Gender-specific pathways in mental health crisis in adolescents, from consultation to (in)voluntary admission: a retrospective study.

Journal: BMC psychiatry

Volume: 24

Issue: 1

Year of Publication: 2024

Affiliated Institutions:  NPI, Arkin, Buikslotermeerplein , WP, Amsterdam, The Netherlands. linda.dil@npsai.nl. Research Department Zelfmoordpreventie, Paasheuvelweg , BP, Amsterdam, The Netherlands. Research Department Arkin, Klaprozenweg , NN, Amsterdam, The Netherlands. Youz, Center for Youth Mental Healthcare, Lupinestraat , CV, Capelle a/d IJssel, The Netherlands. NPI, Arkin, Domselaerstraat , MB, Amsterdam, The Netherlands. Psychiatric Emergency Service, Arkin, e Constantijn Huijgensstraat , BR, Amsterdam, The Netherlands. Department of Clinical Psychology, VU Faculties, De Boelelaan , HV, Amsterdam, The Netherlands.

Abstract summary 

A strong increase in mental health emergency consultations and admissions in youths has been reported in recent years. Although empirical evidence is lacking, gender differences in risk of admission may have contributed to this increase. A clearer understanding of the relationship, if any, between gender and various aspects of (in)voluntary care would help in more evidence-based service planning.We analysed registry data for 2008-2017 on 3770 outpatient emergencies involving young people aged 12 to 18 years from one urban area in the Netherlands, served by outreaching psychiatric emergency services. These adolescents were seen in multiple locations and received a psychosocial assessment including a questionnaire on the severity of their problems and living conditions. Our aims were to (a) investigate the different locations, previous use of mental health service, DSM classifications, severity items, living conditions and family characteristics involved and (b) identify which of these characteristics in particular contribute to an increased risk of admission.In 3770 consultations (concerning 2670 individuals), more girls (58%) were seen than boys. Boys and girls presented mainly with relationship problems, followed by disruptive disorders and internalizing disorders. Diagnostic differences diminished in hospitalisation. More specifically, disruptive disorders were evenly distributed. Suicide risk was rated significantly higher in girls, danger to others significantly higher in boys. More girls than boys had recently been in mental health care prior to admission. Although boys and girls overall did not differ in the severity of their problems, female gender predicted admission more strongly. In both boys and girls severity of problems and lack of involvement of the family significantly predicted admission. Older age and danger to others significantly predicted admission among boys, whereas psychosis, suicidality and poor motivation for treatment predicted admission among girls.There are different pathways for youth admission, which can partly be explained by different psychiatric classifications as well as gender-specific differences with regard to age, suicide risk, danger to others and the influence of motivation for treatment. Finally, for both genders, family desire for hospitalisation is also an important predictor.

Authors & Co-authors:  Dil Mérelle Lommerse Peen So Van Zoeteman Dekker

Study Outcome 

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Statistics
Citations :  Cuypers P, Danckaerts M, Sabbe M, Demyttenaere K, Bruffaerts R. The pediatric psychiatric emergency population in a university teaching hospital in Belgium (2003–2008) Eur J Emerg Med. 2014;21(5):384–6. doi: 10.1097/MEJ.0000000000000096.
Authors :  8
Identifiers
Doi : 235
SSN : 1471-244X
Study Population
Boys,Girls,Female
Mesh Terms
Humans
Other Terms
Adolescents;Crisis;Emergency psychiatry;Gender differences;Predictors of hospitalisation
Study Design
Study Approach
Country of Study
Publication Country
England