ABSTRACT
OBJECTIVE: This study was designed to investigate the traumatic stress levels, participants demonstrating higher than post-traumatic stress disorder (PTSD) cutoff, thus PTSD possibility, levels, and related factors of patients who felt the need to apply to the outpatient clinic for the 1st time during the first period of the outbreak of the pandemic as a traumatic event, when many psychiatry outpatient clinics were mostly closed to face-to-face admissions. In our research, we targeted three objectives. First, we evaluated PTSD as indicated with measure cutoff points and post-traumatic stress symptom (PTSS) rates among the individuals who were admitted to an outpatient psychiatric clinic for the 1st time, 3 months after the first COVID-19 case was reported in Turkiye. Second, we investigated the relationship between PTSS and PTSD cutoff with anxiety, stress, depression, hopelessness, fear of COVID-19, and disability levels. Third, we aimed to explore the sociodemographic data and risk factors related to PTSD cutoff and PTSS controlling levels of disability, hopelessness, fear of COVID-19, anxiety, depression, and stress. METHODS: For our study, a total number of 85 cases were recruited. Post-traumatic Stress Diagnostic Scale (PDS), Beck Hopelessness Scale (BHS), Depression, Anxiety, and Stress Scale (DASS-21), Sheehan Disability Scale (SDS), and Fear of COVID-19 Scale (FCS) were administered to each patient. RESULTS: The rates of possible PTSD and PTSSs were found to be 25.9% and 88.2%. The majority of participants were women (65.9%) who have been presenting complaints with anxiety symptoms (60.1%) and social media users (74.1%). The mean DASS-21 all subscales (anxiety, depression, and stress) (p<0.01), BHS (p<0.01), FCS (p=0.03), and SDS family life/home responsibilities subscale (p<0.01) scores of PTSD cutoff subgroup (n=22) were higher than non-PTSD group (n=63). We observed significant positive correlations between the FCS scores and DASS-21 anxiety subscale (p<0.01), SDS family life/home responsibilities and social life/leisure activities subscales (p<0.05), and PDS symptom severity subscale (p<0.01) scores. CONCLUSION: These results demonstrate that a COVID-19 pandemic is a traumatic life event that causes high rates of possible PTSD, PTSS, anxiety, depression, hopelessness, and disability and leads to admissions to psychiatric outpatient clinics.
ABSTRACT
BACKGROUND: We aimed to explore the impact of the preventive measures and partial lockdown to the psychiatric emergency department (PED) visits during COVID-19 pandemic in a mental health epicenter in Istanbul. METHODS: A total of 5839 patients admitted to PED during the lockdown period (LP) between March 30 and May 31, 2020, were enrolled in this retrospective cohort study. Data of these patients were compared to those of patients in the same period in 2019 between April 1 and June 2, 2019 (non-LP). We also investigated the monthly number of PED visits and hospitalizations between March 1 and December 31, 2020, and compared it to the same period in 2019. RESULTS: The volume of PED visits and hospitalizations in LP decreased by 12% and 41.6%, respectively. The rates of patients presenting anxiety and depressive disorders and bipolar disorders were found to significantly increase in LP than non-LP (p < 0.001; p < 0.001; p < 0.01, respectively). Depressive disorders, prior history of mental illness, and aggressive behavior were found to predict frequent PED visits while decrease in age and male gender found to predict hospitalizations. Regarding suicide attempt, younger patients and those with new-onset mental disorders were found to be at high risk in LP. Patients diagnosed with COVID-19 in PED visits were mostly with psychotic and bipolar disorders. CONCLUSION: Policy-makers should focus on studies on mental health services to reorganize and enhance such services, which are crucial to prevent and manage adverse mental health consequences of the pandemic and congestion in PEDs.