Department of Pre-Clinical medicine, Lake Erie College of Osteopathic Medicine, Erie, PA, USA.
Department of Pre-Clinical medicine, Lake Erie College of Osteopathic Medicine, Erie, PA, USA.
Compr Psychiatry. 2021 Oct;110:152255. doi: 10.1016/j.comppsych.2021.152255. Epub 2021 Jun 12.
Evidence suggested that traumatic events, including pandemics, can be associated with psychiatric symptoms like increased anxiety and depression. However, there were many unknowns concerning the emergent global coronavirus-19 (COVID-19), including its impact on psychiatric health within the United States. Our study aimed to track trends of mental health problems in individuals who presented with psychiatric complaints in an emergent setting.
A total of 1776 patients and 1610 patients presented to Emergency Department (ED) with psychiatric complaints between January 1 - July 9 of the years of 2019 and 2020, respectively, in Millcreek Community Hospital (MCH) Erie, PA. This study was an electronic medical record review (EMR), therefore the data were collected exclusively from EMR over the two-year span. ED prevalence was calculated as the number of total psychiatric MCH ED cases divided by the total number of all MCH ED patients, and prevalence ratio (PR) between 2019 and 2020 was used to reflect change of overall ED psychiatric prevalence.
Clinical notes revealed increased ED psychiatric chief complaint prevalence, as indicated by a PR greater than one, in multiple categories in comparison to before the COVID-19 outbreak. Concerning primary psychiatric disorders, there was increased ED prevalence in chief complaint of total mood disorders (PR = 1.21) with major depressive disorder (PR = 1.23) and bipolar disorder (PR = 1.47), neurodevelopment disorders (PR = 1.25) with attention deficit hyperactivity disorder (ADHD) (PR = 1.19) and intellectual disability (PR = 1.52), trauma- and stressor-related disorders (PR = 1.56) with post-traumatic stress disorder (PTSD) (PR = 1.39) and adjustment disorder (PR = 1.73), substance abuse and addiction disorders (PR = 1.29), and personality disorders (PR = 1.56).
The pandemic outbreak dramatically impacted mental health in an ER setting. Further research on mental health disparities in conjunction with the COVID-19 pandemic is critical to help predict and address risk for chronic symptoms and sequela to help anticipate and improve psychiatric patient care and well-being during potential future pandemics.
有证据表明，创伤性事件，包括大流行病，可能与焦虑和抑郁等精神症状有关。然而，对于新兴的全球冠状病毒-19（COVID-19），仍有许多未知因素，包括其对美国精神健康的影响。我们的研究旨在追踪在紧急情况下出现精神科投诉的个体中心理健康问题的趋势。
2019 年 1 月 1 日至 7 月 9 日期间，共有 1776 名和 1610 名患者分别在宾夕法尼亚州伊利市米尔克里克社区医院（MCH）的急诊部（ED）出现精神科投诉。这项研究是电子病历回顾（EMR），因此数据仅在两年期间内从 EMR 中收集。ED 患病率是指 MCH ED 精神科总病例数除以 MCH ED 总患者数，2019 年和 2020 年的患病率比（PR）用于反映整体 ED 精神科患病率的变化。
临床记录显示，与 COVID-19 爆发前相比，多个类别中的 ED 精神科主要投诉患病率增加，PR 大于 1。就主要精神障碍而言，总心境障碍（PR=1.21）、重度抑郁症（PR=1.23）和双相情感障碍（PR=1.47）、神经发育障碍（PR=1.25）、注意力缺陷多动障碍（PR=1.19）和智力障碍（PR=1.52）、创伤和应激相关障碍（PR=1.56）、创伤后应激障碍（PR=1.39）和适应障碍（PR=1.73）、物质滥用和成瘾障碍（PR=1.29）和人格障碍（PR=1.56）的 ED 患病率增加。
大流行爆发极大地影响了急诊环境中的心理健康。结合 COVID-19 大流行研究心理健康差异对于帮助预测和解决慢性症状和后遗症的风险至关重要，有助于预测和改善未来潜在大流行期间精神科患者的护理和福祉。
