Abstract
The mental health care system in Italy is based on Law 180/70 which leaves great regional autonomy about the management of adolescent patients suffering from psychiatric diseases. The aim of this study is the evaluation of demographic, social, and clinical features of minors admitted to psychiatric wards, as starting point to improve individualized services for them. Data about all under 18s consecutively admitted to Parma's psychiatric wards from 2013 to 2015 were retrospectively collected from medical records. Diagnoses were classified according to ICD-10 criteria, and statistical analysis was performed using SPSS statistical software (IBM SPSS Statistics 22.0) for Windows. Clinical samples include 51 cases, 30 males (mean age: 15.5 years, ranging from 12 to 17 years) and 21 females (mean age: 15.9, ranging from 14 to 17 years). The most frequent diagnosis is conduct disorder (39.2%), with higher prevalence among males. Following this, 23.5% of the patients present comorbidity issues and 9.8% suffer from personality disorders, which is more frequent among females. High percentages of foreigners (31.4%), adopted minors (15.7%), and drug users (40%) are reported. Furthermore, data reveal that unprotective family environment, registered in 80.4% of cases, plays an important role as risk factor for the development of mental disease, readmissions in psychiatric wards, and discharge to residential facilities. Readmissions, as well as compulsory treatments (11 cases), are mainly required in case of conduct disorders and comorbidity diagnosis. Lastly, in contrast with the situation before hospital admission, most patients (63.3%) are discharged and sent to community residential facilities. Findings can be useful to improve the management of psychiatric emergencies in minors, focusing on their specific needs, such as conduct disorders and substance abuse, and to face emerging challenges, for example, mental health disease associated with the growing phenomenon of immigration.
Highlights
Psychiatric emergencies in children and adolescents have been challenging the mental health system with an increasing number of requests over the years, and a systematic review including studies from 27 countries shows that the worldwide prevalence of mental health disease in children and adolescents is 13.4% [1]
Conduct disorder is more frequent among males, while personality disorders show higher prevalence in females
As far as clinical features of these patients are concerned, this study reveals that in each considered year, the most frequent diagnosis reported in medical records is conduct disorders, mainly registered in male, and in female, both in Italians and foreigners, whether voluntary admitted or not
Summary
Psychiatric emergencies in children and adolescents have been challenging the mental health system with an increasing number of requests over the years, and a systematic review including studies from 27 countries shows that the worldwide prevalence of mental health disease in children and adolescents is 13.4% [1]. Many studies report that the onset of mental disease usually occurs in childhood, mostly with behaviour and anxiety disorders, or in adolescence, with high prevalence of anxiety, mood disorders, and substance abuse. Diagnosis of this mental disease can Behavioural Neurology improve their pathologic course, in terms of recurrences, readmission, and in some cases of endurance [5]. Since the beginning of 2000s, childhood and adolescence psychiatric services have been improved, but despite this, a minor presenting an acute or enduring mental health problem is often admitted in adult psychiatry settings. Psychiatric services should promote mental development as healthy as possible [7, 8], creating a suitable setting where minors’ treatment can be carried out [9, 10]
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