Psychiatric Emergencies in Children and Adolescents: A Comprehensive Profile and Short-term Outcome Evaluation in a...

Emergency psychiatry services play a critical role in providing essential care for children and adolescents with mental health concerns, yet research in this field, especially in India, is limited. Our study aims to address this gap by investigating the demographic and clinical characteristics and short-term outcomes of children and adolescents accessing emergency psychiatric care at our tertiary care center.

This prospective study included children and adolescents aged 3-18 who presented with psychiatric disorders to emergency services. All cases were assessed using the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) criteria, the Clinical Global Impression (CGI) scale, and the Children's Global Assessment Scale (CGAS). Follow-ups were done at three weeks and three months. The Shapiro-Wilk test assessed normality, followed by parametric or nonparametric tests as appropriate.

The mean age of the sample was 14.8 (standard deviation [SD]: 2.5) years, with boys comprising 57.1% and girls 42.9%. Most visits to emergency services occurred between 1 PM and 6 PM. The most common diagnoses were bipolar affective disorder (23.2%) and conversion/functional neurological symptom disorder (23.2%). Lorazepam and clonazepam were the most commonly prescribed medications at first visit (baseline). At first follow-up (3 weeks), a significant proportion (41.1%) was admitted as inpatients. Olanzapine was the most common drug prescribed during follow-up visits. The CGI scores decreased, while CGAS scores increased, reflecting improved functioning.

The significant improvement in CGI and CGAS scores over follow-ups demonstrates the effectiveness of crisis intervention and pharmacotherapy in stabilizing clinical severity and enhancing functioning in the short term.