The evaluation of the comparison between pre- and post-pandemic era regarding emergency psychiatric consultations
Abstract
Aim: This study aims to determine the quantitative or qualitative changes in emergency psychiatry consultations before and during the COVID-19 pandemic.
Materials and Methods: The socio-demographic characteristics and clinical features of 233 patients were retrospectively collected and analyzed. And their data were compared regarding their emergency psychiatry consultations before (between March 11th, 2019 and March 10th, 2020) and during (between March 11th, 2020 and March 10th, 2021) the spread of COVID-19.
Results: The patients' consultation ratio (psychiatry consultations to total emergency room administrations) increased during the pandemic (0.03% vs 0.07%). Among these patients, the diagnosis of alcohol and substance use disorder (6.1% vs. 16.1%) (p=0.03) increased while the diagnoses of obsessive-compulsive disorder (5.2% vs. 0%) (p=0.01) and bipolar disorder (21.1% vs.
20.5%) (p=0.02) decreased. Hostility among patients during consultation increased (19.1% vs. 30.8%) (p=0.04). Suicidal thoughts decreased (25.2% vs. 14.5%) (p=0.04). Furthermore, voluntary inpatient treatment (20.9%-34.2%) (p=0.02) increased, transfer to another clinic (25.2% vs. 12%) (p=0.01) and outpatient treatment (46.1% vs. 42.7%) (p=0.01) decreased. An increase in oral treatments (10.4% vs.
26.5%) (p=0.02) and a decrease in parenteral treatments (71.3% vs. 54.7%) (p=0.01) were reported.
Conclusion: Our findings confirmed that after COVID-19 spread, clinical features, diagnosis, and treatment modality have changed among emergency psychiatric consultations. Evaluating these
implications may be the first step in improving the healthcare system and reshaping psychiatric approaches according to the new requirements of the new pandemics.
References
- World Health Organization. (2020). WHO Director-General’s opening remarks at the media briefing on COVID-19-11 March 2020 [cited 5 March 2022]. Available from: https://www.who.int/directorgeneral/speeches/detail/who-director-general-s-opening-remarks-at-the-media-briefing-on-covid-19---11-march-2020.
- Ministry of Health of Turkish Republic. (2020). COVID-19 Rehberi, Genel Bilgiler, Epidemiyoloji ve Tanı [cited5 March 2022]. Available from: https://covid19.saglik.gov.tr/Eklenti/39551/0/covid19rehberigenelbilgilerepidemiyolojivetanipdf.pdf.
- Ilhan MN, Tüzün H, Kılıc R, Yıldırım N. Nonpharmaceutical interventions in Turkey and worldwide during COVID-19 pandemic. Turkish journal of medical sciences 2021; 51 (SI-1): 3207-14.
- Mushtaq R, Shoib S, Shah T, Mushtaq S. Relationship between loneliness, psychiatric disorders and physical health? A review on the psychological aspects of loneliness. Journal of clinical and diagnostic research: JCDR 2014; 8 (9): WE01–WE4.
- Nalleballe K, Reddy Onteddu S, Sharma R, et al. Spectrum of neuropsychiatric manifestations in COVID19. Brain, behavior, and immunity 2020; 88: 71-4.
- Ünal B, Gülseren L. COVID-19 pandemisinin görünmeyen yüzü: Aile içi kadına yönelik şiddet. Klinik Psikiyatri Dergisi 2020; 23 (1): 89-94.
- Troyer EA, Kohn JN, Hong S. Are we facing a crashing wave of neuropsychiatric sequelae of COVID-19? Neuropsychiatric symptoms and potential immunologic mechanisms. Brain, behavior, and immunity 2020; 87:34-9
- Perrin PC, McCabe OL, Everly GS Jr, Links JM. Preparing for an influenza pandemic: mental health considerations. Prehosp Disaster Med 2009; 24 (3): 223-30.
- Pignon B, Gourevitch R, Tebeka S, et al. Dramatic reduction of psychiatric emergency consultations during lockdown linked to COVID-19 in Paris and suburbs. Psychiatry Clin Neurosci 2020; 74(10): 557-9.
- Capuzzi E, Di Brita C, Caldiroli A, et al. Psychiatric emergency care during Coronavirus 2019 (COVID 19) pandemic lockdown: results from a Department of Mental Health and Addiction of northern Italy. Psychiatry research 2020; 293: 113463.
- Turner S, Mota N, Bolton J, Sareen J. Self‐medication with alcohol or drugs for mood and anxiety disorders: A narrative review of the epidemiological literature. Depression and anxiety 2018; 35 (9): 851-60.
- Li J, Yang Z, Qiu H, et al. Anxiety and depression among general population in China at the peak of the COVID‐19 epidemic. World Psychiatry 2020; 19 (2), 249.
