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Purpose: This register-based study aimed to evaluate trends in adolescent psychiatric inpatient care using nationwide data from three consecutive decades. Methods: The study population (N 17,112) comprised all Finnish citizens aged 13-17 receiving their firstever psychiatric inpatient treatment between 1980 and 2010 in Finland. Information on inpatient care in the psychiatric hospital was obtained from the Hospital Discharge Register and the Care Register for Health Care, which contains data on all patients discharged from all Finnish inpatient psychiatric health services. Results: Inpatient admissions remained relatively stable until the early 1990s, after which a steady increase was seen, peaking in 2008 and more marked among females than males. In males, there was an increase in inpatient care episodes for externalizing disorder or mood disorder, and in females for mood disorder. Duration of first inpatient care decreased over time, but level of functioning on admission remained stable or even deteriorated. Females, patients first admitted in the 1980s or diagnosed with schizophrenia were more likely to be re-hospitalized during adolescence. Conclusions: We reported an increase in adolescent psychiatric inpatient care from the latter half of the 1990s up to 2010, which could be explained by societal and policy changes. In particular, as the study period progressed a significant increase was seen in admissions of females and a global reduction of length of stay (LOS) with no concomitant increase in re-hospitalizations.

Mental disorders may for various reasons impair educational attainment, and with far-reaching consequences given the impact of education on subsequent employment, social life, life choices and even health and mortality. This register-based study addresses trends in educational attainment among Finnish adolescents aged 13–17 with mental disorders severe enough to necessitate inpatient treatment between 1980 and 2010. Our subjects (N = 14,435), followed up until the end of 2014, were at greater risk of discontinuing education beyond compulsory comprehensive school or of lower educational attainment than their age-peers in general population. Only 50.0% had completed any post-comprehensive education compared to 84.9% in same-aged general population. Those at highest risk were males and those with organic, intellectual disabilities and developmental, externalizing disorders or schizophrenia group diagnoses. Despite improvements in adolescent psychiatric care, school welfare services and pedagogical support, risks have remained high. Greater effort in psychiatric treatment, school welfare and pedagogy are needed to combat this severe inequality.

Background: Some mental disorders have been associatedwith increased likelihood of sexual offending in adolescents (and adults), but relevant studies tend to be of established sex offenders.Aims: To examine relationships between adolescent mental disorders and subsequent involvement in sex offending and to explore any predictive value of primary diagnoses for subsequent interpersonal offending, whether sexual or violent. Methods: We analyse national register-based longitudinal data on males in Finland admitted for their first psychiatric inpatient treatment between the ages of 13-17 in the period 1980-2010 (N = 6749). Cox regression was used for the analysis of multivariate associations. Results: A subsequent criminal record for sex crime in the 10-year follow up was rare among former child and adolescent psychiatric (CAP) inpatient males (1.5%). Having a subsequent criminal record for non-sex-related violent crime was more common (25%). Time to either sex crimes or non-sex-related violent crimes after a first CAP inpatient treatment was 3-4 years. Whilst the risk of committing non-sex-related violent crimes was elevated in all diagnostic groups compared to those with schizophrenia spectrum