Psychiatric clinics in Egypt and worldwide are increasingly receiving children of different ages, according to a recent World Health Organisation (WHO) report that revealed that one in five children and adolescents now suffers from a psychological disorder.
Ali Al-Nabawi, a professor of psychiatry in Cairo, said that “the surge in children in need of psychiatric care has prompted psychiatric departments across Egypt to establish specialised units to address the rising demand. In the past, conditions such as hyperactivity, autism, bedwetting, and stuttering were not as widely recognised.”
Behavioural pediatrician Ihab Eid concurred. “The stigma surrounding psychiatric care has diminished considerably. In the past, some cultural representations depicted psychiatric clinics as places for extreme cases, fostering shame even among adults seeking help,” he said.
“However, today people understand that psychiatrists diagnose and treat psychological and behavioural disorders, relying primarily on behavioural medicine and public health interventions, with the minimal use of medication.”
“Fifteen years ago, the term ‘autism’ was unfamiliar to most parents. Today, parents themselves are often the first to detect signs of autism in their children and seek professional evaluation and care,” Eid added.
Despite the sensitive nature of the subject, some parents are also sharing their stories to help others. The mother of one boy, Eyad, recounted her experience on condition of anonymity, for example, hoping that her journey might provide guidance and support to other mothers navigating similar challenges.
“I once had the misconception that children with autism were completely nonverbal, immobile, and detached from their environment. However, after watching a video on social media highlighting the early signs of autism, I became aware of behaviours such as hand-flapping, walking on tiptoe, repetitively opening and closing doors, spinning around, a preference for routine, and tantrums when this routine is disrupted,” she said.
“My son, in addition to his difficulty with conversation, exhibits these signs, and he is already over three years old. This was when I sought professional help.”
The mother of Rana, six, observed that her daughter had begun urinating in bed at night or while sitting, playing, or watching television. Initially, she responded with a reprimand, but as the situation worsened, she realised there was a connection between her daughter’s behaviour and the conflicts between her and her husband.
The situation was different with Malik, an eight-year-old boy who suffered from psychological trauma after being harassed at school. Malik’s mother said that she noticed her son crying when he was getting ready to go to school, as well as his fears whenever someone approached him.
“Once I realised what had happened to him, I immediately sought the help of a psychiatrist to address the shock he had experienced and begin his healing process,” she said.
Al-Nabawi explained that the specialised branch of child psychiatry requires practitioners who are trained to understand the distinct psychological makeup of children. “A child’s psychology differs significantly from that of adults. Children mirror the dynamics within their families and internalise information from their surroundings. Today’s children are also profoundly influenced by social media, which was unavailable to previous generations,” he said.
“Children today can exhibit a level of mental maturity that can surpass their years, creating additional psychological pressures for families. When speaking with a child today, you may feel as if you are engaging with an adult. This heightened awareness necessitates a tailored approach to therapy, such as employing techniques like play therapy or therapeutic methods specifically designed for children,” Al-Nabawi said.
Eid stated that the field of child psychology has seen notable advances in recent years. “We now have specialised clinics dedicated to addressing psychological and behavioural issues in children – a far cry from the earlier approach when multiple specialties were combined in general psychiatric and neurological clinics,” he said.
“Scientific progress has led to deeper insights and modern diagnostic tools for behavioural disorders. These advances have allowed us to recognise that children experience behavioural issues distinct from adults and that many of these conditions begin in childhood.”
“Early intervention is also critical. Had some of these disorders been addressed at the outset, many of the challenges we see today could have been prevented,” he noted.
Disorders: “Children may suffer from a range of psychological and behavioural disorders, such as schizophrenia, clinical depression, hyperactivity, and autism spectrum disorder, which may manifest in individuals who do not speak or interact as expected from an early age,” Eid said.
“Other issues include obsessive-compulsive disorder, habits like finger-sucking or nail-biting, lying, stealing, involuntary urination, peculiar sexual behaviours, and teeth grinding.”
