Table 4.

Studies of Psychiatric consultations in Emergency Departments in Italy During the COVID-19 Pandemic

Authors, (Ref)	Units Included in the Study	Methods	Main Findings
Stein et al25	Emergency Dept-San Paolo Hospital (Milan)	Comparison of psychiatric consultations during lockdown (9 March–3 May 2020) and over the previous 2 months (13 January–8 March with psychiatric consultations performed over the same 16 weeks the previous year (13 January–3 May 2019	ED consultations for mental-health-related conditions reduced during lockdown by almost 50%; No variations in the corresponding period of 2019. decrease throughout all diagnostic categories with the exception of personality disorders, alcohol- and substance-abuse disorders, and trauma- and stressor-related disorders
Balestrieri et al26	Emergency departments of nine Italian hospitals (4 located in Lombardy Region)	Comparison of psychiatric consultations during the lockdown and postlockdown periods of 2020 (March 9, 2020 and June 30, 2020) and the equivalent periods of 2019.	37.5% decrease in the number of consultations during the lockdown period and 17.9% after lockdown 34.9% decrease in the number of patients examined during lockdown and 11.2% after lockdown. Higher percentage of patients having previous psychiatric hospitalizations was reported during the lockdown period (61.1 vs 56.3%) and a lower percentage after lockdown (59.7 vs 64.7%). 3.4% decrease in consultations for suicidal ideation and planning during lockdown and subsequent increase for ideation, planning, and suicide attempts after lockdown Increase of antipsychotic (5.2%) and benzodiazepine (4.1%) prescriptions during lockdown Higher number of compulsory hospital admissions after lockdown compared to 2019
Capuzzi et al27	Psychiatric emergency rooms of Department of Mental Health ad Addiction, University Hospitals in Desio and MHA of Monza, Lombardy Region	Comparison of psychiatric consultations during phase 1 of lockdown (21/23 May 2020) compared to the same period in 2019	58% decrease in emergency psychiatric consultations during lockdown compared to the corresponding period in 2019 (n = 388). Consultations for depressive and adjustment disorders lower in 2020 than in 2019, with consultations for OCD more prevalent during lockdown than 2019 Rate of hospitalizations after emergency consultation significantly higher during lockdown (53.3%) compared to 2019 (42.5%)
Di Lorenzo et al28	Emergency Rooms in the 2 General Hospitals in the City of Modena Emilia-Romagna Region	Comparison of urgent psychiatric consultations (UPCs) carried out in emergency rooms (ER) from March 1 to August 31, 2020 with those conducted from March 1 to August 31, 2019	Decrease of UPCs in 2020 (n = 476) respect to 2019 (n = 602) Reasons for UPC: a lower rate of suicidal behavior (ideation, attempts) was detected during the Pandemic (17.3% in 2019 and 14.1% in 2020) as well as manic episodes (8% in 2019 and 2.9% in 2020); a higher prevalence was found for aggressiveness during the pandemic (3.8% in 2019 and 10.7% in 2020) as well as maladjustment disorders (2% in 2019 and 7.8% in 2020). Outcome of UPC: Lower number of psychiatric hospital admissions (mainly voluntary) in 2020 (21.1%) than 2019 (27%),
Di Lorenzo et al29	Community Mental Health Centre, City of Modena, Emilia-Romagna Region	Comparison of urgent psychiatric consultations (UPC) during the coronavirus outbreak from 1 March to 31 August 2020, with the same period in 2019.	Increase in UPC during the pandemic compared to 2019 (n = 811 vs 656) Increase in mean daily number of UPC in 2020 (5.3) compared to 2019 (4.07) UPC more frequently required by patients already in charge of local outpatient services in 2020 than in 2019 Outcomes: more frequent discharge at home in 2020 (66% vs 57% in 2019); drug prescriptions, significantly less frequent in 2020 (55% of cases) compared to 2019 (72%)