[Mental and behavior disorders in children placed in long term care institutions in Hunedoara, Cluj and Timis, Romania].
This article originated from a descriptive study done in 1992-1993 in Romania. The study was initiated and coordinated by the French NGO "Médecins du Monde", was directed by three health organizations (the "Observatoire régional de la santé de Languedoc-Roussillon", the "Unité 265 INSERM", the Romanian League for Mental Health) and was granted by the Romanian government and the European Community Commission. There are many publications about children's mental and behavioural disorders. But there are few epidemiological studies concerning the prevalence of these disorders among children suffering from social difficulties. This article explores the prevalence of mental and behavioral disorders among Romanian children institutionalized and examines specifically the prevalence among children in homes for children ("Casa de Copii") to compare it with similar data published in other countries. First, this article explores the prevalence of mental and behavioral disorders among a population of 4.692 children institutionalized in three Romanian districts in 1992. Second, this article examines the prevalence of these disorders among a population of 1.610 children institutionalized in homes for children ("Casa de Copii"), i.e. 1,610 children ages ranging from 4 to 18 years and suffering from social difficulties. Homes for children are out of home care institutions which are specialised neither in physical deficiencies nor in mental disorders. From this population, a randomized sample of 508 children has been screened by physicians and psychologists based on an evaluation protocol. Then each disorder has been coded as a diagnosis, according to the Tenth International Disease Classification (WHO). Fifty-four percent (54%) of the children institutionalized in homes for children in three Romanian districts in 1992 had a main diagnosis of mental or behavioural disorder. Third, this article compares our results to the prevalence found in other studies. Only three studies could be selected for comparison because they were the only ones with the three following criteria: 1) a focus on a population of children or a randomized sample of children ages ranging from 4 to 18 years, 2) a focus on children suffering from social difficulties and living in out of home care, 3) disorders evaluated by health professionals or a validated methodology. Our results lies within the range of prevalence found in the literature (41-70%). A discussion follows regarding methodological matters and critiques that may be launched from such a comparative designs. Finally, the high frequency of institutionalization in Romania in 1992 illustrates how few solutions there were to social difficulties and how exaggerated institutionalization was. This was a very different situation compared to Western Europe and Northern America. This should not hide, however, the actual modifications that took place in Romania. This article concludes with a brief description of the modifications which have been generated by the evaluation protocol used here.
Pluye
P
P
Groupe de recherche interdisciplinaire en santé, Faculté de médecine, Université de Montréal, CP 6128, succursale Centre-Ville, Montréal (Québec), H3C3J7, Canada. pierre.pluye@umontreal.ca
Lehingue
Y
Y
Aussilloux
C
C
Popa
I
I
Aiguesvives
C
C
D000293:Adolescent; D002648:Child; D002653:Child Behavior Disorders / Q000175:diagnosis / Q000453:epidemiology* / Q000209:etiology / Q000517:prevention & control / Q000523:psychology; D002670:Child, Abandoned / Q000523:psychology; D002674:Child, Institutionalized / Q000523:psychology; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D005581:Foster Home Care / Q000523:psychology; D006801:Humans; D008403:Mass Screening; D001523:Mental Disorders / Q000175:diagnosis / Q000453:epidemiology* / Q000209:etiology / Q000517:prevention & control / Q000523:psychology; D019372:Orphanages; D011159:Population Surveillance; D015995:Prevalence; D012383:Romania / Q000453:epidemiology; D012866:Skilled Nursing Facilities