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Trends in suicidal ideation in an emergency department during COVID-19.
Grossman, Mila N; Fry, Carrie E; Sorg, Emily; MacLean, Rachel L; Nisavic, Mladen; McDowell, Michal J; Masaki, Charles; Bird, Suzanne; Smith, Felicia; Beach, Scott R.
  • Grossman MN; Massachusetts General Hospital, Department of Psychiatry, United States of America; McLean Hospital, United States of America.
  • Fry CE; Vanderbilt University School of Medicine, Department of Health Policy, United States of America.
  • Sorg E; Massachusetts General Hospital, Department of Psychiatry, United States of America.
  • MacLean RL; Massachusetts General Hospital, Department of Psychiatry, United States of America; McLean Hospital, United States of America.
  • Nisavic M; Massachusetts General Hospital, Department of Psychiatry, United States of America.
  • McDowell MJ; Massachusetts General Hospital, Department of Psychiatry, United States of America; McLean Hospital, United States of America.
  • Masaki C; Massachusetts General Hospital, Department of Psychiatry, United States of America; McLean Hospital, United States of America.
  • Bird S; Massachusetts General Hospital, Department of Psychiatry, United States of America.
  • Smith F; Massachusetts General Hospital, Department of Psychiatry, United States of America.
  • Beach SR; Massachusetts General Hospital, Department of Psychiatry, United States of America. Electronic address: SBEACH1@mgh.harvard.edu.
J Psychosom Res ; 150: 110619, 2021 11.
Article in English | MEDLINE | ID: covidwho-1440221
ABSTRACT

OBJECTIVE:

This study aims to detail changes in presentations at a United States Emergency Department for suicidality before and after the outbreak of COVID-19.

METHODS:

A retrospective chart review was conducted of all adult patients who presented to an ED with suicidality and underwent psychiatric consultation during the study period. The cohorts consisted of patients who presented between December 2018 - May 2019 and December 2019 - May 2020. Information was collected on demographics, characteristics of suicidality, reasons for suicidality and disposition. The first wave from March - May 2020 was examined, using a difference-in-differences design to control for factors other than COVID-19 that may have influenced the outcomes' trend.

RESULTS:

Immediately following the pandemic outbreak there was a statistically significant increase in the proportion of undomiciled patients represented in visits for suicidality (40.7% vs. 57.4%; p-value <0.001). In addition, the proportion of patient visits attributed to social (18.0% vs. 29.2%; p-value 0.003) and structural (14.2% vs. 26.4%; p value <0.001) reasons for suicidality increased. Conversely, the proportion of visits due to psychiatric symptoms (70.5% vs 50.0%; p-value <0.001) decreased. Furthermore, patient visits were more likely to result in a medical admission (2.1% vs. 8.3%; p-value 0.002) and less likely to result in a psychiatric admission (68.4% vs 48.6%; p-value <0.001) during the initial phase of the pandemic.

CONCLUSIONS:

COVID-19 was associated with increased ED presentations for suicidality among undomiciled patients, as well as greater likelihood of social and structural reasons driving suicidality among all visits.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Suicidal Ideation / COVID-19 Type of study: Cohort study / Experimental Studies / Observational study / Prognostic study Limits: Adult / Humans Country/Region as subject: North America Language: English Journal: J Psychosom Res Year: 2021 Document Type: Article Affiliation country: J.jpsychores.2021.110619

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Suicidal Ideation / COVID-19 Type of study: Cohort study / Experimental Studies / Observational study / Prognostic study Limits: Adult / Humans Country/Region as subject: North America Language: English Journal: J Psychosom Res Year: 2021 Document Type: Article Affiliation country: J.jpsychores.2021.110619