Psychiatric emergencies in migrant adolescents

Background: Stress factors associated with migration may expose minor immigrants to mental health problems. The aim of the study was to describe acute psychiatric problems, in terms of reasons for hospitalization and diagnosis at discharge, in a sample of Italian and Migrant adolescents (both first and second generation). Methods: We collected data on socio-demographic and clinical-diagnostic characteristics of 423 Italian and Migrant adolescents (mean age: 15 years ± 1.44; range 12-17.91), hospitalized at the Child and Adolescent Neuropsychiatry Unit of the Spedali Civili of Brescia between 2014 and 2019, period prior to the coronavirus disease 19 (COVID-19) pandemic. Results: A reduction in the percentage of hospitalized Italian subjects and an increase of Migrant ones was found among years (p<0.001). Suicidal attempts and psychomotor agitation were the main reasons for hospitalization in both Italian and Migrant groups; in addition, the former presented a higher number of accesses for eating disorders, while the latter for psychotic disorders. Comparing the two groups at discharge, a higher frequency of anxiety disorders (p<0.001), eating disorders (p<0.001), somatic and conversion disorders (p=0.013), and obsessive-compulsive disorder (p=0.022) was detected in the Italian sample; conversely, there was a higher frequency of suicidal attempt (p=0.025), personality disorders (p<0.001), disruptive behavior, impulse control and conduct disorders (p=0.014), and post-traumatic stress disorder (p=0.019) in the Migrant group. Conclusions: These observations, carried out during a pre-COVID-19 period, provide a starting point for understanding the psychopathology of Migrant adolescents and underline the importance of early diagnosis to guide appropriate interventions.