Psychiatric Emergencies in Children and Adolescents

  • Daniel W. Rosenn
Part of the Critical Issues in Psychiatry book series (CIPS)


According to recent estimates, at least 30% of the visits currently being made to hospital emergency rooms involve patients under the age of 18 years.1 One such survey has shown that emergency room visits for minors increased by 127% from 1958 to 1968 compared to a less than 50% increase in overall services for the same period.2 In the last decade, teenagers accounted for approximately 15% of all general hospital psychiatric emergencies. Although there is a corresponding trend toward increased drug dependence and abuse, adolescent emergencies comprise all diagnostic categories.3,4


Suicide Attempt Suicidal Behavior Child Psychiatry Psychiatric Emergency Childhood Depression 


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


General Sections 1–6

  1. 1.
    Khan AV: Preface, in Psychiatric Emergencies in Pediatrics. Year Book Medical Publishers, June 1979, pp vii–viii.Google Scholar
  2. 2.
    Sandifer MG Jr: Service and set in treatment decisions. Am J Psychiatry128: 1140–1145, 1972.PubMedGoogle Scholar
  3. 3.
    Bristol JH, Giller E Jr, Docherty JP: Trends in emergency psychiatry in the last two decades. Am J Psychiatry138: 623–628, 1981.PubMedGoogle Scholar
  4. 4.
    Huffine CL, Craig TJ: Social factors in the utilization of an urban psychiatric emergency service. Arch Gen Psychiatry30: 249–255, 1974.PubMedCrossRefGoogle Scholar
  5. 5.
    Tyson R, Miller S, Brown C: A study of psychiatry emergencies: Part I. Demographic data. Psychiatry Med1: 349–357, 1970.PubMedCrossRefGoogle Scholar
  6. 6.
    Parad JH, Parad LG: A study of crisis oriented planned short-term treatment. Soc Casework49: 346–355; 418–426, 1968.Google Scholar
  7. 7.
    Glasscote RM, Fishman ME, Sonis M: Children and Mental Health: Progress, Problems, Prospects. Washington, Joint Information Service of the American Psychiatric Association, 1972.Google Scholar
  8. 8.
    Morrison GC, Smith WR: Emergencies in child psychiatry: A definition, in Morrison GC (ed): Emergencies in Child Psychiatry. Springfield, 111, Charles C Thomas, 1975, pp 13–20.Google Scholar
  9. 9.
    Morrison GC: Therapeutic intervention in a child psychiatric emergency service. J Am Acad Child Psychiatry8: 542–558, 1969.CrossRefGoogle Scholar
  10. 10.
    Morrison GC, Smith WR: Child psychiatric emergencies: A comparison of two clinic settings and socio-economic groups, in Morrison GC (ed.): Emergencies in Child Psychiatry. Springfield, 111, Charles C Thomas, 1975, pp 107–114.Google Scholar
  11. 11.
    Mattson A, Hawkins JW, Seese LR: Child psychiatric emergencies: Clinical characteristics and follow-up results. Arch Gen Psychiatry17: 584–592, 1967.CrossRefGoogle Scholar
  12. 12.
    Shafii M, Whittinghill R, Healy MG: The pediatric-psychiatric model for emergencies in child psychiatry: A study of 994 cases. Am J Psychiatry136: 1250–1601, 1979.Google Scholar
  13. 13.
    Schowalter JE, Solnit AJ: Child psychiatry consultation in a general hospital emergency room. J Am Acad Child Psychiatry5: 534–549, 1966.CrossRefGoogle Scholar
  14. 14.
    Pruett KD: Home treatment for two infants who witnessed their mother’s murder. J Am Acad Child Psychiatry18: 647–657, 1979.PubMedCrossRefGoogle Scholar
  15. 15.
    Simmons JE: Psychiatric Examination of Children. Philadelphia, Lea & Febiger, 1974.Google Scholar
  16. 16.
    Goodman JD, Sours JA: The Child Mental Status Examination. New York, Basic Books, 1967.Google Scholar
  17. 17.
    Cohen RL: The approach to assessment, in Noshpitz JD (ed.): Basic Handbook of Child Psychiatry, vol I. New York, Basic Books, 1979, pp 485–551.Google Scholar
  18. 18.
    Lewis M: Clinical Aspects of Child Development. Philadelphia, Lea & Febiger, 1982.Google Scholar
  19. 19.
    Group for Advancement of Psychiatry, Report # 38: The Diagnostic Process in Child Psychiatry. New York, 1957, pp 313–353.Google Scholar

