title: Frequency of ICD-10 psychiatric diagnosis in children with intellectual disability in Lahore, Pakistan & Caregivers Perspective.
abstract: OBJECTIVE
  Association between Intellectual disability (ID) and psychiatric disorders in children & adolescents is well established but there is a paucity of published studies from Pakistan on this topic. The main aim of the study was to assess the frequency of ICD-10 psychiatric diagnosis in the hospital outpatient sample of children with ID in Lahore, Pakistan as well as to find out which challenging behaviors, caregivers find difficult to manage in this setup.
  
  
  METHODS
  Socio-demographic information was collected, Wechsler Intelligence Scale for Children-Revised & ICD-10 diagnostic criteria was used to assess children (age range 6 - 16 years) with suspected ID along with identification of behaviors found to be difficult to manage by caregivers.
  
  
  RESULTS
  150 children were assessed with mean age of 10.7 years (males 70 %). Majority (72%) had mild ID while 18.7% and 9.3% had moderate and severe ID respectively. Thirty percent of children met the criteria for any psychiatric diagnosis, the most common being Oppositional Defiant Disorder (14%) and Hyperkinetic Disorders (10%). Verbal and physical aggression, school difficulties, socialization problems, inappropriate behaviors (e.g. disinhibition), sleep & feeding difficulties were the significant areas identified by the caregivers as a cause of major concern.
  
  
  CONCLUSIONS
  Significantly high prevalence of ICD-10 psychiatric diagnosis in children with ID was found in Lahore, Pakistan. Support services for these children should be responsive not only to the needs of the child, but also to the needs of the family.
authors.affiliation: Dr. Nazish Imran, MBBS; MRC Psych (London), Chairperson & Head, Associate Professor, Department of Child & Family Psychiatry, King Edward Medical University/Mayo Hospital, Lahore, Pakistan.
authors.forename: Nazish
authors.initials: N
authors.lastname: Imran
authors.affiliation: Dr. Muhammad Waqar Azeem, MD, FAACAP, DFAPA, Medical Director & Chief of Psychiatry, Albert J. Solnit Children's Center, Associate Clinical Professor Yale Child Study Center, Yale University School of Medicine, Middletown, USA.
authors.forename: Muhammad Waqar
authors.initials: MW
authors.lastname: Azeem
authors.affiliation: Ahsan Sattar, MSc (Psychology), Department of Child & Family Psychiatry, King Edward Medical University/Mayo Hospital, Lahore, Pakistan.
authors.forename: Ahsan
authors.initials: A
authors.lastname: Sattar
authors.affiliation: Muhammad R. Bhatti, F.R.C. Psych., M.R.C. Psych., Former Professor, Academic Department of Psychiatry & Behavioural Sciences, King Edward Medical University, Lahore, Pakistan.
authors.forename: Mohammad Riaz
authors.initials: MR
authors.lastname: Bhatti
keywords: Children and adolescents; Intellectual disability; Pakistan; Psychopathology