| Autor: |
So P; Youz, Center for Youth Mental Healthcare, Rotterdam, The Netherlands. p.so@youz.nl.; Parnassia Psychiatric Institute, Rotterdam, The Netherlands. p.so@youz.nl., Wierdsma AI; Erasmus MC, University Medical Center, Epidemiological and Social Psychiatric Research Institute and Department of Psychiatry, Rotterdam, The Netherlands., Kasius MC; Youz, Center for Youth Mental Healthcare, The Hague, The Netherlands., Cornelis J; Department of Research, Arkin Mental Health Care, Amsterdam, The Netherlands.; Department of Emergency Psychiatry, Arkin Mental Health Care, Amsterdam, The Netherlands., Lommerse M; Department of Emergency Psychiatry, Arkin Mental Health Care, Amsterdam, The Netherlands., Vermeiren RRJM; Youz, Center for Youth Mental Healthcare, Rotterdam, The Netherlands.; Youz, Center for Youth Mental Healthcare, The Hague, The Netherlands.; Department of Child and Adolescent Psychiatry, Curium-LUMC, Leiden University Medical Center, Leiden, The Netherlands., Mulder CL; Parnassia Psychiatric Institute, Rotterdam, The Netherlands.; Erasmus MC, University Medical Center, Epidemiological and Social Psychiatric Research Institute and Department of Psychiatry, Rotterdam, The Netherlands. |
| Abstrakt: |
As hospital beds are scarce, and emergency admissions to a psychiatric ward are major life-events for children and adolescents, it is essential to have insight into the decision-making process that leads to them. To identify potentially modifiable factors, we, therefore, studied the contextual and clinical characteristics associated with the voluntary and compulsory emergency admission of minors. We used registry data (2008-2017) on 1194 outpatient emergencies involving children aged 6-18 who had been referred to the mobile psychiatric emergency service in two city areas in The Netherlands. Demographic and contextual factors were collected, as well as clinical characteristics including diagnoses, psychiatric history, Global Assessment of Functioning (GAF), and the Severity of Psychiatric Illness (SPI) scale. Logistic regression analyses were used to identify factors that predict voluntary or compulsory admission. Of 1194 consultations, 227 (19.0%) resulted in an admission, with 137 patients (11.5%) being admitted voluntarily and 90 (7.5%) compulsorily. Independently of legal status, the following characteristics were associated with admission: severity of psychiatric symptoms, consultation outside the patient's home, and high levels of family disruption. Relative to voluntary admission, compulsory admission was associated with more severe psychiatric problems, higher suicide risk, and prior emergency compulsory admission. Two potentially modifiable factors were associated with psychiatric emergency admission: the place where patients were seen for consultation, and the presence of family problems. Psychiatric emergency admissions may be reduced if, whenever possible, minors are seen in their homes and if a system-oriented approach is used. |
