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Risk Factors for Seclusion in Children and Adolescents Inpatient Psychiatry: The Role of Demographic Characteristics, Clinical Severity, Life Experiences and Diagnoses

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Abstract

Objective

To understand the risk factors for seclusion in a sample of children and adolescents admitted to an inpatient psychiatry unit looking at demographic, clinical severity, life experience, and diagnostic characteristics.

Methods

An unmatched case–control retrospective analysis of psychiatric records in a pediatric inpatient unit from December 2011 to December 2015 (N = 1986)

Results

Individual characteristics, including demographics, clinical severity, and clinical presentation as per the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) jointly predicted seclusion in adolescents, with younger age, male sex, black race, having a prior admission, and having a disruptive behavior or bipolar and related disorder diagnoses being predictive of seclusion. While demographic and clinical severity factors were predictive of seclusion in multivariate models, clinical diagnoses only added modestly to the variance explained.

Conclusions

High-risk demographic and clinical characteristics for seclusion events in children and adolescents can provide valuable information to guide interventions to prevent seclusion events during their hospitalization.

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Authors and Affiliations

  1. School of Medicine, Johns Hopkins University, 1800 Orleans St, Baltimore, MD, 21287-3335, USA

    Carol Vidal, Elizabeth K. Reynolds & Marco Grados

  2. Johns Hopkins Hospital, Baltimore, MD, USA

    Nancy Praglowski

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  1. Carol Vidal
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  2. Elizabeth K. Reynolds
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  3. Nancy Praglowski
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  4. Marco Grados
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Correspondence to Carol Vidal.

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Vidal, C., Reynolds, E.K., Praglowski, N. et al. Risk Factors for Seclusion in Children and Adolescents Inpatient Psychiatry: The Role of Demographic Characteristics, Clinical Severity, Life Experiences and Diagnoses. Child Psychiatry Hum Dev 51, 648–655 (2020). https://doi.org/10.1007/s10578-020-00963-0

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