Psychiatric Emergencies During the Covid-19 Pandemic: A 6-Month Observational Study

Lorenzo, Rosaria Di; Frattini, Nicoletta; Dragone, Diego; Farina, Riccardo; Luisi, Filippa; Ferrari, Silvia; Bandiera, Geminiano; Rovesti, Sergio; Ferri, Paola

doi:10.2147/ndt.s307128

Cited by 27 publications

(36 citation statements)

References 57 publications

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“…In Italy, one of the rst and more heavily affected European countries by the COVID19 pandemic, a reduction of ED accesses for psychiatric consultation was found, ranging from 50% [21] to 37% in the rst phase of the lockdown period (March 8th-May 4th/ 18 th 2020), and a reduction of 11,2 % during the second phase of the lockdown (18th May to June 30 th , 2020) [22] compared with the same periods in 2019. A study considering a longer period of observation (March 1st -August 31 st , 2020) found a persisting reduction in monthly ED access for psychiatric consultation compared with 2019 [23]. Similar results emerged from a Swedish study reporting data from March 2020 to December 2020 and comparing them with the same period in 2019 and 2018 [20].…”

supporting

confidence: 57%

“…To the best of our knowledge, this is the rst study evaluating ED access for psychiatric consultations in Italy before, during, and after the lockdown. Previous studies focused on the impact of the rst lockdown on EDs psychiatric consultations with data from a limited time frame [22,23,26,27], and no study has yet investigated the late phase of the pandemic and the long-term effects of prolonged exposure to the pandemic on psychiatric emergencies.…”

Section: Discussionmentioning

confidence: 99%

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Psychiatric emergencies during, after, and before the COVID-19 lockdown; what happened to our patients? A naturalistic observational study

Brandizzi¹,

Polselli

Corigliano³

et al. 2022

Preprint

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Background: Despite concerns on mental health problems related to COVID19 lockdown, recent reports revealed a reduction in psychiatric admissions in Emergency Departments (ED) during the lockdown period compared with the previous year in several countries. Most of the existing studies focused on the first lockdown not considering the different phases of the COVID-19 crisis. The present study aimed to analyze differences in ED admission for psychiatric consultation during three different phases of the COVID-19 pandemia in Italy. Methods: Information on ED admission for psychiatric consultations were retrospectively collected at the ED of the Santo Spirito Hospital in Rome (Italy), and compared between the three periods: the lockdown (March - June 2020) and the post-lockdown period (June 2020 - June 2021) compared to the pre-lockdown (January 2019 - March 2020). Multinomial logistic regression was used to assess the risk of accessing ED for psychiatric consultation before, during, after the lockdown. Results: 3,871 ED psychiatric consultations were collected. A significant reduction of psychiatric consultations in ED during the lockdown period and the post-lockdown (H: 762,45; p<0.001) was documented. Multinomial logistic regression analysis showed that compared to pre-lockdown during the lockdown and post-lockdown patients were more likely to be men (RRR: 1.52; 95% CI: 1.10 - 2.12) and more often diagnosed with non-severe mental illnesses (nSMI) (relative risk ratio [RRR]: 1.53, 95% CI: 1.10 - 2.15; and 1.72, 95% CI: 1.42 - 2.08); during the lockdown, patients were also more often diagnosed with alcohol/substance abuse (A&S) (RRR: 1.70; 95% CI: 1.10 - 2.65). Conclusions: Several changes in the clinical characteristics of psychiatric consultations during and after the lockdown emerged from the present study; nSMI and A&S abuse patients were more likely to present at the ED in the lockdown and post-lockdown periods while SMI patients appeared to be less likely. These may inform clinicians and future preventive strategies among community mental health services.

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supporting

confidence: 57%

Section: Discussionmentioning

confidence: 99%

Psychiatric emergencies during, after, and before the COVID-19 lockdown; what happened to our patients? A naturalistic observational study

Brandizzi¹,

Polselli

Corigliano³

et al. 2022

Preprint

View full text Add to dashboard Cite

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“…However, recent studies of psychiatric emergency contacts show that regular out-patient contacts have decreased in all psychiatric patients since the pandemic, as a result of restricted face-to-face regulations, hinting at an non-selective decrease of admission rate for all psychiatric patients. 44 – 46 Finally, our results cannot be generalised to all other mental healthcare settings because of inherent differences in mental health service provision across the globe.…”

