A Review of Solvent Abusers and their Management by a Child Psychiatric Out-patient Service

Abstract

1 This study reviews 45 solvent abusers referred, over a 3-year period, to the Departments of Child Psychiatry attached to a large postgraduate teaching hospital.

2 Abusers are considered in 3 defined groups: chronic, periodic, experimental.

3 Boys predominate mainly in the group of chronic abusers, where a strong association is seen with delinquent behaviour and disrupted family backgrounds.

4 Many chronic users report transient symptoms of a toxic psychosis. A marked affective component may be evident, often depressive in character.

5 Systemic physical symptoms are common, especially amongst chronic users. Weight loss, nausea and vomiting, acute bronchospasm, cardiac arrhythmias have all been reported.

6 Other illicit drug use is widespread through the whole sample, but of little significance. Most children report alcohol and cigarette consumption, use of which can be very heavy.

7 Treatment was offered to most children, and comprised mainly family and individual work. A favourable outcome was correlated with high motivation, at least 6 months' duration of out-patient attendance, or with residential care and therapy. Approximately half the children who were chronic or periodic users had improved at follow-up.

8 Recommendations for more systematic recording of solvent abuse have been made as a result of these findings. All cases in the future will be separately registered, and their progress followed prospectively.