- Seifert J, Meissner C, Birkenstock A, et al. Peripandemic psychiatric emergencies: impact of the COVID-19 pandemic on patients according to diagnostic subgroup. European archives of psychiatry and clinical neuroscience 2021; 271 (2): 259–70.
- Dragovic M, Pascu V, Hall T, Ingram J, Waters F. Emergency department mental health presentations before and during the COVID-19 outbreak in Western Australia. Australasian psychiatry: bulletin of Royal Australian and New Zealand College of Psychiatrists 2020; 28 (6): 627–31.
- McAndrew J, O'Leary J, Cotter D, et al. Impact of initial COVID-19 restrictions on psychiatry presentations to the emergency department of a large academic teaching hospital. Ir J Psychol Med 2021; 38 (2): 108-15.
- Jelinek L, Moritz S, Miegel F, Voderholzer U. Obsessive-compulsive disorder during COVID-19: Turning a problem into an opportunity? Journal of Anxiety Disorders 2021; 77: 102329.
- Davide P, Andrea P, Martina O, Andrea E, Davide D, Mario A. The impact of the COVID-19 pandemic on patients with OCD: Effects of contamination symptoms and remission state before the quarantine in a preliminary naturalistic study. Psychiatry Research 2020; 291: 113213.
- Orhan M, Korten N, Paans N, et al. Psychiatric symptoms during the COVID‐19 outbreak in older adults with bipolar disorder. International Journal of Geriatric Psychiatry 2021; 36 (6): 892-900.
- Tundo A, Betro S, Necci R. What Is the Impact of COVID-19 Pandemic on Patients with Pre-Existing Mood or Anxiety Disorder? An Observational Prospective Study. Medicina 2021; 57(4): 304.
- Stefana A, Youngstrom EA, Jun C, et al. The COVID-19 pandemic is a crisis and opportunity for bipolar disorder. Bipolar Disord 2020; 22 (6): 641-3.
- Yocum AK, Zhai Y, McInnis MG, Han P. Covid-19 pandemic and lockdown impacts: A description in a longitudinal study of bipolar disorder. Journal of Affective Disorders 2021; 282: 1226-33.
- Sylvia LG, Shelton RC, Kemp DE, et al. Medical burden in bipolar disorder: findings from the clinical and health outcomes initiative in comparative effectiveness for bipolar disorder study (bipolar choice). Bipolar Disord 2015; 17(2): 212–23.
- Heitzman J. Impact of COVID-19 pandemic on mental health. Psychiatr Pol 2020; 54 (2): 187-98.
- Parola A, Rossi A, Tessitore F, Troisi G, Mannarini S. Mental Health Through the COVID-19 Quarantine: A Growth Curve Analysis on Italian Young Adults. Frontiers in psychology 2020; 11: 567484.
- Hernández-Calle D, Martínez-Alés G, Mediavilla R, Aguirre P, Rodríguez-Vega B, Bravo-Ortiz MF. Trends in psychiatric emergency department visits due to suicidal ideation and suicide attempts during the COVID-19 pandemic in Madrid, Spain. J Clin Psychiatry 2020; 81 (5): 20l13419.
- Qin P, Mehlum L. National observation of death by suicide in the first 3 months under COVID-19 pandemic.Acta Psychiatr Scand 2021; 143 (1): 92-3.
- Tanaka T, Okamoto S. Increase in suicide following an initial decline during the COVID-19 pandemic in Japan. Nature human behaviour 2021; 5(2): 229-38.
- Kõlves K, Kõlves KE, De Leo D. Natural disasters and suicidal behaviours: a systematic literature review. J Affect Disord 2013; 146(1): 1-14.
- Reger MA, Stanley IH, Joiner TE. Suicide Mortality and Coronavirus Disease 2019—A Perfect Storm? JAMA Psychiatry 2020; 77 (11): 1093–4.
- Clerici M, Durbano F, Spinogatti F, Vita A, de Girolamo G, Micciolo R. Psychiatric hospitalization rates in Italy before and during COVID-19: did they change? An analysis of register data. Irish journal of psychological medicine 2020; 37 (4): 283–90.
- Itrat A, Jagadheesan K, Danivas V, Lakra V. A comparative study of access to inpatient psychiatric treatment in a public mental health service in Melbourne during COVID-19. Indian journal of psychiatry 2020; 62 (Suppl 3): S454–58
Abstract
Amaç: Bu çalışmada COVID-19 pandemi öncesi ve COVID-19 sürecinde acil psikiyatri konsültasyonlarındaki nicel veya nitel değişikliklerin belirlenmesi amaçlamaktadır.
