# Psychiatric readmission of children and adolescents in China: a scoping review

## TL;DR

This review examines the frequency and factors behind psychiatric readmissions for children and adolescents in China, highlighting the need for better interventions.

## Contribution

The study is the first scoping review on psychiatric readmission in Chinese children and adolescents, identifying risk and protective factors.

## Key findings

- The overall weighted average readmission rate was 18.6% for children and adolescents with mental health diagnoses.
- Risk factors include poor medication adherence, frequent treatment changes, and family history of mental illness.
- Protective factors include family and social support for depression and obsessive–compulsive symptoms in schizophrenia.

## Abstract

Psychiatric readmission in children and adolescents is not uncommon in developed countries. Despite increasing medical resources being allocated to children and adolescents with mental health problems in China, the effectiveness of psychiatric inpatient treatment and the current situation of rehospitalization are not well documented.

A scoping review was conducted to describe the actual prevalence, associative factors and potential interventions for psychiatric readmission among children and adolescents in China. Documents indexed in PubMed, PsycINFO, Web of Science, Wanfang and CNKI were searched for up to May 2025. Two authors independently reviewed the records.

Of the 723 records, 19 met the inclusion criteria. For children and adolescents with heterogeneous mental health diagnoses, the weighted average readmission rate was 18.6% overall, with rates of 8.6% for follow-up periods under one year and 20.9% for periods of one year or more, respectively. The readmission rate was higher in patients with schizophrenia spectrum disorders and lower in those with mood disorders. The risk factors related to psychiatric readmission included longer follow-up duration and hospitalization of the initial treatment, poor adherence to medication, frequent changes in treatment regimens, poor treatment responses, childhood onset, family history of mental illness, excitability/hostility, insufficient sleep, anxiety, and obesity. The protective factors related to psychiatric readmission included support from family, teachers and friends for patients with depression, and obsessive–compulsive symptoms for patients with schizophrenia. Only preliminary evidence was found regarding interventions to reduce readmission for pediatric psychiatric inpatients or their parents.

This review provides a significant overview of current psychiatric inpatient treatments for children and adolescents in China. Our findings underscore the notable frequency of psychiatric readmissions, highlighting the need for targeted interventions, particularly for children and adolescents exhibiting certain clinical features and challenges with treatment adherence or responsiveness.