ABSTRACT
Objectives:
It is aimed to present pediatric psychiatry consultations requested from children and adolescents applying to the emergency departments of a university hospital and to evaluate the mental health services provided to these children.
Materials and Methods:
This study was carried out with 127 children and adolescents who applied to Child and Adult Emergency Departments of Karadeniz Technical University, Faculty of Medicine between 01.12.2017-31.12.2019 and asked for child psychiatry consultation. In addition to the sociodemographic data of the participants, data such as consultation reason, length of stay in the emergency room, psychiatric diagnoses, and treatment recommendations of children were collected. These data were recorded in SPSS 23.0 package program and the required statistics were applied
Results:
61.4% of the participants were female (n=78) and 75.6% were between 13-18 years old. 10.6% of the children were not with their caregiver. Children between 0-12 years mostly applied for the drug side effects, and those between 13-18 years applied for suicide attempt. 25.2% of children had repeated emergency applications, and the rate of repeated applications was significantly higher due to somatic symptoms and panic attack. It was found that 10.6% of the children were offered hospitalization and those stayed in the emergency room for significantly longer time, but no one could be refered to a child psychiatry service. There was no child asked for consultation due to child maltreatment. 26% of the children were consulted due to suicide attempt, the rate of the children attempting suicide at least once was found to be significantly higher.
Conclusion:
It is thought that the results of this study would be beneficial in terms of reflecting the mental health services provided to children brought to the emergency room of a general hospital, defining the clinical features of these children, thus leading to cost effective mental health policies and emergency services policies.
Keywords:
Psychiatric emergency, emergency service, child psychiatry, consultation liaison psychiatry
References
1Coşkun M. Çocuk ve ergen psikiyatrisinde acil durumlar: In Akay A, Ercan E (editors) Çocuk ve Ergen Ruh Sağlığı ve Hastalıkları. Ankara: HYB basım yayın, 2016;545-573.
2Mutlu C, Kılıcoğlu AG, Gunes H, Adaletli H, Metin H, Bahalı K, İpek H, Uneri ÖŞ. Characteristics of pediatric psychiatric emergency population in a mental health hospital. Eur J Emerg Med. 2015;14:123-130.
3Bilginer SC, İnce C, Karadeniz S, Duran B, Kandil S. Bir üniversite hastanesinde yatan hastalardan istenen çocuk ve ergen psikiyatrisi konsültasyonlarının değerlendirilmesi. Turk J Child Adolesc Ment Health Sağlığı Dergisi. 2013;20:87-96.
4Colpan M, Eray Ş, Vural P. Uludağ Üniversitesi Hastanesinde son bir yılda istenen çocuk ve ergen psikiyatrisi konsültasyonlarının değerlendirilmesi. Güncel Pediatri. 2013;11:101-106.
5Simşek EG, Eyüboğlu D, Eyüboğlu M. Bir üniversite hastanesinde çocuk ve ergen psikiyatrisi konsültasyonlarının değerlendirilmesi. Osmangazi Tıp Dergisi. 2019;41:248-256.
6Newton AS, Ali S, Johnson DW, Haines C, Rosychuk RJ, Keaschuk RA, Jacobs P, Cappelli M, Klassen TP. Who comes back? Characteristics and predictors of return to emergency department services for pediatric mental health care. Acad Emerg Med. 2010;17:177-186.
7Lee J, Korczak D. Emergency physician referrals to the pediatric crisis clinic: reasons for referral, diagnosis and disposition. J Can Acad Child Adolesc Psychiatry. 2010;19:297-302.
8Cloutier P, Kennedy A, Maysenhoelder H, Glennie EJ, Cappelli M, Gray C. Pediatric mental health concerns in the emergency department: caregiver and youth perceptions and expectations. Pediatr Emerg Care. 2010;26:99-106.
9Janssens A, Hayen S, Walraven V, Leys M, Deboutte D. Emergency psychiatric care for children and adolescents: a literature review. Pediatr Emerg Care. 2013;29:1041-1050.
10Pittsenbarger ZE, Mannix R. Trends in pediatric visits to the emergency department for psychiatric illnesses. Acad Emerg Med. 2014;21:25-30.
11Cuypers PJ, Danckaerts M, Sabbe M, Demyttenaere K, Bruffaerts R. The paediatric psychiatric emergency population in a university teaching hospital in Belgium (2003-2008). Eur J Emerg Med. 2014;21:384-386.
12Stewart C, Spicer M, Babl FE. Caring for adolescents with mental health problems: challenges in the emergency department. J Paediatr Child Health. 2006;42:726-730.
13Healy E, Saha S, Subotsky F, Fombonne E. Emergency presentations to an inner-city adolescent psychiatric service. J Adolesc. 2002;25:397-404.
14Santiago LI, Tunik MG, Foltin GL, Mojica MA. Children requiring psychiatric consultation in the pediatric emergency department: epidemiology, resource utilization, and complications. Pediatr Emerg Care. 2006;22:85-89.
15Frosch E, McCulloch J, Yoon Y, DosReis S. Pediatric emergency consultations: prior mental health service use in suicide attempters. J Behav Health Serv Res. 2011;38:68-79.
16Adın E. Çocuklarda aydınlatılmış onam sorunu. Çocuk Sağlığı ve Hastalıkları Dergisi. 2003;46:148-152.
17Sheridan DC, Spiro DM, Fu R, Johnson KP, Sheridan JS, Oue AA, Wang W, Van Nes R, Hansen ML. Mental Health Utilization in a Pediatric Emergency Department. Pediatr Emerg Care. 2015;31:555-559.
18Bilginer Ç , Cop E, Goker Z, Hekim Ö, Sekmen E , Uneri Ö. Overview of young people attempting suicide by drug over dose and prevention and protection services. Dusunen Adam: The Journal of Psychiatry and Neurological Sciences. 2017;3:243-250.
19Roberts N, Nesdole R, Hu T. Emergency department referrals for adolescent urgent psychiatric consultation: Comparison of clinical characteristics of repeat-presentations and single-presentation. J Can Acad Child Adolesc Psychiatry. 2018;27:33-38.
20Pikard J, Roberts N, Groll D. Pediatric referrals for urgent psychiatric consultation: Clinical characteristics, diagnoses and outcome of 4 to 12 year old children. J Can Acad Child Adolesc Psychiatry. 2018;27:245-251.
21Louwers EC, Korfage IJ, Affourtit MJ, Scheewe DJ, van de Merwe MH, Vooijs-Moulaert FA, Woltering CM, Jongejan MH, Ruige M, Moll HA, De Koning HJ. Detection of child abuse in emergency departments: a multi-centre study. Arch Dis Child. 2011;96:422-425.
22Solís-García G, Marañón R, Medina Muñoz M, de Lucas Volle S, García-Morín M, Rivas García A. Maltrato infantil en Urgencias: epidemiología, manejo y seguimiento [Child abuse in the Emergency department: Epidemiology, management, and follow-up]. An Pediatr (Barc). 2019;91:37-41.
23Oral R, Can D, Kaplan S, Polat S, Ates N, Cetin G, Miral S, Hanci H, Ersahin Y, Tepeli N, Bulguc AG, Tiras B. Child abuse in Turkey: an experience in overcoming denial and a description of 50 cases. Child Abuse Negl. 2001;25:279-290.