Gereç ve Yöntem: 11 Mart 2019 tarihinden önce ve sonraki 1 yıllık süreçte acil servisten psikiyatri konsültasyonu istenmiş olan 233 hastanın sosyodemografik özellikleri ve klinik özellikleri geriye dönük
olarak toplandı ve analiz edildi.
Bulgular: Pandemi sürecinde öncesine göre acil servise başvuran hastalardan psikiyatriye konsulte edilenlerin oranının arttığı saptandı (%0,03'e karşı %0,07). Alkol ve madde kullanım bozukluğu tanısı alan hasta sayısı artarken (%6,1'e karşı %16,1) (p=0,03), obsesif kompulsif bozukluk (%5,2'ye karşı %0) (p=0,01) ve bipolar bozukluk (%21,1'e karşı %20,5) (p=0,02) azaldığı görüldü.Konsülte edilen hastalar arasında hostilitenin arttığı (%19,1'e karşı %30,8) (p=0,04), intihar düşüncelerinin (%25,2'ye karşı %14,5) (p=0,04) azaldığı saptandı. Ayrıca, gönüllü yatarak tedavi (%20,9-%34,2) (p=0,02) oranının arttığı; başka bir kliniğe transfer edilme (%25,2’ye karşı %12) (p=0,01) ve ayakta tedavi oranları (%46,1’e karşı %42,7) (p=0,01) azaldığı görüldü. Oral tedavi oranlarında artış (%10,4'e karşı %26,5) (p=0,02) ve parenteral tedavilerde azalma (%71,3'e karşı %54,7) (p=0,01) izlendi.
Sonuç: Bulgularımız, COVID-19 yayılımından sonra acil psikiyatri konsültasyonları arasında klinik özelliklerin, tanı ve tedavi şeklinin değiştiğini doğruladı. Bu sonuçların değerlendirilmesi sağlık
sistemini iyileştirmenin ve psikiyatrik yaklaşımları yeni pandemilerin yeni taleplerine göre yeniden şekillendirmenin ilk adımı olabilir.
Keywords
References
- World Health Organization. (2020). WHO Director-General’s opening remarks at the media briefing on COVID-19-11 March 2020 [cited 5 March 2022]. Available from: https://www.who.int/directorgeneral/speeches/detail/who-director-general-s-opening-remarks-at-the-media-briefing-on-covid-19---11-march-2020.
- Ministry of Health of Turkish Republic. (2020). COVID-19 Rehberi, Genel Bilgiler, Epidemiyoloji ve Tanı [cited5 March 2022]. Available from: https://covid19.saglik.gov.tr/Eklenti/39551/0/covid19rehberigenelbilgilerepidemiyolojivetanipdf.pdf.
- Ilhan MN, Tüzün H, Kılıc R, Yıldırım N. Nonpharmaceutical interventions in Turkey and worldwide during COVID-19 pandemic. Turkish journal of medical sciences 2021; 51 (SI-1): 3207-14.
- Mushtaq R, Shoib S, Shah T, Mushtaq S. Relationship between loneliness, psychiatric disorders and physical health? A review on the psychological aspects of loneliness. Journal of clinical and diagnostic research: JCDR 2014; 8 (9): WE01–WE4.
- Nalleballe K, Reddy Onteddu S, Sharma R, et al. Spectrum of neuropsychiatric manifestations in COVID19. Brain, behavior, and immunity 2020; 88: 71-4.
- Ünal B, Gülseren L. COVID-19 pandemisinin görünmeyen yüzü: Aile içi kadına yönelik şiddet. Klinik Psikiyatri Dergisi 2020; 23 (1): 89-94.
- Troyer EA, Kohn JN, Hong S. Are we facing a crashing wave of neuropsychiatric sequelae of COVID-19? Neuropsychiatric symptoms and potential immunologic mechanisms. Brain, behavior, and immunity 2020; 87:34-9
- Perrin PC, McCabe OL, Everly GS Jr, Links JM. Preparing for an influenza pandemic: mental health considerations. Prehosp Disaster Med 2009; 24 (3): 223-30.
- Pignon B, Gourevitch R, Tebeka S, et al. Dramatic reduction of psychiatric emergency consultations during lockdown linked to COVID-19 in Paris and suburbs. Psychiatry Clin Neurosci 2020; 74(10): 557-9.
- Capuzzi E, Di Brita C, Caldiroli A, et al. Psychiatric emergency care during Coronavirus 2019 (COVID 19) pandemic lockdown: results from a Department of Mental Health and Addiction of northern Italy. Psychiatry research 2020; 293: 113463.
- Turner S, Mota N, Bolton J, Sareen J. Self‐medication with alcohol or drugs for mood and anxiety disorders: A narrative review of the epidemiological literature. Depression and anxiety 2018; 35 (9): 851-60.
