Is diagnosis relevant in the hospitalization of potentially dangerous children and adolescents?
OBJECTIVE
This study tests the assumption that psychiatric diagnosis facilitates clinical evaluations of need in emergency care before and after controlling for danger.


METHODS
The data are from structured crisis assessments completed by emergency clinicians in four ethnically diverse locales (N = 653). Clinician-assigned diagnosis was categorized as adjustment, disruptive, mood, psychotic, and other, and a Danger scale score reflected danger to self or others.


RESULTS
Mood and psychotic disorders significantly increased hospital rates in multivariate analyses which controlled for demographic characteristics, site, and danger when relevant. The model with the best fit included both diagnosis and danger.


CONCLUSIONS
Decisions should be linked to verifiable ratings of need and attention to danger, and its measurement should complement the current focus on diagnosis.
Gutterman
E M
EM
Rutgers University School of Social Work, New Brunswick, NJ, USA. Gutterma@rci.rutgers.edu
D000293:Adolescent; D002648:Child; D003617:Dangerous Behavior; D005260:Female; D006301:Health Services Needs and Demand / Q000706:statistics & numerical data; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000175:diagnosis* / Q000453:epidemiology / Q000628:therapy; D019964:Mood Disorders / Q000175:diagnosis / Q000453:epidemiology / Q000628:therapy; D011618:Psychotic Disorders / Q000175:diagnosis / Q000453:epidemiology / Q000628:therapy; D018570:Risk Assessment