Profile of stress factors associated with mental disorders in children and adolescents referred for evaluation and treatment to the Free State Psychiatric Complex, 2007

Introduction. South African children and adolescents face serious challenges. Over the past decades children have been exposed to rapid and stressful changes in their environment, including increased crime and violence. Aim of study. The aim of the study was to determine the profile of stress factors leading to mental disorders in children and adolescents referred to the Child and Adolescent Unit at the Free State Psychiatric Complex, Bloemfontein, from January 2006 to December 2007. Methods. A total of 669 children (0 - 12 years) and adolescents (13 - 18 years) referred to the unit for evaluation and treatment were included in the study. Results. Thirty per cent were diagnosed with attention deficit and disruptive behaviour disorders, followed by major depressive disorders (22.7%), anxiety disorders (18.5%), conduct disorders (16.1%), mild mental retardation (15.7%), adjustment disorders (9.6%), elimination disorders (8.8%), developmental disorders (7.6%) and bereavement (7.0%). Social stressors were identified in 64.1% of participants, and psychological stressors in 19%. Conclusions. Stress plays an important role in the lives of children and adolescents, which could lead to emotional problems if not well managed. The functioning of children and adolescents should be monitored continuously. Schools are in a favourable position to identify stressors affecting children and adolescents. Educators therefore need training and opportunities to consult on mental health matters. Furthermore, religious organisations should be enlisted to identify stressors manifesting as spiritual dysfunction. School health services can play a role in the recognition of biological stressors such as epilepsy, pregnancy, enuresis, illness, speech problems and sensory dysfunction.