Dolp Reinhard, Roberts Nasreen, Groll Dianne
Department of Psychiatry, Queen's University, Kingston, Ontario.
Paediatr Child Health. 2019 Aug 30;25(8):525-528. doi: 10.1093/pch/pxz108. eCollection 2020 Dec.
The objective was 1) to describe the clinical characteristics of children referred for an urgent psychiatric consult with and without, a history of abuse; 2) to study differences in demographic and clinical variables between the groups; and 3) to examine the relationship between different types of abuse and disposition after assessment.
This is a 2-year retrospective cohort study of all patients aged 12 to 17 years referred to a hospital urgent psychiatric clinic. Patients were divided into two groups, those with a history of abuse and those without. Study variables included demographics, reason for referral, history of emotional, physical, sexual abuse, substance use, bullying victimization, DSM-5 diagnoses, and disposition. The study population was described using means, frequencies, and percentages, while relationships between types of abuse and clinical and demographic variables were assessed using Mann-Whitney U statistics, Spearman correlations, and logistic regression.
The prevalence of any type of abuse was 30.4% (227 of 746 referrals). The abused group were older, more likely to be female, to have a history of substance use, bullying victimization, diagnosis of an externalizing disorder, and more likely to be admitted. Among the abused group, males were significantly more likely to report physical/emotional abuse, and female sexual abuse. There was no difference between different kinds of abuse and final diagnoses.
Almost one-third of children and adolescents referred for urgent psychiatric consultation reported a history of abuse. Awareness of the association between abuse and emergency visits may assist physicians in triaging for urgent psychiatric assessment.
目标是1）描述有和没有虐待史的因紧急精神科会诊前来就诊的儿童的临床特征；2）研究两组之间人口统计学和临床变量的差异；3）检查不同类型的虐待与评估后的处置之间的关系。
这是一项对所有转诊至医院紧急精神科门诊的12至17岁患者进行的为期2年的回顾性队列研究。患者分为两组，有虐待史的和没有虐待史的。研究变量包括人口统计学、转诊原因、情感、身体、性虐待史、物质使用、受欺凌情况、DSM-5诊断和处置情况。使用均值、频率和百分比来描述研究人群，同时使用曼-惠特尼U统计量、斯皮尔曼相关性和逻辑回归来评估虐待类型与临床和人口统计学变量之间的关系。
任何类型虐待的患病率为30.4%（746例转诊中有227例）。受虐待组年龄更大，更可能为女性，有物质使用史、受欺凌情况、被诊断为外向性障碍，且更可能被收治。在受虐待组中，男性报告身体/情感虐待的可能性显著更高，女性报告性虐待的可能性显著更高。不同类型的虐待与最终诊断之间没有差异。
几乎三分之一因紧急精神科会诊前来就诊的儿童和青少年报告有虐待史。认识到虐待与紧急就诊之间的关联可能有助于医生对紧急精神科评估进行分诊。
