Diferencias clínicas entre adolescentes hospitalizados por intento suicida y adolescentes hospitalizados por otra causa psiquiátrica / Clinical differences between suicide and non suicide attempter hospitalized adolescents

Background: Suicide is the third cause of death among adolescents in United States and between 5 to 12 percent of teenagers have a history of suicide attempt. Therefore, suicide is a public health problem in this age group. Aim: To compare the clinical characteristics of hospitalized adolescents who attempted suicide with those without a history of suicide attempt. Material and Methods: The clinical records of adolescents aged less than 18years, hospitalized in a psychiatric clinic, were analyzed. Forty six patients aged 15 ±2years (72 percent females) had a history of suicide attempt and were considered cases and 81 patients aged 15 ±2 years (52 percent females) did not have a history of suicide attempt and were considered controls. Demographical and clinical characteristics of both groups were compared. Psychiatric diagnoses were based on the Diagnostic and Statistical Manual of Mental Disorders IV (DSMIV). Results: No significant differences were found between groups in the length of hospital stay. The most common psychiatric diagnosis was depressive disorder, found in 71 and 35 percent of suicide and non-suicide attempters, respectively (p < 0.01). Personality diagnosis was deferred in most studied cases. Conclusions: Depression is more common among hospitalized adolescents who attempt suicide.

Características clínicas de niños y adolescentes menores de 18 años hospitalizados en una clínica psiquiátrica universitaria / Clinical characteristics of children and adolescent hospitalized in a University Psychiatric Clinic

Blackground: Five percent of children and adolescents consults in mental health services in one year. Approximately one every ten children has a mental health problem. Aim To assess clinical and demographic factors of children and adolescents hospitalized by psychiatric cause in a university psychiatric clinic. Patients and Methods: Review of medical records of 167 subjects aged 9 to 17 years, 97 women, admitted to a Psychiatric Service in the period 2001-2004. The International Classification of Primary Care (ICPC) manual of the World Organization of National Colleges, Academies and Academic Associations of General Practitioners/Family Physicians (WONCA) was used to classify admission complaints and symptoms and DSMIV to classify psychiatric disorders. Results: Mean hospital stay was 11+8 days. The main admission causes were suicidal attempts and psychomotor agitation/impulsive behavior in 54 percent and 26 percent of cases, respectively. The main psychiatric diagnoses were depressive disorder, suicide attempt and bipolar disorder. In 69 percent of patients, the personality diagnosis was deferred. Only 25 percent of families were considered functional. Conclusions: Affective disorders and suicidal behavior are the main psychiatric diagnoses at discharge in children and adolescents admitted to a psychiatric impatient service.

Programa de transtornos de alimentación en adolescentes y jóvenes chilenos: variaciones a seis meses de tratamiento / Multidisciplinary treatment of eating disorders in Chilean adolescents and young adults: Six months outcome

Background: Eating disorders may have serious organic consequences derived from under nutrition, specific nutrient deficiencies and electrolytic disturbances and reach a mortality as high as 12 percent. Aim: To describe the features and outcome after six months of treatment of patients attending the Eating Disorders Unit at the Catholic University Hospital in Chile. Material and methods: Review of medical records of patients with eating disorders that received a multidisciplinary treatment by a team of nutritionists, psychiatrists and psychologists and were seen at least twice in a period of six months. Results: The records of 81 patients (mean age 16.3±3 years, only one male) were included in the review. Forty nine patients had Anorexia Nervosa of the restricting type, five of the purging type, 22 had Bulimia Nervosa of the purging type and two of the non purging type and three patients had an eating disorder not otherwise specified. Eighty percent consulted within the first year of symptom appearance. Sixty five percent came from families with both parents living together, 57 percent had a rigid and agglutinated family structure and 65 percent had occult crises. Depression or dysthymia was found in 45 percent of patients and drug therapy was required at the beginning of treatment in 25 percent. Obsessive traits (40.4 percent) were significantly related to restrictive eaters. A past history of obesity or overweight was common. After six months of treatment, body mass index increasing significantly in restrictive eaters with obsessive traits and occult family crises was noticed. Conclusions: A multidisciplinary therapeutic intervention improved body mass index and family symptoms in patients with restrictive eating disorders.