Psicopatología de los adolescentes residentes en hogares funcionales que precisan hospitalización psiquiátrica / Psychopathology of adolescents living in foster care who require a psychiatric hospitalization

INTRODUCCIÓN: Los adolescentes residentes en Hogares Funcionales presentan más riesgo de presentar Trastorno disocial y consumo de tóxicos. MÉTODO: Se estudió una muestra compuesta por todos los 431 adolescentes (12 y 17 años, 50,1% varones) que requirieron hospitalización en la Unidad de Psiquiatría Infanto-Juvenil del Hospital Universitario Basurto a lo largo de 68 meses consecutivos. Analizamos las características diferenciadoras respecto al motivo de ingreso, diagnóstico psiquiátrico, consumo de tabaco, alcohol y drogas, antecedentes psiquiátricos personales y familiares entre aquellos adolescentes ingresados que residían en hogares funcionales y los que residían con sus familias. RESULTADOS: El motivo más frecuente de ingreso para el total de la muestra fue alteración de la conducta (60,7% para los menores residentes en hogares funcionales y 33% para los residentes con familia de origen), seguidos de descompensación psicótica (24,7%) para residentes en hogares funcionales, y trastorno de la conducta alimentaria (16,4%) para los residentes con sus familias (p < 0,001). El diagnóstico psiquiátrico al alta más frecuente en ambos grupos fue trastorno psicótico (39,3% y 28,9%), siendo el trastorno disocial (37,1%) más prevalente en los adolescentes de hogares funcionales (p < 0,001). Los residentes en hogares funcionales consumían más tabaco (59,6%) (p < 0,001), cannabis (50,6%) (p < 0,001), anfetaminas (15,7%) (p < 0,01) y cocaína (14,6 %) (p < 0,05), y tenían más antecedentes de tratamiento psiquiátrico previo (p < 0,05) y antecedentes familiares psiquiátricos (p < 0,001). CONCLUSIONES: Los adolescentes que residen en hogares funcionales y precisan una hospitalización psiquiátrica representan un grupo de población en mayor riesgo de presentar trastorno disocial, consumir tabaco, cannabis y otras sustancias y poseer más antecedentes familiares psiquiátricos

INTRODUCTION: adolescents living in Foster care show high risk of conduct disorder and drug use. METHOD: A sample comprised by all 431 adolescents (ages 12-17, 50,1% men) admitted at the Child and Adolescent Psychiatric Inpatient Unit of Hospital Universitario Basurto during a period of 68 months was collected. Reason for admission, psychiatric diagnosis, tobacco, alcohol and drug use, personal and family psychiatric history were studied comparing those adolescents who live in Foster care with those living with their families. RESULTS: The most common reason for admission was behavioral problems (60.7% in those living in foster care and 33% in those living with their families), followed by psychotic symptoms (24.7%) for adolescents in foster care, and eating disorders (16.4%) for those living with their families (p < 0.001). The most frequent psychiatric diagnosis at discharge was in both groups psychotic disorder (39.3%, 28.9%); and conduct disorder (37.1%) was more prevalent in adolescents in foster care (p < 0.001). Those adolescents in Foster care smoke more frequently (59.6%) (p < 0.001), and use cannabis (50.6%) (p < 0.001), amphetamines (15.7%) (p < 0.01), and cocaine (14.6 %) (p < 0.05) also more frequently. They had had more previous psychiatric treatments (p < 0.05) and more psychiatric disorders in their families (p < 0.001). CONCLUSIONS: Adolescents in Foster Care who are admitted to inpatient psychiatric units are a group at a high risk of conduct disorder, tobacco, cannabis and drug use, and have more frequent history of psychiatric disorders in their families

Adopción y alteraciones de conducta en la adolescencia. Estudio en población hospitalaria / Adoption and behavioural disturbances in adolescence. A hospital patient sample

