L'accueil d'urgence en psychiatrie de l'enfant et de l'adolescent: évolution sur 20 ans dans un site hospitalo-universitaire

Abstract: Because of the close relationship between child and adolescents with their environment, Psychiatric emergencies in this population are very specific. Situations seen and their management are different from psychiatric adult emergencies. Beside real psychiatric emergencies, we often see situations characterised by psychological distress with an important social component. Our retrospective study compares two populations of youth people seen in the outpatient psychiatric emergency unit of the Pitié-Salpêtrière hospital in Paris. We analyse 196 cases seen during 1992 and 314 seen during 2002. The purpose is to evaluate the evolution of demographic and clinical characteristics of these two populations. The results are completed by a previous study conducted in 1981. Main demographic results are: 1) a dramatic increase of the number of patients seen; 2) a significant decrease of the mean age of consultation (13.6 yo in 1992 vs 12.3 yo in 2002); 3) sex-ratio stay the same, with more girls among old ages and more boys among young ages; 4) families themselves ask for consultation more and more often (58% in 2002). Clinical results are: 1) main reason of consultation stays acting-out disorders, especially in boys (50% in 1992 and 2002); 2) a greater proportion of patients has a psychiatric follow-up at the time of the consultation (38.2% in 1992; 55.4% in 2002); 3) major depression is the first diagnosis in 1992 (24.2%) and 2002 (35.8%); 4) psychiatric hospitalisation occurs in 34.2% in 1992 vs 19.8% in 2002, but absolute numbers remains stable. These results might be useful for the public health system in order to improve our answers for these requests more and more numerous for patients younger and younger. [Copyright &y& Elsevier]