scholarly journals Impact of the COVID-19 Pandemic on Psychiatric Admissions to a Large Swiss Emergency Department: An Observational Study

2021 ◽  
Vol 18 (3) ◽  
pp. 1174
Author(s):  
Julia Ambrosetti ◽  
Laura Macheret ◽  
Aline Folliet ◽  
Alexandre Wullschleger ◽  
Andrea Amerio ◽  
...  
Keyword(s):  
Mental Health ◽  
Emergency Department ◽  
Logistic Regression ◽  
Regression Analysis ◽  
Logistic Regression Analysis ◽  
Point Of View ◽  
Bivariate Analysis ◽  
Mental Health Crisis ◽  
Health Crisis ◽  
Psychiatric Admissions

The coronavirus disease 2019 (COVID-19) pandemic is a public health emergency with profound mental health consequences. The psychiatric emergency department (ED) plays a key role during this mental health crisis. This study aimed to investigate differences in admissions at a Swiss psychiatric ED from 1 April to 15 May during a “pandemic-free” period in 2016 and a “during-pandemic” period in 2020. The study included 579 consultations at psychiatric ED in the “during-pandemic” period and 702 in the “pandemic-free” period. Sociodemographic and clinical characteristics were compared, and logistic regression analysis was performed to identify variables associated with psychiatric admissions during the pandemic. A reduction in total psychiatric ED admissions was documented during COVID-19. Logistic regression analysis predicted the independent variable (ED admission during the pandemic) and estimated odds ratio (OR) for being unmarried/not in a relationship, arrival in an ambulance, suicidal behavior, behavioral disorders and psychomotor agitation. Though only statistically significant in bivariate analysis, patients were also more likely to be involuntarily hospitalized. This picture appears to be reversed from a sociodemographic and clinical point of view to our observation of psychiatric ED consultation in 2016. These findings highlight that the reduction in psychiatric ED admissions during the pandemic seems to be associated with living alone and more severe psychopathologies, which must alert psychiatrists to ensure access to mental health care in times of pandemic.

ANALISIS HUBUNGAN SARANA, PENGETAHUAN, DAN SIKAP BIDAN PRAKTIK MANDIRI DENGAN KEPATUHAN MENJALANKAN STANDAR PELAYANAN ANTENATAL CARE DI KOTA PADANGSIDIMPUAN

2019 ◽  
Vol 2 (1) ◽  
pp. 27-33
Author(s):  
Megawati Sinambela ◽  
Evi Erianty Hasibuan
Keyword(s):  
Logistic Regression ◽  
Regression Analysis ◽  
Antenatal Care ◽  
Pregnant Women ◽  
Logistic Regression Analysis ◽  
Care Service ◽  
Multivariate Logistic Regression Analysis ◽  
Bivariate Analysis ◽  
Cross Sectional ◽  
The North

Antenatal care is a service provided to pregnant women to monitor, support maternal health and detect mothers whether normal or problematic pregnant women. According to the WHO, globally more than 70% of maternal deaths are caused by complications of pregnancy and childbirth such as hemorrhage, hypertension, sepsis, and abortion. Based on data obtained from the profile of the North Sumatra provincial health office in 2017, in the city of Padangsidimpuan in 2017 the coverage of ANC visits reached (76.58%) and had not reached the target in accordance with the 2017 Provincial Health Office strategy plan (95%). This type of research was an observational analytic study with a cross sectional design. The population in this study were independent practice midwives who were in the Padangsidimpuan, the sample in this study amounted to 102 respondents. The technique of collecting data used questionnaires and data analysis used univariate, bivariate and multivariate analysis with logistic regression analysis. Based on bivariate analysis showed that there was a relationship between facilities, knowledge and attitudes of independent midwives with compliance with the standards of antenatal care services with a value of p <0.05. The results of the study with multivariate logistic regression analysis showed that the factors associated with the compliance of independent midwives in carrying out antenatal care service standards were attitudes with values (p = 0.026).

The Crisis and Transition Services (CATS) Model: A Program to Divert Youths in Mental Health Crisis From the Emergency Department

2020 ◽  
Vol 71 (11) ◽  
pp. 1203-1206
Author(s):  
Amanda Ribbers ◽  
David Sheridan ◽  
Ajit Jetmalani ◽  
Julie Magers ◽  
Amber Laurie Lin ◽  
...  
Keyword(s):  
Mental Health ◽  
Emergency Department ◽  
Transition Services ◽  
Mental Health Crisis ◽  
Health Crisis

A randomized study of urgent computed tomography–based hematoma puncture and aspiration in the emergency department and subsequent evacuation using craniectomy versus craniectomy only

2012 ◽  
Vol 117 (3) ◽  
pp. 566-573 ◽  
Author(s):  
Bo Xiao ◽  
Fang-Fang Wu ◽  
Hong Zhang ◽  
Yan-Bin Ma
Keyword(s):  
Emergency Department ◽  
Logistic Regression ◽  
Regression Analysis ◽  
Scale Score ◽  
Logistic Regression Analysis ◽  
Randomized Study ◽  
Surgical Decompression ◽  
Pupil Response ◽  
Group A ◽  
Group B

