Paediatric emergency departments are increasingly reporting a significant rise in visits for neuropsychiatric concerns. Although not always severe, these presentations often involve acute episodes of agitation, anxiety, behavioural dysregulation, self-injurious behaviour, or suicidal ideation that require prompt assessment and intervention. Many children and adolescents presenting with these symptoms have predisposing conditions such as autism spectrum disorder (ASD), attention deficit hyperactivity disorder (ADHD), or other behavioural disorders and their episodes are frequently exacerbated by external factors [1–3]. It is important to emphasise, however, that in psychiatry a diagnosis is fundamentally one of exclusion: organic causes must always be considered and ruled out, as timely recognition and treatment of an underlying medical condition can result in complete recovery.
