title: Changes in the clinical features of child and adolescent psychiatric inpatients: a nationwide time-trend study from Finland.
abstract: BACKGROUND
  Few studies have focused on the recent trends in clinical features child and adolescent inpatient.
  
  
  OBJECTIVE
  This study focuses on the change in the characteristics of child and adolescent psychiatric inpatients in Finland.
  
  
  METHODS
  The data collection was carried out on selected study days in 2000 and 2011. Questionnaires were sent to the psychiatrists of all child and adolescent wards in Finland.
  
  
  RESULTS
  By comparing the data obtained in 2000 (n = 504) and 2011 (n = 412), several changes were found: the percentage of girls in adolescent wards grew and the diagnoses of depression, anxiety disorders, attention deficit hyperactivity disorder and eating disorders increased. In contrast, the diagnoses of psychosis and conduct or oppositional disorders decreased. General functioning was evaluated with the Childreńs Global Assessment Scale (CGAS). There were no changes in the distribution of CGAS scores among child inpatients, whereas among adolescents the share of inpatients with lowest CGAS scores (1-30) increased significantly. The mean length of stay dropped.
  
  
  CONCLUSIONS
  The growing percentage of girls in adolescent wards is associated with an increase in diagnoses that are more prevalent among girls than boys, namely depression, anxiety, and eating disorders. The changes in the distribution of diagnoses may be due to changes in diagnostic or referral practices, or reflect true changes in the prevalence of disorders among children and adolescents in need of inpatient treatment. The share of adolescent inpatients with the poorest general functioning has increased. The observed shortening in inpatient treatment time seems to be a result of changes in treatment practices.
authors.affiliation: a Department of Adolescent Psychiatry , Turku University Hospital, Hospital District of Southwest Finland , Turku , Finland ;
authors.forename: Kim
authors.initials: K
authors.lastname: Kronström
authors.affiliation: b Department of Part-Time Studies, Faculty of Health and Wellbeing , Turku University of Applied Sciences , Turku , Finland ;
authors.forename: Heikki
authors.initials: H
authors.lastname: Ellilä
authors.affiliation: c Department of Nursing Science , University of Turku , Turku , Finland ;|d Social and Healthcare Department , City of Vantaa , Vantaa , Finland ;
authors.forename: Lauri
authors.initials: L
authors.lastname: Kuosmanen
authors.affiliation: e Turku Institute for Child and Youth Research, Medical Faculty , University of Turku , Turku , Finland ;
authors.forename: Anne
authors.initials: A
authors.lastname: Kaljonen
authors.affiliation: f Department of Child Psychiatry, Clinical Sciences, Medical Faculty , University of Turku , Turku , Finland ;|g Department of Child Psychiatry , Turku University Hospital, Hospital District of Southwest Finland , Turku , Finland.
authors.forename: Andre
authors.initials: A
authors.lastname: Sourander
mesh_terms: D000293:Adolescent; D000294:Adolescent Behavior / Q000523:psychology; D001008:Anxiety Disorders / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology; D002648:Child; D002653:Child Behavior Disorders / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology; D003866:Depressive Disorder / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology; D001068:Feeding and Eating Disorders / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology; D005260:Female; D005387:Finland / Q000453:epidemiology; D006760:Hospitalization / Q000639:trends*; D006801:Humans; D007297:Inpatients / Q000523:psychology; D008297:Male; D001523:Mental Disorders / Q000175:diagnosis* / Q000453:epidemiology* / Q000523:psychology; D011567:Psychiatric Department, Hospital / Q000639:trends*; D011795:Surveys and Questionnaires; D013997:Time Factors
keywords: Adolescent psychiatry; Child psychiatry; Diagnoses; Inpatient treatment; Time-trend study