Characteristics of psychiatric emergency department visits in children and adolescents: A cross-sectional observational study focusing on children and adolescents in out-of-home care.
Author
Graversen, Krista Maria Løvgren
Term
5. Term (Master thesis)
Education
Publication year
2025
Abstract
Background: There is limited knowledge about children and adolescents who seek acute care in psychiatric emergency departments (PEDs). This study aimed to describe the demographic and clinical characteristics of those presenting to the PED at Aalborg University Hospital and to compare children in out-of-home care (OHC; e.g., foster or residential care) with those living with their parents (in-home care, IHC). Methods: Cross-sectional study using a retrospective review of all PED notes for ages 0–18 from October 1, 2022 to December 31, 2023; 388 visits were recorded and 384 notes were analyzed. Results: Most visits involved girls (78.7%), the median age was 15 years, and suicidal ideation was the most common referral reason (73.7%). Children in OHC accounted for 23.7% of visits and more often presented with psychotic symptoms (39.6% vs. 16.0%), aggressive behavior (24.3% vs. 14.7%), and previous suicide attempts (35.2% vs. 18.8%) than children in IHC. They were also more frequently admitted to inpatient psychiatric care (44.0% vs. 18.8%). Conclusion: Girls are overrepresented among PED patients, and children in OHC constitute a substantial share despite being a small fraction of the general population. They present with more diagnoses and more severe symptoms, including psychosis and suicidal behavior, and more often require admission. The PED may be a key setting to identify and target support for this vulnerable group.
Baggrund: Der er begrænset viden om børn og unge, der søger akut hjælp i psykiatrisk skadestue (PED). Formålet var at beskrive de demografiske og kliniske kendetegn ved børn og unge, der henvendte sig i PED på Aalborg Universitetshospital, samt at undersøge forskelle mellem anbragte børn (out-of-home care, OHC; fx plejefamilie eller institution) og børn, der bor hos deres forældre (in-home care, IHC). Metoder: Tværsnitsstudie baseret på retrospektiv gennemgang af alle skadestuenotater for 0–18-årige i perioden 1. oktober 2022 til 31. december 2023; 388 besøg blev registreret, og 384 notater indgik i analysen. Resultater: De fleste besøg gjaldt piger (78,7%), medianalderen var 15 år, og selvmordstanker var hyppigste henvisningsårsag (73,7%). Anbragte børn udgjorde 23,7% af kontakterne og havde oftere psykotiske symptomer (39,6% vs. 16,0%), aggressiv adfærd (24,3% vs. 14,7%) og tidligere selvmordsforsøg (35,2% vs. 18,8%) end børn i IHC. De blev også oftere indlagt på psykiatrisk afdeling (44,0% vs. 18,8%). Konklusion: Piger er overrepræsenterede blandt børn og unge, der ses i PED, og anbragte børn udgør en markant andel trods deres lille andel i befolkningen. De præsenterer sig med flere diagnoser og mere alvorlige symptomer, inkl. psykose og selvmordsadfærd, og har oftere behov for indlæggelse. Skadestuen kan være et vigtigt sted at identificere og målrette støtte til denne sårbare gruppe.
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