 months age; 1^st or 2^nd  birth order; males; coming from a low socioeconomic status; rural, joint family background with low  parental literacy; product  of consanguineous, full term spontaneous vaginal delivery. Age of child and Mothers literacy was significantly associated with DQ of the child. Perinatal factors of statistical significance included neonatal seizures(NNS), neonatal jaundice(NNJ), septicaemia. NNS and HIE were significantly correlated with seizures later in life. Co morbidities significantly associated with DD included seizures, Down’s syndrome, cerebral palsy, autism and behavioural problems. Other co-morbidities included microcephaly, hydrocephalus, congenital talipes equno varus, cleft palate, congenital heart disease, visual and hearing impairment.

Limitations-It was a cross sectional hospital based study on a small number of patients. Long term effects of intervention were not studied.

Conclusions and Future directions- Increasing awareness for prevention and early identification with a multi disciplinary approach for the management of the developmentally delayed child will improve the long term prognosis.

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Abstract

Background-There are several factors affecting duration of untreated psychosis (DUP) which may affect the long term prognosis of the patient’s illness? Understanding them will help us in early intervention and management at all levels of illness.

Aim: To study factors influencing duration of untreated psychosis (DUP) in a tertiary care centre.

Methods: Sample collected from inpatients of a tertiary care psychiatric hospital in a purposive way. Socio demographic and illness factors were analysed and correlated with DUP statistically.

Results: There was a predominance of males (52%); younger age (16-25 years)-40%; illiterates-40%; Hindus-86%; rural background-80%. Majority (92%) belonged to low economic status; 62% belonged to nuclear families and 60% were married. However there was no significant difference between the sociodemographic factors when compared with DUP except for background being rural or urban area. Family history of mental illness was present in 10%; Schizophrenia and other psychosis constituted 78 % . Predominant symptom danger to others was seen in 40%, suicidal risk in 16% and lack of motivation in 6 %. 80% patients had no associated substance abuse. Majority of the patients were brought by parents (68%) and by police in 26% cases. There was no statistically significant difference when compared with DUP in all the factors above. Age of onset of illness was 52% in below 25 years age group; 26 % in 26-35 years group; 12 % in 36-45 years and 10 % in 46 years and above group. There was statistically significant difference when compared with DUP.

Conclusion: Age of onset of psychosis was the only illness factor and background being rural or urban was associated with DUP in a statistically significant way; others not being significant.

Limitations: Study was done in a tertiary care setup with a small sample which is not representative of the whole population

Future Directions: Need to increase awareness about mental illness in the public with improving general practitioner’s ability to identify symptoms for early diagnosis.

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