Psychiatric Emergencies During the Height of the COVID-19 Pandemic in the Suburban New York City Area

Ferrando, Stephen J.; Lynch, Sean; Klepacz, Lidia; Shahar, Sivan; Dornbush, Rhea L.; Smiley, Abbas; Miller, Ivan W.; Tavakkoli, Mohammad; Regan, John J.; Bartell, Abraham

doi:10.2139/ssrn.3673198

Cited by 8 publications

(11 citation statements)

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“…Over the period examined, there was a 30% reduction in HED psychiatric consultations in 2020 compared with 2019. This reduction in psychiatric consultations in the early stages of the pandemic is consistent with evidence from other countries (4)(5)(6)(7)(8)(9)(10)(11).…”

Section: Discussionsupporting

confidence: 88%

“…In a prospective cohort monitored using smartphonedelivered assessment, Cobo et al, observed that self-reported suicide risk decreased during the COVID-19-related lockdown period (26). These data corroborate historical data indicating a decrease in suicides under conditions of severe social distress, such as wars, and early published data on psychiatric emergencies during the 2020 pandemic (4,(27)(28)(29).…”

Section: Discussionmentioning

confidence: 56%

“…In general, projections indicate an increase in depression and post-traumatic stress disorder (PTSD) on a basis of biological mechanisms and social consequences (2,3). On the other hand, some preliminary reports on mental health management in the acute phase of the pandemic have found a decrease in requests for psychiatric consultations in hospital emergency departments (HEDs) (4)(5)(6)(7)(8)(9)(10)(11). Clearly, the type of organization of mental health care has a strong influence on how each country copes with the crisis.…”

Section: Introductionmentioning

confidence: 99%

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Emergency Psychiatric Consultations During and After the COVID-19 Lockdown in Italy. A Multicentre Study

et al. 2021

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Aims: The aim was to analyse the psychiatric consultations in nine Italian hospital emergency departments, by comparing the lockdown and post-lockdown periods of 2020 with the equivalent periods of 2019.Methods: Characteristics of psychiatric consultations, patients, and drug prescriptions were analyzed. Joinpoint models were used to identify changes in the weekly trend of consultations.Results: A 37.5% decrease in the number of consultations was seen during the lockdown period and 17.9% after the lockdown. The number of individual patients seen decreased by 34.9% during the lockdown and 11.2% after the lockdown. A significant change in the number of consultations from week 11 to week 18 occurred, followed by a gradual increase. There was a higher percentage of patients with previous psychiatric hospitalizations during the lockdown period (61.1 vs. 56.3%) and a lower percentage after the lockdown (59.7 vs. 64.7%). During the lockdown there was a large increase in psychiatric consultations for substance use disorders, whereas more consultations for manic episodes occurred after the lockdown. A 3.4% decrease was observed in consultations for suicidal ideation and planning during the lockdown, followed by an upward rebound after the lockdown, along with an increase in consultations for suicide attempts. During lockdown antipsychotic and benzodiazepine prescriptions increased by 5.2 and 4.1%, respectively. After the lockdown, the number of compulsory hospitalizations was higher than in 2019.Conclusions: We observed a decrease of psychiatric consultations during and after the lockdown. There was an increase in consultations for manic episodes and suicidality after the lockdown. The focus of psychiatric services must remain high particularly in this latter period.

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Section: Discussionsupporting

confidence: 88%

Section: Discussionmentioning

confidence: 56%

Section: Introductionmentioning

confidence: 99%

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Emergency Psychiatric Consultations During and After the COVID-19 Lockdown in Italy. A Multicentre Study

et al. 2021

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“…In line with these results and despite rising concerns of increased mental health problems during the pandemic, several studies highlighted a reduction of help-seeking behavior for psychiatric problems [12]; also, psychiatric hospitalizations appeared to be reduced during the lockdown period [13]. Recent reports on the impact of the COVID-19 pandemic on psychiatric admissions to Emergency Departments (ED) revealed a reduction in psychiatric admissions during the lockdown period compared with the previous year in several countries [14][15][16][17][18][19]. Even if the reduction in ED accesses might be associated with periods of lockdown or confinement it was observed also in countries where the restrictions imposed were markedly less strict [20].…”