Object When treating patients with a spontaneous supratentorial massive (≥ 70 ml) intracerebral hemorrhage (ICH), the results of surgery are gloomy. A worsening pupil response has been observed in patients preoperatively, despite blood pressure control and diuretic administration. Because open surgery needs time for decompression to occur, the authors conducted a prospective randomized study to determine whether patients who have suffered a massive ICH can benefit from a more urgently performed decompressive procedure. Methods Overall, 36 eligible patients admitted 6 or fewer hours post-ictus were enrolled in the study. In Group A, 12 patients underwent CT-based hematoma puncture and partial aspiration in the emergency department (ED) and subsequent evacuation via a craniectomy; in Group B, 24 patients underwent hematoma evacuation via a craniectomy only. Pupil responses were categorized into 5 grades (Grade 0, bilaterally fixed; Grade 1, unilaterally fixed with the fixed pupil > 7 mm; Grade 2, unilaterally fixed with the fixed pupil ≤ 7 mm; Grade 3, a unilaterally sluggish response; and Grade 4, a bilaterally brisk response). Grades were obtained on admission, at surgical decompression (defined as the point at which liquid hematoma began to flow out in Group A and at dural opening in Group B), and at completion of craniectomy. The Barthel Scale was used to assess survivors' functional outcome at 12 months. Comparisons were made between Groups A and B. Logistic regression analysis was used to evaluate the positive likelihood ratio of all variables for survival and function (Barthel Scale score of ≥ 35 at 12 months). Results Decompressive surgery was undertaken approximately 60 minutes earlier in Group A than B. A worsening pupil reflex before decompression was observed in no Group A patient and in 9 Group B patients. At the time of decompression pupil response was better in Group A than B (p < 0.05). Although only approximately one-third of the hematoma volume documented on initial CT scanning had been drained before the craniectomy in Group A, when partial aspiration was followed by craniectomy, better pupil-response results were obtained in Group A at the completion of craniectomy, and survival rate and 12-month Barthel Scale score were better as well (p < 0.05). Logistic regression analysis revealed that one variable, a minimum pupil grade of 3 at the time of decompression, had the highest predictive value for survival at 12 months (8.0, 95% CI 2.0–32.0), and a pupil grade of 4 at the same time was the most valuable predictor of a Barthel Scale score of 35 or greater at 12 months (15.0, 95% CI 1.9–120.9). Conclusions Patients with massive spontaneous supratentorial ICHs may benefit from more urgent surgical decompression. The results of logistic regression analysis implied that, to improve long-term functional outcome, decompression should be performed in patients before herniation occurs. Due to the fact that most of these patients have signs of herniation when presenting to the ED and because conventional surgical decompression requires time to take effect, this combination of surgical treatment provides a feasible and effective surgical option.

scholarly journals Psychiatric liaison referrals: a thematic analysis during peak COVID-19

BJPsych Open ◽  
2021 ◽  
Vol 7 (S1) ◽  
pp. S294-S294
Author(s):  
Kaj Svedberg ◽  
William Hancox ◽  
Hugh Grant-Peterkin
Keyword(s):  
Mental Health ◽  
Emergency Department ◽  
Careful Consideration ◽  
University Hospital ◽  
Medical Attention ◽  
Mental Health Crisis ◽  
Health Crisis ◽  
Low Mood ◽  
Crisis Care

AimsWith the advent of the COVID-19 Pandemic the NHS long term Plan commitments of January 2019 to improve crisis care nationwide became all the more pressing. The aim of this study was to thematically investigate what mental health crisis presentations might be diverted from the Emergency department to external crisis hubs in order to reduce the COVID-19 contamination risks.MethodAll referrals made to the Homerton University Hospital (HUH) mental health liaison service were looked at between 1/3/20-11/6/20 (n = 846), coinciding with the first peak of the COVID-19 Pandemic.Referral data was anonymised and sorted independently into naturally emerging thematic classes by two junior liaison doctors.Cases that did not clearly fit any of the 14 themes generated were further looked into to determine outcome of referral and discussed to try and match to an appropriate class.Result14 frequent themes for mental health crisis referrals were identified. The distribution of these ranged from most common (suicidality) to neurocognitive presentation and identified shifts in themes over the course of the pandemic peak such as increases of low mood, anxiety and intoxication requiring medical attention over the three month period.ConclusionAlthough themes for presentations may be identified in acute referrals to mental health liaison services it is problematic determining how these may be parsed safely to crisis hubs without risking overlooking cases that may require medical attention. The most common theme that was identified and remained throughout the first wave of the COVID-19 Pandemic was acute suicidal presentation. The remaining themes would require careful consideration around risk thresholds for what a service may wish to accept in devolving the emergency department liaison and balance these against future risks of repeat COVID-19 waves.

scholarly journals Fear as a mental health crisis in the context of global risks and changes

2021 ◽  
Vol 10 (1) ◽  
pp. 17-26
Author(s):  
M.I. Rozenova ◽  
V.I. Ekimova ◽  
A.S. Ognev ◽  
E.V. Likhacheva
Keyword(s):  
Mental Health ◽  
Theoretical Model ◽  
The State ◽  
Point Of View ◽  
Mental Health Crisis ◽  
Health Crisis ◽  
Structural Concept ◽  
Emergency Events ◽  
The Impact

The paper presents the analysis of the results of international and national research in the field of studying the impact of global crises and pandemic situations (including COVID-19) on the state of mental health of people. Traditionally, the fear that accompanies emergency events and situations is considered as a source of mental and psychological traumatology of various kinds, however, the authors consider fear in a period of global risks and changes, from the point of view of not the cause, but an indicator of a decrease in the integrity of a person's mental health. The initial theoretical model that allows us to differentiate and diagnose different qualities of fear was the "I-structural" concept of G. Amon, which allows us to describe and understand the specific phenomenology of fears in the pandemic period. The qualities of fear, manifested in its constructive, destructive and deficient form, according to the authors, reflect the resource reserve of a person's mental health and the level of his psychological stability.

Sign in / Sign up

Export Citation Format

Share Document