2.63 PROTECTIVE AND RISK FACTORS ASSOCIATED WITH PSYCHIATRIC EMERGENCY DEPARTMENT VISITS AND ADMISSIONS AMONG THE CHILD AND ADOLESCENT POPULATION

Objectives: The goal of this session is to determine which psychosocial factors and diagnoses are associated with an increase in psychiatric emergency department (ED) visits and admissions in the child and adolescent population. Methods: Electronic medical records of patients (N = 613) below the age of 18 years who visited the psychiatric ED from January 2014 through December 2014 were reviewed. Demographics, biopsychosocial history, ED visits, and admissions were collected. Descriptive statistics, chi-square tests, and independent t-test analyses were used to examine differences. Results: Patients from two biological parent homes had significantly fewer ED visits (1.2 vs. 1.7, P < 0.01) and admissions (0.09 vs. 0.26, P < 0.01). Increasing age and grade level were significant for higher admissions (R2 = 0.122, P < 0.01 and R2 = 0.123, P < 0.01, respectively). Sexual activity was significant with increasing admissions (0.432 vs. 0.166, P < 0.001). Patients who reported abuse had a greater number of ED visits (2.1 vs. 1.5, P < 0.01) and admissions (0.61 vs. 0.14, P < 0.01), as did those with legal issues (0.54 vs. 0.18, P < 0.01). Those with substance use, specifically marijuana, were associated with increased admissions (0.461 vs. 0.176, P < 0.001). ADHD and mood disorders both had significantly higher admissions (0.366 vs. 0.19, P < 0.05; 0.500 vs. 0.13, P < 0.001) and ED visits (2.14 vs. 1.44, P < 0.01; 1.99 vs. 1.45, P < 0.001), respectively. Increasing number of diagnoses was significant with both ED visits (R2 = 0.163, P < 0.001) and admissions (R2 = 0.271, P < 0.001). Conclusions: Abuse can compound an existing diagnosis, resulting in increased hospital visits or admissions. Patients with substance abuse and/or legal issues can result in risky behavior, impaired judgment, and disorderly conduct requiring hospital admission. Substance abuse can precipitate mood, anxiety, and/or psychotic symptoms. Marijuana use may speak to the psychotropic nature of tetrahydrocannabinols and their role in mental illness. Effective parenting on sexual behavior and marijuana use may decrease hospital admission. ADHD and mood disorders both had more ED visits and admissions that could be a result of impulsive behavior of these illnesses. By understanding the factors that increase psychiatric ED and hospital admissions, we can intervene and thereby decrease the time spent in psychiatric facilities.