Suicide (Section 7)

  1. 20.
    Holinger PC: Adolescent suicide: An epidemiological study of recent trades. Am J Psychiatry135: 754–756, 1978.PubMedGoogle Scholar
  2. 21.
    Data from the Mortality Statistics Branch, National Center for Health Statistics, Department of Health, Education and Welfare, in Children’s World. Boston, Children’s Hospital, Fall 1980.Google Scholar
  3. 22.
    Khan AV: Grief, depression and suicide, in Psychiatric Emergencies in Pediatrics. Year Book Medical Publishers, 1979, pp 96–119.Google Scholar
  4. 23.
    Mclntire MS, Angle CR: “Suicide” as seen in poison control centers. Pediatrics 48: 914–922, 1971.Google Scholar
  5. 24.
    Lawler RH, Nakielny W, Wright N: Suicidal attempts in children. Can Med Assoc J89: 751, 1963.PubMedGoogle Scholar
  6. 25.
    Jacobziner H: Attempted suicides in adolescence. JAMA191: 101–105, 1965.CrossRefGoogle Scholar
  7. 26.
    Weiner IB: Psychological Disturbance in Adolescence. New York, Wiley-Interscience, 1970.Google Scholar
  8. 27.
    McAnarney ER: Suicidal behavior of children and youth. Pediatr Clin North Am22: 595–614, 1975.PubMedGoogle Scholar
  9. 28.
    Tuckman J, Cannon HE: Attempted suicide in adolescents. Am J Psychiatry119: 228–232, 1962.PubMedGoogle Scholar
  10. 29.
    Teicher JD: Suicide and suicide attempts, in Noshpitz J (ed): Basic Handbook of Child Psychiatry, vol. II. New York, Basic Books, 1979, pp 685–697.Google Scholar
  11. 30.
    Morrison GC, Collier JG: Family treatment approaches to suicidal children and adolescents. J Am Acad Child Psychiatry8: 140–153, 1969.PubMedCrossRefGoogle Scholar
  12. 31.
    Ackerly WC: Latency age children who threaten or attempt to kill themselves. J Am Acad Child Psychiatry6: 242–261, 1967.PubMedCrossRefGoogle Scholar
  13. 32.
    Paulson MJ, Stone D, Sposto R: Suicide potential and behavior in children ages 4 to 12. Suicide Life Threat Behav8: 225–242, 1978.PubMedGoogle Scholar
  14. 33.
    Aleksandrowicz MK: The biological strangers. Bull Menninger Clin39: 163–176, 1975.PubMedGoogle Scholar
  15. 34.
    Haider I: Suicidal attempts in children and adolescents. Br J Psychiatry114: 1133–1134, 1968.PubMedCrossRefGoogle Scholar
  16. 35.
    Otto U: Suicidal acts by children and adolescents. Acta Psychiatr Scand Suppl233: 5–123, 1972.Google Scholar
  17. 36.
    Green AH: Self-destructive behavior in battered children. Am J Psychiatry135: 579–582, 1978.PubMedGoogle Scholar
  18. 37.
    Schrut A: Suicidal adolescents and children. JAMA188: 1103–1107, 1964.PubMedCrossRefGoogle Scholar
  19. 38.
    Schecter MD: The recognition and treatment of suicide in children, in Shneidman ES, Farberow N (eds.): Clues to Suicide. New York, McGraw-Hill, 1957, pp 131–143.Google Scholar
  20. 39.
    Litman RE: Sigmund Freud on suicide, in Schneidman ES (ed.): Essays on Self Destruction. New York, Holt, Rinehart & Winston, 1968.Google Scholar
  21. 40.
    Margolin NL, Teicher JD: Thirteen adolescent male suicide attempts. J Am Acad Child Psychiatry8: 296–315, 1968.Google Scholar
  22. 41.
    Toolan JM: Suicide and suicidal attempts in children and adolescents. Am J Psychiatry118: 719–724, 1962.PubMedGoogle Scholar
  23. 42.
    Mattson A, Hawkins JW, Seese LR: Suicidal behavior as a child psychiatric emergency. Arch Gen Psychiatry20: 100–109, 1969.CrossRefGoogle Scholar
  24. 43.
    Teicher JD, Jacobs J: Adolescents who attempt suicide: Preliminary findings. Am J Psychiatry122: 1248–1257, 1966.PubMedGoogle Scholar
  25. 44.
