Factors Associated With Psychiatric Emergency Visits of Children and Adolescents With Autism Spectrum Disorder in an Upper-Middle-Income Country

PURPOSE: This study aimed to characterize the epidemiological and clinical profile of children and adolescents with Autism Spectrum Disorder (ASD) evaluated at a regional Youth Psychiatric Emergency Unit, and to explore factors leading families to seek emergency psychiatric care. METHODS: A cross-sectional, descriptive study was conducted through retrospective chart review of patients seen in the emergency service over a one-year period. Patients with a confirmed ASD diagnosis were included. Categorical variables were compared using Pearson's chi-square or Fisher's exact test, and continuous variables were analyzed using independent samples Student's t-test. RESULTS: During the study period, 112 patients with ASD (6.7% of total visits) were seen, and 26 (23.2%) received their first ASD diagnosis at the emergency service. The majority were male (83%) with a mean age of 10 ± 4 years. The mean age at diagnosis among those identified for the first time in the emergency setting was 8.86 ± 4.7 years, indicating a late diagnosis. The most frequent presenting complaints were agitation, aggression, and irritability. Compared to the non-ASD group, ASD patients had significantly higher rates of intellectual disability and epilepsy. CONCLUSION: Findings highlight the role of psychiatric emergency units as potential entry points into the mental health system for children and adolescents with ASD, particularly in middle-income countries where early access to specialized care is often limited. These results underscore the importance of training emergency professionals in managing neurodevelopmental crises and providing families with guidance on how to respond to behavioral emergencies.