559 - When Pediatric Use of Electronic Devices Leads to Psychiatric Hospitalization

Poster Number: 559
Publication Number: 559.245

Debra V. McQuade, University of alabama at birmingham, Homewood, AL, United States; Matthew Meek, University of Utah School of Medicine, Taylorsville, UT, United States; Phillip Johnson, Indiana University Health, Indianapolis, IN, United States

Background: Increased use of internet connecting Electronic Devices (EDs) by children and adolescents (C&As) has led to concerning reports that use can be associated with psychiatric symptoms, sometimes leading to hospitalization.

Objective: To better understand how ED use leads to pediatric psychiatric hospitalization by reviewing a previously identified set of cases where this has occurred.

Design/Methods: A qualitative thematic analysis of the individual circumstances of previously identified cases where ED use was reported to be meaningfully related to C&As' subsequent psychiatric hospitalization. Chart reviews were undertaken for all patients admitted to Primary Childrens Hospital Wasatch Canyons Campus from 2/1/2018 to 6/1/2018(n=269). For each patient, the ER note, the psychiatric admission and the psychosocial evaluation were read for evidence of historical reports of ED use as a meaningful part of the evnts leading to hospitalization. A qualitative description of this use was maintained for each of the 46 patients(17%)that met this standard. These data underwent further qualitative analysis to identify themes in these experiences, along with frequencies of each.

Results: The following themes were identified:EXTERNAL RESTRICTIONS ON ED USE:28% of patients became angry and/or despairing with expression of suicidal thoughts when use of their ED was unexpectedly restricted, typcially by a parent or teacher. REACTION TO CONTENT REVIEWED OR DELIVERED ON ED:17% of patients' distress was related to the content of the material they read or sent on the ED; commonly this involved reading negative social commentary about themselves, or viewing information about an event that was socially hurtful, also included patients who became distressed when their own inappropriate use of the ED was discovered by others(eg,sexting, researching violence). COMMUNICATION OF SA/SI:11% of patients used the ED to request help following a suicide attempt. The largest group-43%-used the ED to communicate ongoing suicidality (by texting, posting videos on social media) but without requesting help, suggesting a different pathology. A list of individual reports associated with the identified themes will be available for review at presentation.Conclusion(s): Qualitative review of documented circumstances of ED use by psychiatrically hospitalized C&As led to identification of three separate avenues of contributory emotional distress. Anticipation of these circumstances could prove useful in future management of ED use and/or C&A's emotional responses when using EDs to avoid development of safety concerns leading to psychiatric hospitalization.