Adolescents hospitalisés dans les services de psychiatrie adulte : une étude descriptive à la lumière des problématiques relevant de la protection de l’enfance

Abstract

BackgroundAdolescents hospitalized in adult mental health departments are many, and an important part of them benefit from a child welfare system. Many teenagers hospitalized at the adult psychiatric services have symptoms of auto- or hetero-aggressive behaviours. The aim of our study was to describe the population of adolescents supported by these services by analyzing their demographic and psychiatric characteristics and their links with the areas of child protection and disability. MethodsWe performed a retrospective descriptive study based on the analysis of hospital records of teenagers supported by the adult psychiatric services. Criteria for the analysis include sociodemographic, psychiatric morbidity and schooling data, data on the terrain, and those related to child protection or disability. Then subpopulations were analyzed in order to compare the different criteria whether or not within the child welfare system. ResultsSixty teenagers were included in our study. An analysis of the total population shows that these adolescents wer exposed to risk factors for psychiatric disorders: lower socioeconomic conditions, psychiatric family history and traumatic life events. Many were also school-leavers compared to the general population. Furthermore, a majority of the teenagers benefited from a child protection measure (n=33) and were institutionalized. The subpopulation analysis helped realize the particular vulnerability of adolescents under the care of child protection. Indeed, we significantly emphasized among them an increased prevalence of parental isolation (P=0.001), of psychiatric family history (P=0.001) and of having experienced traumatic events (P<0.0001). Concerning psychiatric disorders, we also found by the child welfare system that mild to moderate mental retardation was significantly more frequent among teens (P=0.003). In addition, our results show that these adolescents were significantly more often hospitalized (P=0.013). Finally, still in comparison with the other adolescents, these teens were significantly more school-leavers (P=0.032), mostly in specialized or adapted course of study (P<0.001), and more subject to disability (P<0.001), implying a double care. ConclusionThis study has allowed us to better know the youth population supported by adult psychiatric services. It has also enlightened the specific vulnerability of the teenagers under the child protection care who need psychiatric treatment. It offers interesting discussion topics to develop new modalities of care for these young people.