Psychiatric emergency visit trends and characteristics in a mental health epicenter in Istanbul during COVID-19 lockdown

Abstract

Background We aimed to explore the impact of the preventive measures and partial lockdown to the psychiatric emergency department (PED) visits during COVID-19 pandemic in a mental health epicenter in Istanbul. Methods A total of 5839 patients admitted to PED during the lockdown period (LP) between March 30 and May 31, 2020, were enrolled in this retrospective cohort study. Data of these patients were compared to those of patients in the same period in 2019 between April 1 and June 2, 2019 (non-LP). We also investigated the monthly number of PED visits and hospitalizations between March 1 and December 31, 2020, and compared it to the same period in 2019. Results The volume of PED visits and hospitalizations in LP decreased by 12% and 41.6%, respectively. The rates of patients presenting anxiety and depressive disorders and bipolar disorders were found to significantly increase in LP than non-LP ( p < 0.001; p < 0.001; p < 0.01, respectively). Depressive disorders, prior history of mental illness, and aggressive behavior were found to predict frequent PED visits while decrease in age and male gender found to predict hospitalizations. Regarding suicide attempt, younger patients and those with new-onset mental disorders were found to be at high risk in LP. Patients diagnosed with COVID-19 in PED visits were mostly with psychotic and bipolar disorders. Conclusion Policy-makers should focus on studies on mental health services to reorganize and enhance such services, which are crucial to prevent and manage adverse mental health consequences of the pandemic and congestion in PEDs.

The Impact of SARS-CoV-2 Infection on Youth Mental Health: A Narrative Review

“…In Turkey, Yalçın and collaborators [152] reported a change in the volume of pediatric emergency department visits and hospitalizations in the lockdown period (30 March to 31 May 2020) compared to the same non-lockdown period. They reported a reduction of 12% in emergency department visits and 41.6% in hospitalization, respectively.…”

Pediatric mental health emergency visits during the COVID-19 pandemic

“…Particular emphasis should be placed in ensuring access to interventions to prevent suicide and suicidal behaviors, as the most salient increase in child and adolescent mental health ED visits corresponded to suicide-related consultations. Similar increases in youth ED visits or hospital admissions due to suicide attempts during the initial months of the pandemic period were seen in Turkey ( 24 ), the United States ( 25 ), and elsewhere in Spain ( 26 ).…”

Changes in psychiatric services dynamics during the COVID-19 pandemic: Recognizing the need for resources shift

“…While the pandemic is still not over, enough time has passed since its beginning that we can analyze the effects it has had on mental health services. It has become evident that lockdowns we experienced have not affected rates of psychiatric hospitalizations in the way that was expected by some at the onset of the pandemic ( Yalçın et al, 2021 , Ambrosetti et al, 2021 ). Several studies confirm that psychiatric hospitalization rates have fallen during lockdowns in Europe and Australia, but also in other parts of the world ( Fasshauer et al, 2021 , Gómez-Ramiro et al, 2021 , Yalçın et al, 2021 , Hakansson & Grudet, 2021 , Simpson et al, 2021 , Ilic et al, 2011 , Cesarec et al, 2013 ).…”

“…It has become evident that lockdowns we experienced have not affected rates of psychiatric hospitalizations in the way that was expected by some at the onset of the pandemic ( Yalçın et al, 2021 , Ambrosetti et al, 2021 ). Several studies confirm that psychiatric hospitalization rates have fallen during lockdowns in Europe and Australia, but also in other parts of the world ( Fasshauer et al, 2021 , Gómez-Ramiro et al, 2021 , Yalçın et al, 2021 , Hakansson & Grudet, 2021 , Simpson et al, 2021 , Ilic et al, 2011 , Cesarec et al, 2013 ). During the lockdown, the number of all services utilized by patients fell by 12% to 37%, depending on the country ( Gómez-Ramiro et al, 2021 , Yalçın et al, 2021 , Balestrieri et al, 2021 ).…”

“…Several studies confirm that psychiatric hospitalization rates have fallen during lockdowns in Europe and Australia, but also in other parts of the world ( Fasshauer et al, 2021 , Gómez-Ramiro et al, 2021 , Yalçın et al, 2021 , Hakansson & Grudet, 2021 , Simpson et al, 2021 , Ilic et al, 2011 , Cesarec et al, 2013 ). During the lockdown, the number of all services utilized by patients fell by 12% to 37%, depending on the country ( Gómez-Ramiro et al, 2021 , Yalçın et al, 2021 , Balestrieri et al, 2021 ). A trend that can be observed in the literature is that, although the hospitalization rates have fallen, the number of emergency visits has, in many cases, risen ( Fasshauer et al, 2021 , Gómez-Ramiro et al, 2021 , Rømer et al, 2021 ).…”