Irritability in an open-door pediatric psychiatric emergency service in a middle-income country

Abstract

BackgroundIrritability is a main reason for referral of a child to a pediatric emergency. Few psychiatric services are dedicated to care for children and adolescents in middle income countries. Thus, there is not a clear picture about the real needs of an emergency unit to optimize the service's demands. This study aims to describe a sociodemographic profile of children and adolescents in a psychiatric emergency service due to complaints of irritability. MethodsIn total, 2,255 medical records were reviewed from patients referred within a year at an emergency department of a mental health service for children and adolescents. Patients with and without irritability were compared in terms of sociodemographic features, psychiatric complaints and associated somatic and psychiatric disorders. ResultsAbout 30% of youths attending at this service had irritability. Most were boys (67%) with an average age of 12.6 years (±3.9). Irritability was associated with a diagnosis of mood disorder, attention deficit hyperactivity disorder and oppositional defiant disorder. LimitationsThere are concerns about the setting in which data was collected, since it might have some time restrictions and data imprecision. ConclusionIrritability was a frequent complaint taking children and adolescents to the emergency department. This symptom co-occurs with several psychiatric disorders. These findings support the trans-nosographic view of irritability, in particular its co-occurrence with neurodevelopmental disorders.