Emergency Psychiatric Consultations During and After the COVID-19 Lockdown in Italy. A Multicentre Study.
Matteo Balestrieri, Paola Rucci, Davide Amendola, Miki Bonizzoni, Giancarlo Cerveri, Chiara Colli, Filippo Dragogna, Giuseppe Ducci, Maria Giuseppa Elmo, Lucio Ghio, Federico Grasso, Clara Locatelli, Claudio Mencacci, Leonardo Monaco, Alessandra Nicotra, Giulia Piccinini, Livia Pischiutta, Marco Toscano, Marco Vaggi, Vincenzo Villari, Alberto Vitalucci, Giulio Castelpietra, Emi Bondi
Author Information
Matteo Balestrieri: Unit of Psychiatry, Department of Medicine (DAME), University of Udine, Udine, Italy.
Paola Rucci: Department of Biomedical and Neuromotor Sciences, Alma Mater Studiorum, University of Bologna, Bologna, Italy.
Davide Amendola: Servizio Psichiatrico Diagnosi e Cura, Dipartimento Salute Mentale, Azienda Sanitaria Locale (ASL) Sa/2, Salerno, Italy.
Miki Bonizzoni: Department of Mental Health and Addiction, Azienda Socio-Sanitaria Territoriale (ASST) Lodi, Lodi, Italy.
Giancarlo Cerveri: Department of Mental Health and Addiction, Azienda Socio-Sanitaria Territoriale (ASST) Lodi, Lodi, Italy.
Chiara Colli: Unit of Psychiatry, Department of Medicine (DAME), University of Udine, Udine, Italy.
Filippo Dragogna: Department of Mental Health-Addiction and Neuroscience, Azienda Socio-Sanitaria Territoriale (ASST) Fbf-Sacco, Milan, Italy.
Giuseppe Ducci: Dipartimento Salute Mentale, Azienda Sanitaria Locale (ASL) Roma 1 - Serivzio Psichiatrico di Diagnosi e Cura (SPDC) Ospedale San Filippo Neri, Rome, Italy.
Maria Giuseppa Elmo: Dipartimento Salute Mentale, Azienda Sanitaria Locale (ASL) Roma 1 - Serivzio Psichiatrico di Diagnosi e Cura (SPDC) Ospedale San Filippo Neri, Rome, Italy.
Lucio Ghio: Department of Mental Health and Addiction, Azienda Sanitaria Locale 3 (ASL3) Genova, Genova, Italy.
Federico Grasso: Department of Mental Health and Addiction, Azienda Socio-Sanitaria Territoriale (ASST) Lodi, Lodi, Italy.
Clara Locatelli: Department of Psychiatry, Azienda Socio-Sanitaria Territoriale (ASST) Papa Giovanni XXIII, Bergamo, Italy.
Claudio Mencacci: Department of Mental Health-Addiction and Neuroscience, Azienda Socio-Sanitaria Territoriale (ASST) Fbf-Sacco, Milan, Italy.
Leonardo Monaco: Dipartimento Salute Mentale, Azienda Sanitaria Locale (ASL) Roma 1 - Serivzio Psichiatrico di Diagnosi e Cura (SPDC) Ospedale San Filippo Neri, Rome, Italy.
Alessandra Nicotra: Unit of Psychiatry, Department of Medicine (DAME), University of Udine, Udine, Italy.
Giulia Piccinini: Department of Mental Health and Addiction, Azienda Sanitaria Locale 3 (ASL3) Genova, Genova, Italy.
Livia Pischiutta: Unit of Psychiatry, Department of Medicine (DAME), University of Udine, Udine, Italy.
Marco Toscano: Azienda Socio-Sanitaria Territoriale (ASST) Rhodense, Garbagnate Milanese, Italy.
Marco Vaggi: Department of Mental Health and Addiction, Azienda Sanitaria Locale 3 (ASL3) Genova, Genova, Italy.
Vincenzo Villari: Struttura Complessa (SC) Psichiatria Serivzio Psichiatrico di Diagnosi e Cura (SPDC), Dipartimento Neuroscienze e Salute Mentale, Azienda Ospedaliera Universitaria (AOU) Città della Salute e della Scienza, Torino, Italy.
Alberto Vitalucci: Struttura Complessa (SC) Psichiatria Serivzio Psichiatrico di Diagnosi e Cura (SPDC), Dipartimento Neuroscienze e Salute Mentale, Azienda Ospedaliera Universitaria (AOU) Città della Salute e della Scienza, Torino, Italy.
Giulio Castelpietra: Outpatient and Inpatient Care Service, Central Health Directorate, Friuli Venezia Giulia Region, Trieste, Italy.
Emi Bondi: Department of Psychiatry, Azienda Socio-Sanitaria Territoriale (ASST) Papa Giovanni XXIII, Bergamo, Italy.
The aim was to analyse the psychiatric consultations in nine Italian hospital emergency departments, by comparing the lockdown and post-lockdown periods of 2020 with the equivalent periods of 2019. Characteristics of psychiatric consultations, patients, and drug prescriptions were analyzed. Joinpoint models were used to identify changes in the weekly trend of consultations. A 37.5% decrease in the number of consultations was seen during the lockdown period and 17.9% after the lockdown. The number of individual patients seen decreased by 34.9% during the lockdown and 11.2% after the lockdown. A significant change in the number of consultations from week 11 to week 18 occurred, followed by a gradual increase. There was a higher percentage of patients with previous psychiatric hospitalizations during the lockdown period (61.1 vs. 56.3%) and a lower percentage after the lockdown (59.7 vs. 64.7%). During the lockdown there was a large increase in psychiatric consultations for substance use disorders, whereas more consultations for manic episodes occurred after the lockdown. A 3.4% decrease was observed in consultations for suicidal ideation and planning during the lockdown, followed by an upward rebound after the lockdown, along with an increase in consultations for suicide attempts. During lockdown antipsychotic and benzodiazepine prescriptions increased by 5.2 and 4.1%, respectively. After the lockdown, the number of compulsory hospitalizations was higher than in 2019. We observed a decrease of psychiatric consultations during and after the lockdown. There was an increase in consultations for manic episodes and suicidality after the lockdown. The focus of psychiatric services must remain high particularly in this latter period.
