The profile of psychosocial disorders in children and the attendant patterns of referrals and health communication, were investigated within the context of a tertiary referral centre in the Eastern Cape Province. Literature on childhood disorders points to a high level of functional and substance related disorders in technologically developed countries of Europe and North America, in contrast to the developing countries of Asia and Africa, where the burden of infectious diseases and disorders of deprivation and lack still predominate in the profile of psychosocial disorders in children. In South Africa however, there is almost non-existent research on clinical psychosocial disorders profile and the research sets out to be an exploratory study in this area. A combination design was employed in which interviews and observations complemented a primarily quantitative descriptive cross sectional analysis of hospitalcase records. A pilot study was performed using an information gathering questionnaire and interviews, with findings subsequently explored in the main study. The International Classification of Diseases (ICD-10) (WHO, 1992) diagnostic categories were used to create a profile of all ailments in the paediatric unit. Psychosocial disorders both in terms of aetiology and illness course, can be viewed from the perspective of socialadjustment and functioning (in which there is a potential role of social factors as provoking, causal or modifying factors) (Williams &Clare, 1979); and the DSM-IV (Diagnostic and Statistical Manual of Mental Disorders) (American Psychiatric Association,1994) criteria was used to create the profile of these disorders in the paediatric unit at Frere Hospital which accounted for 45% of the ailments managed in one year. The derived profile is a picture in between the profile found in technologically advanced countries, and developing countries. While the infection burden and malnutrition appear to be readily contained or curtailed, there appears to be a serious problem with access to health care services which manifest especially at the level of perinatal events, with resultant high level of hypoxic brain damage and consequently mental retardation and varying levels of impairment or disability. These medical consequences in turn are fundamentally psychosocial, requiring psychosocial care with heavy reliance on strategic communication and referrals. The referrals in respect of psychosocial disorders are mainly at primary care level revolving around local health care clinics, private clinics, special schools and rehabilitation centres.