    Lukianowicz N: Attempted suicide in children. Acta Psychiatr Scand44: 415–435, 1968.PubMedCrossRefGoogle Scholar
  26. 45.
    Pfeffer CR, Conte HR, Plutchik R, et al: Suicidal behavior in latency age children: An out-patient population. J Am Acad Child Psychiatry19: 703–710, 1980.PubMedCrossRefGoogle Scholar
  27. 46.
    Poznanski RO, Krahenbuhl V, Zrull JP: Childhood depression: A longitudinal perspective. J Am Acad Child Psychiatry15: 491–501, 1976.PubMedCrossRefGoogle Scholar
  28. 47.
    Waldron S: The significance of childhood neurosis for adult mental health: A follow-up study. Am J Psychiatry133: 532–538, 1976.PubMedGoogle Scholar
  29. 48.
    Duncan W: Immediate management of suicide attempts in children and adolescents: Psychological aspects. J Family Practice4: 77–80, 1977.Google Scholar
  30. 49.
    Shaffer D: Suicide in childhood and early adolescence. J Child Psychol Psychiatry15: 275–291, 1974.PubMedCrossRefGoogle Scholar
  31. 50.
    Petti TA: Depression in hospitalized child psychiatry patients: Approaches to measuring depression. J Am Acad Child Psychiatry17: 49–59, 1978.PubMedCrossRefGoogle Scholar
  32. 51.
    Piug-Antich J, Blau S, Marx N: Prepubertal major depressive disorder: A pilot study. J Am Acad Child Psychiatry17: 695–707, 1978.CrossRefGoogle Scholar
  33. 52.
    Citryn L, MckNew DH Jr, Barney WF Jr: Diagnosis of depression in children: A reassessment. Am J Psychiatry137: 22–25, 1980.Google Scholar
  34. 53.
    Kashani JH, Husain A, Shekim WO, et al: Current perspectives on childhood depression: An overview. Am J Psychiatry138: 143–152, 1981.PubMedGoogle Scholar
  35. 54.
    Carlson GA, Cantwell DP: Unmasking marked depression in children and adolescents. Am J Psychiatry137: 445–449, 1980.PubMedGoogle Scholar
  36. 55.
    Anthony EJ: Childhood depression, in Anthony EJ, Benedek T (eds.): Depression and Human Existence. Boston, Little, Brown & Co, 1975, pp 231–277.Google Scholar
  37. 56.
    Bemporad JR, Wilson A: A developmental approach to depression in childhood and adolescence. J Am Acad Psychoanal6: 325–352, 1978.PubMedGoogle Scholar
  38. 57.
    Glaser K: Marked depression in children and adolescents: Psychodynamic observations. Am J Psychother21: 565–574, 1967.PubMedGoogle Scholar
  39. 58.
    Maurer A: Motivation of concepts of death. Br J Med Psychol39: 35–41, 1966.PubMedCrossRefGoogle Scholar
  40. 59.
    Pfeffer PR, Conte HR, Plutchik R, et al: Suicidal behavior in latency aged children: An empirical study. J Am Acad Child Psychiatry18: 679–692, 1979.PubMedCrossRefGoogle Scholar
  41. 60.
    Toolan JM: Depression in children and adolescents. Am J Orthopsychiatry32: 404–414, 1962.PubMedCrossRefGoogle Scholar
  42. 61.
    Nagy M: The child’s view of death, in Feifel H (ed): The Meaning of Death. New York, McGraw-Hill, 1959.Google Scholar
  43. 62.
    Gould RE: Suicidal problems in children and adolescents. Am J Psychother19: 228–246, 1965.PubMedGoogle Scholar
  44. 63.
    Shaw CR, Schelkun RF: Suicidal behavior in children. Psychiatry28: 157–168, 1965.PubMedGoogle Scholar
  45. 64.
    Anthony S: Discovery of Death in Childhood and After. New York, Basic Books, 1972.Google Scholar
  46. 65.
    Jacobs J: Adolescent Suicide. New York, Wiley Interscience, 1971.Google Scholar
  47. 66.
    Laufer M: The body image, the function of masturbation, and adolescence: Problems of the ownership of the body. Psychoanal Study Child23: 114–137, 1968.PubMedGoogle Scholar
  48. 67.
    Erlich HS: Adolescent suicide. Psychoanal Study Child33: 261–277, 1978.PubMedGoogle Scholar

