Effects of lockdown on emergency room admissions for psychiatric evaluation: an observational study from the AUSL Romagna, Italy

Abstract

Objectives

An observation of the admissions to the emergency room (ER) requiring psychiatric evaluation during the lockdown and investigation of the demographic and clinical variables.

Methods

Retrospective longitudinal observational study of ER accesses for psychiatric evaluation was performed, comparing two periods (9 March–3 May 2020 vs. 9 March–3 May 2019). Data (number of admissions, key baseline demographic and clinical variables) were extracted from the ER databases of referral centres in a well-defined geographic area of North-Eastern Italy (Cesena, Ravenna, Forlì, and Rimini).

Results

A 15% reduction of psychiatric referrals was observed, together with a 17% reduction in the total number of patients referring to the ER. This reduction was most evident in the first month of the lockdown period (almost 25% reduction of both referrals and patients). Female gender (OR: 1.52: 95%, CI: 1.12–2.06) and being a local resident (OR: 1.54: 95%CI: 1.02–2.34) were factors associated with the decrease.

Conclusions

Lockdown changed dramatically health priorities in the local population, including people with mental health. We speculate that our observations do not only refer to the confinement due to the lockdown regime but also to fear of contagion and adoption of different coping strategies, especially in women.

Key-points

• During lockdown 15% reduction of psychiatric visits and >17% reduction in the number of psychiatric patients referring to the ER was observed.

• in the first four weeks of the lockdown almost 25% reduction of both visits and patients was observed

• Female gender and being a local resident were factors associated with the decrease.

Keywords:

• Lockdown
• outbreak
• pandemic
• COVID-19
• mental health
• consultation

Acknowledgements

We would thank Eleonora Monti and Dina Mezzena for their important contribution in data collection, dr Elisa Bianchi for statistical analysis, dr Antonella Mastrocola, dr Roberto Zanfini, dr. Nazario Santolini, dr. Claudio Aurigemma and dr. Pietro Nucera for sharing their databases.

Disclosure statement

No potential competing interest was reported by the authors