Al-Nabawi said that depression is one of the most prevalent psychological disorders among children. “It’s important to note that depression in children does not mirror the symptoms typically seen in adults. Instead, it may manifest as involuntary urination, social withdrawal, academic numbness, stubbornness, or stuttering.”
There is a widespread belief that psychological disorders in children stem from parenting practices, a view supported by many psychiatrists. However, Eid said that numerous factors contributing to mental health issues lie beyond parental control or awareness.
“Mental illnesses and behavioural disorders often arise from a combination of factors, including genetic predispositions that may remain dormant until triggered by specific developmental stages,” he said.
“Mental health risks may begin with problems encountered by women before marriage. Exposure to harmful chemicals, even through inhalation, or stressful experiences can affect the quality of a mother’s eggs, potentially passing on vulnerabilities that predispose children to psychological disorders.”
“Beyond physical factors, adverse environmental conditions play a significant role. Children exposed to toxic family dynamics, such as parental conflicts, discrimination among siblings, or inconsistent parenting, are at higher risk. Homes marked by tension, poor relationships between spouses, and unhealthy environments create fertile ground for psychological disturbances,” Eid said.
Al-Nabawi said that marital discord is one of the most frequent issues brought to pediatric psychiatric clinics. “Children are highly sensitive to parental disputes. They often manifest their distress through nervousness or a range of psychological disorders,” he commented.
“Effective treatment begins with a thorough exploration of the family background and the nature of the relationship between the parents. A child’s mental health is inherently tied to the quality of the social environment.”
“Behavioural therapy is one of the most effective treatments and includes positive reinforcement to encourage desired behaviours and moral punishments, such as withdrawing privileges. Ignoring minor undesirable behaviours can also be part of this strategy.”
“Conditions like hyperactivity, attention deficit disorder, and autism require specialised interventions. Treatments often focus on calming the child and channelling their energy into constructive activities. Exercises designed to enhance social communication are also pivotal in transforming challenges into opportunities for growth.”
Delving into parental awareness and socioeconomic influences, Eid explained that “there is a growing number of informed parents who recognise the importance of behavioural medicine and take immediate action when they notice behavioural or psychological signs in their children, seeking professional help without hesitation.”
In order to safeguard children’s mental well-being, Eid advised reducing screen time to ensure children engage in other activities. Parents should interact with their children, moving beyond passive observation to active participation, he added.
“Parents should also encourage games that involve dialogue, physical participation, and mental engagement, such as puzzles or building blocks, and promote activities that stimulate creativity, like role-playing or acting out stories, which enhance cognitive and social development,” he said.
Gamil Sobhi, a consultant in psychological disorders and an expert in educational guidance, warned that “when exposed to frequent family disputes, children may feel alienated, anxious, and distant from their parents. Over time, these feelings manifest as chronic stress and anxiety, which persist into adulthood.”
“Raising your voice or resorting to physical discipline creates an environment where the child feels unsafe and insecure,” Sobhi explained. “It is natural for children to make mistakes as part of their learning process. Rather than punishing them, parents should provide guidance and patiently nurture them through repeated understanding and awareness.”
“Children must feel that they are loved. Even when parents are upset or disappointed by their child’s actions, the love should remain evident. Negative remarks can inflict deep emotional wounds,” Sobhi said.
Sobhi also advised parents to avoid making comparisons between their children and others. “Comparing children to their peers undermines their self-esteem and fosters a belief that they are inferior. Instead, parents should celebrate their child’s unique qualities and achievements to nurture a positive self-image.”
“Mobile phones offer a form of negative pleasure that captivates children, but this passive activity hinders the growth of brain cells,” he added. This negative pleasure isolates children, making them less likely to engage in meaningful interactions or participate in activities with others.
“Parents often instruct their children to limit their screen time, yet they themselves are on their mobile phones 24/7. Parents must lead by example and reduce their own screen usage to set a healthy precedent,” he concluded.
* A version of this article appears in print in the 23 January, 2025 edition of Al-Ahram Weekly
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