Clinical Profile and Sex Differences in Brazilian Children and Adolescents Receiving Psychiatric Services in the Emergency Department

Tonezer, Jordana; Muller, Thomaz; Rocha, Gibsi P.; Recondo, Rogéria; Nogueira, Eduardo Lopes; Spanemberg, Lucas

doi:10.1097/pec.0000000000000505

Cited by 7 publications

(10 citation statements)

References 26 publications

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“… 22 Prior literature on the gender of pediatric patients presenting with psychiatric emergencies is mixed with some studies finding a female predominance and others finding a male predominance. 2 , 5 , 8 , 23 , 24 However, none found such a striking predominance of one gender. It is notable that childhood-onset developmental and psychiatric disorders such as ADHD, autism and conduct disorders show a male predominance, while there is a female predominance in mood and anxiety disorders, which more commonly present in adolescence.…”

Section: Discussionmentioning

confidence: 84%

Involuntary Psychiatric Holds in Preadolescent Children

Santillanes

Kearl

Lam

et al. 2017

WestJEM

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IntroductionLittle is known about the use of involuntary psychiatric holds in preadolescent children. The primary objective was to characterize patients under the age of 10 years on involuntary psychiatric holds.MethodsThis was a two-year retrospective study from April 2013 – April 2015 in one urban pediatric emergency department (ED). Subjects were all children under the age of 10 years who were on an involuntary psychiatric hold at any point during their ED visit. We collected demographic data including age, gender, ethnicity and details about living situation, child protective services involvement and prior mental health treatment, as well as ED disposition.ResultsThere were 308 visits by 265 patients in a two-year period. Ninety percent of involuntary psychiatric holds were initiated in the prehospital setting. The following were common characteristics: male (75%), in custody of child protective services (23%), child protective services involvement (42%), and a prior psychiatric hospitalization (32%). Fifty-six percent of visits resulted in discharge from the ED, 42% in transfer to a psychiatric hospital and 1% in admission to the pediatric medical ward. Median length of stay was 4.7 hours for discharged patients and 11.7 hours for patients transferred to psychiatric hospitals.ConclusionTo our knowledge, this study presents the first characterization of preadolescent children on involuntary psychiatric holds. Ideally, mental health screening and services could be initiated in children with similar high-risk characteristics before escalation results in placement of an involuntary psychiatric hold. Furthermore, given that many patients were discharged from the ED, the current pattern of utilization of involuntary psychiatric holds in young children should be reconsidered.

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Section: Discussionmentioning

confidence: 84%

Involuntary Psychiatric Holds in Preadolescent Children

Santillanes

Kearl

Lam

et al. 2017

WestJEM

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“…The analyses of patients' self-report questionnaires (YSR [11][12][13][14][15][16][17][18] show an association between length of stay and greater social, attentional, anxiety-depression, withdrawaldepression, and internalizing problems, and obsessive compulsive and post-traumatic symptoms. Furthermore, in line with the ratings provided by both parents, the length of hospitalization is positively correlated with thought problems.…”

Section: Discussionmentioning

confidence: 99%

“…CBCL and YSR Achenbach questionnaires [29,30] are among the most commonly used scales for rating child and adolescent behavior, used internationally in the clinical setting and in research. We used self-completed questionnaires: one completed by the adolescents (Youth Self-Report [11][12][13][14][15][16][17][18] and one completed at least by one parent or both (Child Behaviour Checklist 1.5-5 and 6-18 version). These questionnaires yielded two profiles: one for competences (activities, social functioning, and school performance), which provided information about the adolescent's level of personal autonomy and social skills and about how well the adolescent performs in sports, hobbies, and school; the other for behavioral and emotional problems, both of which can be assessed as "normal", "borderline", or "clinical" on eight specific syndrome scales.…”

