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Clinical Research Case Report

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Dr. Saurabh Kumar

MBBS, M.D. (Psychiatry) 15 years experience overall Psychiatrist , Neuropsychiatrist , Sexologist

Pediatric Psychiatric Emergencies at a Tertiary Care Center in India

Published In: Indian Pediatrics

About Indian Pediatrics: Indian Pediatrics is a leading, peer-reviewed medical journal that publishes original research, reviews, and clinical studies relevant to pediatric medicine. The journal is committed to advancing knowledge and practices in pediatric healthcare, particularly in the Indian context, by disseminating high-quality research that addresses the unique challenges of child and adolescent health.


Abstract

Co-authored by Dr. Saurabh Kumar, along with Swarndeep Singh and Raman Deep, this article, published in Indian Pediatrics, presents a retrospective study of pediatric psychiatric emergencies at a tertiary care center in India. The study provides a detailed analysis of the clinical profile, presenting symptoms, and psychiatric diagnoses of children and adolescents who were referred to the psychiatric emergency services over a 13-month period. It sheds light on the unique characteristics of pediatric psychiatric emergencies and underscores the need for targeted interventions in managing these cases.
 

Key Findings of the Research:

  1. Demographic and Clinical Profile: The study included 65 pediatric psychiatric patients, with an average age of 14.2 years, of which 63.1% were female. Nearly one-third of the children presented with a risk of harm to themselves or others, with aggression (18.5%) and self-harm attempts (16.9%) being the most common presenting behaviors.
  2. Psychiatric Diagnoses: The most frequently diagnosed condition was dissociative disorder (27.7%), followed by mood disorders (9.3%) and psychotic disorders (7.7%). Interestingly, dissociative disorders were significantly more common in the pediatric group compared to adults seen during the same period, highlighting the distinct nature of pediatric psychiatric emergencies.
  3. Medicolegal Concerns: Approximately 21.5% of the pediatric cases involved medicolegal issues, with the majority of these related to suicide or self-harm attempts. This finding underscores the complexity of managing psychiatric emergencies in children and adolescents, especially when legal considerations are involved.
  4. Treatment and Management: Psychotropic medications were prescribed in 63.1% of cases, with benzodiazepines being the most commonly used (38.4%). A small percentage of children (6.2%) required psychiatric admission, mainly for imminent suicidal risk or severe behavioral issues that could not be managed at home.
  5. Comparison with Adult Psychiatric Emergencies: Compared to adult psychiatric emergencies, the pediatric group had a higher prevalence of dissociative disorders and a lower frequency of substance use-related issues. Moreover, pediatric patients were less likely to be prescribed psychotropic medications during their emergency visits, reflecting the cautious approach taken when managing psychiatric medications in younger populations.

Applicability to the General Population:

The findings of this study have significant implications for the management of pediatric psychiatric emergencies in both clinical and public health contexts. Given that a majority of the pediatric patients had new-onset symptoms and no prior psychiatric diagnosis, the study emphasizes the critical role of emergency services as a first point of contact for many children and adolescents experiencing mental health crises.

For the general population, this research highlights the importance of early detection and intervention in pediatric mental health. Parents, caregivers, and educators should be aware of the signs of psychiatric distress in children and adolescents, particularly when there is a risk of harm to self or others. Timely access to mental health services can prevent the escalation of symptoms and improve long-term outcomes for young patients.

In conclusion, "Pediatric Psychiatric Emergencies at a Tertiary Care Center in India" provides valuable insights into the unique challenges of managing psychiatric emergencies in children and adolescents. Dr. Saurabh Kumar and his colleagues offer critical recommendations for improving emergency psychiatric care, advocating for enhanced training for pediatricians, better coordination between mental health professionals, and the need for tailored interventions to address the specific needs of young patients. This study serves as an important contribution to the ongoing efforts to improve pediatric mental health care in India.

Author Information:Singh Swarndeep, Saurabh Kumar, and Raman Deep. "Pediatric psychiatric emergencies at a tertiary care center in India." Indian pediatrics 57 (2020): 1124-1126.

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