EPA-1231 – Study of psychiatric emergencies in children and adolescents

Abstract

The urgent children and adolescent psychiatric consultations have increased recently[1] and may be the first contact with the mental health network[2]. To describe and analyze the population<18 years old admitted at the psychiatry emergency department(ED) of Hospital Clínic of Barcelona between june/12-may/13. Demographic and clinical data were collected, using SPSSv.19.0 for statistical analysis. 596 emergency visits from out of 420 patients were recorded[46.3% male, mean age 14.52(6-17)years]. The most frequent consultation reason was behavior disorder(54.4%), being the most common diagnosis externalizing disorder(51.2%). 44.8% had been previously attended an average of 3(1-17)times in our ED. 85.6% were already under psychiatric follow-up and 67.8% had been psychopharmacologically treated. Prior psychiatric hospitalizations occurred in 35.1%[average 1-3times]. 27.4% required acute hospitalization at the ED discharge. Most of consultations were between 12:00–13:00PM and 18:00–20:00PM, maximal activity was detected on Monday(17.6%) and minimal on Sunday(9.1%). Holiday periods coincided with a consultation decrease while April-May-June period accumulated a third of them. The stay time average in ED was 6.41 hours(15min-3days) and a 32.6% required pharmacological treatment. Since 2009 a reduction of 14.16% of the total psychiatric emergencies has been detected in our ED, but children and adolescents consultations have increased an 18%.Data obtained of the most common diagnosis and circadian and weekly distribution of visits are consistent with previous studies[1]. Greater prevalence of behavioral disorder was found in frequenters (3emergent consultations/year), which calls for further studies to optimize the approach to this problem.