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Factors ID'd for Pediatric Involuntary Psychiatric Hospitalization

FRIDAY, May 14, 2021 -- Children and adolescents with involuntary psychiatric hospitalization are more likely to have a diagnosis of psychosis, substance misuse, or intellectual disability than those admitted voluntarily, according to a review published online April 27 in The Lancet Child & Adolescent Health.

Susan Walker, M.B., B.Ch., Ph.D., from University College London, and colleagues conducted a systematic review, meta-analysis, and narrative synthesis to examine the social and clinical factors associated with involuntary psychiatric hospitalization among children and adolescents using data from 19 studies with 31,212 participants.

The researchers found that involuntary rather than voluntary hospitalization of minors correlated with a diagnosis of psychosis, substance misuse, or intellectual disability in meta-analyses (odds ratios, 3.63, 1.87, and 3.33, respectively) and with presenting with a perceived risk for harm to self or to others (odds ratios, 2.05 and 2.37, respectively). Involuntary hospitalization also correlated with being aged 12 years or older and being from a Black versus White ethnic group (odds ratios, 3.57 and 2.72, respectively). For most factors included in the meta-analysis, there was substantial between-study heterogeneity (, 51.3 to 92.3 percent). More severe illness and poorer global functioning correlated with involuntary hospitalization in a narrative synthesis.

"We hope that a greater understanding of the factors associated with involuntary psychiatric hospitalization of children and adolescents will contribute to the creation of more equitable pathways to psychiatric treatment for patients of all ages and, ultimately, a reduction in long-standing health care inequalities," the authors write.

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