Factors behind a remarkable increase in adolescent psychiatric inpatient treatment between 1980 and 2010 – a nationwide register study

Abstract

Purpose This register-based study aimed to evaluate trends in adolescent psychiatric inpatient care using nationwide data from three consecutive decades. Methods The study population (N 17,112) comprised all Finnish citizens aged 13–17 receiving their first-ever psychiatric inpatient treatment between 1980 and 2010 in Finland. Information on inpatient care in the psychiatric hospital was obtained from the Hospital Discharge Register and the Care Register for Health Care, which contains data on all patients discharged from all Finnish inpatient psychiatric health services. Results Inpatient admissions remained relatively stable until the early 1990s, after which a steady increase was seen, peaking in 2008 and more marked among females than males. In males, there was an increase in inpatient care episodes for externalizing disorder or mood disorder, and in females for mood disorder. Duration of first inpatient care decreased over time, but level of functioning on admission remained stable or even deteriorated. Females, patients first admitted in the 1980s or diagnosed with schizophrenia were more likely to be re-hospitalized during adolescence. Conclusions We reported an increase in adolescent psychiatric inpatient care from the latter half of the 1990s up to 2010, which could be explained by societal and policy changes. In particular, as the study period progressed a significant increase was seen in admissions of females and a global reduction of length of stay (LOS) with no concomitant increase in re-hospitalizations.