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Evaluation of child and adolescent psychiatry consultations in a tertiary university hospital

Year 2017, Volume: 3 Issue: 1, 35 - 42, 04.03.2017
https://doi.org/10.18621/eurj.2017.5000206690

Abstract

Objective. The aim of this retrospective study was to examine referral pathways to department of Child and Adolescent Psychiatry in a tertiary university hospital for consultation-liaison and to identify patterns associated with demographic characteristics of children, referral sources, the presenting problems, diagnoses and the treatments. Methods. The consultation demands from inpatient and outpatient clinics of our hospital between October 2015 and October 2016 were screened retrospectively. Results. Psychiatric consultations were demanded for 263 child and adolescent patients who were treated in inpatient and outpatient units for one-year period. The children consulted were primarily females (52.5%) and who were in 12 or older age group (62%). Children were referred mostly because of mood and anxiety related complaints. Major depressive disorder was the most common diagnosis. Children were referred mostly from the pediatric emergency service. The intensive care, oncology, hematology and endocrinology departments of pediatrics were also the common referral sources. Psychotropic medications were recommended for 22 percent of children. Psychotherapeutic interventions were conducted in approximately half of the children. Conclusions. Pediatricians have to pay an extra attention to female adolescents. Emergency service demands for suicide attempts are higher than the other departments and there is a need for more collaboration with emergency service. Future studies of child and adolescent psychiatry consultants need to be aware of the growing body of literature supporting the biopsychosocial model of understanding the process of adjustment to chronic childhood illness and the experience of hospitalization. 

References

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  • [3] Sommer A, Fleisher S, Kim WJ. Workforce update 2008: Progress made, but challenges remain. Steering Committee on Workforce Issues. AACAP News. J Am Acad Child Adolesc Psychiatry 2009;40:143-44.
  • [4] Yellowlees PM, Hilty DM, Marks SL, Neufeld J, Bourgeois JA. A retrospective analysis of a child and adolescent eMental Health program. J Am Acad Child Adolesc Psychiatry 2008;47:103-7.
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  • [7] Pinquart M, Shen Y. Behavior problems in children and adolescents with chronic physical illness: a meta-analysis. J Pediatr Psychol 2011;36:1003-16.
  • [8] Gortmaker SL, Sappenfield W. Chronic childhood disorders: prevalence and impact. Pediatr Clin North Am 1984;31:3-18.
  • [9] Lewis M. Consultation process in psychiatry consultation-liaison in pediatrics. In: Lewis M, King RA, eds. Consultation-Liaison in Pediatrics. Psychiatric Clinics of North America. Phildelphia, WB Saunders;1994:427-63.
  • [10] Gortmaker S, Walker D, Weitzman M, Sobol, AM. Chronic conditions, socioeconomic risks, and behavioural problems in children and adolescents. Pediatr 1990;85:267-76.
  • [11] Knapp PK, Harris ES. Consultation-liaison in child psychiatry: a review of the past 10 years. Part I: Clinical findings. J Am Acad Child Adolesc Psychiatry 1998;37:17-25.
  • [12] Brown JF. Emergency department psychiatric consultation arrangements. Health Care Manage Rev 2005;30:251-61.
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  • [17] Byrne P, Power L, Boylan C, Iqbal M, Anglim M, Fitzpatrick C. Providing 24-hour child and adolescent mental health services: demand and outcomes. The Psychiatrist 2011;35:374-79.
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  • [19] Verhulst FC, Achenbach TM, van der Ende J, Erol N, Lambert MC, Leung PWL, et al. Comparison of problems reported by youths from seven countries. Am J Psychiatry 2003;160:1479-85.
  • [20] Natsuaki MN, Klimes-Dougan B, Ge X, Shirtcliff EA, Hastings PD, Zahn-Waxler C. Early pubertal maturation and internalizing problems in adolescence: sex differences in the role of cortisol reactivity to interpersonal stress. J Clin Child Adolesc Psychol 2009;38:513-24.
  • [21] Shaw RJ, Wamboldt M, Bursch B, Stuber M. Practice patterns in pediatric consultation-liaison psychiatry a national survey. Psychosomatics 2006;47:43-49.
  • [22] Hauser M, Galling B, Corell CU. Suicidal ideation and suicide attempts in children and adolescents with bipolar disorder: a systematic review of prevalence and incidence rates, correlates and targeted interventions. Bipolar Disord 2013;15:507-23.
  • [23] Hysinger EB, Callahan ST, Caples TL, Fuchs DC, Shelton R, Cooper WO. Suicidal behavior differs among early and late adolescents treated with antidepressant agents. Pediatrics 2011;128:447-54.
  • [24] Belfer ML, Saxena S. WHO Child Atlas Project. Lancet 2006;367:551-52.
  • [25] Kessler RC, Amminger GP, Aguilar-Gaxiola S, Alonso J, Lee S, Ustun TB. Age of onset of mental disorders: a review of recent literature. Curr Opin Psychiatr 2007;20:359-64.
  • [26] Olson R, Holden EW, Friedman A, Faust J, Kenning M, Mason PJ. Psychological consultation in a children’s hospital: an evaluation of services. J Pediatr Psychol 1988;13:479-92.
  • [27] Rodrigue, JR, Hoffman RG, Rayfield A, Lescano C, Kubar W, Streisand R, et al. Evaluating pediatric psychology consultation services in a medical setting: an example. J Clin Psychol Med S 1995;2:89-107.
  • [28] Vogel W, Holford L. Child psychiatry in Johannesburg, South Africa. A descriptive account of cases presenting at two clinics in 1997. Eur Child Adoles Psy 1999;8:181-188.
  • [29] Kilic BG, Uslu R, Aysev A. A preliminary evaluation of consultation-liaison psychiatry services for children at a university hospital: lessons learned to enhance efficacy. New Symposium J 2007;45:163-69.
  • [30] Kara H, Bayir A, Degirmenci S, Kayis SA, Akinci M, Ak A, et al. Causes of poisoning in patients evaluated in a hospital emergency department in Konya, Turkey. J Pak Med Assoc 2014;64:1042-48.
  • [31] Olguin HJ, Garduno LB, Perez JF, Bastida MA, Flores-Perez C. Frequency of suicide attempts by ingestion of drugs seen at a tertiary care pediatric hospital in Mexico. J Popul Ther Clin Pharmacol 2011;18:161-65.
  • [32] Aysev A, Kerimoglu E, Cocuk psikiyatrisinde istenen konsultasyonların 1 yillik degerlendirilmesi. Kerimoglu E, eds. Cocuk Psikiyatrisinde Konsultasyon-Liyezon. Ankara, AUTF Basimevi;1995:123-37.
  • [33] Carter BD, Kronenberger WG, Baker J, Grimes LM, Crabtree VM, Smith C, et al. Inpatient pediatric consultation-liaison: a case-controlled study. J Pediatr Psychol 2003;28:423-32.
  • [34] Thompson RJ, Gustafson KE. Epidemiology and classification. In: Thompson RJ, Gustafson KE, eds. Adaptation to chronic childhood illness. American Psychological Association. Washington, 1996;27-56.
Year 2017, Volume: 3 Issue: 1, 35 - 42, 04.03.2017
https://doi.org/10.18621/eurj.2017.5000206690

