Abstract
Background: Given the paucity of data concerning the care of adolescents attending an emergency department (ED) for mental disorders, we performed an observational study with the aim to describe psychotropic drug use in an Italian ED. Methods: A retrospective chart review of adolescents (13–17 years) visited in the ED of the San Paolo University Hospital in Milan for mental disorders between January and June 2018 was conducted. Information concerning age, gender, type of disorder, psychotropic drug use in the ED and outcome of the visit were analyzed, using an anonymous patient code. Results: A total of 1298 adolescents, 13–17 years old, were visited in the ED, 56 (4%) of whom had a diagnosis of mental disorder (34 females and 22 males). The most common disorder was anxiety (21 patients), followed by predominant psychomotor disorder (13 patients). In all, 30 adolescents received a psychotropic drug. Benzodiazepines were the most commonly used drugs (73% of the subjects), and delorazepam was administered/prescribed to 17 adolescents, despite the fact that evidence on its safety, efficacy, and its off-label use in the pediatric population is lacking. Conclusions: One out of two adolescents attending the ED for an acute episode of mental disorder received a psychotropic drug prescription, mainly in an off-label manner. More evidence is needed to guide the pharmacological management of acute episodes of mental disorders.
Highlights
Psychiatric disorders, neurological pathologies, and substance abuse represent 13% of the global burden of disease in the world’s population [1]
The present study aims to analyze the characteristics of emergency department (ED) accesses for psychiatric reasons, and to evaluate the pattern and appropriateness of psychotropic drugs prescribed to adolescents with acute mental disorders accessing the ED of a polyclinic hospital
Five adolescents with personality or mood disorders were visited in the ED for self-harm, in two cases associated with suicidal ideation
Summary
Psychiatric disorders, neurological pathologies, and substance abuse represent 13% of the global burden of disease in the world’s population [1]. The emergency department (ED) has become an important gateway for access to mental health services for children and youth due to limited access and long waiting times for specialized assessment and services [3,4]. Both international and Italian studies show that ED visits for mental health disorders. Given the paucity of data concerning the care of adolescents attending an emergency department (ED) for mental disorders, we performed an observational study with the aim to describe psychotropic drug use in an Italian ED. More evidence is needed to guide the pharmacological management of acute episodes of mental disorders
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