NPI, Arkin, Buikslotermeerplein 420, 1025 WP, Amsterdam, The Netherlands.
Department of Clinical Psychology, VU Faculties, De Boelelaan 1105, 1081 HV, Amsterdam, The Netherlands.
BMC Psychiatry. 2024 Mar 28;24(1):235. doi: 10.1186/s12888-024-05680-9.
A strong increase in mental health emergency consultations and admissions in youths has been reported in recent years. Although empirical evidence is lacking, gender differences in risk of admission may have contributed to this increase. A clearer understanding of the relationship, if any, between gender and various aspects of (in)voluntary care would help in more evidence-based service planning.
We analysed registry data for 2008-2017 on 3770 outpatient emergencies involving young people aged 12 to 18 years from one urban area in the Netherlands, served by outreaching psychiatric emergency services. These adolescents were seen in multiple locations and received a psychosocial assessment including a questionnaire on the severity of their problems and living conditions. Our aims were to (a) investigate the different locations, previous use of mental health service, DSM classifications, severity items, living conditions and family characteristics involved and (b) identify which of these characteristics in particular contribute to an increased risk of admission.
In 3770 consultations (concerning 2670 individuals), more girls (58%) were seen than boys. Boys and girls presented mainly with relationship problems, followed by disruptive disorders and internalizing disorders. Diagnostic differences diminished in hospitalisation. More specifically, disruptive disorders were evenly distributed. Suicide risk was rated significantly higher in girls, danger to others significantly higher in boys. More girls than boys had recently been in mental health care prior to admission. Although boys and girls overall did not differ in the severity of their problems, female gender predicted admission more strongly. In both boys and girls severity of problems and lack of involvement of the family significantly predicted admission. Older age and danger to others significantly predicted admission among boys, whereas psychosis, suicidality and poor motivation for treatment predicted admission among girls.
There are different pathways for youth admission, which can partly be explained by different psychiatric classifications as well as gender-specific differences with regard to age, suicide risk, danger to others and the influence of motivation for treatment. Finally, for both genders, family desire for hospitalisation is also an important predictor.
近年来，有报道称年轻人的心理健康急诊咨询和入院人数大幅增加。尽管缺乏经验证据，但入院风险的性别差异可能导致了这种增加。更清楚地了解性别与（自愿和非自愿）护理的各个方面之间的关系，如果有的话，将有助于更有针对性地进行基于证据的服务规划。
我们分析了 2008 年至 2017 年期间，荷兰一个城市地区外展精神科急诊服务为 3770 名 12 至 18 岁年轻人提供的门诊急诊登记数据。这些青少年在多个地点就诊，并接受了心理社会评估，包括一份关于他们问题严重程度和生活条件的问卷。我们的目的是：（a）调查涉及的不同地点、以前使用的心理健康服务、DSM 分类、严重程度项目、生活条件和家庭特征；（b）确定哪些特征特别是导致入院风险增加。
在 3770 次咨询（涉及 2670 人）中，女孩（58%）的就诊人数多于男孩。男孩和女孩主要表现为人际关系问题，其次是破坏性行为障碍和内化障碍。诊断差异在住院治疗中减少。更具体地说，破坏性行为障碍分布均匀。女孩的自杀风险评分显著较高，男孩的对他人的危险程度显著较高。与男孩相比，更多的女孩在入院前最近接受过心理健康护理。尽管男孩和女孩的问题严重程度总体上没有差异，但女性性别对入院的预测作用更强。在男孩和女孩中，问题的严重程度和家庭参与程度显著预测了入院。年龄较大和对他人的危险程度显著预测了男孩的入院，而精神病、自杀意念和治疗动机差则预测了女孩的入院。
青少年入院有不同的途径，这部分可以通过不同的精神病学分类以及与年龄、自杀风险、对他人的危险和治疗动机等方面的性别特异性差异来解释。最后，对于两种性别，家庭对住院的渴望也是一个重要的预测因素。