Abstract

References

  • [1] Lipowski Z. Review of consultation psychiatry and psychosomatic medicine. Psycho Med 1967;29:153-71.
  • [2] Kim WJ. Child and adolescent psychiatry workforce: A critical shortage and national challenge. AACAP Task force on workforce needs. Acad Psychiatry 2003;27:277-82.
  • [3] Sommer A, Fleisher S, Kim WJ. Workforce update 2008: Progress made, but challenges remain. Steering Committee on Workforce Issues. AACAP News. J Am Acad Child Adolesc Psychiatry 2009;40:143-44.
  • [4] Yellowlees PM, Hilty DM, Marks SL, Neufeld J, Bourgeois JA. A retrospective analysis of a child and adolescent eMental Health program. J Am Acad Child Adolesc Psychiatry 2008;47:103-7.
  • [5] Ortiz P. General principles in child liasion consultation service: a literature review. Eur Child Adolesc Psychiatry 1997;6:1-6.
  • [6] Hysing M, Elgen I, Gillberg C, Lie SA, Lundervold AJ. Chronic physical illness and mental health in children. Results from a large-scale population study. J Child Psychol Psychiatry 2007;48:785-92.
  • [7] Pinquart M, Shen Y. Behavior problems in children and adolescents with chronic physical illness: a meta-analysis. J Pediatr Psychol 2011;36:1003-16.
  • [8] Gortmaker SL, Sappenfield W. Chronic childhood disorders: prevalence and impact. Pediatr Clin North Am 1984;31:3-18.
  • [9] Lewis M. Consultation process in psychiatry consultation-liaison in pediatrics. In: Lewis M, King RA, eds. Consultation-Liaison in Pediatrics. Psychiatric Clinics of North America. Phildelphia, WB Saunders;1994:427-63.
  • [10] Gortmaker S, Walker D, Weitzman M, Sobol, AM. Chronic conditions, socioeconomic risks, and behavioural problems in children and adolescents. Pediatr 1990;85:267-76.
  • [11] Knapp PK, Harris ES. Consultation-liaison in child psychiatry: a review of the past 10 years. Part I: Clinical findings. J Am Acad Child Adolesc Psychiatry 1998;37:17-25.
  • [12] Brown JF. Emergency department psychiatric consultation arrangements. Health Care Manage Rev 2005;30:251-61.
  • [13] American Psychiatric Association. Diagnostic and statistical manual of mental disorders. 4th ed. Washington, DC:American Psychiatric Publishers Inc.; 2000.
  • [14] Emiroglu N, Aras S, Yalın S, Dogan O, Akay A. [Evaluation of the child and adolescent psychiatric inpatient consultations]. Anadolu Psikiyatri Derg 2009;10:217-25. [Article in Turkish]
  • [15] Gokcen C, Celik YI. [The evaluation of child and adolescent psychiatry consultations from other inpatient clinics in a training hospital]. Sakarya Med J 2011;4:140-44. [Article in Turkish]
  • [16] Dil LM, Vuijk PJ. Emergency presentations to an inner-city psychiatricsService for children and adolescents. Child Care in Pract 2012;18:255-69.
  • [17] Byrne P, Power L, Boylan C, Iqbal M, Anglim M, Fitzpatrick C. Providing 24-hour child and adolescent mental health services: demand and outcomes. The Psychiatrist 2011;35:374-79.
  • [18] Costello EJ, Mustillo S, Erkanli A, Keeler G, Angold A. Prevalence and development of psychiatric disorders in childhood and adolescence. Arch Gen Psychiatry 2003;60:837-44.
  • [19] Verhulst FC, Achenbach TM, van der Ende J, Erol N, Lambert MC, Leung PWL, et al. Comparison of problems reported by youths from seven countries. Am J Psychiatry 2003;160:1479-85.