Section: Introductionmentioning

confidence: 98%

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

et al. 2022

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Background Despite concerns on mental health problems related to lockdowns, 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 health crisis 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 Three thousand and eight hundred seventy-one 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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“…Eine andere Arbeit aus Wuhan 72 verglich die Aufnahmen mit der Diagnose Schizophrenie im Januar 2020 mit den Jahren davor und fand eine Zunahme von Erstmanifestationen um 25%, allerdings müsste dann auf Grund des Zeitkriteriums für die Diagnose Schizophrenie die Erkrankung schon vor Beginn der Pandemie begonnen haben. In der psychiatrischen Akutambulanz einer Klinik in New York waren psychotische Störungen am Höhepunkt der Pandemie nicht häufiger als vor COVID-19, allerdings waren diese Patienten viel häufiger SARS-CoV-2 positiv als andere Diagnosegruppen 73 . Ein Bericht aus Kroatien vermeldet eine Abnahme der Hospitalisierungen von Patienten mit Psychosen während des ersten Höhepunkts der Pandemie, was umso erstaunlicher ist, als sich zeitgleich auch eine Naturkatastrophe (Erdbeben) ereignete.…”

Section: Methodikunclassified

Neuropsychiatrische Aspekte von COVID-19 – Eine narrative Übersicht

Rittmannsberger¹,

Barth²,

Malík³

et al. 2021

Fortschr Neurol Psychiatr

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ZusammenfassungDas Virus SARS-CoV-2 (Severe Acute Respiratory Syndrome Coronavirus Type 2) und die von ihm ausgelöste Erkrankung COVID-19 (Coronavirus Disease 2019) können zahlreiche Organsysteme betreffen. In vorliegender Arbeit bieten wir einen Überblick bezüglich des aktuellen Wissensstands über die psychiatrischen Aspekte der SARS-CoV-2 Infektion.Die Datenbanken Medline, Embase und LIVIVO wurden nach relevanter Literatur untersucht, die letzte Abfrage erfolgte am 02.03.2021. Unterschiedliche Stressfaktoren im Rahmen der Epidemie können zu manifesten psychischen Erkrankungen führen. Zusätzlich besteht das Risiko psychischer Veränderungen durch die biologischen Effekte des Virus selbst.Beschrieben werden in unserer Arbeit psychische Symptome von an COVID-19 Erkrankten selbst sowie die psychischen Auswirkungen der Epidemie und der damit einhergehenden sozioökonomischen und psychosozialen Stressfaktoren auch auf nicht Erkrankte.Bei an COVID-19 Erkrankten zeigen sich als häufigste psychiatrische Komplikation das Auftreten von Delirien, bei hospitalisierten Patienten scheint es zu gehäuftem Auftreten von Symptomen von Angst, Depression und posttraumatischen Belastungsstörungen zu kommen. Es liegen auch zahlreiche Kasuistiken über psychotische Störungen vor. Allgemein steigert eine vorliegende psychiatrische Erkrankung (besonders eine psychotische oder dementielle Störung) auch das Risiko einer Infektion und eines schweren Verlaufes. Nach Ablauf einer COVID-19-Infektion ist ebenfalls eine höhere Inzidenz von psychischen Erkrankungen zu finden, hier ist das „Chronic Post-SARS Syndrome“ mit seinen Ausprägungen wie Fatigue, Angst, Depression und PTSD zu nennen. Außerdem scheint der Verlauf einer dementiellen Erkrankung durch eine Infektion mit SARS-CoV-2 negativ beeinflusst zu werden.Ferner wird auf die Auswirkungen eingegangen, die das Bedrohungsszenario der Epidemie und die etablierten gesellschaftlichen Schutzmaßnahmen auf die psychische Gesundheit von Menschen mit und ohne psychische Vorerkrankungen haben. Es zeigen sich hier in der derzeit vorliegenden Literatur hohe Symptomwerte betreffend Angst- und depressiven Störungen sowie posttraumatischen Belastungsstörungen, Stress, Suizidalität, Schlafstörungen, etc. Risikofaktoren scheinen unter anderem weibliches Geschlecht, jüngeres Alter und geringere Ressourcen sowie psychische oder körperliche Vorerkrankungen darzustellen. Extrinsische Faktoren wie z-B. hohes Infektionsgeschehen, große Anzahl von Todesfällen, lange Ausgangssperren/Lockdowns, geringes Vertrauen in die Regierung und ineffektive Maßnahmen gegen wirtschaftliche und soziale Folgen steigern die Belastung.

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Psychiatric Emergencies During the Height of the COVID-19 Pandemic in the Suburban New York City Area

Cited by 8 publications

References 0 publications

Emergency Psychiatric Consultations During and After the COVID-19 Lockdown in Italy. A Multicentre Study

Emergency Psychiatric Consultations During and After the COVID-19 Lockdown in Italy. A Multicentre Study

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

Neuropsychiatrische Aspekte von COVID-19 – Eine narrative Übersicht

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