IntroductionThe CPOA (Centre Psychiatrique d’Orientation et d’Accueil) is the largest psychiatric emergency center in France, with more than 10,000 consultations per year. The aim of our retrospective observational study is to describe the population of patients aged 15 to 18 years (18 years old not included) consulting our center (reasons for consultation, psychiatric diagnoses, referral decision by specifying the structures to which these minors are referred) and to describe a predictive model for the decision to hospitalize. MethodsAll consecutive patients aged over 15 and under 18 consulting in the CPOA between January 1, 2017 and December 31, 2021 were included in the study. The characteristics of our study sample are described in terms of proportions for qualitative variables and with means and standard deviations for quantitative variables. The probability of being hospitalized was modeled on the entire sample using a multivariate Probit model for which the hypotheses of validity were tested. ResultsWe have recorded 2712 visits, corresponding to 1873 patients included in our study (mean age=16.2±0.72, 54% girls), i.e. an average of 5.2% of the total patients. The main reasons for consultation were depressive ideations (22%), anxiety (19%), and suicidal thoughts (18%). The most frequently diagnosed psychiatric disorders according to the 10th revision of the International Classification of Diseases were F30-39 (mood disorders) (34%), F40-48 (neurotic, stress-related and somatoform disorders) (24%) and F60–69 (personality and behavioral disorders) (11%). Among the patients with an indication for hospitalization, i.e. 27%, 85% were admitted in adult units and fewer than 12% in adolescent specific units, while among the patients with an outpatient care, i.e. 65% in total, only 11% were referred to child psychiatry consultations. An older age, a suicide attempt in the week preceding the visit to the psychiatric emergency department, suicidal behaviour and suicidal ideations, hetero-aggressive behaviour, psychomotor agitation or excitement, delusions, wandering, running away or pathological travel, and a diagnosis of type F20–F29 (Schizophrenia, schizotypal disorder and delusional disorders) and F30–F39 were significantly predictive of a decision to hospitalize. ConclusionPsychiatric hospitalization of adolescents consulting due to psychiatric emergencies is a major problem. The predictive factors for hospitalization reflect an absolute need for immediate care. Unfortunately the lack of structures dedicated to adolescents is such that three quarters of adolescents end up hospitalized in adult structures, which is neither appropriate nor acceptable.