KARACHI (APP) - Speakers at a session on," Child Abuse" during the ongoing National Symposium of Pakistan Paediatric Association here on Sunday said a large chunk of child abuse problem remains hidden and what is seen is just the tip of iceberg. They said all the current good work was directed to the apparent figures while the "hidden" mass was still deprived of the attention. There are still a number of "silent" abuses that take place in homes and are not reported, however, the scars of it are found to be visible among adults who present to the psychiatric clinics with a number of mental health problems. The session was chaired by Prof, Afroze Ramzan and co-chaired by Prof. Salma Shaikh. Its speakers were Samandra Pope (UNICEF), Diedre Keinin and Dr. Jabeen Abbas, Dr. Amin Gadit, Mrs. Jacoline , Dr. Aisha Mehnaz and Dr.Ashfaq Mala. Speakers extensively discussed issues ranging from Protection of CSA in Child Protection System, Child Protection Bill: Role of Pakistan Commission of Child Welfare and Development and Social Welfare Department, Beyond Child Abuse - The long term Challenge, Dilemma of Child Abuse Knowledge and perception of Parents about Child Abuse, Knowledge and Skills of Healthcare Professionals in the Diagnosis and Management of Child Abuse and Neglect. The speakers said a huge burden of depressive illness among patients was attributable to child abuse and there was urgency to re-sensitise the medical professionals, parents and policy makers. They were unanimous that the subject of child abuse with particular reference to its longer-term sequel be included in the postgraduate syllabus of mental health specialists. They agreed with Prof. Amin A Gadit that there must be a room for family clinics and home visits by trained primary care workers with an aim and focus on primary prevention of child abuse. The psychiatrist said Pakistan could not afford to increase the burden of mental health morbidity in Pakistan. Presentations generated interesting debate viz a viz need to curb the menace of child abuse more forcefully by means of awareness through media and stricter legislation. Participants, comprising paediatricians, psychiatrists and activists noted with deep concern that Major Depression has been a common presentation among adults who comes across the psychiatric out patient clinics. Dr. Gadit said the clinical problem could be a possible extension of childhood depression that was reported among 65% of the abused children in a local study. Adults of childhood abuse might continue to numb their emotions by using alcohol, drugs, self-harming behaviour or unhealthy eating habits. Post-Traumatic Stress Disorder (PTSD) was said to be another serious complication of childhood abuse with which the adults do present themselves in the psychiatric clinics.