Psychiatric emergencies during the height of the COVID-19 pandemic in the suburban New York City area.
Psychiatric emergencies during the height of the COVID-19 pandemic in the suburban New York City area.
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DOI：
10.1016/j.jpsychires.2020.10.029
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发表时间：
2021-04
影响因子：
4.8
通讯作者：
Bartell A
中科院分区：
文献类型：
--
作者：
Ferrando SJ;Klepacz L;Lynch S;Shahar S;Dornbush R;Smiley A;Miller I;Tavakkoli M;Regan J;Bartell A
本报告描述了在COVID-19大流行期间出现精神紧急情况的患者的特征，并描述了与COVID-19相关的压力源。将2019冠状病毒病高峰期（2020年3月1日至4月30日，N = 201）就诊的紧急精神病学评估患者与2019冠状病毒病前期（2020年1月1日至2月28日，N = 355）的社会人口学特征、精神病学诊断、症状和倾向进行比较。将COVID-19检测呈阳性的患者与相同结果检测呈阴性的患者进行比较。对影响应急报告的covid -19压力因素的流行程度和性质进行了评级。在这两个时期最常见的精神诊断和表现症状是抑郁和自杀意念。比较COVID-19前和COVID-19期间，儿童和青少年（C/ a）的急诊精神科数量显著下降，但成人没有。COVID-19期间C/A患者有更多新发疾病，更有可能住院治疗，但不太可能出现自杀企图、冲动控制障碍和躁动/攻击。成年人更有可能无法获得门诊治疗，出现焦虑症，也更有可能接受住院治疗。COVID-19直接影响了25%的患者的精神紧急情况，其中更严重的压力源是由害怕感染COVID（包括精神病），自己或家人实际感染COVID（包括亲人死亡）引发的。与covid - 19阴性患者相比，covid - 19阳性患者更容易患精神病，包括新发精神病，而且抑郁/自杀的可能性更小。本报告表明，在2019冠状病毒病大流行期间需要紧急精神科服务，需要对精神科急诊患者进行临床和诊断性COVID-19筛查。新的和严重的病理情况突出表明，需要增加门诊患者获得远程精神卫生、危机热线和在线心理治疗服务的机会，以及有能力安全护理COVID-19患者的精神科住院服务。
This report characterizes patients presenting for psychiatric emergencies during the COVID-19 pandemic and describes COVID-19-related stressors. Patients seen for emergency psychiatric evaluation during the height of the COVID-19 period (March 1-April 30, 2020; N = 201) were compared with those in the immediate Pre-COVID-19 period (January 1-February 28, 2020; N = 355), on sociodemographic characteristics, psychiatric diagnoses, symptoms, and disposition. Patients tested positive for COVID-19 were compared with those that tested negative on the same outcomes. Prevalence and nature of COVID-19-stressors that influenced the emergency presentation were rated. The most common psychiatric diagnoses and presenting symptoms during both periods were depression and suicidal ideation. Comparing the Pre-COVID-19 and COVID-19 periods, a significant decline in emergency psychiatric volume was observed in children and adolescents (C/A), but not adults. COVID-19 period C/A patients had more new onset disorders and were more likely to be admitted to inpatient care, but were less likely to present with suicide attempts, impulse control disorders and agitation/aggression. Adults were more likely to have no access to outpatient care, present with anxiety disorders, and were also more likely to be admitted for inpatient care. COVID-19 directly affected the psychiatric emergency in 25% of patients, with the more severe stressors triggered by fear of COVID infection (including psychosis), actual COVID infection in self or family members, including death of a loved one. COVID-positive patients were more likely to have psychosis, including new-onset, and were less likely to be depressed/suicidal compared to their COVID-negative counterparts. This report demonstrates the need for emergency psychiatric services throughout the COVID-19 pandemic and the need for clinical and diagnostic COVID-19 screening of psychiatric emergency patients. New and severe pathology underscore the need for enhanced outpatient access to tele-mental health, crisis hotline and on-line psychotherapeutic services, as well as psychiatric inpatient services with capacity to safely care for COVID-19 patients.
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影响因子：
6.6
作者：
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通讯作者：
Xu, Jiuping
影响因子：
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DOI：
10.1007/s00406-020-01151-w
发表时间：
2020-06-09
影响因子：
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作者：
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通讯作者：
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影响因子：
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