Managing bipolar youths in a psychiatric inpatient emergency service.
Among the youths referred to our Psychiatric Inpatient Emergency Service, we focused on bipolar disorder (BD), to explore predictive elements for the outcome. Fifty-one patients (30 males, 21 females, age range 8-18 years, mean age 14.2 ± 3.1 years) received a diagnosis of BD, according to historical information, prolonged observations, and a structured clinical interview (K-SADS-PL). Twenty-seven patients (52.9%) were responders at the end of hospitalization according to CGI-I 1 or 2 and 50% decrease of both Brief Psychiatric Rating Scale (BPRS) and Young Mania Rating Scale (YMRS). Responders received a longer hospitalization. Non responders were more severe at baseline, had higher scores at BPRS (namely positive symptoms), and were more aggressive. Environmental/social stressors and comorbidities were frequent, but they did not affect the outcome. In summary, BD in emergency settings may represent a subtype with clinical and therapeutic peculiarities, and specific challenges for mental health services.
Masi
Gabriele
G
IRCCS Stella Maris, Scientific Institute of Child Neurology and Psychiatry, Via dei Giacinti 2, 56018 Calambrone, Pisa, Italy. gabriele.masi@inpe.unipi.it
Mucci
Maria
M
Pias
Paola
P
Muratori
Filippo
F
D000293:Adolescent; D014150:Antipsychotic Agents / Q000008:administration & dosage; D001714:Bipolar Disorder / Q000175:diagnosis / Q000188:drug therapy / Q000523:psychology; D002648:Child; D015331:Cohort Studies; D039721:Diagnostic and Statistical Manual of Mental Disorders; D004637:Emergency Services, Psychiatric / Q000706:statistics & numerical data*; D005260:Female; D006760:Hospitalization; D006801:Humans; D008297:Male; D011569:Psychiatric Status Rating Scales; D011613:Psychotherapy; D012720:Severity of Illness Index; D012931:Social Environment; D012959:Socioeconomic Factors; D016896:Treatment Outcome
D014150:Antipsychotic Agents