  • [20] Natsuaki MN, Klimes-Dougan B, Ge X, Shirtcliff EA, Hastings PD, Zahn-Waxler C. Early pubertal maturation and internalizing problems in adolescence: sex differences in the role of cortisol reactivity to interpersonal stress. J Clin Child Adolesc Psychol 2009;38:513-24.
  • [21] Shaw RJ, Wamboldt M, Bursch B, Stuber M. Practice patterns in pediatric consultation-liaison psychiatry a national survey. Psychosomatics 2006;47:43-49.
  • [22] Hauser M, Galling B, Corell CU. Suicidal ideation and suicide attempts in children and adolescents with bipolar disorder: a systematic review of prevalence and incidence rates, correlates and targeted interventions. Bipolar Disord 2013;15:507-23.
  • [23] Hysinger EB, Callahan ST, Caples TL, Fuchs DC, Shelton R, Cooper WO. Suicidal behavior differs among early and late adolescents treated with antidepressant agents. Pediatrics 2011;128:447-54.
  • [24] Belfer ML, Saxena S. WHO Child Atlas Project. Lancet 2006;367:551-52.
  • [25] Kessler RC, Amminger GP, Aguilar-Gaxiola S, Alonso J, Lee S, Ustun TB. Age of onset of mental disorders: a review of recent literature. Curr Opin Psychiatr 2007;20:359-64.
  • [26] Olson R, Holden EW, Friedman A, Faust J, Kenning M, Mason PJ. Psychological consultation in a children’s hospital: an evaluation of services. J Pediatr Psychol 1988;13:479-92.
  • [27] Rodrigue, JR, Hoffman RG, Rayfield A, Lescano C, Kubar W, Streisand R, et al. Evaluating pediatric psychology consultation services in a medical setting: an example. J Clin Psychol Med S 1995;2:89-107.
  • [28] Vogel W, Holford L. Child psychiatry in Johannesburg, South Africa. A descriptive account of cases presenting at two clinics in 1997. Eur Child Adoles Psy 1999;8:181-188.
  • [29] Kilic BG, Uslu R, Aysev A. A preliminary evaluation of consultation-liaison psychiatry services for children at a university hospital: lessons learned to enhance efficacy. New Symposium J 2007;45:163-69.
  • [30] Kara H, Bayir A, Degirmenci S, Kayis SA, Akinci M, Ak A, et al. Causes of poisoning in patients evaluated in a hospital emergency department in Konya, Turkey. J Pak Med Assoc 2014;64:1042-48.
  • [31] Olguin HJ, Garduno LB, Perez JF, Bastida MA, Flores-Perez C. Frequency of suicide attempts by ingestion of drugs seen at a tertiary care pediatric hospital in Mexico. J Popul Ther Clin Pharmacol 2011;18:161-65.
  • [32] Aysev A, Kerimoglu E, Cocuk psikiyatrisinde istenen konsultasyonların 1 yillik degerlendirilmesi. Kerimoglu E, eds. Cocuk Psikiyatrisinde Konsultasyon-Liyezon. Ankara, AUTF Basimevi;1995:123-37.
  • [33] Carter BD, Kronenberger WG, Baker J, Grimes LM, Crabtree VM, Smith C, et al. Inpatient pediatric consultation-liaison: a case-controlled study. J Pediatr Psychol 2003;28:423-32.
  • [34] Thompson RJ, Gustafson KE. Epidemiology and classification. In: Thompson RJ, Gustafson KE, eds. Adaptation to chronic childhood illness. American Psychological Association. Washington, 1996;27-56.
There are 34 citations in total.

Details

Subjects Health Care Administration
Journal Section Original Articles
Authors

Pinar Uran

Mehmet Sertcelik

Publication Date March 4, 2017
Submission Date November 4, 2016
Acceptance Date November 15, 2016
Published in Issue Year 2017 Volume: 3 Issue: 1

Cite

AMA Uran P, Sertcelik M. Evaluation of child and adolescent psychiatry consultations in a tertiary university hospital. Eur Res J. March 2017;3(1):35-42. doi:10.18621/eurj.2017.5000206690

e-ISSN: 2149-3189 


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