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Hospitalisation in Child Neuropsychiatry: A Case Study Along a Five-Year Epidemiological-Clinical Trend
Michela Gatta1, Alessia Raffagnato1, Sara Iannattone2
1Department of Woman and Child's Health, Padua University Hospital, 35128 Padua, Italy.
Insights
Child and adolescent psychiatric admissions are rising in Italy. Suicidal behavior and affective disorders are common, with non-suicidal self-injury affecting 40.8% of patients. Enhanced protocols and prevention are needed.
Area of Science:
- Child and Adolescent Psychiatry
- Mental Health Services Research
Background:
- Child and adolescent neuropsychiatry services in Italy have seen a near doubling of patient admissions over the past decade.
- There is a significant gap in literature concerning mental disorders within the pediatric population, despite increased demand.
- This study addresses the need for more data on the clinical and socio-demographic profiles of young psychiatric inpatients.
Purpose of the Study:
- To investigate and describe the clinical and socio-demographic characteristics of young Italian inpatients with psychiatric disorders.
- To contribute to the limited existing literature on pediatric mental health.
- To provide actionable insights for organizing mental health services for children and adolescents.
Main Methods:
- Retrospective cohort study of 361 hospitalized patients aged 1-18 years.
- Data collected from a Child Neuropsychiatry Unit in Northern Italy between January 2016 and December 2020.
- Statistical analyses included descriptive statistics, Analysis of Variance (ANOVA), and Chi-square tests.
Main Results:
- Females had a higher admission rate; the average inpatient age was 13.4 years.
- Suicidal behavior was the most frequent admission reason, often via the Pediatric Emergency Department.
- Affective disorders were the primary diagnoses at discharge, particularly in patients with self-injurious behaviors (40.8% of sample).
- Nearly half of patients reported suicidal ideation, and 21.1% attempted suicide.
- Hospitalization length decreased between 2016-2018 and 2019-2020, with psychotic disorders associated with longest stays.
Conclusions:
- Development of specialized diagnostic-therapeutic protocols for pediatric psychiatric emergencies is crucial.
- Adequate training for healthcare personnel in managing acute psychiatric conditions in children and adolescents is essential.
- Implementation of primary and secondary prevention programs is necessary for early recognition and treatment of mental health issues.
Objective:
In Italy, the number of patients admitted to child and adolescent neuropsychiatry services has almost doubled in the last 10 years. Despite this significant increase in demand, there is still a paucity of literature on mental disorders in the paediatric population. Therefore, we investigated and described the clinical and socio-demographic characteristics of a sample of young Italian inpatients with psychiatric disorders. The aim was to contribute to the jet scarce literature on this topic, while also providing useful information for the clinical-care organisation of mental health services dedicated to children and adolescents.
Method:
In this retrospective cohort study, data were collected from 361 hospitalised patients aged̀ 1 to 18 who had been admitted to a Child Neuropsychiatry Unit in Northern Italy, from January 2016 to December 2020. Descriptive analyses, Univariate Analysis of Variance (ANOVA), and Chi-square tests were applied.
Results:
During a five-year timeline, a higher admission rate for females was recorded, and the average age of inpatients was 13.4 years (SD = 3.01). Most of the admissions occurred through the Paediatric Emergency Department, and suicidal behaviour was the most frequent reason for admission. At discharge, affective disorders were the main diagnoses, which were also found to be the most frequent in patients with self-injurious behaviours. Non-suicidal self-injury, which was mainly reported as occurring in order to obtain relief from suffering, regarded 40.8% of the total sample. Almost half of the subjects reported suicidal ideation, and 21.1% attempted suicide. The mean hospitalisation length significantly decreased from 2016-2018 to 2019-2020. In general, patients with psychotic disorders had the longest stays.
Conclusions:
Ad hoc diagnostic-therapeutic protocols should be developed for psychiatric emergencies, and health personnel should be adequately trained to manage acute psychiatric conditions in developmental age. Primary and secondary prevention programs should be implemented to promptly recognise and treat mental health issues in this age group.
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