Mental Health Emergencies in Paediatric Services: Characteristics, Diagnostic Stability and Gender differences.

INTRODUCTION: Child and adolescent psychiatric emergencies have increased in recent years. The main objective of our study is to analyze sociodemographic and clinical characteristics of psychiatric emergencies under 18 years old that came to our hospital. Secondary objectives were to study diagnostic stability made in the emergency department and undertake a gender analysis. METHODS: Descriptive cross-sectional study of patients attending the pediatric emergency department who required consultation to psychiatry service during 2010 and 2011, comparing data with two previous cross-sectional cuts (2002-2003 and 2006-2007). Then we track the diagnoses assigned during a year. Statistical analysis was descriptive. We also include a gender analysis. RESULTS: We analyzed 328 episodes corresponding to 179 different patients (average age 14.48). We detected a progressive increase of prevalence of psychiatric emergencies from 2002 to 2011. Diagnostic distribution showed a significant association of Behavioral Disorders with males and an association of Self-injured Behaviors and Eating Disorders with females. The admission rate was 18.5%. One-year diagnostic outcomes showed differences comparing to emergency diagnosis. CONCLUSIONS: Increase and complexity of psychiatric consultations in Pediatric Emergency Department requires a greater coordination and training of these services to enhance patients care. Emergency visit could mean the entrance of complex and severe patients to a specialized care. Our results detect gender differences: more Behavioral Disorders, Psychosis and Substance Use Disorders in males and Self-Injury and Eating Behavior Disorders in females.

Urgencias Psiquiátricas en Pediatría: características, estabilidad diagnóstica y diferencias de género / Mental Health Emergencies in Paediatric Services: Characteristics, Diagnostic Stability and Gender differences

Introducción. Existe una tendencia en los últimos años al aumento de las urgencias infanto-juveniles por motivos psiquiátricos. El objetivo principal del estudio fue analizar las características sociodemográficas y clínicas en las urgencias psiquiátricas de los menores de 18 años. Como objetivos secundarios, estudiamos la estabilidad diagnóstica y realizamos un análisis de género. Metodología. Estudio transversal descriptivo de pacientes que consultaron entre 2010 y 2011 al servicio de urgencias pediátricas por motivos psiquiátricos. Comparamos con dos cortes previos (2002-2003 y 2006-2007) y realizamos un seguimiento al año de los diagnósticos asignados. Estadística descriptiva, incluyendo un análisis comparativo de género. Resultados. Se analizaron 328 episodios (179 pacientes, edad media 14,48 años). Se detecta un incremento de prevalencia de 2002 a 2011. La distribución de diagnósticos por género muestra una asociación significativa de la alteración conductual con el masculino y de las conductas autolesivas y los trastornos alimentarios con el femenino. La tasa de ingreso fue del 18,5%. Tras revisar el diagnóstico al año de seguimiento, muestra diferencias con respecto a la orientación diagnóstica en urgencias. Conclusiones. El incremento de las consultas psiquiátricas urgentes en pediatría requiere una mayor coordinación y formación de los servicios para mejorar y adaptarse a esta emergencia. La consulta urgente supone la puerta de entrada a la atención psiquiátrica especializada de pacientes complejos y graves. Existen diferencias de género relevantes: se observan más trastornos conductuales, psicosis y trastornos por uso de substancias en el género masculino y más conductas autolesivas y trastornos alimentarios en el femenino

Introduction. Child and adolescent psychiatric emergencies have increased in recent years. The main objective of our study is to analyze sociodemographic and clinical characteristics of psychiatric emergencies under 18 years old that came to our hospital. Secondary objectives were to study diagnostic stability made in the emergency department and undertake a gender analysis. Methods. Descriptive cross-sectional study of patients attending the pediatric emergency department who required consultation to psychiatry service during 2010 and 2011, comparing data with two previous cross-sectional cuts (2002-2003 and 2006-2007). Then we track the diagnoses assigned during a year. Statistical analysis was descriptive. We also include a gender analysis. Results. We analyzed 328 episodes corresponding to 179 different patients (average age 14.48). We detected a progressive increase of prevalence of psychiatric emergencies from 2002 to 2011. Diagnostic distribution showed a significant association of Behavioral Disorders with males and an association of Self-injured Behaviors and Eating Disorders with females. The admission rate was 18.5%. One-year diagnostic outcomes showed differences comparing to emergency diagnosis. Conclusions. Increase and complexity of psychiatric consultations in Pediatric Emergency Department requires a psiquiágreater coordination and training of these services to enhance patients care. Emergency visit could mean the entrance of complex and severe patients to a specialized care. Our results detect gender differences: more Behavioral Disorders, Psychosis and Substance Use Disorders in males and Self-Injury and Eating Behavior Disorders in females