In recent years the increase in urgent child neuropsychiatric visits has been exponential
Around the world, almost one billion people, approximately one in eight, live with at least one mental disorder. An emergency among the very young, as attested by data from the World Health Organization which counts 10-20% of children and adolescents affected, with 75% of psychiatric illnesses appearing before the age of 25 and half giving symptoms within the 14th.
In Italy alone “neuropsychic disorders affect almost 2 million children and young people, with very different manifestations in terms of type, course and prognosis”. On the eve of World Mental Health Day which occurs on 10 October, the specialists of the Italian Society of Child and Adolescent Neuropsychiatry (Sinpia) raise the alarm of distress among minors: in recent years the increase in child neuropsychiatric visits urgent has been “exponential”, they report, urging the need for prevention, early diagnosis and timely treatment. “We need to intervene at a developmental age”, warn the experts.
“It is only by placing a magnifying glass on the developmental age, which has specificity and peculiarities compared to adulthood, that we can intervene early”, explains the president Sinpia Elisa Fazzi, director of the Childhood Neuropsychiatry Operational Unit and adolescence of the Asst Spedali Civili – University of Brescia and member of the Technical Table for Mental Health at the Ministry of Health. “The demand for interventions in this area – she reports – is constantly growing. It is a true public health emergency, with an inevitable impact on social, human and economic aspects in all countries of the world”.
“The global burden of mental disorders in developmental age continues to grow in Italy too”, underlines Fazzi. Yet “the institutional commitment of our country appears” to Sinpia “still negligible in this field, placing itself among the last places in Europe in terms of share of health expenditure dedicated to mental health, with approximately 3.4% of overall health expenditure compared of the 10% of the main high-income countries, and with particularly lacking resources for hospital and local child neuropsychiatry services which in recent years are facing a real emergency”.
Sinpia highlights the results of a multicentric collaborative study coordinated by the Child Neuropsychiatry of the University of Turin directed by Benedetto Vitiello. “We analyzed the data from 9 Italian hospitals which collected around 25 thousand urgent neuropsychiatric visits aimed at children and adolescents from 2018 to 2021, and we were able to record – reports Vitiello – a dramatic increase in visits especially with regards to eating disorders, in particular anorexia, and disorders such as self-harm and suicidal ideation or behavior, in adolescent subjects with a predominance of females”.
Most depressive disorders begin in adolescence (one in 4 females and one in 10 males), but are often preceded by other disorders such as sleep disorders, psychiatrists describe. 59% of cases of eating disorders are between 13 and 25 years of age, 6% are under 12 years of age and suicide represents the leading cause of death in Italy among adolescents (2019 data). The early onset of these pathologies is also associated with more serious and complex conditions. Hence the appeal: “A public health policy cannot fail to take into account such data – warns Rosamaria Siracusano, head of the Psychiatry Section of Sinpia and medical director of the Child Neuropsychiatry Unit of the Federico II Hospital of Naples – which become even more significant if we consider that 20-40% of children and adolescents present high levels of mental suffering, but only less than half of these come to the attention of child neuropsychiatry services”.
Numerous studies – the experts point out – also indicate that in many cases the clinical pictures seen in adolescence represent the evolution of often sub-threshold conditions in the child. “Neurodevelopmental disorders that begin in the first years of life – concludes Chiara Davico, child neuropsychiatrist at the University of Turin – represent the precursors for serious psychopathological developmental trajectories with the greatest impact on adolescence. From this perspective, promoting neurodevelopment by supporting harmonious and serene growth, as well as intervening when difficulties and disorders appear, must represent a priority of the healthcare system, as well as of the community in a broader sense”.