Impact of the COVID-19 Pandemic on Psychiatric Admissions to a Large Swiss Emergency Department: An Observational Study

The coronavirus disease 2019 (COVID-19) pandemic is a public health emergency with profound mental health consequences. The psychiatric emergency department (ED) plays a key role during this mental health crisis. This study aimed to investigate differences in admissions at a Swiss psychiatric ED fro...

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Vydáno v:	International journal of environmental research and public health Ročník 18; číslo 3; s. 1174
Hlavní autoři:	Ambrosetti, Julia, Macheret, Laura, Folliet, Aline, Wullschleger, Alexandre, Amerio, Andrea, Aguglia, Andrea, Serafini, Gianluca, Prada, Paco, Kaiser, Stefan, Bondolfi, Guido, Sarasin, François, Costanza, Alessandra
Médium:	Journal Article
Jazyk:	angličtina
Vydáno:	Switzerland MDPI 28.01.2021
Témata:	COVID-19 - psychology Emergency Service, Hospital - statistics & numerical data Hospitalization - statistics & numerical data Humans Mental Health Pandemics Psychiatric Department, Hospital - statistics & numerical data Switzerland - epidemiology Switzerland COVID-19 pandemic psychotic episode public mental health suicide coronavirus psychiatric admissions substance use disorder depression emergency department suicidal behavior
ISSN:	1660-4601, 1661-7827, 1660-4601
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Abstract	The coronavirus disease 2019 (COVID-19) pandemic is a public health emergency with profound mental health consequences. The psychiatric emergency department (ED) plays a key role during this mental health crisis. This study aimed to investigate differences in admissions at a Swiss psychiatric ED from 1 April to 15 May during a “pandemic-free” period in 2016 and a “during-pandemic” period in 2020. The study included 579 consultations at psychiatric ED in the “during-pandemic” period and 702 in the “pandemic-free” period. Sociodemographic and clinical characteristics were compared, and logistic regression analysis was performed to identify variables associated with psychiatric admissions during the pandemic. A reduction in total psychiatric ED admissions was documented during COVID-19. Logistic regression analysis predicted the independent variable (ED admission during the pandemic) and estimated odds ratio (OR) for being unmarried/not in a relationship, arrival in an ambulance, suicidal behavior, behavioral disorders and psychomotor agitation. Though only statistically significant in bivariate analysis, patients were also more likely to be involuntarily hospitalized. This picture appears to be reversed from a sociodemographic and clinical point of view to our observation of psychiatric ED consultation in 2016. These findings highlight that the reduction in psychiatric ED admissions during the pandemic seems to be associated with living alone and more severe psychopathologies, which must alert psychiatrists to ensure access to mental health care in times of pandemic.
AbstractList	The coronavirus disease 2019 (COVID-19) pandemic is a public health emergency with profound mental health consequences. The psychiatric emergency department (ED) plays a key role during this mental health crisis. This study aimed to investigate differences in admissions at a Swiss psychiatric ED from 1 April to 15 May during a "pandemic-free" period in 2016 and a "during-pandemic" period in 2020. The study included 579 consultations at psychiatric ED in the "during-pandemic" period and 702 in the "pandemic-free" period. Sociodemographic and clinical characteristics were compared, and logistic regression analysis was performed to identify variables associated with psychiatric admissions during the pandemic. A reduction in total psychiatric ED admissions was documented during COVID-19. Logistic regression analysis predicted the independent variable (ED admission during the pandemic) and estimated odds ratio (OR) for being unmarried/not in a relationship, arrival in an ambulance, suicidal behavior, behavioral disorders and