Two-year prospective study of characteristics and outcome of adolescents referred to an adolescent urgent psychiatric clinic.

OBJECTIVE: (a) To describe the clinical characteristics and outcome of adolescents referred for urgent psychiatric consultation, and (b) compare suicidal with non-suicidal referrals.

METHODS: This was a 2-year prospective study. Data was gathered on demographic, historical and clinical variables. Comparison of suicidal and non-suicidal patients was conducted using χ2. A hospital database was used for referral and wait times.

RESULTS: Of 805 assessments, 55% were referred by emergency physicians and 28% by primary care physicians. Sixty-four percent of referrals were referred for suicidal behavior and depression and 19.6% for aggression. Eighty percent had a positive family psychiatric history and 59% were bullied. The most frequent psychiatrist assigned diagnosis was attention deficit disorder/attention deficit hyperactivity disorder (ADD/ADHD). Almost a quarter did not require psychiatric follow-up. Referrals to an outpatient clinic and admission were reduced significantly. Greater suicidality was associated with being female, presence of bullying-victimization and substance abuse [χ2(1)=9.33, p=0.002].

CONCLUSION: Suicidal behavior is the most common reason for urgent psychiatric consults. ADHD was the most frequent psychiatrist assigned diagnosis. Urgent psychiatric services can reduce admissions, referrals and wait times for hospital based clinics for low lethality, low intent suicidal behaviors and facilitate triage to community services.