BOSTON, May 17 (Reuters Health) - An increasing number of children are being admitted to hospital emergency departments because of a psychiatric--instead of a physical--crisis, according to a survey performed at the Children's Hospital affiliated with Yale University School of Medicine in New Haven, Connecticut.

      While emergency admissions for trauma, abdominal pain and other routine hazards of childhood increased 20% from 1995 to 1999, the admissions for violence, drug ingestion, suicide attempts, depression and behavior changes increased 59% over the same time period, according to Dr. Karen A. Santucci, a pediatric emergency specialist at Yale.

      Currently, 4% of childhood emergency department visits at the hospital are due to psychiatric problems.

      "It's very important to realize that there is a problem," Santucci said. "Many more children are in crisis and we're not realizing it until it's too late."

      The children in this study, mostly adolescents, were taken in for self-inflicted wounds, deliberate drug overdoses, life-threatening reactions to street drugs, or for out-of-control, dangerous or disturbing behaviors, such as cruelty to household pets. Violent behavior in particular has been increasing over the past 5 years, Santucci pointed out.

      No one knows why psychiatric emergencies are increasing, but Santucci urges physicians to be alert for potential problems.

      "When pediatricians do a well-child check, they should assess affect and mood, ask how the child is doing in school, and ask the parents--Is Peter a happy child? A sad child?" she said. "Maybe we can troubleshoot a little better."

      The high proportion of psychiatric admissions places a heavy burden on the emergency department staff, who for the most part are not trained to handle these problems, Santucci said. "We were living with these numbers every day without realizing (how high) these numbers were," she said.

      What's more, about one third of these children need admission to the hospital, but many are too dangerous to admit to a general pediatric floor, she said. As a result, compared with 2-1/2 hours for children admitted with non-psychiatric problems, on average these youngsters spend 6-1/2 hours in the emergency department. Some stay as long as 12 hours.