Ambrosetti Julia, Macheret Laura, Folliet Aline, Wullschleger Alexandre, Amerio Andrea, Aguglia Andrea, Serafini Gianluca, Prada Paco, Kaiser Stefan, Bondolfi Guido, Sarasin François, Costanza Alessandra
Emergency Psychiatric Unit, Department of Psychiatry and Department of Emergency (UAUP), Geneva University Hospitals (HUG), 1211 Geneva, Switzerland.
Adult Psychiatry Division, Department of Psychiatry, University Hospital of Geneva (HUG), 1211 Geneva, Switzerland.
Int J Environ Res Public Health. 2021 Jan 28;18(3):1174. doi: 10.3390/ijerph18031174.
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.
2019年冠状病毒病（COVID-19）大流行是一场对心理健康有深远影响的公共卫生突发事件。精神科急诊科在这场心理健康危机中发挥着关键作用。本研究旨在调查瑞士一家精神科急诊科在2016年“无大流行”期间和2020年“大流行期间”4月1日至5月15日期间的就诊差异。该研究纳入了“大流行期间”精神科急诊科的579例会诊以及“无大流行期间”的702例会诊。对社会人口统计学和临床特征进行了比较，并进行了逻辑回归分析，以确定与大流行期间精神科住院相关的变量。在COVID-19期间，精神科急诊科的总住院人数有所减少。逻辑回归分析预测了自变量（大流行期间急诊科住院）以及未婚/非恋爱关系、乘救护车前来、自杀行为、行为障碍和精神运动性激越的估计比值比（OR）。尽管仅在双变量分析中具有统计学意义，但患者也更有可能被非自愿住院。从社会人口统计学和临床角度来看，这一情况似乎与我们2016年对精神科急诊科会诊的观察结果相反。这些发现突出表明，大流行期间精神科急诊科住院人数的减少似乎与独居和更严重的精神病理学有关，这必须提醒精神科医生在大流行期间确保提供心理健康护理。
