Francesco Accomando, Melodie O Aricò, Enrico Valletta
Background: To assess temporal trends in psychiatric hospitalizations among adolescents admitted to a general pediatric ward in Forlì, Italy, between 2016 and 2025 and to examine diagnostic patterns and their association with sex and age, using the individual patient as the primary unit of analysis. Methods: Single-center retrospective study including all hospitalizations for psychiatric disorders in patients aged 10-17 years over a 10-year period. Each discharge episode was assigned to a single dominant diagnostic category. The primary analyses were conducted at the level of the individual patient (first admission), while episode-level analyses were retained as a pre-specified sensitivity analysis reflecting inpatient burden. Results: A total of 165 adolescents (210 hospitalization episodes) were included; mean (SD) age was 14.47 (1.73) years, and females were 77% of patients (80.5% of episodes). Admissions increased significantly over time (patients: IRR 1.20 per year, 95% CI 1.13-1.27; p < 0.001), with 124/165 (75.2%) patients first admitted in 2021-2025. Suicidal ideation/attempt (27.3%) and eating disorders (15.2%) were the most frequent diagnoses, and both showed a significant upward trend. Overall, diagnosis was associated with sex (p = 0.004): most diagnoses, including the two most frequent, were female-predominant, whereas psychomotor agitation was over-represented in males. Age at admission increased modestly over time and was higher in 2021-2025. Twenty-seven patients accounted for 45 readmissions, concentrated in the most severe diagnoses. Conclusions: Psychiatric hospitalizations of adolescents in a general pediatric ward rose substantially over the decade, especially from 2021, driven mainly by suicidal ideation/attempt and eating disorders. Findings were robust to analysis at the patient level and support the role of the general pediatric ward as a sentinel setting for severe adolescent mental distress.