More than half (53.4%, N = 918) of the patients consulting our emergency clinic had a migration background, 46.6% (N = 800) were native Austrians, 9.5% originated from former Yugoslavia, 7.6% from Turkey, and 36.4% from other countries like India, Pakistan, Iran, Iraq, Afghanistan, Egypt etc.
Significantly more female patients (59.2%) were treated at the emergency outpatients’ clinic: 56.4% females among the Austrian, 71.5% among Turkish, and 63.2% among Serbian/Croatian/Bosnian patients (χ2 = 11.9; p = 0.003).
The mean age of the patients was 14.6 (SD = 3.0, range 4–18) years with the majority being between 12–18 years old (83.6%). Mean ages of Austrian (14.6 years), Turkish (15.1 years), and Serbian/Croatian/Bosnian children (14.1 years) were similar. Female patients were significantly older than males (14.97 ± 2.9 (SD) vs. 14.0 ± 3.2 (SD) years, t = 123.6, p < 0.001).
The majority of the patients (60.3%) had no previous psychiatric treatment, 57.2% of the Austrian, 70.8% of the Turkish and 66.9% of the Serbian/Croatian/Bosnian patients attended the psychiatric emergency clinic for the first time (χ2 = 12.0; p = 0.002). The remaining patients had already consulted our emergency clinic more than once because of acute problems.
Reasons for referral
Reasons for referral and gender
The most frequently observed reasons for acute consultation (Table 1) were acute stress disorder (20.3%), behavioral problems (13.9%) and attempted suicide (13.4%). There were significant gender differences: female patients were most frequently seen with acute stress disorder (22.9%), suicide attempts (17.2%), or suicidality (10.0%), males for behavioral problems (24.9%), acute stress disorder (16.4%), or anxiety disorders (11.0%, χ2 = 125.4, p < 0.001).
Reasons for referral by three study groups
Austrian children and adolescents were predominantly referred for acute stress disorder (20.9%), behavioral problems (14.8%), or suicidal ideation (11.9%), Turkish patients for attempted suicide (23.1%), acute stress disorder (18.5%), or anxiety/panic disorders (13.1%), and Serbian/Croatian/Bosnian children for acute stress disorder (19.0%), suicide attempts (16.6%), and behavioral problems (14.7%). The differences between the three study groups concerning their major reason for an acute referral were highly significant (χ2 = 72.4; p < 0.001).
We found significant gender differences (χ2 = 114.3, p < 0.001) in the Austrian group but not in the groups with migration background concerning the primary reason of referral (Table 1).
In 68.6% of the patients a psychiatric diagnosis was assigned (Table 2). In the remaining patients the presented problems did not justify a psychiatric diagnosis or the attending physician did not assign a specific diagnosis.
The most frequently assigned diagnoses were F 4 – neurotic, stress-related and somatoform disorders (24.9%) followed by F 3 – affective disorders (15.0%) and F 9 – behavioral and emotional disorders (13.4%).
Psychiatric diagnoses and gender
We observed gender differences for ICD-10 defined diagnostic groups (χ2 = 108.0, p < 0.001): the most frequently observed diagnostic groups were F 4 (neurotic, stress-related and somatoform disorders, 36.6%), F 3 (affective disorders, 26.4%), and F 9 (behavioral and emotional disorders, 9.9%) in female patients; and F 9 (behavioral and emotional disorders, 33.9%), F 4 (neurotic, stress-related, and somatoform disorders, 32.7%), and F 3 (affective disorders, 16.7%) in males.
Psychiatric diagnosis, migration background and gender
We observed gender differences for ICD-10 diagnoses in the Austrian (X2 = 95.244; df = 8; p < 0.001) and Serbian/Croatian/Bosnian population (X2 = 16.333; df = 8; p = 0.038) but not in the Turkish (X2 = 13.736; df = 8; p = 0.089) population: In Serbian/Croatian/Bosnian and Austrian males the diagnosis, F 9 (behavioral and emotional disorders 27.0% vs. 33.9%), and in Serbian/Croatian/Bosnian and Austrian girls, the diagnosis, F 4 (neurotic, stress-related and somatoform disorders, 46.7% vs. 36.6%), were most frequently assigned. In Turkish males and females, the diagnosis, F 4 (neurotic, stress-related and somatoform disorders, 30.0 vs. 51.6%) was the predominantly assigned diagnosis (Table 2).
Contrary to the Austrian (5.6%) and Serbian/Croatian/Bosnian patients (7.2%), the diagnosis of eating disorders (F 50) was only rarely assigned to the Turkish population (3.8%). Personality disorders (F 60) were more frequently diagnosed in Austrian (5.6%) than in Turkish (1.3%) and Serbian/Croatian/Bosnian patients (4.1%).
Patients were most frequently referred to our emergency clinic by their social network (45.5%), 15.6% of the patients were referred by physicians, 12.4% by various institutions, and 9.1% of the patients came on their own, and in 17.6%, the referring person was not known.
There were differences among the three groups concerning the referring persons: Austrian and Serbian/Croatian/Bosnian patients were mostly referred by their social network (48.0% vs. 50.9%), followed by physicians (15.0% vs. 20.2%). In the majority of the Turkish patients, the referring person was unknown (50.8%), followed by persons from the social network (23.1%; χ2 = 122.5; p < 0.001).