Goldstein Amy B, Silverman Mary Alice C, Phillips Sheridan, Lichenstein Richard
Department of Mental Health Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205-1900, USA.
Pediatr Emerg Care. 2005 Oct;21(10):653-7. doi: 10.1097/01.pec.0000181420.56729.4f.
Over the past decade, there has been a significant increase in the rate at which children and adolescents present to emergency departments (EDs) with mental health complaints. The goal of the current study was to assess the rate of ED usage for children and adolescents and to determine if there was an association between mental health emergencies and the school year.
Retrospective chart review of 719 psychiatric consultations to an urban ED affiliated with an academic medical center. Records of consultations from April 2001 to March 2002 were reviewed and abstracted for variables such as age, sex, time and date of presentation, and psychosocial factors.
Chi2 analyses reveal significant associations between presentation to the ED for a psychiatric complaint and time of day, day of week, and month of year. One-way analyses of variance also demonstrated mean differences in presentations for day of week and month of year.
The current study supports previous research findings of an association between the school year and child and adolescent mental health emergencies. In the current study, the school year appears to exacerbate childhood problems, as there is a greater frequency of psychiatric emergencies while children are in school. Implications for ED program development and school-based mental health service delivery are reviewed.
在过去十年中，儿童和青少年因心理健康问题前往急诊科（ED）就诊的比例显著上升。本研究的目的是评估儿童和青少年使用急诊科的比例，并确定心理健康紧急情况与学年之间是否存在关联。
对一家学术医疗中心附属城市急诊科的719例精神科会诊进行回顾性病历审查。审查并提取了2001年4月至2002年3月会诊记录中的年龄、性别、就诊时间和日期以及社会心理因素等变量。
卡方分析显示，因精神科问题前往急诊科就诊与一天中的时间、一周中的日期和一年中的月份之间存在显著关联。单因素方差分析也显示了一周中的日期和一年中的月份在就诊方面的平均差异。
本研究支持了先前关于学年与儿童和青少年心理健康紧急情况之间存在关联的研究结果。在本研究中，学年似乎加剧了儿童期问题，因为儿童在上学期间精神科紧急情况的发生率更高。本文还探讨了对急诊科项目发展和基于学校的心理健康服务提供的影响。
