P.693 Differences in an acute psychiatric hospitalization unit before and during the coronavirus pandemic

Introduction: The coronavirus pandemic has entailed a series of changes globally. It has also lead to altered functioning and organisation of a number of hospitals worldwide. Especially in mental health, many physicians in Spain have been teleworking in order to do a proper follow-up of patients in a safe manner, but other changes have been implemented. In Acute Psychiatric Wards, some adaptations have been needed, such as the suspension of visits and exit permits. Recently, a negative impact of lockdown in mental health has been reported.

Objectives: We conducted a descriptive study with the aim to explain the changes implemented in the Acute Psychiatric Ward in Hospital Clínic of Barcelona, and also to observe the differences in patients’ characteristics and recovery through a comparison of the patients admitted in periods of 28 days just before and during the lockdown.

Methods: We reviewed medical records of patients who were admitted to our Acute Psychiatric Unit from January 7th and February 4th and also from March 17th and April 14th, which correspond to periods before and during the lockdown respectively. Descriptive and comparative analyses were conducted with SPSS v. 23.0.

Results: No significant differences were found in sociodemographic characteristics when both groups of patients were compared. A significant reduction in the patients admitted was observed, being 44 people admitted within the first dates and 16 in the second period of time. In 31% of patients admitted during the second period, stress related with lockdown was identified and related to the current episode. In terms of pharmacotherapy, the second group of patients took significantly less antidepressants during the hospitalisation and at discharge, with no significant differences with other drugs, which could be related with a significantly higher rate of manic episodes in the second period. Despite the lack of visits and exit permits and the need of social distance in the second group, no differences were found in the frequency of agitations, mechanical restraints, electroconvulsive therapy use and oral and intramuscular rescue medications. There were significant differences in the destination after discharge when both groups were compared, since only 56.8% of patients from the first group but 93.8% of participants in the second group were discharged at home, which might be related to the lack of complementary resources during the lockdown. This implied the necessity of a complete remission in the Acute Psychiatric Ward of episodes before discharge, since other units, such as Day Hospital, were not available. Despite this, no differences were observed in the duration of hospitalisations between the two groups.

Conclusions: A better knowledge of patients’ characheristics and follow-up during the lockdown might be useful in case of the necessity of future lockdowns and also to observe the impact of the changes implemented in an Acute Psychiatric Ward during this period, which could be considered in specific situations if they resulted beneficial for patients [1].

No conflict of interest