RESUMO
A retrospective study was conducted which comprised 212 patients who attended the Comprehensive Health Center Child Guidance Clinic and 107 who attended the University of the West Indies Child Guidance Clinic. Both clinics were similar in most areas. The mean age was 10.5 ñ 3 with 48.3 percent in the age group 11-15 years. 62. 4 percent of the patients were male and 87.1 percent were from the Kingston Metropolitan area. 37.5 percent of the patients were attending primary schools. 20.4 percent of the patients were from two-parent families. The most common diagnosis was conduct disorder (32.3 percent). The most common presenting complaints were stealing (36.4 percent), learning problems (32.6 percent) and aggressive behaviour (26.6 percent). Psychotheraphy was the favored mode of therapy. The attrition rate was greater than 70 percent. One major difference between the clinics was that there were more referrals (31.1 percent vs. 9.3 percent) from family members and less referrals (25.0 vs 44.9 percent) from health professionals at the Comprehensive Clinic in comparison to the University Clinic. Another difference was that some findings at the Comprehensive Clinic were statistically significant while similar findings at the University Clinic were not. There was a significantly higher percentage of patients receiving individual (61.8 percent vs 39.3 percent), group psychotheraphy (21.8 percent vs 11.2 percent) as well as laboratory investigations (8.5 percent vs 2.8 percent) at the Comprehensive Clinic and referrals to other agencies (15.0 percent vs 6.6 percent) at the University Clinic. There was a higher prevalence (10.4 percent vs 0 percent) of sexual abuse at the Comprehensive Clinic. These findings of high attrition rates and high percentage of conduct disorder indicate the important need for a major study of the Child Guidance Clinics in the island looking at clinic utilization, especially at outcome of patients diagnosed with conduct disorder and the factors affecting attrition from the clinics. It is recommended that a community survey assessing prevalence rates of psychiatric disorders in children should be done to give a picture of the mental health needs of children in Jamaica.(AU)
