rESEArCH ArTIClE Characteristics of Children and Youth Who Visit the Emergency Department for a Behavioural Disorder

Objective: Relatively little is known about children who present to emergency departments (EDs) to stabilize acute emergencies related to behavioural disorders. This study describes patient and treatment characteristics of such children/ youth. Methods: We conducted a retrospective medical record review of consecutive ED presentations made by children/ youth (10 to 17 years) between January 2009 and December 2011 for visits with a main discharge diagnosis of hyperkinetic disorder, mixed disorder of conduct and emotions, or conduct disorder. Socio-demographic and ED visit data were analyzed descriptively. Results: During the study period, 365 consecutive presentations made by 325 children/youth. The most common presenting complaints were related to depression/self-harm (45.8%) and violent behaviours (28.8%). Many children/youth had a previously diagnosed psychiatric disorder (59.4%) and identified being under the care of a child psychiatrist (42.2%). The majority of ED visits were triaged as urgent or emergent (51.5 % and 41.1%, respectively) and included mood and suicidality assessments (84.7 % and 80.8%, respectively). Follow-up with various services was made for all visits. Conclusion: Children and youth presented to the ED for a behavioural disorder had urgent needs related to self-harm, depression and violent behaviours. These findings draw attention to the important role of the ED in managing physical safety and well-being concerns for families and recommending follow-up in the post-crisis period. Key Words: behavioural disorders, mental health, emergency department, pediatric