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. 2021 Jun 30;16(6):e0253805.
doi: 10.1371/journal.pone.0253805. eCollection 2021.

Evaluating the association between COVID-19 and psychiatric presentations, suicidal ideation in an emergency department

Michal J McDowell  1   2 , Carrie E Fry  3 , Mladen Nisavic  1 , Mila Grossman  1   2 , Charles Masaki  1   2 , Emily Sorg  1 , Suzanne Bird  1 , Felicia Smith  1 , Scott R Beach  1
Affiliations

Evaluating the association between COVID-19 and psychiatric presentations, suicidal ideation in an emergency department

Michal J McDowell et al. PLoS One. .

Abstract

Objective: To estimate the association between COVID-19 and Emergency Department (ED) psychiatric presentations, including suicidal ideation.

Methods: Using an interrupted time series design, we analyzed psychiatric presentations using electronic health record data in an academic medical center ED between 2018 and 2020. We used regression models to assess the association between the onset of the COVID-19 outbreak and certain psychiatric presentations. The period February 26-March 6, 2020 was used to define patterns in psychiatric presentations before and after the coronavirus outbreak.

Results: We found a 36.2% decrease (unadjusted) in ED psychiatric consults following the coronavirus outbreak, as compared to the previous year. After accounting for underlying trends, our results estimate significant differential change associated with suicidal ideation and substance use disorder (SUD) presentations following the outbreak. Specifically, we noted a significant differential increase in presentations with suicidal ideation six weeks after the outbreak (36.4 percentage points change; 95% CI: 5.3, 67.6). For presentations with SUD, we found a differential increase in the COVID-19 time series relative to the comparison time series at all post-outbreak time points and this differential increase was significant three weeks (32.8 percentage points; 95% CI: 4.0, 61.6) following the outbreak. Our results estimate no differential changes significant at the P value < 0.05 level associated with affective disorder or psychotic disorder presentations in the COVID-19 time series relative to the comparator time series.

Conclusions: The COVID-19 outbreak in Boston was associated with significant differential increases in ED presentations with suicidal ideation and SUD.

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Conflict of interest statement

No authors have competing interests.

Figures

Fig 1
Fig 1. Study period timeline.
Fig 2
Fig 2. Comparison of unadjusted trends in psychiatry consults between 2019 and 2020 cohorts.
Fig 3
Fig 3. Differential changes in ED psychiatry consult presentations in the COVID versus non-COVID post periods.
See this image and copyright information in PMC

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