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Hospitalized Youth and Child Abuse: A Systematic Examination of Psychiatric Morbidity and Clinical Severity

NCJ Number
245303
Journal
Child Abuse & Neglect Volume: 38 Issue: 1 Dated: January 2014 Pages: 76-83
Author(s)
Brooks R. Keeshin; Jeffrey R. Strawn; Aaron M. Luebbe; Shannon N. Saldana; Anna M. Wehry; Melissa P. DelBello; Frank W. Putnam
Date Published
January 2014
Length
8 pages
Annotation
In order to determine any association between histories of abuse and the complexities and severity of mental disorders among psychiatrically hospitalized children and youth, this study conducted systematic chart reviews of 1,433 consecutive psychiatric hospitalizations of children and adolescents diagnosed with multiple DSM-IV-TR disorders.
Abstract
The findings show the adverse impact of childhood abuse on the psychiatric morbidity and complexity of children and youth admitted for psychiatric hospitalization, suggesting the need for trauma-informed treatment in psychiatric hospital settings. Also, primary prevention strategies for child abuse are important in decreasing the risk for subsequent significant psychological sequelae that require hospitalization. Abuse occurred frequently, with over one-third of patients having a history of physical and/or sexual abuse. Children with a history of abuse were more likely to be diagnosed with multiple DSM-IV-TR disorders than non-traumatized children. A history of sexual abuse was associated with more medication use than in non-traumatized peers, as well as a higher likelihood of treatment with antipsychotic medications, both at admission and discharge. Physical and sexual abuse was independently associated with increased length of stay compared to non-traumatized patients. The three objective measures of clinical complexity and illness severity were cross-category comorbidity (e.g., mood disorder, substance abuse disorder); medication use; and length of stay. 4 tables and 33 references