Homicide (Section 8)

  1. 68.
    Marohn RC: Adolescent violence: Causes and treatment. J Am Acad Child Psychiatry21: 354–360, 1982.PubMedCrossRefGoogle Scholar
  2. 69.
    Hollinger P: Violent deaths among the young: Recent trends in suicide, homicide and accidents. Am J Psychiatry136: 1144–1147, 1979.Google Scholar
  3. 70.
    Hollinger P: Violent deaths as a leading cause of mortality: An epidemological study of suicide, homicide and accidents. Am J Psychiatry137: 472–476, 1980.Google Scholar
  4. 71.
    Bender L: Children and adolescents who have killed. Am J Psychiatry116: 510–513, 1959.Google Scholar
  5. 72.
    Carek DJ, Watson AS: Treatment of a family involved in fratricide. Arch Gen Psychiatry11: 533–542, 1964.PubMedCrossRefGoogle Scholar
  6. 73.
    Curtis GC: Violence breeds violence—perhaps? Am J Psychiatry120: 386–387, 1963.PubMedGoogle Scholar
  7. 74.
    Paluszny MD, NcNable M: Therapy of a 6-year-old who committed fratricide. J Am Acad Child Psychiatry14: 319–336, 1975.PubMedCrossRefGoogle Scholar
  8. 75.
    Adelson L: The battering child. JAMA22: 159–161, 1972.CrossRefGoogle Scholar
  9. 76.
    Tooley K: The small assassins. Clinical notes on a subgroup of murderous children. J Am Acad Child Psychiatry14: 306–318, 1975.PubMedCrossRefGoogle Scholar
  10. 77.
    Malmquist CP: Premonitory sign of homicidal aggression in juveniles. Am J Psychiatry123: 461–465, 1971.Google Scholar
  11. 78.
    West DJ: Murder Followed by Suicide. Cambridge, Harvard University Press, 1967.Google Scholar
  12. 79.
    Burks HL, Harrison SI: Aggressive behavior as a means of avoiding depression. Am J Orthopsychiatry32: 416–422, 1962.PubMedCrossRefGoogle Scholar
  13. 80.
    Macdonald JM: Homicidal threats. Am J Psychiatry124: 475–482, 1967.PubMedGoogle Scholar
  14. 81.
    Gibson E, Klein S: Murder. London, H. M. Stationery Office, 1961.Google Scholar
  15. 82.
    King CH: The ego and the integration of violence in homicidal youth. Am J Orthopsychiatry45: 134–145, 1975.PubMedCrossRefGoogle Scholar
  16. 83.
    Hellman DS, Blackman N: Enuresis, firesetting, and cruelty to animals: A triad predictive of adult crime. Am J Psychiatry122: 1431–1435, 1966.PubMedGoogle Scholar
  17. 84.
    Justice B, Justice R, Kraft IA: Early-warning signs of violence: Is a triad enough? Am J Psychiatry131: 457–459, 1974.PubMedGoogle Scholar
  18. 85.
    Sendi IB, Blomgren PG: A comparative study of predictive criteria in the predisposition of homicidal adolescents. Am J Psychiatry132: 423–427, 1975.PubMedGoogle Scholar
  19. 86.
    Lewis DO, Pincus JH, Shanok SS, Glaser GH: Psychomotor epilepsy and violence in a group of incarcerated adolescent boys. Am J Psychiatry139: 882–887, 1982.PubMedGoogle Scholar
  20. 87.
    Robins L: Deviant Children Grown Up. Baltimore, Williams & Wilkins, 1966.Google Scholar
  21. 88.
    Detre TP, Kupfer DJ, Taub S: The Nosology of violence. Read at Symposium on the Neural Basis of Violence and Aggression, Houston, Tex, 1972.Google Scholar
  22. 89.
    Pincus JH, Tucker GJ: Violence in children and adults: A neurological view. J Am Acad Child Psychiatry17: 227–288, 1978.Google Scholar
  23. 90.
    Inamdar SC, Lewis DD, Siomopulous G, Shanok SS, Lamela M: Violent and suicidal behavior in psychotic adolescents. Am J Psychiatry139: 932–935, 1982.PubMedGoogle Scholar

Firesetting (Section 9)

