Changes in the clinical features of child and adolescent psychiatric inpatients: a nationwide
time-trend study from Finland
Sammanfattning
Background: Few studies have focused on the recent trends in clinical features child and
adolescent inpatient. Aims: This study focuses on the change in the characteristics of child and
adolescent psychiatric inpatients in Finland. Methods: The data collection was carried out on
selected study days in 2000 and 2011. Questionnaires were sent to the psychiatrists of all child and
adolescent wards in Finland. Results: By comparing the data obtained in 2000 (n = 504) and 2011 (n
= 412), several changes were found: the percentage of girls in adolescent wards grew and the
diagnoses of depression, anxiety disorders, attention deficit hyperactivity disorder and eating
disorders increased. In contrast, the diagnoses of psychosis and conduct or oppositional disorders
decreased. General functioning was evaluated with the Childrens Global Assessment Scale (CGAS).
There were no changes in the distribution of CGAS scores among child inpatients, whereas among
adolescents the share of inpatients with lowest CGAS scores (1-30) increased significantly. The mean
length of stay dropped. Conclusions: The growing percentage of girls in adolescent wards is
associated with an increase in diagnoses that are more prevalent among girls than boys, namely
depression, anxiety, and eating disorders. The changes in the distribution of diagnoses may be due
to changes in diagnostic or referral practices, or reflect true changes in the prevalence of disorders
among children and adolescents in need of inpatient treatment. The share of adolescent inpatients
with the poorest general functioning has increased. The observed shortening in inpatient treatment
time seems to be a result of changes in treatment practices.