- Li J, Yang Z, Qiu H, et al. Anxiety and depression among general population in China at the peak of the COVID‐19 epidemic. World Psychiatry 2020; 19 (2), 249.
- Seifert J, Meissner C, Birkenstock A, et al. Peripandemic psychiatric emergencies: impact of the COVID-19 pandemic on patients according to diagnostic subgroup. European archives of psychiatry and clinical neuroscience 2021; 271 (2): 259–70.
- Dragovic M, Pascu V, Hall T, Ingram J, Waters F. Emergency department mental health presentations before and during the COVID-19 outbreak in Western Australia. Australasian psychiatry: bulletin of Royal Australian and New Zealand College of Psychiatrists 2020; 28 (6): 627–31.
- McAndrew J, O'Leary J, Cotter D, et al. Impact of initial COVID-19 restrictions on psychiatry presentations to the emergency department of a large academic teaching hospital. Ir J Psychol Med 2021; 38 (2): 108-15.
- Jelinek L, Moritz S, Miegel F, Voderholzer U. Obsessive-compulsive disorder during COVID-19: Turning a problem into an opportunity? Journal of Anxiety Disorders 2021; 77: 102329.
- Davide P, Andrea P, Martina O, Andrea E, Davide D, Mario A. The impact of the COVID-19 pandemic on patients with OCD: Effects of contamination symptoms and remission state before the quarantine in a preliminary naturalistic study. Psychiatry Research 2020; 291: 113213.
- Orhan M, Korten N, Paans N, et al. Psychiatric symptoms during the COVID‐19 outbreak in older adults with bipolar disorder. International Journal of Geriatric Psychiatry 2021; 36 (6): 892-900.
- Tundo A, Betro S, Necci R. What Is the Impact of COVID-19 Pandemic on Patients with Pre-Existing Mood or Anxiety Disorder? An Observational Prospective Study. Medicina 2021; 57(4): 304.
- Stefana A, Youngstrom EA, Jun C, et al. The COVID-19 pandemic is a crisis and opportunity for bipolar disorder. Bipolar Disord 2020; 22 (6): 641-3.
- Yocum AK, Zhai Y, McInnis MG, Han P. Covid-19 pandemic and lockdown impacts: A description in a longitudinal study of bipolar disorder. Journal of Affective Disorders 2021; 282: 1226-33.
- Sylvia LG, Shelton RC, Kemp DE, et al. Medical burden in bipolar disorder: findings from the clinical and health outcomes initiative in comparative effectiveness for bipolar disorder study (bipolar choice). Bipolar Disord 2015; 17(2): 212–23.
- Heitzman J. Impact of COVID-19 pandemic on mental health. Psychiatr Pol 2020; 54 (2): 187-98.
- Parola A, Rossi A, Tessitore F, Troisi G, Mannarini S. Mental Health Through the COVID-19 Quarantine: A Growth Curve Analysis on Italian Young Adults. Frontiers in psychology 2020; 11: 567484.
- Hernández-Calle D, Martínez-Alés G, Mediavilla R, Aguirre P, Rodríguez-Vega B, Bravo-Ortiz MF. Trends in psychiatric emergency department visits due to suicidal ideation and suicide attempts during the COVID-19 pandemic in Madrid, Spain. J Clin Psychiatry 2020; 81 (5): 20l13419.
- Qin P, Mehlum L. National observation of death by suicide in the first 3 months under COVID-19 pandemic.Acta Psychiatr Scand 2021; 143 (1): 92-3.
- Tanaka T, Okamoto S. Increase in suicide following an initial decline during the COVID-19 pandemic in Japan. Nature human behaviour 2021; 5(2): 229-38.
- Kõlves K, Kõlves KE, De Leo D. Natural disasters and suicidal behaviours: a systematic literature review. J Affect Disord 2013; 146(1): 1-14.
- Reger MA, Stanley IH, Joiner TE. Suicide Mortality and Coronavirus Disease 2019—A Perfect Storm? JAMA Psychiatry 2020; 77 (11): 1093–4.
- Clerici M, Durbano F, Spinogatti F, Vita A, de Girolamo G, Micciolo R. Psychiatric hospitalization rates in Italy before and during COVID-19: did they change? An analysis of register data. Irish journal of psychological medicine 2020; 37 (4): 283–90.
- Itrat A, Jagadheesan K, Danivas V, Lakra V. A comparative study of access to inpatient psychiatric treatment in a public mental health service in Melbourne during COVID-19. Indian journal of psychiatry 2020; 62 (Suppl 3): S454–58
Details
| Primary Language | English |
|---|---|
| Subjects | Health Care Administration |
| Journal Section | Research Articles |
| Authors | |
| Publication Date | March 15, 2023 |
| Submission Date | April 25, 2022 |
| Published in Issue | Year 2023Volume: 62 Issue: 1 |
