Dataset Information

Impact of the COVID-19 pandemic on mental health service use among psychiatric outpatients in a tertiary hospital.

ABSTRACT:

Background

The aim was to explore the impact of the COVID-19 pandemic on mental health service use according to mental disorder diagnosis among psychiatric outpatients.

Methods

Psychiatric outpatient visits and patient diagnostic information were extracted from the EHR(electronic health records) of a Korean tertiary hospital during 3 months of the COVID-19 pandemic and 3 months before the COVID-19 outbreak. Visit rates of psychiatric outpatients according to primary psychiatric diagnosis category before and after the COVID-19 pandemic were compared using an over-dispersed Poisson regression model. The temporal associations between the number of daily outpatient visits and the daily number of newly confirmed cases were examined by time-series analysis within each diagnosis category.

Results

Total daily outpatient visit rate was significantly reduced during the pandemic. Among the nine most prevalent diagnosis categories, the daily visit rates for anxiety disorders, depressive disorders, and schizophrenia-spectrum disorders were significantly reduced by about 29.8%, 14.8%, and 13.3% respectively. Time-series analysis showed significant temporal correlations between the daily number of newly confirmed cases and the daily visit rates for anxiety disorders and depressive disorders, whereas patients with schizophrenia-spectrum disorders showed no significant temporal association.

Limitations

Potential confounding factors unrelated to the pandemic might have influenced the results.

Conclusions

The present findings suggest that patients with anxiety or depressive disorders may have concerns regarding the spread of COVID-19, and may be more reluctant to visit psychiatry outpatient clinics. Delivery strategies for mental healthcare services, such as telepsychiatry, would be helpful to enhance continuity of care during the pandemic.

SUBMITTER: Seo JH

PROVIDER: S-EPMC9754757 | biostudies-literature | 2021 Jul

REPOSITORIES: biostudies-literature

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Publications

Impact of the COVID-19 pandemic on mental health service use among psychiatric outpatients in a tertiary hospital.

Seo Jun Ho JH Kim Se Joo SJ Lee Myeongjee M Kang Jee In JI

Journal of affective disorders 20210503

<h4>Background</h4>The aim was to explore the impact of the COVID-19 pandemic on mental health service use according to mental disorder diagnosis among psychiatric outpatients.<h4>Methods</h4>Psychiatric outpatient visits and patient diagnostic information were extracted from the EHR(electronic health records) of a Korean tertiary hospital during 3 months of the COVID-19 pandemic and 3 months before the COVID-19 outbreak. Visit rates of psychiatric outpatients according to primary psychiatric di ...[more]

PMID: 34015622

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Project description:BackgroundThis study assessed the caries experience and gingival health of outpatients with mental disorders, comparing those with psychotic disorders to those with non-psychotic disorders at a specialist psychiatry clinic. Oral health is vital for overall health, making it essential to examine the oral health status of these individuals with a focus on specific variables.MethodsA quantitative descriptive cross-sectional study was conducted at the Federal Neuropsychiatric Hospital psychiatry clinic in Enugu State, Nigeria, between May and June 2023. Data on demographic variables were collected from 260 respondents using an interviewer-administered questionnaire. Oral health status was clinically assessed using the Decayed, Missing, and Filled Teeth (DMFT) index, the Oral Hygiene Index-Simplified (OHI-S), and the Gingival Index (GI). Data were analyzed using SPSS version 25, with significance at p < 0.05.ResultsOut of 260 respondents, 155 (60%) had psychotic disorders, while 105 (40%) had non-psychotic disorders. Both groups had low mean DMFT scores of 1.0± (1.07) for psychotic and 1.0± (0.9) for non-psychotic disorders. The OHI-S indicated that 68 (69.4%) of patients with psychotic disorders and 30 (30.6%) of those with non-psychotic disorders had poor oral hygiene. Additionally, 137 (58.5%) participants in the psychotic group and 97 (41.5%) in the non-psychotic group brushed their teeth once daily. A total of 145 (58.9%) participants in the psychotic group and 101 (41.1%) in the non-psychotic group did not receive assistance while brushing. Furthermore, 98 (59.8%) participants in the psychotic group and 66 (40.2%) in the non-psychotic group did not consume alcohol, while 149 (59.1%) in the psychotic group and 103 (40.9%) in the non-psychotic group were non-smokers.ConclusionParticipants exhibited low caries experience due to their motivation to practice self-care, as evidenced by a majority brushing at least once daily without assistance, utilizing a toothbrush and toothpaste, and low alcohol consumption and tobacco use. However, poor oral hygiene persisted, particularly among those with psychotic disorders compared to non-psychotic disorders. This highlights the importance of integrating oral health education, counselling, and routine intraoral examinations in the care of psychiatric patients to prevent the onset or progression of oral diseases in this population.

Project description:IntroductionMental disorders are prevalent among older adults, often leading to the use of multiple medications, many with anticholinergic properties. Polypharmacy, common in this population, is a major contributor to anticholinergic burden, which is linked to cognitive and physical decline. This study investigates the relationship between polypharmacy and anticholinergic burden across seven anticholinergic burden scales in elderly patients attending the psychiatric outpatient.MethodsStudy was conducted at a psychiatry outpatient clinic at All India Institute of Medical Sciences, Rishikesh, India, from December 2021 to March 2023. Elderly patients (aged ≥ 60 years) who were on at least one psychotropic medication and had a primary working diagnosis of psychiatric illness were included. All psychotropic medications, including antidepressants, antipsychotics, mood stabilizers, and hypnotics, were evaluated. Anticholinergic burden scales were calculated by the respective tools. Univariate analysis was adopted to determine the factors that may affect polypharmacy.ResultsStudy included 1165 elderly patients aged ≥ 60 years. The prevalence of polypharmacy was 20.43% (n = 238). Clonazepam (n = 364, 17.28%), escitalopram (n = 197, 9.35%), metformin (n = 165, 7.83%), sertraline (n = 141, 6.69%), mirtazapine (n = 129, 6.12%), and lorazepam (n = 110, 5.22%) were among the most frequently prescribed anticholinergic drugs. Univariate analysis demonstrated that all anticholinergic risk assessment scales were closely correlated with polypharmacy, with the strongest association observed for the Anticholinergic Load Scale (ALS) (Odds Ratio = 4.3; p < 0.001). Polypharmacy was also positively associated with adverse drug reactions (Odds Ratio = 1.81; 95% Confidence Interval = 1.27-2.56).ConclusionThe anticholinergic burden in this cohort of elderly psychiatry patients was high, with 95.1% (n = 1108) experiencing a significant burden. Adverse drug events and anticholinergic burden scales were positively associated with polypharmacy, with a stronger correlation between polypharmacy and ALS scores than with other anticholinergic burden scales in older adults.

Dataset Information

Impact of the COVID-19 pandemic on mental health service use among psychiatric outpatients in a tertiary hospital.

Background

Methods

Results

Limitations

Conclusions

Publications

Impact of the COVID-19 pandemic on mental health service use among psychiatric outpatients in a tertiary hospital.

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