Faire une analyse descriptive et comparative de la population adolescente consultante âgée de 15 à 20ans dans les services de pédopsychiatrie et de psychiatrie adulte d’un même secteur géographique.

Il s’agit d’une étude rétrospective sur dossiers ayant pour but de comparer sur une année tous les adolescents consultants dans un service de psychiatrie adulte versus ceux consultants dans un service de pédopsychiatrie. Une grille de question a été construite spécialement pour l’étude afin de recueillir les données.

Sur l’année 2008, 184 adolescents âgés de 15 à 20ans ont été reçus en consultation dont 112 sur les structures ambulatoires du service infanto-juvénile et 72 sur celles du service de psychiatrie adulte. Les adolescents consultants en psychiatrie adulte sont plus âgés, adressés par des institutions, la famille ou un médecin, ils sont plus souvent déscolarisés (17 %) et ils ont reçu le plus souvent comme diagnostic un trouble de l’humeur, et des difficultés liées à l’environnement. Contrairement à ce que l’on attendait, ils n’ont pas plus d’antécédents d’hospitalisation en psychiatrie. Leur prise en charge diffère selon leur lieu de consultation. Les pédopsychiatres adressent plus souvent le patient vers un thérapeute (29 % versus 13 %) et prescrivent moins souvent de traitement médicamenteux (24 % versus 40 %) p<0,05.

Les soins pour les adolescents dans les services adultes et infanto-juvénile, loin de se concurrencer, sont complémentaires. Une étude prospective sur plusieurs années ainsi que d’autres études sur d’autres secteurs géographiques permettraient de confirmer ces données.

Describing, analyzing and comparing the teenage population from 15 to 20years old who was consulting a psychiatrist during one year, in the pedopsychiatric and adult psychiatric services of a given geographic sector.

We conducted a retrospective survey based on the files/cases of teenagers having consulted at least once over the year 2008, in one or the other ambulatory care service. Grid-in questions were elaborated specifically for the purpose of this survey, in order to collect sociodemographic data, analyze medical courses, psychiatric histories and therapeutic support.

Over the year 2008, 184 teenagers from 15 to 20years old were admitted in consultation among which 112 on the ambulatory pedopsychiatric department and 72 on the adult psychiatric department. The consultant teenagers having in the pedopsychiatric department are younger, they were more often referred by their school institution, more than half of them were living within a single-parent family and were diagnosed a personality or a neurotic disorder, whereas teenagers consulting in adult psychiatry department were referred by institutions, their family or a doctor, are more likely to be out of school (17 %), and were more often diagnosed with mood disorder or troubles related to their environment. Against all expectations, they do not have more psychiatric history (hospitalization). However, their care differs according to where they consult. Pedopsychiatrists more often refer their patients to a therapist (29 % versus 13 %) and prescribe less often medicinal treatment (24 % versus 40 %).

Teenagers who are monitored in psychiatric department for adults hardly differ from those who were monitored in pedopsychiatric department. Far from competing pedopsychiatric and adult psychiatric departments are complementary. A prospective survey over several years and extra surveys covering other geographical sectors would allow to confirm these data.