A 5-year retrospective study of demographic, anamnestic, and clinical factors related to psychiatric hospitalizations of adolescent patients

Abstract

BackgroundPsychiatric emergencies of children and adolescents have greatly increased during the last years, but this phenomenon has not been studied in detail. The aim of this study was to analyze the correlation between acute psychiatric hospitalizations of adolescents and selected variables to highlight risk factors for psychiatric emergencies.MethodsThis retrospective research was conducted in the acute psychiatric public ward, Service of Psychiatric Diagnosis and Treatment (SPDT), and in the residential facility for adolescents, “The Medlar”, located in Modena. The sample was constituted by all adolescent patients (n=101, age range 14–18) who had acute hospitalizations (n=140) in SPDT and had been successively transferred to “The Medlar” (n=83), from February 2, 2010 to January 31, 2015. From clinical charts, we extracted demographic and anamnestic characteristics of patients and clinical variables related to hospitalizations. Data were statistically analyzed.ResultsSixty-one percent of our patients lived with one divorced parent, with adoptive or immigrant family, or in institutions; 51% had experienced stressful events during childhood; 81% had a normal intellective level, but only 6% presented regular school performance. Parental psychiatric illness was negatively related, in a statistically significantly way, with onset age of adolescent mental disorders (coefficient −2.28, 95% confidence interval [CI]: −3.53 to 1.01, P<0.001, single linear regression; odds ratio: 4.39, 95% CI: 1.43–13.47, P<0.010, single logistic regression). The most frequent reasons for admission were aggressive behavior in males and suicide risk in females (P=0.002). The most frequent psychiatric diagnosis at SPDT discharge was “conduct disorder”, more frequent in males, followed by “adjustment disorder”, more frequent in females (P=0.001). In SPDT, the adolescent hospitalizations progressively increased fivefold at the end of the observation period.ConclusionOur results overlap the worldwide trend of increasing adolescent psychiatric hospitalizations, suggest risk factors like parental psychiatric illness and early life stressful events, and highlight the different prevalence of aggressiveness and suicide in males and females.

Aggression and related stressful life events among Chinese adolescents living in rural areas: A cross-sectional study

“…Consistent with existing studies, boys were more likely to exhibit aggression than were girls (McEachern and Snyder, 2012). In a 5-year retrospective study from Di Lorenzo et al (2016), aggressive behavior was the most frequent reason for psychiatric hospitalization among boys. This phenomenon is likely explained by "social role theory," whereby gender-related behavioral differences are culturally determined.…”

Predictors of voluntary and compulsory admissions after psychiatric emergency consultation in youth

“…While the overall prevalence of mental health conditions in youth has remained relatively stable [1], many recent studies have reported an increase in psychiatric emergencies in children and adolescents. Such increase has been noted in the United States [2][3][4][5], Canada [6][7][8], and Europe [9][10][11]. Over the same period, most countries have reduced the number of child and adolescent psychiatric inpatient beds [12][13][14].…”

Emergencias psiquiátricas en niños y adolescentes: Relación entre características clínicas y demográficas

“…Con respecto al intento suicida, no se hallaron datos estadísticamente significativos asociados al sexo, como los reportados en otros estudios (17,18) . Los trastornos psicóticos y del ánimo estuvieron más frecuentemente asociados a emergencias pediátricas infantiles a nivel local, en concordancia con estudios anteriores (10,11) .…”

“…Al respecto, los datos de este estudio indicaron que el sexo femenino tuvo hasta dos veces más riesgo de presentar algún trastorno del ánimo. Sin embargo, estos datos contrastaron con los reportados a nivel internacional, en donde los trastornos de conducta y trastornos de adaptación fueron los más frecuentes (18) . Un hallazgo particular del presente estudio fue que los trastornos de personalidad escalaron en el ranking de presentación como diagnóstico asociado a una emergencia psiquiátrica en la adolescencia, a pesar de ser diagnósticos establecidos para la población adulta, teniendo el sexo femenino hasta dos veces más riesgo de mostrarlo.…”