Section: Toolsmentioning

confidence: 99%

“…In the literature, little information emerges regarding hospitalization trends [ 13 ]. Nonetheless, the demographic and clinical factors most associated with psychiatric hospitalizations during child development appear to be adolescence, suicidal ideation and/or suicide attempts (more frequent among females), psychomotor agitation (more frequent among males), a psychiatric family history, past hospitalizations, psychiatric comorbidity, a history of victimization (bullying, physical, psychological, and/or sexual abuse, neglect, and witnessing violence), and academic and relational difficulties [ 2 , 7 , 14 , 15 , 16 , 17 , 18 ]. In particular, a large number of studies identify parental psychiatric illness as one of the most significant risk factors for pediatric-age psychiatric hospitalization [ 16 , 19 , 20 , 21 ].…”

Section: Introductionmentioning

confidence: 99%

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A Retrospective Study on the Factors Associated with Long-Stay Hospitalization in a Child Neuropsychiatry Unit

et al. 2021

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The past twenty years have seen a rapid increase in acute psychiatric symptoms in children and adolescents, with a subsequent rise in the number of psychiatric hospitalizations. This paper aims to: (a) describe the epidemiology of hospitalizations and some of the clinical and sociodemographic characteristics of pediatric patients admitted to a regional referral Complex Operative Child Neuropsychiatry Hospital Unit in Northeast Italy and (b) identify potential factors correlated with the length of hospital stay. Methods: 318 (M = 12.8 years; SD = 3.11; 72% Female) patients hospitalized for mental health disorders from 2013 to 2019. Results: Around 60% of hospital admissions occurred via the emergency room, mostly due to suicidal ideation and/or suicide attempts (24%). Affective disorders were the most frequent discharge diagnosis (40%). As for factors correlated with length of hospital stay, we found significant links with chronological age, way of hospital admission, cause of admission, discharge diagnosis, presence of psychiatric comorbidity, family conflict, and psychiatric family history. Conclusions: These results provide information about global characteristics associated with the length of psychiatric hospital stays in pediatric patients and provide a basis on which specific precautions can be hypothesized with the aim of developing more focused treatments.

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“…In a previous study investigating emergency psychiatric care at our facility, the number one specific reason for psychiatric care among children and adolescents was suicide attempts. 18 …”

Section: Discussionmentioning

confidence: 99%

Trends in suicidal behavior at a general hospital emergency department in southern Brazil

Lejderman

Parisotto

Spanemberg

2020

Trends Psychiatry Psychother.

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Objective: To assess the prevalence of and factors associated with suicidal behavior in patients seen at the emergency department (ED) of a general hospital in southern Brazil. Method: Descriptive, observational, cross-sectional study. The records of all patients who had an emergency psychiatric consultation at the ED conducted by the emergency psychiatric consultation service at Hospital São Lucas da Pontifícia Universidade Católica do Rio Grande do Sul in 2016 and 2017 were analyzed and stratified by sex and by age groups (15-29 years, 30-49 years, 50-69 years, and 70 years and older). Suicidal behavior was characterized by factors such as thoughts of death, suicidal thoughts, and suicidal risk. Suicidal behavior was compared by sex and between age groups with chisquare tests. Multivariate analysis of suicidal behavior and gender, age, and specific diagnoses were compared with Poisson regression. Results: A total of 1,172 records from January 2016 to December 2017 were examined. There were more ED visits by females (63.1%) than males. Younger patients (15-29 years) had a higher severe risk of suicide than elderly (≥ 70 years) patients (54.1 vs. 19%; p < 0.01). Indicators of suicide behavior stratified by sex and by age group revealed marked differences between age groups for all variables among female patients. Overall, age group patterns for males were very similar in terms of suicidal behavior variables. Conclusions: A high prevalence of suicidal behavior was observed in this sample, particularly among young adults and especially associated with female gender and diagnoses of depression and personality disorders.

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Clinical Profile and Sex Differences in Brazilian Children and Adolescents Receiving Psychiatric Services in the Emergency Department

Cited by 7 publications

References 26 publications

Involuntary Psychiatric Holds in Preadolescent Children

Involuntary Psychiatric Holds in Preadolescent Children

A Retrospective Study on the Factors Associated with Long-Stay Hospitalization in a Child Neuropsychiatry Unit

Trends in suicidal behavior at a general hospital emergency department in southern Brazil

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