Psychiatric emergencies in childhood and adolescence

Abstract

Objective: The prevalence of psychiatric disorders in childhood and adolescence ranges between 10% and 15%. The most frequent causes requiring psychiatric emergency care at this age are behavioral disturbances, suicidal behavior, and depression. The objective of this study is to present the most relevant clinical issues and to guide the initial procedures in psychiatric emergency care in childhood and adolescence. Method: This was a non-systematic review. Results: Relevant clinical issues for the evaluation of children and adolescents in psychiatric emergency settings are presented. Clinical presentations are divided in relevant groups of symptoms according to their frequency and impact on patients and their families. The following syndromes are presented: aggressive behavior, intoxications, suicidal behavior, psychosis, anxiety disorders, eating disorders, and abuse against children and adolescents. The initial procedures recommended for each of these conditions are described. Conclusion: Psychiatric emergencies in childhood and adolescence include relapse of pre-existing conditions and first episodes of psychiatric disorders. The objectives of emergency assessment are: establishment of the diagnosis, assessment of risks factors for the child/adolescent, and identification of triggering and maintaining factors and of the presence of familiar and social support.