psychomotor agitation. Though only statistically significant in bivariate analysis, patients were also more likely to be involuntarily hospitalized. This picture appears to be reversed from a sociodemographic and clinical point of view to our observation of psychiatric ED consultation in 2016. These findings highlight that the reduction in psychiatric ED admissions during the pandemic seems to be associated with living alone and more severe psychopathologies, which must alert psychiatrists to ensure access to mental health care in times of pandemic. The coronavirus disease 2019 (COVID-19) pandemic is a public health emergency with profound mental health consequences. The psychiatric emergency department (ED) plays a key role during this mental health crisis. This study aimed to investigate differences in admissions at a Swiss psychiatric ED from 1 April to 15 May during a "pandemic-free" period in 2016 and a "during-pandemic" period in 2020. The study included 579 consultations at psychiatric ED in the "during-pandemic" period and 702 in the "pandemic-free" period. Sociodemographic and clinical characteristics were compared, and logistic regression analysis was performed to identify variables associated with psychiatric admissions during the pandemic. A reduction in total psychiatric ED admissions was documented during COVID-19. Logistic regression analysis predicted the independent variable (ED admission during the pandemic) and estimated odds ratio (OR) for being unmarried/not in a relationship, arrival in an ambulance, suicidal behavior, behavioral disorders and psychomotor agitation. Though only statistically significant in bivariate analysis, patients were also more likely to be involuntarily hospitalized. This picture appears to be reversed from a sociodemographic and clinical point of view to our observation of psychiatric ED consultation in 2016. These findings highlight that the reduction in psychiatric ED admissions during the pandemic seems to be associated with living alone and more severe psychopathologies, which must alert psychiatrists to ensure access to mental health care in times of pandemic.The coronavirus disease 2019 (COVID-19) pandemic is a public health emergency with profound mental health consequences. The psychiatric emergency department (ED) plays a key role during this mental health crisis. This study aimed to investigate differences in admissions at a Swiss psychiatric ED from 1 April to 15 May during a "pandemic-free" period in 2016 and a "during-pandemic" period in 2020. The study included 579 consultations at psychiatric ED in the "during-pandemic" period and 702 in the "pandemic-free" period. Sociodemographic and clinical characteristics were compared, and logistic regression analysis was performed to identify variables associated with psychiatric admissions during the pandemic. A reduction in total psychiatric ED admissions was documented during COVID-19. Logistic regression analysis predicted the independent variable (ED admission during the pandemic) and estimated odds ratio (OR) for being unmarried/not in a relationship, arrival in an ambulance, suicidal behavior, behavioral disorders and psychomotor agitation. Though only statistically significant in bivariate analysis, patients were also more likely to be involuntarily hospitalized. This picture appears to be reversed from a sociodemographic and clinical point of view to our observation of psychiatric ED consultation in 2016. These findings highlight that the reduction in psychiatric ED admissions during the pandemic seems to be associated with living alone and more severe psychopathologies, which must alert psychiatrists to ensure access to mental health care in times of pandemic.
Author	Bondolfi, Guido Ambrosetti, Julia Sarasin, François Wullschleger, Alexandre Serafini, Gianluca Macheret, Laura Prada, Paco Kaiser, Stefan Amerio, Andrea Aguglia, Andrea Costanza, Alessandra Folliet, Aline
