A 6-month study on the pattern of emergency department presentations for schizophrenia and other psychotic disorders during COVID-19 lockdown

Jagadheesan, Karuppiah; Danivas, Vijay; Itrat, Quratulain; Shekaran, Lokesh; Lakra, Vinay

doi:10.1016/j.psychres.2021.114081

Cited by 27 publications

(36 citation statements)

References 26 publications

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“…It has been noted that fragmentation symptoms that found their place in the ‘outside world’ during the lockdown subsequently came back into the inside world, resulting in discomfort, and a consequent worsening of psychotic symptoms [ 28 ]. Our results are similar to those of other authors [ 29 ].…”

Section: Discussionsupporting

confidence: 94%

Mid-term psychiatric consequences of the COVID-19 pandemic: a 4 months observational study on emergency room admissions for psychiatric evaluation after the (first) lockdown period in Italy

Beghi

Ferrari

Biondi

et al. 2022

Soc Psychiatry Psychiatr Epidemiol

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Purpose The aim of our study is to evaluate the number and the features of admissions to the emergency room (ER) requiring psychiatric consultation, in the period between May 4th and August 31st 2020. Methods We carried out a retrospective longitudinal observational study examining the 4 months following the initial lockdown imposed during the COVID-19 outbreak (May 4th and August 31st 2020). More specifically, the ER admissions leading to psychiatric referral were reviewed at all seven public hospitals of AUSL Romagna (Emilia Romagna region, Italy). Socio-demographic variables, history of medical comorbidities or psychiatric disorders, reason for ER admission, psychiatric diagnosis at discharge, and actions taken by the psychiatrist were collected. Results An 11.3% ( p = 0.007) increase in psychiatric assessments was observed when compared with the same period of the previous year (2019). A positive personal history of psychiatric disorders (OR:0.68, CI: 0.53–0.87) and assessments leading to no indication for follow-up (OR: 0.22, CI: 0.13–0.39) were significantly less frequent, while there was a significant increase of cases featuring organic comorbidities (OR: 1.24, CI: 1.00–1.52) and suicidal ideation/self-harm/suicide attempt (OR: 1,71, CI: 1.19–2.45) or psychomotor agitation (OR: 1.46, CI: 1.02–2.07) as reason for admission. Conclusions Our results showed an increase in ER psychiatric consultations compared to the previous year, underlying the increased psychological distress caused by the lockdown.

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Section: Discussionsupporting

confidence: 94%

Mid-term psychiatric consequences of the COVID-19 pandemic: a 4 months observational study on emergency room admissions for psychiatric evaluation after the (first) lockdown period in Italy

Beghi

Ferrari

Biondi

et al. 2022

Soc Psychiatry Psychiatr Epidemiol

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“…The unaltered number of PEVs among patients with schizophrenia and other related psychotic disorders stands in contrast to a report by the National Board of Health and Welfare in Sweden where other Swedish regions showed an increased rate of visits among patients with this psychiatric diagnosis ( 12 ). On the other hand, there are studies that show similar results to ours with either no significant reduction in this patient group ( 15 , 24 ) or a smaller absolute reduction compared to other diagnoses ( 11 ). The largest absolute reduction among the different psychiatric diagnoses was seen among patients with substance abuse disorders and those with neurotic, stress-related, and somatoform disorders.…”

Section: Discussionsupporting

confidence: 86%

Changes in Psychiatric Inpatient Service Utilization During the First and Second Waves of the COVID-19 Pandemic

et al. 2022

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The COVID-19 pandemic has caused societal restrictions and public fear which may have impacted the pattern of seeking psychiatric care. There has generally been a decrease in the numbers seeking acute psychiatric care. It is important to investigate which groups seeking psychiatric treatment have decreased in number. The aim of our investigation was to identify which groups have a changed pattern in acute psychiatric service utilization during the first two waves of the COVID-19 pandemic. The study investigated changes in the rate and pattern of visits and hospital admissions for psychiatric disorders at a large Swedish hospital. A register-based study was conducted using administrative data on adult psychiatric emergency department visits (PEVs) and hospital admission rates. Data during the first two COVID-19 waves were compared to corresponding control periods in 2018–2019. Furthermore, a survey was performed among patients visiting the Psychiatric Emergency Department on their views of COVID-19 and acute psychiatric care. During the COVID-19 periods, PEVs were reduced overall by 16 and 15% during the first and second wave, respectively (p < 0.001 in both cases), while the rate of admissions remained unaltered. PEVs were significantly reduced for most psychiatric diagnosis subgroups except for patients with schizophrenia and other related psychotic disorders as well as for those who required ongoing outpatient care. Most of the survey respondents disagreed that the pandemic affected their visit and about a quarter thought a video call with a doctor could have replaced their visit. In conclusion, there was a significant reduction in overall PEVs during both COVID-19 waves but this did not affect the numbers requiring admission for psychiatric inpatient care.

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“…Additionally, annual rates of psychiatric presentations to emergency departments were largely observed to fall during the COVID-19 pandemic compared with before in data from the USA [26] and Spain [27].Inmoretargetedexaminations, however, presentation rates of individuals with psychotic disorders specifically were elevated during lockdown periods across multiple countries relative to other groups [27,28,29 ▪ ]. Given stretched resources during the COVID-19 pandemic, these suggest that individuals with psychotic disorders may not be getting the help they need.…”

Section: Impact On Acute and Emergency Servicesmentioning

confidence: 93%

Psychotic disorders amid the COVID-19 pandemic: a consideration of risks and impacts

Tan

Neill²,

Rossell³

2022

Current Opinion in Psychiatry

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Purpose of reviewThe COVID-19 pandemic has had a severe and widespread global impact but particularly for those with psychosis. This review summarizes recent evidence on the relationship between the COVID-19 pandemic and psychotic disorders, highlighting the risks faced by these individuals including the negative impacts on treatment services, complications from contracting COVID-19, and the acceptability of digital interventions.Recent findingsMortality, morbidity, and infection outcomes are among the worst for individuals with psychotic disorders. Presentation rates for psychotic disorders are elevated at emergency departments compared with before the COVID-19 pandemic; demand for inpatient services has increased, and there have been complications in access because of pandemic restrictions. COVID-19 related stressors have led to the exacerbation and incidence of psychotic symptoms among individuals with and without preexisting psychotic diagnoses. Digital interventions may be an acceptable method for maintaining patient contact and treatment during extended isolation.SummaryMore data is needed on the longitudinal trajectory for psychotic symptoms post-COVID-19 infection and pandemic restrictions to better support individuals with psychotic disorders. Development of a long-term pandemic management plan is needed to monitor and support psychiatric health across the population.

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A 6-month study on the pattern of emergency department presentations for schizophrenia and other psychotic disorders during COVID-19 lockdown

Cited by 27 publications

References 26 publications

Mid-term psychiatric consequences of the COVID-19 pandemic: a 4 months observational study on emergency room admissions for psychiatric evaluation after the (first) lockdown period in Italy

Mid-term psychiatric consequences of the COVID-19 pandemic: a 4 months observational study on emergency room admissions for psychiatric evaluation after the (first) lockdown period in Italy

Changes in Psychiatric Inpatient Service Utilization During the First and Second Waves of the COVID-19 Pandemic

Psychotic disorders amid the COVID-19 pandemic: a consideration of risks and impacts

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