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. 2021 Mar 1:282:26-32.
doi: 10.1016/j.jad.2020.12.057. Epub 2020 Dec 27.

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

Marta Gómez-Ramiro  1 , Giovanna Fico  2 , Gerard Anmella  3 , Mireia Vázquez  4 , Maria Sagué-Vilavella  3 , Diego Hidalgo-Mazzei  3 , Isabella Pacchiarotti  3 , Marina Garriga  3 , Andrea Murru  3 , Eduard Parellada  5 , Eduard Vieta  6
Affiliations

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

Marta Gómez-Ramiro et al. J Affect Disord. .

Abstract

Background: During the COVID-19 pandemic, a structural reorganization was imposed on public health systems. Psychiatry services were also affected with the imposed reduction of non-urgent consultations. We aim to explore the effect of these changes on a Psychiatry Emergency Service during COVID-19 lockdown in Spain.

Methods: A retrospective analysis was performed on all patients admitted to our Psychiatric Emergency Service 90 days before and after March 14th, 2020, the first day of lockdown in Spain. Extracted data were compared between the two periods. Poisson regression analysis was performed to analyze changes in admission rates.

Results: 1,958 psychiatric emergency admissions were analyzed. Although the number of admissions decreased by 37.9%, we observed a significant increase in the percentage of acute psychiatric hospitalization during the lockdown. Anxiety spectrum disorders accumulated the greatest significant decrease in admission rates during the lockdown. On the other hand, a significant increase in admissions rates was found in patients with dementia, autism spectrum disorders, and substance use disorders during the lockdown.

Limitations: This study was conducted in a single psychiatric emergency service, preventing a generalization of our results. The comparison time period might have biased our results due to the influence of external factors.

Conclusion: Mental health consequences of COVID-19 are becoming apparent. A reduction of admission rates for anxiety disorders might be related telepsychiatry implementation during the lockdown. Other conditions particularly vulnerable to the routine changes and lack of social support have suffered the most, and efforts should be placed to treat these situations.

Keywords: Admission; COVID-19; Emergency psychiatry; Mental health; Pandemic; Quarantine.

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Conflict of interest statement

EV has received grants and served as consultant, advisor or CME speaker unrelated to the present work for the following entities: AB-Biotics, Abbott, Allergan, Angelini, Dainippon Sumitomo Pharma, Ferrer, Gedeon Richter, Janssen, Lundbeck, Otsuka, Sage, Sanofi-Aventis, Sunovion, and Takeda. MG has received grants and served as consultant or advisor for Ferrer, Lundbeck, Janssen, Spanish Ministry of Economy and Competitiveness, Instituto de Salud Carlos III through a ‘Rıo Hortega’ contract (CM17/00102), FEDER, Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Secretaria d'Universitats i Recerca del Departament d'Economia i Coneixement (2017SGR1365), and the CERCA Programme/Generalitat de Catalunya. G.F. has received CME-related honoraria, or consulting fees from Angelini, Janssen-Cilag and Lundbeck. MV has received CME-related honoraria, or consulting fees from Lundbeck. MSV has received financial support for CME activities or travel funds from Janssen-Cilag and Lundbeck, and has served as a speaker for Casen Recordati. She reports no financial or other relationship relevant to the subject of this article. IP has received CME-related honoraria, or consulting fees from ADAMED, Janssen-Cilag and Lundbeck and reports no financial or other relationship relevant to the subject of this article. MGR has received grants from Instituto Carlos III and ADAMED and non-financial support from Angelini, Janssen-Cilag, Lundbeck and Pfizer, non relationated with this job. GA has received CME-related honoraria or consulting fees from Janssen-Cilag, Lundbeck and Angelini and reports no financial or other relationship relevant to the subject of this article.

Figures

Fig 1
Fig. 1
A. Number of psychiatric emergency admission per month from January 2019 to June 2020. The Day of lockdown declaration in Spain in written in red. B. Number of psychiatric emergency admission per 90 days before and during lockdown. The respective time periods of pre-lockdown and on-lockdown, as well as the day of declaration of lockdown in Spain, are written in red. (For interpretation of the references to color in this figure legend, the reader is referred to the web version of this article.).
Fig 2
Fig. 2
Number of psychiatric emergency admission per months and percentage of acute inpatient psychiatric admissions in the 90 days before and during lockdown. The bars show a significant decrease in emergency admission rates, while the line show a significant increase in percentage of acute inpatient psychiatric admissions during lockdown. N = Numbers.
See this image and copyright information in PMC

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