AuthorAffiliation	3 Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), Section of Psychiatry, University of Genoa, 16132 Genoa, Italy; andrea.amerio@unige.it (A.A.); andrea.aguglia@unige.it (A.A.); gianluca.serafini@unige.it (G.S.) 6 Department of Psychiatry, Faculty of Medicine, University of Geneva (UNIGE), 1206 Geneva, Switzerland; paco.prada@hcuge.ch (P.P.); guido.bondolfi@hcuge.ch (G.B.); francois.sarasin@hcuge.ch (F.S.); alessandra.costanza@unige.ch (A.C.) 7 Service of Liaison Psychiatry and Crisis Intervention (SPLIC), Department of Psychiatry, Geneva University Hospitals (HUG), 1211 Geneva, Switzerland 9 Department of Psychiatry, ASO Santi Antonio e Biagio e Cesare Arrigo Hospital, 15121 Alessandria, Italy 2 Adult Psychiatry Division, Department of Psychiatry, University Hospital of Geneva (HUG), 1205 Geneva, Switzerland; alexandre.wullschleger@hcuge.ch (A.W.); stefan.kaiser@hcuge.ch (S.K.) 1 Emergency Psychiatric Unit, Department of Psychiatry a
AuthorAffiliation_xml	– name: 2 Adult Psychiatry Division, Department of Psychiatry, University Hospital of Geneva (HUG), 1205 Geneva, Switzerland; alexandre.wullschleger@hcuge.ch (A.W.); stefan.kaiser@hcuge.ch (S.K.) – name: 4 IRCCS Ospedale Policlinico San Martino, 16132 Genoa, Italy – name: 6 Department of Psychiatry, Faculty of Medicine, University of Geneva (UNIGE), 1206 Geneva, Switzerland; paco.prada@hcuge.ch (P.P.); guido.bondolfi@hcuge.ch (G.B.); francois.sarasin@hcuge.ch (F.S.); alessandra.costanza@unige.ch (A.C.) – name: 9 Department of Psychiatry, ASO Santi Antonio e Biagio e Cesare Arrigo Hospital, 15121 Alessandria, Italy – name: 1 Emergency Psychiatric Unit, Department of Psychiatry and Department of Emergency (UAUP), Geneva University Hospitals (HUG), 1211 Geneva, Switzerland; laura.macheret@hcuge.ch (L.M.); aline.folliet@hcuge.ch (A.F.) – name: 3 Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), Section of Psychiatry, University of Genoa, 16132 Genoa, Italy; andrea.amerio@unige.it (A.A.); andrea.aguglia@unige.it (A.A.); gianluca.serafini@unige.it (G.S.) – name: 5 Department of Psychiatry, Tufts University, Boston, MA 02111, USA – name: 7 Service of Liaison Psychiatry and Crisis Intervention (SPLIC), Department of Psychiatry, Geneva University Hospitals (HUG), 1211 Geneva, Switzerland – name: 8 Emergency Medicine Unit, Department of Emergency, Geneva University Hospitals (HUG), 1211 Geneva, Switzerland
Author_xml	– sequence: 1 givenname: Julia surname: Ambrosetti fullname: Ambrosetti, Julia – sequence: 2 givenname: Laura surname: Macheret fullname: Macheret, Laura – sequence: 3 givenname: Aline surname: Folliet fullname: Folliet, Aline – sequence: 4 givenname: Alexandre surname: Wullschleger fullname: Wullschleger, Alexandre – sequence: 5 givenname: Andrea orcidid: 0000-0002-3439-340X surname: Amerio fullname: Amerio, Andrea – sequence: 6 givenname: Andrea orcidid: 0000-0002-2003-2101 surname: Aguglia fullname: Aguglia, Andrea – sequence: 7 givenname: Gianluca orcidid: 0000-0002-6631-856X surname: Serafini fullname: Serafini, Gianluca – sequence: 8 givenname: Paco surname: Prada fullname: Prada, Paco – sequence: 9 givenname: Stefan surname: Kaiser fullname: Kaiser, Stefan – sequence: 10 givenname: Guido surname: Bondolfi fullname: Bondolfi, Guido – sequence: 11 givenname: François surname: Sarasin fullname: Sarasin, François – sequence: 12 givenname: Alessandra orcidid: 0000-0001-6387-6462 surname: Costanza fullname: Costanza, Alessandra
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Snippet	The coronavirus disease 2019 (COVID-19) pandemic is a public health emergency with profound mental health consequences. The psychiatric emergency department...
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SubjectTerms	COVID-19 - psychology Emergency Service, Hospital - statistics & numerical data Hospitalization - statistics & numerical data Humans Mental Health Pandemics Psychiatric Department, Hospital - statistics & numerical data Switzerland - epidemiology
Title	Impact of the COVID-19 Pandemic on Psychiatric Admissions to a Large Swiss Emergency Department: An Observational Study
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