  1. 91.
    Dietz J: Punishment no answer for kids who set fires, doctors say. Boston Globe, February 14, 1982, p 31.Google Scholar
  2. 92.
    Kaufman I, Herms LW, Reiser DE: A réévaluation of the psychodynamics of firesetting. Am J Orthopsychiatyr 31:123–136, 1961.Google Scholar
  3. 93.
    Vanersall TA, Weiner JM: Children who set fires. Arch Gen Psychiatry 22:63–71, 1970.CrossRefGoogle Scholar
  4. 94.
    Yarnell H: Firesetting in children. Am J Orthopsychiatry 10:272–286, 1940.Google Scholar
  5. 95.
    Macht LB, Mack JE: The firesetter syndrome. Psychiatry 31:277–288, 1968.PubMedGoogle Scholar
  6. 96.
    Lewis NDC, Yarnell H: Pathological firesetting (pyromania). Nerv Ment Dis Monogr No. 82, 1951.Google Scholar

Runaway (Section 10)

  1. 97.
    Schmidt WM: Runaway children. JAMA232: 651–652, 1975.PubMedCrossRefGoogle Scholar
  2. 98.
    Montgomery BJ: Teenagers trade homes for streets: Why? JAMA240: 16–17, 1978.PubMedCrossRefGoogle Scholar
  3. 99.
    Shafii M, Whittinghill R, Healy MG: The pediatric psychiatric model for emergencies in child psychiatry: A study of 994 cases. Am J Psychiatry136: 1660–1601, 1979.Google Scholar
  4. 100.
    Stierlin H: A family perspective on adolescent runaways. Arch Gen Psychiatry29: 56–62, 1973.PubMedCrossRefGoogle Scholar
  5. 101.
    Stierlin H, Ravenscroft K: Varieties of adolescent “separation,” Br J Med Psychol45: 299–313, 1972.PubMedCrossRefGoogle Scholar

School Refusal (Section 11)

  1. 102.
    Rogers K, Reese G: Health studies. Am J Dis Child109: 9–27, 1965.PubMedGoogle Scholar
  2. 103.
    Berganza CE, Anders TF: An epidemiologic approach to school absenteesm. J Am Acad Child Psychiatry17: 117–125, 1978.PubMedCrossRefGoogle Scholar
  3. 104.
    Crusnley FE. A school phobia in a three-generational family conflict. J Am Acad Child Psychiatry13: 536–550, 1974.CrossRefGoogle Scholar
  4. 105.
    Skynner AC: School phobia: A reappraisal. Br J Med Psychol47: 1–16, 1974.PubMedCrossRefGoogle Scholar
  5. 106.
    Waldron S Jr, Shrier DK, Stone B, Tobin F: School phobia and other childhood neuroses: A systematic study of the children and their families. Am J Psychiatry132: 882–888, 1975.Google Scholar
  6. 107.
    Coolidge JC: School phobia, in Noshpitz JD (ed): Basic Handbook of Child Psychiatry, vol. II. New York, Basic Books, 1979, pp 453–463.Google Scholar
  7. 108.
    Green M, Solnit AJ: Reactions to the threatened loss of a child: A vulnerable child syndrome. Pediatrics34: 58–61, 1964.PubMedGoogle Scholar
  8. 109.
    Rodriguez A, Rodriguez M, Eisenberg L: The outcome of school phobia: A follow-up study based on 41 cases. Am J Psychiatry116: 540–544, 1959.Google Scholar
  9. 110.
    Coolidge JC, Brodie RD: Observation of mothers of 49 school phobia children evaluated in a 10-year old follow-up study. J Am Acad Child Psychiatry13: 275–285, 1974.PubMedCrossRefGoogle Scholar
  10. 111.
    Waldfogel S, Tessman E, Hahn PB. A program for early intervention in school phobia. Am J Orthopsychiatry29: 324–352, 1959.PubMedCrossRefGoogle Scholar
  11. 112.
    Coolidge JC, Hahn PB, Peck AL: School phobia: Neurotic crisis or way of life. Am J Orthopsychiatry27: 296–306, 1957.CrossRefGoogle Scholar
  12. 113.
    Lassers E, Nordan R, Bladholm S: Steps in the return to school of children with school phobia. Am J Psychiatry130: 265–268, 1973.PubMedGoogle Scholar
  13. 114.
    Kaplan C: Pediatric psychopharmacology, in Bassuk EL, Schoonover SC, Gelenberg AJ (eds.): The Practitioner’s Guide to Psychoactive Drugs, ed 2. New York, Plenum Publishing Corp, 1983, pp 313–352.Google Scholar

Copyright information

© Plenum Press, New York 1984

Authors and Affiliations

  • Daniel W. Rosenn
    • 1
    • 2
  1. 1.Harvard Medical SchoolBostonUSA
  2. 2.McLean HospitalBelmontUSA

Personalised recommendations