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Abstract
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Objective: Knowledge about rationales for child and adolescent psychiatry consultation, psychiatric diagnosis and treatment to date is critical to better identify existing child and adolescent needs, the current functioning and incompetence of consultation services. We aim to examine the referral pathways to Ankara University School of Medicine Child and Adolescent Psychiatry Department for consultation liaison and to identify the demographic characteristics of children, the presenting complaints, diagnoses and the treatments. Methods: The consultation demands from inpatient and outpatient clinics of Ankara University School of Medicine between November 2013 and November 2015 were screened retrospectively. Results: Psychiatric consultations were demanded for 347 child and adolescent patients. The children consulted were primarily females (n=196, 57%) and consultations were requested mostly for adolescents (n=215, 62%). Mood and anxiety related complaints (n=82, 24%), suicide attempts (n=79, 23%) aggression/self harm (n=27, 8%) and conversion symptoms (n=21, 6%) were the most common presenting complaints. Major depressive disorder and adjustment disorder were the most common diagnoses. Among the cases, 179 (52%) were referred to follow-up sessions and to further evaluations like psychological testing and no diagnosis was given and no medication was recommended for this group. Children were referred mostly from the pediatric emergency service (n=134, 39%). The surgery, oncology, intensive care, nephrology, gastroenterology departments of pediatrics were also the frequent referral sources. All of the suicide attempts were with drug intoxication and attempters were adolescents. Psychotropic medications and/or psychotherapeutic interventions were recommended for 136 (39%) child and adolescent. Psychotropic medications were recommended for 87 children and mostly selective serotonin reuptake inhibitors were suggested (n=62, 71%). Psychotherapeutic interventions were conducted in approximately half of the children. Within the first 12 hours 63% of consultation demands were evaluated. Conclusion: Symptoms of mood disorders especially major depressive disorder should be carefully screened before the hospitalization of children and adolescents with a chronic illness. There is a need for more collaboration with emergency service to manage the evaluations and perform accurate interventions for the risky adolescents who do commit suicide.
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