Common psychological disorders among institutionalized children in rural and urban settings in Kenya
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Date
2008Author
Mutiso, Victoria N
Type
ThesisLanguage
enMetadata
Show full item recordAbstract
Objective
To determine the prevalence of psychological disorders among institutionalized orphans
in rural and urban settings in Kenya.
Design
A cross-sectional descriptive method was adopted. Quantitative methods were employed
using self-administered questionnaires (ReADS) for the children to identify emotional
disorders.The teacher-rated Rutters scale for the identification of emotional and behavioural
problems was also used.
Focus group discussions were held with selected key staff of the orphanages to gain an
understanding of the objectives of the various orphanages and how the orphans viewed the
institutions,according to the caretakers.
Setting
The study was conducted in two study settings in Kenya: urban and rural. The
representative study sites for both urban and rural were selected using purposive
sampling.
Subjects
Six hundred and seventy three children aged 8 years and above were interviewed. Teachers
were also interviewed regarding their own observations about the children's emotional and
behavioural problems.
Results
Bothorphans and non-orphans had high levels of psychological distress with a statistically
significant difference on separation anxiety subscale (p = 0.021). Total orphans had a higher
prevalence of depression of 2.9% than non-orphans who had a depression prevalence of
2.6%.Depressionco-existed with obsessive compulsive disorder with a prevalence of 13.4% among
non-orphansand 10.4% among total orphans. Separation anxiety prevalence was higher
amongnon-orphans (16.7%) and (11.7%) among total orphans, than other categories of
children.
Childrenin the rural setting were twice more likely to suffer from psychological disorders than
the children in the urban setting. There were statistical differences for obsessive compulsive
disorder and panic disorder subscales (p = 0.031 and p = 0.040 respectively).
Focusgroups discussions revealed that staff in the orphanages cannot easily identify
psychologica disturbances.
Conclusions
Children in institutions have emotional and behavioural problems that need to be identified
and managed. Children suffer from depression and other co-morbid illnesses such as
obsessive compulsive disorder, generalized anxiety disorder, separation anxiety and social
phobiaas early as 8 years and these ought to be recognized early to prevent debilitating
psychiatric illnesses later in adulthood.
This study concluded that parental deprivation either through death or separation from
significantattachment figures was a major factor affecting the psychological well-being of a
child.
It is important for teachers and other adults to learn how to identify psychological problems in
children.
From he findings of this study, institutionalization is not the only practical response to the
orphancrisis.
Citation
Master of Science in Clinical psychologySponsorhip
University of NairobiPublisher
Department of psychiatry School of medicine College of health sciences University of Nairobi