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Child mental health

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R. Lynn, D. Nicholls, R. Viner.Institute of Child Health, London, UK

Background: Rare disease and infections are by definition individually uncommon, but collectively are an important cause of morbidity and mortality in childhood. For 20 years the British Paediatric Surveillance Unit (BPSU) has been successful in addressing this via the collection of national data on rare childhood conditions. Many such conditions affect a child’s mental wellbeing but their epidemiology cannot be investigated without the input of child and adolescent psychiatrists.

Aims: (1) To evaluate a system set up to undertake surveillance of early onset eating disorders (EOED); (2) to undertake an evaluation of the clinicians views on such a system; (3) identify potential areas for future study.

Method: For a period of 15 months from March 2005 a yellow card, modelled on the BPSU orange card, was sent monthly to child and adolescent psychiatrists identified through the Royal College of Psychiatrists. The card asked participants to report EOEDs for children aged 5–12 years inclusive, seen in the previous month. Study details including the case definition, objectives and reporting instructions were circulated along with a monthly newsletter. Paediatricians also reported EOEDs through the BPSU orange card. Non-respondents were re-contacted after 3 months. Following a reported case, a proforma was sent to the respondent seeking descriptive data on the case. After 15 months of surveillance an evaluation questionnaire was sent out to those who were eligible to receive a report card.

Results: The average monthly response rate for the yellow card was 84%. 379 (75%) of 505 reports were via the card, of which 321 were confirmed, 234 (73%) by psychiatrists. The overall questionnaire response rate was 87%, 81% by psychiatrists. 95% of psychiatrists were willing to contribute to a monthly card-reporting scheme; 20% would prefer to report electronically. Psychiatrists identified …

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