Examination of Consultations Requested from the Child and Adolescent Psychiatry Clinic and Factors Predicting Subsequent Outpatient Clinic Attendance

Abstract

Objective: The aim of this study is to evaluate consultations received by the child and adolescent psychiatry consultation-liaison unit and identify factors predicting attendance at the outpatient clinic following consultation. Methods: A retrospective review was conducted on all consultations requested from the consultation-liaison psychiatry (CLP) unit at our clinic between August 2021 and March 2022. The files of cases who subsequently attended the recommended outpatient clinic were also examined. Data including age, gender, birth and developmental history, family characteristics, school history, clinical features, and number of consultations were recorded and analyzed. Results: The median age of the sample was 15.1 years (25%: 13.3 – 75%: 16.7). Among the cases, 128 (61.5%) were female and 80 (38.5%) were male. Of the consultations requested, 149 (71.6%) were from emergency services, while 52 (25%) were from inpatient services, with pediatric hematology being the most frequent service. The primary reasons for consultation were suicide attempts (22.1%) and agitation (19.2%). Approximately 26% of cases remained undiagnosed. Major depressive disorder was the most frequently diagnosed condition, accounting for 25.5% of cases. Among the cases recommended for outpatient follow-up at the time of consultation (86% of the total), 53% attended their scheduled appointments. In the predictive model for outpatient attendance, agitation (β=2.11, p<0.05) and suicide attempts (β=0.564, p<0.001) significantly predicted attendance. Conclusion: This study contributes to the existing literature by examining factors influencing the follow-up process. Our findings support the notion that agitation and suicide attempts are associated with increased morbidity. Early detection of high-risk behaviors such as suicide attempts and agitation is believed to reduce psychiatric morbidity and mortality rates, while also improving treatment compliance.