Pacientes psiquiátricos en el servicio de urgencias de pediatría de un hospital terciario: revisión de un período de 6 meses

Abstract

In the last few years, a marked increase in the number of psychiatric emergencies treated at pediatric emergency departments has been observed. The aim of the present study was to characterize these patients.We performed a descriptive, prospective, cross sectional study, based on all psychiatric emergencies treated at the pediatric emergency department of Hospital General Universitario Gregorio Marañón, Madrid, from 1-10-04 to 31-3-05. The following variables were analyzed: age, sex, time of consultation, day of the week, day of the month, month of the year, psychiatric antecedents, previous psychiatric pharmacologic treatment, the person or service who took the child to hospital, diagnosis, and whether the patient was admitted to the hospital.Of a total of 36,449 emergencies, 79 were psychiatric (0.21 %). Sex rates were 48.1 % boys and 51.9 % girls. The mean (+/-2 SD) age was 13.73 +/- 2.5 years. Visits were most frequent on Mondays (19 %), in the evening, and in January and February. A total of 13.23 % of the patients were brought by extrahospital services. The main diagnoses were: behavioral disorders (36.76 %), anxiety disorders (20.58 %) and suicidal ideation or suicide attempt (13.23 %). There was a clear male predominance in behavioral disorders (67.85 %) and a female predominance in anxiety disorders (71.42 %) and suicidal ideation or suicide attempt (76.92 %). The hospitalization rate among these patients was 32.35 %.The incidence of psychiatric disorders in our pediatric emergency department was low. The patients were aged 11-15 years old, without differences between the sexes. Peak demand was reached on Mondays in January and February, at the end of the evening and beginning of the night. The most common diagnosis was behavioral disorder. The hospitalization rate was exceptionally high, more than 6 times higher than the average in our hospital.