Characteristics of Pediatric Psychiatric Emergency Population in a Mental Health Hospital

Abstract

Aim: We aimed to investigate the characteristics of children and adolescents presented to the psychiatric emergency service (PES) of a mental health hospital. Materials and Methods:Medical records of patients under 18 years of age were reviewed for the first psychiatric emergency visit during a 1-year period. Results:The mean age was 15.82 years and 65.8% (n=711) were female. The most presenting symptoms were suicidal ideation (21.0%; most for girls) and homicide/violence toward others (20.7%; most for boys). The mean duration of symptoms was 265.36 days. The most common diagnoses were conduct disorder (16.7%; most for boys) and conversion disorder (15.5%; most for girls). Of the patients, 51.7% never used any mental health services before. The rate of prior use of mental health service was significantly higher in patients presenting with homicide/violence toward others and self-harm and lower in patients presenting with anxiety and somatic symptoms (p<0.05). Of the patients, 292 (27.0%) took no treatment and 271 (25.1%) were admitted to the psychiatric inpatient unit.Conclusion: PES can be used by half of the families as a first-line therapy unit. PES seems to serve an important role in the continuum of pediatric mental health care, particularly for youths with homicide/violence toward others, and to be a point of access to mental healthcare, particularly for youths with anxiety and somatic symptoms. (Eurasian J Emerg Med 2015; 14: 123-30)

Examination of Consultations Requested from the Child and Adolescent Psychiatry Clinic and Factors Predicting Subsequent Outpatient Clinic Attendance

“…15 Mutlu et al conducted a study revealing that the predominant symptoms leading to admissions to the psychiatry emergency department over a one-year period were suicidal ideation (21.0%) and aggression (20.7%). 25 Our study findings are consistent with the existing literature regarding the reasons for requesting consultations. Furthermore, given that psychosomatic symptoms emerged as the third most common reason for consultation in our sample, it underlines the importance of employing comprehensive psychiatric evaluation and treatment approaches.…”

“…Furthermore, agitation can also occur in medical conditions unrelated to psychiatric disorders, such as delirium, traumatic brain injury, infections, and adverse effects of medications. 25 Since agitation is a symptom covering many conditions, it may have appeared as a factor predicting the follow-up. At the same time, the outward and sometimes destructive nature of such symptoms leads the person or the physician to seek assistance and intervention.…”

Psychiatric Emergency in Children and Adolescents: A Retrospective Study in Parma Local Health Unit

“…As far as clinical features of these patients are concerned, this study reveals that in each considered year, the most frequent diagnosis reported in medical records is conduct disorders, mainly registered in male, but also in female, both in Italians and foreigners, whether voluntary admitted or not. This result is consistent with Finnish, Turkish, and German research that consider minors in psychiatric emergency setting [ 12 , 13 , 15 ]. In addition, this study points out that comorbidity is often associated with admission age older than the average (17 years) because during the process of growing up the onset of a new psychiatric condition in people already affected by another one is not rare, which can be both cause and consequence of the previous mental health status and share with the latter the same biologic and environmental background.…”

“…Results show that minor inpatients' mean age is 15.7 years, which is consistent with several studies carried out in other countries such as Turkey, where in a sample of 1080 patients, the mean age was 15.8 years [ 12 ], and Finland, where a mean age of 15.1 and 15.9 years was found in two different hospital districts [ 13 ]. This indicates that the process of growing up, from childhood to adulthood, is a period of weakness for the mental health status.…”

“…Regarding other European countries, German studies found higher percentage of males in both voluntary (58.7%) and involuntary (53.8%) admitted patients [ 15 ]. However, previous research carried out in Turkey and Finland showed a higher presentation of female to psychiatric emergency services (65.8% of Turkish sample and 60%-87.5% in the Finnish study) [ 12 , 13 ].…”