Ezquerra Berta, Peñuelas-Calvo Inmaculada, Marti-Estevez Ines, Taracena-Cuerda Maria, Baca-García Enrique, Porras-Segovia Alejandro
Department of Psychiatry, Hospital Universitario Fundación Jiménez Díaz, Madrid, Spain.
Department of Child and Adolescent Psychiatry, Hospital Universitario 12 de Octubre, Avda. De Córdoba s/n, Madrid, 28041, Spain.
Eur Child Adolesc Psychiatry. 2024 Nov 7. doi: 10.1007/s00787-024-02594-5.
Given the increased demand for mental health resources in the child and adolescent population, this study aims to describe the emergency psychiatric care of the children and adolescents and to explore factors associated with multiple visits and hospital admissions. All patients < 18 years of age who visited the psychiatric ED(ED) of a University Hospital in Madrid, Spain, during 2022 were included. Data were collected by the attending psychiatrist upon first 2022 ED visit (index visit) and during any ED revisit. Electronic health records of all included patients were revised to contrast information and complete missing data. Logistic regressions and correlation analyses were used to explore factors associated with multiple ED visits and hospitalisations. N = 397 patients were included. Factors associated with multiple ED visits were: being LGTBQ+, having eating problems, substance use, consulting for psychosis upon first visit, having a history of suicidal behaviour, previous mental health service use or previous hospitalisations, having two or more psychiatric diagnoses, and being diagnosed of eating disorders or depression. Factors associated with hospitalisation include female gender, older age, LGTBQ+, family conflicts, first or second-generation migrants, history of abuse, eating problems, drug use, history of suicidal behaviour, previous mental health service use or previous hospitalisations, psychiatric comorbidity, and eating disorders diagnosis. Identifying predictors that lead to different clinical pathways and use of mental health services can improve clinical outcomes and resource use.
鉴于儿童和青少年人群对心理健康资源的需求增加，本研究旨在描述儿童和青少年的急诊精神科护理情况，并探讨与多次就诊和住院相关的因素。纳入了2022年期间在西班牙马德里一家大学医院的精神科急诊科就诊的所有18岁以下患者。数据由主治精神科医生在2022年首次急诊科就诊（索引就诊）时以及任何急诊科复诊时收集。对所有纳入患者的电子健康记录进行了审查，以核对信息并补充缺失数据。采用逻辑回归和相关分析来探讨与多次急诊科就诊和住院相关的因素。共纳入了397例患者。与多次急诊科就诊相关的因素包括：属于 LGBTQ+群体、有饮食问题、使用药物、首次就诊时因精神病咨询、有自杀行为史、既往使用过心理健康服务或有过住院史、有两种或更多种精神科诊断，以及被诊断为饮食失调或抑郁症。与住院相关的因素包括女性、年龄较大、属于 LGBTQ+群体、家庭冲突、第一代或第二代移民、虐待史、饮食问题、药物使用、自杀行为史、既往使用过心理健康服务或有过住院史、精神科合并症，以及饮食失调诊断。识别导致不同临床路径和心理健康服务使用情况的预测因素可以改善临床结局和资源利用。
