Changing trends in psychiatric emergency service admissions during the COVID-19 outbreak: Report from a worldwide epicentre

Gómez-Ramiro, Marta; Fico, Giovanna; Anmella, Gerard; Vázquez, Mireia; Sagué-Vilavella, María; Hidalgo‐Mazzei, Diego; Pacchiarotti, Isabella; Garriga, Marina; Murru, Andréa; Parellada, Eduard; Vieta, Eduard

doi:10.1016/j.jad.2020.12.057

Cited by 83 publications

(91 citation statements)

References 38 publications

(42 reference statements)

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“…A significant negative finding is the lack of difference in the total number of admissions, and in the distribution of admissions across the 11-week periods. This differs from existing literature that demonstrated a decrease in mental health-related emergency department encounters during public health restrictions; for example, a retrospective analysis of psychiatric emergency consultations in Spain demonstrated a decrease of 38% during lockdown ( Gómez-Ramiro et al, 2021 ). However, the authors also noted that the proportion of consulted patients who were subsequently admitted to inpatient care increased.…”

Section: Discussioncontrasting

confidence: 97%

Examination of the impact of COVID-19 public health quarantine measures on acute mental health care services: A retrospective observational study

Nejati

Crocker

Kolajova

et al. 2021

Psychiatry Research

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This study assesses for the impact of Covid-19 public health quarantine measures on acute care psychiatric admissions, by comparing admission data from the quarantine period to a comparator period. A chart review was conducted for all admissions to an urban acute care psychiatric centre from Mar 22 – June 5 2020 (quarantine) and January 5 – Mar 21 2020 (comparator). Data was collected on the number of admissions, demographics, patients’ psychiatric history, characteristics of admissions, discharge information, patients’ substance use and social factors. Data was analyzed using a student's t-test for continuous variables and Chi squared analyses for categorical variables. Results demonstrated 185 admissions during quarantine and 190 during the comparator, with no significant differences in the distribution of admissions across time periods. There was a significantly greater frequency of admissions in the 35-44 age bracket and admissions involving substance use during quarantine. Additionally, admissions during quarantine were significantly shorter, with increased frequency of involuntary status and use of seclusion. The data suggests a vulnerability specific to individuals in their 30-40s during quarantine and demonstrates a need to better understand factors impacting this group. It also suggests that quarantine is associated with changes to substance use, potentiating high acuity illness requiring admission.

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Section: Discussioncontrasting

confidence: 97%

Examination of the impact of COVID-19 public health quarantine measures on acute mental health care services: A retrospective observational study

Nejati

Crocker

Kolajova

et al. 2021

Psychiatry Research

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“…Regarding the diagnosis profile of admittances during the lockdown in comparison to the same period of the previous year, there were mostly onsets of first psychotic episodes, schizophrenia relapses, and alcohol and other psycho active substances acute intoxications or withdrawal states, in consonance with other international studies [37][38][39]. But quite surprising, there were less mood disorders of any polarity (either depressions of any severity or bipolar disorder spectrum), or suicide attempts despite frequent predictions.…”

Section: Dynamics Of Psychiatric Pathology: Emergency Hospitals Outpasupporting

confidence: 80%

Psychiatric Services and Teaching during the Covid-19 Pandemic in Romania

Miclutia¹

2021

Anxiety, Uncertainty, and Resilience During the Pandemic Period - Anthropological and Psychological Perspectives

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The Covid-19 pandemic has been declared in Romania on the 16th March 2020.The medical system reacted promptly: chronic patients had to be discharged within 48 h and further scheduled admittances were postponed, adequate epidemiological measures and circuits were organized. Anxiety, insomnia, frustration, binge eating, domestic violence were reported. The majority respected the general advises but soon, persons selected their information sources rather from social media, being victims of the infodemia and peculiar conspirationist theories. A new disorder has been described: coronaphobia. The psychiatric hospitals and outpatient settings had to reduce or innactivate their activity, switch as much as possible to TelePsychiatry. Psychiatry admittances were: onsets of psychosis, relapses of schizophrenia and alcohol, other psychoactive substances abuses, intoxications, and withdrawal states. Later, there were depressions, bipolar disorders, suicide attempts, self-harm in borderline disorder, dementia and delirium. Due to the closure of outpatient units for several months, patients visited the Emergency rooms. Personnel experienced burnout and new psychiatric pathology developed in the aftermath of Covid-19 infection. A big relief occurred with the initial vaccination of the medical staff and seniors, chronically ill persons, psychiatric patients being again left behind. Medical teaching shifted entirely to online and in 2021 the hybrid teaching system has been employed.

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“…Furthermore, individuals with ID and neurodevelopmental disorders face various challenges secondary to the pandemic, including limited access to behavioral health services, changes in health services delivery, disruption of educational services, and vocational changes[ 53 ]. During the lockdown period in Spain, there were increased psychiatric emergency admissions in individuals with ASD, most likely due to an observed disruption of family daily routines[ 54 ].…”

Section: Disparities In Children With Developmental Disabilitiesmentioning

confidence: 99%

Global health disparities in vulnerable populations of psychiatric patients during the COVID-19 pandemic

Diaz¹,

Baweja²,

Bonatakis³

et al. 2021

WJP

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The coronavirus disease 2019 pandemic affects psychiatric patients disproportionately compared to the general population. In this narrative review, we examine the impact of the pandemic on significant global health disparities affecting vulnerable populations of psychiatric patients: People of diverse ethnic background and color, children with disabilities, sexual and gender minorities, pregnant women, mature adults, and those patients living in urban and rural communities. The identified disparities cause worsened mental health outcomes placing psychiatric patients at higher risk for depression, anxiety and posttraumatic stress disorder symptoms. Those psychiatric patients who are ethnic minorities display barriers to care, including collective trauma and structural racism. Sexual and gender minorities with mental illness face discrimination and limited access to treatment. Pregnant women with psychiatric diagnoses show higher exposure to domestic violence. Children with disabilities face a higher risk of worsening behavior. Mature adults with psychiatric problems show depression due to social isolation. Psychiatric patients who live in urban communities face pollutants and overcrowding compared to those living in rural communities, which face limited access to telehealth services. We suggest that social programs that decrease discrimination, enhance communal resilience, and help overcome systemic barriers of care should be developed to decrease global health disparities in vulnerable population.

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Changing trends in psychiatric emergency service admissions during the COVID-19 outbreak: Report from a worldwide epicentre

Cited by 83 publications

References 38 publications

Examination of the impact of COVID-19 public health quarantine measures on acute mental health care services: A retrospective observational study

Examination of the impact of COVID-19 public health quarantine measures on acute mental health care services: A retrospective observational study

Psychiatric Services and Teaching during the Covid-19 Pandemic in Romania

Global health disparities in vulnerable populations of psychiatric patients during the COVID-19 pandemic

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