Clinical Characteristics of Adolescents Admitted to a Child and Adolescent Psychiatry Department in Poland: A...

Background/Objectives: Adolescents admitted for emergency psychiatric hospitalization frequently present with severe and heterogeneous psychopathology. In clinical practice, some adolescent inpatients appear to present a broader symptom pattern suggestive of emotional dysregulation. However, it remains unclear whether they can truly be distinguished in this population and whether they differ meaningfully from adolescents with predominantly depressive presentations. Methods: We conducted a retrospective cross-sectional chart review with subgroup analysis based on the medical records of patients aged 11-17 years hospitalized on an emergency basis at the Department of Child and Adolescent Psychiatry in Poznań, Poland, between January and December 2024. Patients were assigned either to an emotional dysregulation group, defined by affective dysregulation and behavioral dyscontrol, or to a depressive presentations group, comprising adolescents with depressive presentations who did not meet criteria for the emotional dysregulation profile. Broader clinical characteristics, adverse childhood experiences, and prior treatment history were compared between groups. Results: A total of 139 adolescents were included (85 in the emotional dysregulation group and 54 in the depressive presentations group). The median age was 13 years [Q1-Q3: 13-14] in the emotional dysregulation group and 14 years [Q1-Q3: 12.25-14] in the depressive presentations group; girls comprised 77.6% and 83.3% of the groups, respectively. The emotional dysregulation group more often presented with conflict-ridden relationships, a more frequent history of suicide attempts (72.9% vs. 50.0%, p = 0.006), and a higher number of suicide attempts (median 1 [Q1-Q3: 0-2] vs. 0.5 [Q1-Q3: 0-1], p = 0.012), as well as more frequent exposure to adversity-related experiences. Furthermore, this group had a higher number of previous psychiatric hospitalizations (median 1 [Q1-Q3: 1-2] vs. 1 [Q1-Q3: 1-1], p = 0.001) and a longer history of psychiatric treatment. In contrast, social withdrawal was more characteristic of the depressive presentations group. Conclusions: Routinely collected clinical records may capture a clinically meaningful subgroup of adolescents with a symptom profile suggestive of emotional dysregulation. Compared with the depressive presentations group, these adolescents showed greater interpersonal difficulties, more recurrent suicide attempts, greater adversity burden, and a longer history of psychiatric treatment. Further prospective studies using standardized measures are needed.