Hospitalisation in Child Neuropsychiatry: A Case Study Along a Five-Year Epidemiological-Clinical Trend

Abstract

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.

Keywords: adolescents; children; hospitalisation; neuropsychiatry services;; psychiatric disorders.

Figure 1.

Percentage of male and female patients per year

Figure 2.

Frequencies (percentage) of NSSI, suicidal thoughts, and suicide attempts per year

Figure 3.

Frequencies of re-admissions (“Readmissions”) calculated based on the total number of hospitalisations (“Total Hospitalisations”) per year

Figure 4.

Frequencies (percentage) of the primary ICD-10 diagnosis per year