Trends in Hospitalizations of Adolescents With Psychiatric Disorders in Acute Care Hospitals.

Abstract

Purpose: Children with medical and psychiatric disorders often require acute hospital care. This study aimed to investigate 10-year trends in the hospitalization of adolescents with psychiatric diagnoses and examine how these trends vary according to the comorbidity status of psychiatric and medical disorders in acute care settings.

Methods: We conducted a retrospective, longitudinal cohort analysis of a Japanese nationwide database of acute care hospitalizations that included data from 1763 hospitals for patients aged 6 through 24 years from 2010 to 2019. Multivariate Poisson regression with robust variance estimation using cluster robust inference was conducted to assess time trends in hospitalizations with psychiatric disorders in the 3 comorbid groups (psychiatric disorders without medical diagnoses, psychiatric disorders with medical disorders, and medical disorders with comorbid psychiatric disorders).

Results: Hospitalizations with psychiatric disorders increased from 4.7% to 6.3% between 2010 and 2019 (cumulative percentage growth: 34.1% [95% CI 33.1%-36.9%]). The largest increase was in the medical disorders with comorbid psychiatric disorders group (cumulative percentage growth: 38.1%). Multivariate analysis also showed an increase in hospitalizations with psychiatric disorders (annual percentage change: 3.1%; 95% CI 2.3%-3.9%). The most common psychiatric disorders were anxiety disorders, eating disorders, and autism spectrum disorders. Attention deficit hyperactive disorder increased during the study period in all comorbidity groups.

Conclusion: We found that hospitalizations with psychiatric disorders increased by 34.1% from 2010 to 2019, particularly in the comorbid medical disorders with psychiatric disorders group. These findings suggest that health care systems for pediatric hospitalization require multidisciplinary medical and psychiatric services in acute care hospitals.