INTRODUCCIÓN: En las últimas décadas se han incrementado las adopciones en el mundo occidental. Se ha descrito que los adolescentes adoptados están sobrerrepresentados en los servicios de salud mental y que consultan con mayor frecuencia por trastornos de externalización. Planteamos un estudio para valorar la proporción de adolescentes adoptivos y la presencia de conductas externalizantes en una muestra hospitalaria. MÉTODOS: Se recogen prospectivamente los datos de todos los ingresos de adolescentes (12-17 años) hospitalizados en la Unidad de Hospitalización Infanto-Juvenil, que atiende a todo el territorio de Bizkaia, durante 56 meses (n = 431). Dividimos la muestra en adoptados (2,6%) y no adoptados (97,4%), y comparamos las siguientes variables: edad media al ingreso, sexo, motivo de ingreso, ingresos previos, diagnóstico al alta, consumo de tóxicos y resultados de la Overt Aggression Scale al ingreso. RESULTADOS: Los adolescentes adoptados están sobrerrepresentados en nuestra muestra (2,84% vs. 0,6% en la población general; p < 0,001). Comparándolos con el subgrupo de no adoptivos, ingresan significativamente más jóvenes (14,09 vs. 15,21 años; p = 0,017) y tienden a hacerlo más frecuentemente por alteraciones de conducta (63,6% vs. 38,1%; p = 0,086). CONCLUSIONES: Los adolescentes adoptados presentan más ingresos y lo hacen a una edad más temprana, datos que indican una mayor gravedad de la afección de estos adolescentes o una menor capacidad de contención de las familias adoptivas. Además, observamos que tienden a ingresar más por alteraciones conductuales, sin existir diferencias significativas en los diagnósticos al alta, lo que sugiere una tendencia a expresar la sintomatología de forma más externalizadora

INTRODUCTION: The number of adoptions has increased in the Western world in recent decades. An over-representation in mental health services and an increased risk of displaying behavioural disorders has been reported among adopted adolescents. In this study, we aim to assess the proportions of adopted and non-adopted adolescents and the presence of externalizing disorders in an inpatient setting. METHODS: Prospective data were collected over 56 months (n = 431) from all adolescent admissions (12-17 years of age) to the Child and Adolescent's Inpatient Psychiatric Unit, which serves the Biscay province (Basque Country, Spain). The sample was divided into adopted (2.6%) and non-adopted adolescents (97.4%), and the following variables were compared: age, gender, cause of admission, prior admissions, main diagnosis, drug use and Overt Aggression Scale score at admission. RESULTS: Adopted adolescents were over-represented in our sample (2.84% vs. 0.6% in the general population of Biscay, P<0.001). Compared to the non-adopted, age at admission was significantly lower (14.09 vs. 15.21 years old, P=.017) and they showed a statistical tendency to be admitted more frequently for behavioural disorders (63.6% vs. 38.1%, P=0.086). CONCLUSIONS: The over-representation and the earlier age at admission suggest that the conditions of adopted adolescents are more serious and-or adoptive families are less able to manage them. The data also show that they tend to be admitted more for behavioural disorders, whilst no significant differences in the diagnosis on discharge were found, which suggests that they tend to externalise their symptoms more

[Adoption and behavioural disturbances in adolescence. A hospital patient sample]. / Adopción y alteraciones de conducta en la adolescencia. Estudio en población hospitalaria.

INTRODUCTION: The number of adoptions has increased in the Western world in recent decades. An over-representation in mental health services and an increased risk of displaying behavioural disorders has been reported among adopted adolescents. In this study, we aim to assess the proportions of adopted and non-adopted adolescents and the presence of externalizing disorders in an inpatient setting. METHODS: Prospective data were collected over 56 months (n=431) from all adolescent admissions (12-17 years of age) to the Child and Adolescent's Inpatient Psychiatric Unit, which serves the Biscay province (Basque Country, Spain). The sample was divided into adopted (2.6%) and non-adopted adolescents (97.4%), and the following variables were compared: age, gender, cause of admission, prior admissions, main diagnosis, drug use and Overt Aggression Scale score at admission. RESULTS: Adopted adolescents were over-represented in our sample (2.84% vs. 0.6% in the general population of Biscay, P<.001). Compared to the non-adopted, age at admission was significantly lower (14.09 vs. 15.21 years old, P=.017) and they showed a statistical tendency to be admitted more frequently for behavioural disorders (63.6% vs. 38.1%, P=.086). CONCLUSIONS: The over-representation and the earlier age at admission suggest that the conditions of adopted adolescents are more serious and-or adoptive families are less able to manage them. The data also show that they tend to be admitted more for behavioural disorders, whilst no significant differences in the diagnosis on discharge were found, which suggests that they tend to externalise their symptoms more.