Introduction: The COVID-19 pandemic had a significant impact worldwide [1,2]. Consultations in the Emergency Service of the Hospital Clínic of Barcelona varied in terms of reasons for consultations, psychopathology, and other aspects, before and during the pandemic.
Objectives: To examine changes in the profile of patients admitted before the COVID-19 pandemic, during the lockdown, and after the strict lockdown to the Psychiatric Emergency Service of a third-level hospital, in order to assess variations in the period of lockdown in the number of patients, clinical characteristics, diagnoses, and the severity of cases, and also to study the tendency of these variations in the first period of time after the strict lockdown.
Methods: All adult psychiatric inpatients admitted from December 13th to June 14th to the Psychiatric Emergency Service of Hospital Clínic of Barcelona, Spain, were retrospectively included for analysis and divided into three groups –T0, T1, and T2- depending on the time they attended the Emergency Service, including T0 those patients admitted before lockdown, T1 those who attended during the strict lockdown and T2 those visited just after that period. SPSS v25.0 was used in order to compare the differences between groups.
Results: A total of 1991 patients were included -1224 in T0, 546 in T1, and 221 in T2. The majority of patients were male (52.08%), with a mean age of 41.21 years (SD 16.53). Significant differences in the proportion of males and females were found comparing groups, with a proportion significantly higher of females in T0 (50.3%) compared with T1 (43.6%) and T2 (45.2%; p<0.05). No significant differences in mean age were found between groups. The ratio of the number of patients per day was significantly higher in T0 than in T1 and T2 (p<0.05). A significant difference was found in the proportion of patients consulting with substance use disorders, being significantly lower in T0 than in T1 and T2 (12.2% vs 15.9% and 15.4%, respectively; p<0.05). Patients visited during lockdown (T1) showed a significantly higher proportion of admissions in an acute unit (38.1% vs 24.1% in T0 and 27.1% in T2), a significantly higher proportion of patients consulting with dementia (1.5% in T1 vs 0.5% in T0 and 0.9% in T2), and a lower proportion of patients consulting with anxiety (13.9% in T1 vs 25.2% in T0 and 23.5% in T2).
Conclusions: The COVID-19 pandemic and the situation of lockdown lead to a significant reduction in the overall consultations to the Emergency Service [3], showing a higher proportion of severe cases and patients with a longer duration of symptoms before the consultation. The increase in the proportion of patients visited with dementia might be explained by cohabitation with their relatives due to lockdown and teleworking, and also the lack of availability of caregivers. This study also suggests that patients with anxiety might have avoided Emergency consultations during the initial period of the pandemic [4], even though visits had more tendency to be telematic and anxiety disorders have been prevalent during the lockdown.
References
[1] Bojdani, E., Rajagopalan, A., Chen, A., Gearin, P., Olcott, W., Shankar, V., DeLisi, L. E., 2020. COVID-19 Pandemic: Impact on psychiatric care in the United States. Psychiatry Research 289 6;289:113069.
[2] Gualano, M. R., Lo Moro, G., Voglino, G., Bert, F., & Siliquini, R., 2020. Effects of COVID-19 lockdown on mental health and sleep disturbances in Italy. International Journal of Environmental Research and Public Health, 17(13), 1–13.
[3] Torales, J., O’Higgins, M., Castaldelli-Maia, J. M., & Ventriglio, A., 2020. The outbreak of COVID-19 coronavirus and its impact on global mental health. International Journal of Social Psychiatry 66(4), 317–320.
[4] Hwang, T. J., Rabheru, K., Peisah, C., Reichman, W., & Ikeda, M., 2020. Loneliness and Social Isolation during the COVID-19 Pandemic. International Psychogeriatrics 32(10):1217-1220.
Conflict of interest
Disclosure statement: I have received support from Janssen-Cilag, Lundbeck and Angelini, and declare no support related to the subject of this article.
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