Department of Psychiatry, Massachusetts General Hospital, Boston, MA, United States of America.
McLean Hospital, Belmont, MA, United States of America.
PLoS One. 2021 Jun 30;16(6):e0253805. doi: 10.1371/journal.pone.0253805. eCollection 2021.
To estimate the association between COVID-19 and Emergency Department (ED) psychiatric presentations, including suicidal ideation.
Using an interrupted time series design, we analyzed psychiatric presentations using electronic health record data in an academic medical center ED between 2018 and 2020. We used regression models to assess the association between the onset of the COVID-19 outbreak and certain psychiatric presentations. The period February 26-March 6, 2020 was used to define patterns in psychiatric presentations before and after the coronavirus outbreak.
We found a 36.2% decrease (unadjusted) in ED psychiatric consults following the coronavirus outbreak, as compared to the previous year. After accounting for underlying trends, our results estimate significant differential change associated with suicidal ideation and substance use disorder (SUD) presentations following the outbreak. Specifically, we noted a significant differential increase in presentations with suicidal ideation six weeks after the outbreak (36.4 percentage points change; 95% CI: 5.3, 67.6). For presentations with SUD, we found a differential increase in the COVID-19 time series relative to the comparison time series at all post-outbreak time points and this differential increase was significant three weeks (32.8 percentage points; 95% CI: 4.0, 61.6) following the outbreak. Our results estimate no differential changes significant at the P value < 0.05 level associated with affective disorder or psychotic disorder presentations in the COVID-19 time series relative to the comparator time series.
The COVID-19 outbreak in Boston was associated with significant differential increases in ED presentations with suicidal ideation and SUD.
评估 COVID-19 与急诊科（ED）精神科就诊的关联，包括自杀意念。
使用中断时间序列设计，我们使用学术医疗中心 ED 的电子健康记录数据分析 2018 年至 2020 年间的精神科就诊情况。我们使用回归模型评估 COVID-19 爆发与某些精神科就诊之间的关联。2020 年 2 月 26 日至 3 月 6 日期间用于定义冠状病毒爆发前后精神科就诊模式。
与前一年相比，冠状病毒爆发后 ED 精神科会诊减少了 36.2%（未经调整）。在考虑到潜在趋势后，我们的结果估计与自杀意念和物质使用障碍（SUD）就诊相关的差异变化显著。具体而言，我们注意到在爆发后六周自杀意念就诊的差异显著增加（36.4 个百分点变化；95%CI：5.3，67.6）。对于 SUD 就诊，我们发现 COVID-19 时间序列相对于比较时间序列在所有爆发后时间点的差异增加，并且这种差异增加在爆发后三周时具有统计学意义（32.8 个百分点；95%CI：4.0，61.6）。我们的结果估计，在 COVID-19 时间序列中，与比较时间序列相比，与情感障碍或精神病障碍就诊相关的差异变化在 P 值<0.05 水平上没有显著差异。
波士顿的 COVID-19 爆发与 ED 就诊中自杀意念和 SUD 的显著差异增加有关。
