Factors associated with psychiatric readmission of children and adolescents in the U.S.: A systematic review of the literature.

OBJECTIVE: A systematic review of research assessing factors associated with inpatient psychiatric readmission of children and adolescents. METHODS: In accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA), we searched 8 databases (1994-2018) to identify relevant articles on factors associated with youth psychiatric readmission. Selected articles addressed one or more factors associated with psychiatric readmission for children and adolescents (≤21 years of age) admitted to a psychiatric hospital in the United States for a primary mental health diagnosis. Two authors independently reviewed article abstracts, titles, and text. RESULTS: Of 7903 retrieved articles, 30 studies met inclusion criteria. Analyzed variables were categorized according to child demographic and clinical characteristics; family, provider, and community characteristics; and treatment and aftercare characteristics. Available studies were markedly heterogeneous in methodology and outcomes. Factors associated with an increased risk of readmission included greater symptom severity, clinical diagnoses such as psychosis and affective disorders, suicidal behavior and self-injury, poor family functioning, and longer lengths of index hospital stay. CONCLUSIONS: Controlled trials of interventions to improve care and reduce recidivism for psychiatrically hospitalized youth are needed. Future research will benefit from a guiding theoretical framework, more representative samples, and standardized exposure/outcome measures.

Cosmetic-Related Injuries Treated in US Emergency Departments: 2002 to 2016.

A retrospective analysis was conducted by using data from the National Electronic Injury Surveillance System for children <5 years who were treated in US emergency departments (EDs) from 2002-2016) for a cosmetic-related injury. An estimated 64 686 (95% confidence interval = 53 037-76 335) children were treated in EDs for cosmetic-related injuries during the 15-year study period. There was no significant change in the rate (slope = 1.1 per 10 000 children per year, P = .95) of injuries over the study period. Injuries were most commonly associated with nail care (28.3%), hair care (27.0%), skin care (25.0%), and fragrance (12.7%) products. Children aged <2 years were most frequently injured (59.3%), and poisoning was the most common diagnosis (86.2%). To our knowledge, this is the first study to use a nationally representative sample to describe the epidemiology of cosmetic-related injuries among children aged <5 years. Unintentional exposure to cosmetics is an important source of injury for young children.