Detailed contribution information
| Contribution title | 3476 - Pediatric Psychiatric emergencies in the University Hospital of Padua |
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| Contribution code | PS02-29 (P) |
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| Form of presentation | Poster |
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| Abstract |
Objectives Childhood and adolescence "psychiatric emergencies" are increasing all over the world (Janssens et al, 2013) with a raising number of hospitalizations and finally, of amount of resources needed (Bardach et al, 2014). The present report describes the experience the Pediatric Psychiatric Unit of the Department of WCH of Padua, Italy, has maturated in the last five years in dealing with children seeking acute medical care for psychiatric emergencies. Methods The clinical charts of all consecutive children aged < 16 years admitted to the Department of WCH of Padua from 2011 and 2016 for psychiatric acute problems were reviewed. Patient evaluation included an assessment for life-threatening risk factors, history and physical examination. Each patient received a psychiatric consultation. The assessment was conducted with observations, clinical interview and with the use of standardized specific tests. Patients were stabilized with a combined psychological and pharmacological therapy. Results Since 2011, admission rate for psychiatric conditions in emergency rooms has shown an increasing trend (+ 56%). The average length of hospital stay has progressively diminished (-6 days). Spontaneous admissions were mainly due to self-cutting and non-suicidal self-injury, suicidal thoughts and behaviors, deterioration in general health for maladaptive eating behaviors and agitation. In the remaining situations, children were admitted under request of a specialist. Most of the patients were females (69%). The median age at admission increased during the time period considered (from 11 to 13 years). Diagnosis were mainly represented by affective disorders, eating disorders (mainly anorexia nervosa) and psychosis. The yearly percentage of children who required acute pharmacological treatment with benzodiazepine and/or antipsychotic varied in the years considered from 18% and 54%. Conclusions The increase of "psychiatric emergencies" reveals the need to improve psychiatric patient-tailored care in acute pediatric services, providing adequate setting and specialists and ensuring a targeted diagnostic and therapeutic management in order to finally reduce costs and time of hospital stay. Studies are needed to analyze acute treatment seeking in pediatric mental health problems. Policy interventions are desirable to reinforce psychiatric services. |