Children with Psychiatric Emergencies Have Unique Issues That Require New Strategies for Treatment
Study at Children's Hospital of NewYork-Presbyterian To Be Presented at Pediatric Academic Societies Meeting
May 4, 2002
A study done at the Children's Hospital of NewYork-Presbyterian and Columbia University College of Physicians & Surgeons was presented today at the annual meeting of the Pediatric Academic Societies in Baltimore, Maryland. Dr. Meridith Sonnett, associate director of pediatric emergency medicine, assistant clinical professor of pediatrics, and principal investigator, showed that children and older teenagers presenting to the Hospital's emergency department (ED) with psychiatric emergencies differed in types of illnesses and the need for care between age groups.
Dr. Sonnett said that the results of this study were extremely important in highlighting the future direction of psychiatric care for children. "It is clear that psychiatric emergencies in children have reached epidemic proportions," she says. "It is also clear that younger children have unique needs that must be addressed separately from older children and adults. For example, 25 percent of children diagnosed with 'diseases usually diagnosed in childhood' such as attention deficit disorder may require a more specialized approach, given that their problems may not strictly be psychiatric in nature, but more behavioral in origin."
Over the last decade, the incidence of psychiatric emergencies in children has increased dramatically. Despite the fact that mood disturbances (such as depression) were most common in both groups, twice as many older children (age 17-19) suffered from schizophrenia/psychosis. The most striking result related to the magnitude of the problem in both groups. Pediatric patients with psychiatric emergencies had a much higher rate of admission and extended ED stays than pediatric patients with medical conditions. Additionally, many of these patients required extensive services. Seventy-one percent of the older group and 28% percent of the younger group required ED stays of at least one day. Despite these differences, it is clear that the psychiatric needs for both groups are significant.
The Children's Hospital of NewYork-Presbyterian is unique in having a pediatric emergency room separate from the adult emergency department, allowing the investigators a special opportunity to study this group of patients.
The other authors of the study were Steven Z. Miller, M.D.; Peter S. Dayan, M.D.; Kenneth M. Rosenstein, M.S.; Jennifer F. Havens, M.D.; Julia E. Najara, M.D.; and Carlos Almeida, M.D. of Children's Hospital of NewYork-Presbyterian and Columbia University College of Physicians & Surgeons.