1800 patients of a community hospital were compared with 150 patients of a neuropediatric
centre with respect to their neurological/psychiatric comorbidity. In the psychiatric
sample, we identified 130 patients with a neurological disorder: 41% of the patients
had an epileptic disorder, 20% a motor dysfunction, 11% a microcephaly, 10% migraine
and 8% sleep disorders. Patients with an epileptic disorder had an adjustment disorder
(23%), an attention deficit hyperactivity disorder (21%), an emotional disorder (15%)
or an autistic spectrum disorder (11%). 4% of these patients were mentally retarded.
The most common psychiatric diagnosis in the neuropediatric sample was an attention
deficit hyperactivity disorder (38%), followed by somatoform disorders (30%), mental
disorders due to brain damage (20%) and autistic spectrum disorder (10%). The evaluation
and the treatment of complex developmental disorders requires a competent multiprofessional
team with neuropediatric and psychiatric expertise. In our experience, the challenge
lies in providing an integrated and well coordinated therapeutic approach, as speech
and language disorders, mental retardation and abnormal psychosocial circumstances
all have to be taken into account to provide an optimal setting for the development
of the child. Optimisation of the medication is but one aspect of the approach.
