title: Children and adolescents in the Psychiatric Emergency Department: a 10-year survey in Copenhagen County.
abstract: BACKGROUND
  Knowledge on psychiatric emergencies in children and adolescents is limited. The Psychiatric Emergency Departments (PED) in Copenhagen enable the acute examination of children and adolescents 24 h a day, 7 days a week. However, very little is known about who presents to the PED, and the reason for their visit.
  
  
  OBJECTIVE
  To describe the prevalence and characteristics of presentations in PED and treatment provided.
  
  
  METHODS
  A retrospective population based study comprising data of more than 4000 visitors presenting to PED from 2001-2010. In 2003 and 2006, two randomly chosen years, a more thorough analysis was performed, based on the individual emergency charts. Inter-rater reliability was high.
  
  
  RESULTS
  Visits increased nearly threefold during the period. Symptom score for 2003 and 2006 revealed that more than one third of the visitors had suicidal ideation. Depressive and anxiety symptoms together with suicidal ideation rose significantly (P < 0.001). Psychoses and suicidal attempts remained unchanged. In one third of the visits, the discharge diagnosis was anxiety and stress-related disorders, followed by personality, behavioural and emotional disorders. Between 15% and 20% of the visits resulted in admission and more than 50% in referral for outpatient follow-up.
  
  
  CONCLUSIONS
  The number of presenting psychiatric emergencies has increased over the last 10 years. Comparing symptoms from 2003 and 2006 showed a significant rise in their severity. This study highlights the need for 24-h access for acute evaluation by physicians skilled in child and adolescent psychiatry, and raises concern that the severity could increase.
authors.affiliation: Centre for Child and Adolescents Psychiatry , Glostrup, Copenhagen , Denmark.
authors.forename: Annette
authors.initials: A
authors.lastname: Taastrøm
authors.forename: Julie
authors.initials: J
authors.lastname: Klahn
authors.forename: Nina
authors.initials: N
authors.lastname: Staal
authors.forename: Per Hove
authors.initials: PH
authors.lastname: Thomsen
authors.forename: Anders
authors.initials: A
authors.lastname: Johansen
mesh_terms: D000293:Adolescent; D002648:Child; D003718:Denmark / Q000453:epidemiology; D004630:Emergencies; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data; D004637:Emergency Services, Psychiatric / Q000706:statistics & numerical data*; D005260:Female; D019538:Health Care Surveys; D006301:Health Services Needs and Demand / Q000706:statistics & numerical data; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000453:epidemiology*; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data; D015995:Prevalence; D012017:Referral and Consultation / Q000706:statistics & numerical data; D015203:Reproducibility of Results; D012189:Retrospective Studies; D059020:Suicidal Ideation; D013406:Suicide, Attempted / Q000523:psychology
keywords: Children and adolescents; Psychiatric emergencies; Social difficulties; Suicidal behaviour