Section: Discussionmentioning

confidence: 89%

Impact of the first COVID-19 outbreak on mental health service utilisation at a Dutch mental health centre: retrospective observational study

et al. 2021

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Background Previous studies into mental health service utilisation during the COVID-19 pandemic are limited to a few countries or specific type of service. In addition, data on changes in telepsychiatry are currently lacking. Aims We aimed to investigate whether the COVID-19 pandemic is associated with changes in mental health service utilisation, including telepsychiatry, and how these changes were distributed among patients with mental illness during the first COVID-19 outbreak. Method This retrospective study obtained routinely assessed healthcare data from a large Dutch mental healthcare institute. Data from the second quarter of 2020 (the first COVID-19 outbreak period) were compared with the pre-pandemic period between January 2018 and March 2020. Time-series analyses were performed with the quasi-Poisson generalised linear model, to examine the effect of the COVID-19 lockdown and the overall trend of mental health service utilisation per communication modality and diagnostic category. Results We analysed 204 808 care contacts of 28 038 patients. The overall number of care contacts in the second quarter of 2020 remained the same as in the previous 2 years, because the number of video consultations significantly increased (B = 2.17, P = 0.488 × 10−3) as the number of face-to-face out-patient contacts significantly decreased (B = −0.98, P = 0.011). This was true for all different diagnostic categories, although this change was less pronounced in patients with psychotic disorders. Conclusions Diminished face-to-face out-patient contacts were well-compensated by the substantial increase of video consultations during the first COVID-19 outbreak in The Netherlands. This increase was less pronounced for psychotic disorders. Further research should elucidate the need for disorder-specific digital mental healthcare delivery.

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“…During the first weeks of the pandemic, a significant reduction in accessing emergency rooms [ 30 , 31 , 32 ] and in psychiatric hospitalization rates [ 31 , 33 ] was documented in both the United States and European countries, including Italy. Moreover, a mean decrease of 37% in overall access to healthcare has been reported worldwide, both in outpatient visits and inpatient admissions to different healthcare services [ 34 , 35 ].…”

Section: Introductionmentioning

confidence: 99%

Access to Mental Health Care during the First Wave of the COVID-19 Pandemic in Italy: Results from the COMET Multicentric Study

et al. 2021

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The COVID-19 pandemic represents an unprecedented public health emergency, with consequences at the political, social, and economic levels. Mental health services have been called to play a key role in facing the impact of the pandemic on the mental health of the general population. In the period March–May 2020, an online survey was implemented as part of the Covid Mental Health Trial (COMET), a multicentric collaborative study carried out in Italy, one of the Western countries most severely hit by the pandemic. The present study aims to investigate the use of mental health resources during the first wave of the pandemic. The final sample consisted of 20,712 participants, mainly females (N = 14,712, 71%) with a mean age of 40.4 ± 14.3 years. Access to mental health services was reported in 7.7% of cases. Among those referred to mental health services, in 93.9% of cases (N = 1503 subjects) a psychological assessment was requested and in 15.7% of cases (N = 252) a psychiatric consultation. People reporting higher levels of perceived loneliness (OR 1.079, 95% CI 1.056–1.101, p < 0.001), practicing smart-working (OR 1.122, 95% CI 0.980–1.285, p = 0.095), using avoidant (OR 1.586, 95% CI 1.458–1.725, p < 0.001) and approach (OR 1.215, 95% CI 1.138–1.299, p < 0.001) coping strategies more frequently accessed mental health services. On the other hand, having higher levels of perceived social support (OR 0.833, 95% CI 0.795–0.873, p < 0.001) was associated with a reduced probability to access mental health services. The COVID-19 pandemic represents a new threat to the mental health and well-being of the general population, therefore specific strategies should be implemented to promote access to mental healthcare during the pandemic and afterwards.

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Psychiatric Emergencies During the Covid-19 Pandemic: A 6-Month Observational Study

Cited by 27 publications

References 57 publications

Psychiatric emergencies during, after, and before the COVID-19 lockdown; what happened to our patients? A naturalistic observational study

Psychiatric emergencies during, after, and before the COVID-19 lockdown; what happened to our patients? A naturalistic observational study

Impact of the first COVID-19 outbreak on mental health service utilisation at a Dutch mental health centre: retrospective observational study

Access to Mental Health Care during the First Wave of the COVID-19 Pandemic in Italy: Results from the COMET Multicentric Study

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