Attention deficit hyperactivity disorder (ADHD) is a common neurodevelopmental disorder in children. ADHD leads to significant impairment in overall functioning of the child. There is limited information concerning the clinical scenario of ADHD within Nepal. The study aims to determine the clinico-demographic profile and pattern of medication use in the treatment of ADHD.
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Sirjana AdhikariID1,2*, Jasmine Ma2, Suraj Shakya3, Per Håkan Brøndbo1, BjørnHelge Handegård4, Anne Cecilie Javo51 Department of Psychology, Faculty of Health Sciences, UiT, The Arctic University of Norway, Tromsø, Norway, 2 Child & Adolescent Psychiatry Unit, Kanti Children’s Hospital, Kathmandu, Nepal, 3 Department of Psychiatry and Mental Health, Institute of Medicine, Tribhuvan University, Kathmandu, Nepal, 4 Regional Centre for Child and Youth Mental Health and Child Welfare—North, Faculty of Health Sciences, UiT, The Arctic University of Norway, Tromsø, Norway, 5 Sami National Competence Center for Mental Health (SANKS), Sami Klinihkka, Finnmark Hospital Trust, Karasjok, Norway
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Abstract Background: The COVID-19 pandemic has brought in significant changes in the lifestyles of families worldwide. This study is aimed to look at the parental perspectives and concerns related to the challenges in parenting in the ongoing COVID-19 pandemic through qualitative methodology. Methods: The dataset for the study was the queries raised by parents who participated in a parent training program that addressed concerns related to parenting in the initial phase of the pandemic situation (April 2020). Two training sessions were conducted by one of the authors as part of community outreach activities in the department of child and adolescent psychiatry at a tertiary care academic institute of national importance. Content analysis was used to analyze the dataset manually. Results: The major themes that emerged were concerns related to handling children in home-bound situation, handing siblings of different age groups, caring for children with developmental disorders, managing work-life balance, concerns related to screen time among children, and general parenting-related queries for young children and adolescents. Based on the themes emerged, information pamphlets addressing these specific concerns were prepared for wide dissemination among parents. Conclusion: This study attempted to understand the parental perspectives and experiences related to parenting challenges in the current pandemic situation. Parental narratives highlighted some of the unique challenges pertaining to the “new normal.” Disseminating educational and informational resources during the pandemic are an essential systemic response that will benefit the community in resource-limited settings.
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Catatonia is a psycho-motor disorder associated with various psychiatric, neurological, and medical illnesses. It is due to alteration in GABAergic circuits and basal ganglia. Management includes identifying the underlying cause and handling complications with supportive treatment. It can cause life-threatening complications like dehydration and cardiac arrest. The risks are more in children and adolescent populations. Benzodiazepines and electro-convulsive therapy are treatment modalities. In this case report we discuss about a child who was resistant to both lorazepam and electroconvulsive therapy. Resistance to both first-line management is a rare phenomenon. We were able to manage with a combination of antipsychotics and antidepressants. Catatonia in children may respond late to treatment. Symptomatic treatment, ruling out organic causes, and judicious use of pharmacotherapy can be beneficial in resistant cases.
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Abstract Background: Teacher reports of child emotional and behavioral problems (EBPs) are sparse in many low- and middle-income countries, especially when compared to reports from parents. Cross-informant information is pivotal to clinicians when dealing with mentally ill children. In this study from Nepal, we examined teacher reports of child EBPs, the agreement between teacher and parent reports, and how this agreement varied by type of EBP and child gender. Methods: This cross-sectional, observational study included 3808 schoolchildren aged 6–18 years from 16 districts of Nepal. Teacher and parent reports of EBPs were measured by the Nepali versions of the Teacher Report Form (TRF) and the Child Behavior Checklist (CBCL), respectively. Linear mixed model analysis was used for group comparisons and intraclass correlations. Agreement between TRF and CBCL scale scores were analyzed using Pearson’s correlation coefcient. Results: The prevalence of EBPs according to teacher reports was 15.4%, whereas the previous parent-reported prevalence was 19.1%. Also, the mean TRF score was signifcantly lower than mean CBCL score for the 90 common items. Mean TRF scores for Total Problems, Externalizing Problems, and Internalizing Problems were 26.9 (standard deviation, SD 24.5), 6.1 (SD 7.2), and 7.9 (SD 7.3), respectively. Consistent with parent reports, mean TRF scores for Total Problems and Externalizing Problems were higher among boys than girls, whereas no signifcant gender diferences were found for Internalizing Problems. Teacher-parent agreement was moderate (r=.38), and slightly higher for Externalizing Problems than for Internalizing Problems (r=.37 versus r=.34). Moderate to low correlations were found for all syndrome scales, with coefcients ranging from r=.26 (Social Problems) to r=.37 (Attention Problems). The efect of child gender on the teacher-parent agreement was signifcant for Internalizing Problems only, with a higher agreement for girls than for boys. Conclusion: Nepali teachers reported fewer child EBPs than parents. Teacher-parent agreement was moderate and varied by type of EBP and child gender. Our fndings underscore the importance of obtaining information on child EBPs from both parents and teachers when evaluating and treating children in low- and middle-income countries like Nepal. Keywords: Cross-informant, Teacher, Nepal, Children, Emotional and behavioral problems
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Jasmine Ma ,Pashupati Mahat,Per Håkan Brøndbo,Bjørn H. Handegård,Siv Kvernmo,Anne Cecilie Javo
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