Dramatic reduction of psychiatric emergency consultations during lockdown linked to COVID-19 in Paris and suburbs

Abstract

Background The COVID-19 pandemic and associated lockdown may have psychiatric consequences and increase the number of psychiatric emergency consultations. Methods Three psychiatric centers in Paris and its suburbs took part in the study. We compared the number of total psychiatric emergency consultations during the 4 first weeks of the lockdown in France to the corresponding 4 weeks in 2019. We also compared the number of consultations during these 4-week time periods in 2020 and 2019 across different diagnostic categories. Findings In the 4 first weeks of the lockdown in France, 553 emergency psychiatry consultations were carried out, compared to 1224 consultations during the corresponding period of 2019, representing a 54.8 % decrease. This decrease was evident across all psychiatric disorders, including anxiety (number of consultations in 2020 representing 36.1 % of 2019), mood (41.1 %), and psychotic disorders (57.3 %). The number of suicide attempts also decreased (number of suicide attempts in 2020 representing 42.6 % of 2019). In comparison to 2019, the proportion of total consultations for anxiety disorders also decreased (16.6 % vs. 20.8 %), whilst the proportion of total consultations increased for psychotic disorders (31.1 % vs. 24.1 %). Conclusions The total number of psychiatric emergency consultations during lockdown dramatically decreased. The psychological consequences of lockdown may be delayed, indicating that psychiatric services should be prepared for a secondary increase in emergency presentations.

Patterns of use of secondary mental health services before and during COVID-19 lockdown: observational study

“…A developing body of research is suggested that for certain groups, there has been an unexpected increase in well-being during COVID-19, known as the 'lockdown paradox'. 18 In France, Pignon and colleagues 6 reported a 54% drop in psychiatric emergency consultations in the first 4 weeks of COVID-19 lockdown, relative to the same period in 2019. The authors cited possible increased strengths and improved coping strategies during disasters as a possible explanation for this phenomenon, 16 as such a trend in mental health presentations was also observed following the September 11 World Trade Centre terrorist attacks.…”

“…5 This may have a consequent effect on the number of referrals to specialist mental health services, as well as the number of admissions to mental health in-patient units. Indeed, a recent French study 6 reports a 54% reduction in psychiatric emergency consultations in the 4 weeks immediately subsequent to COVID-19 lockdown, compared with the equivalent 4-week period in 2019.…”

The impact of COVID‐19 on an early intervention in psychosis service

“…Equally, a reduction in psychiatric emergency consultations was reported in a France‐based study, 14 where Pignon and colleagues reported a 54.8% fall in consultations in the first 4 weeks of lockdown, compared with the equivalent 4 weeks in 2019. However, it should be noted that although they observed a fall in consultations for patients specifically with psychotic disorders (from 295 in 2019 to 172 in 2020), this reduction was relatively small compared with the corresponding reductions for mood disorders (from 379 to 156) and anxiety disorders (from 175 to 52), such that psychotic disorders represented an increased proportion of total consultations (from 24.1% in 2019 to 31.1% in 2020).…”

Les urgences psychiatriques pendant l’état d’urgence sanitaire

“…Au CPOA, plus gros service d’urgence psychiatrique, en France, qui compte près de 10 000 passages par an, les résultats ci-dessous montrent une surprenante baisse de 60 % du nombre de consultations psychiatriques d’urgence, pendant le confinement, par rapport à la même période en 2019 [8] . D’autres centres d’urgences psychiatriques français ont constaté le même phénomène [4] , [9] ( Fig. 1 ).…”