Peripandemic psychiatric emergencies: impact of the COVID-19 pandemic on patients according to diagnostic subgroup

Eur Arch Psychiatry Clin Neurosci. 2021 Mar;271(2):259-270. doi: 10.1007/s00406-020-01228-6. Epub 2021 Feb 5.


On March 11th, 2020, the outbreak of coronavirus disease 2019 (COVID-19) was declared a pandemic. Governments took drastic measures in an effort to reduce transmission rates and virus-associated morbidity. This study aims to present the immediate effects of the pandemic on patients presenting in the psychiatric emergency department (PED) of Hannover Medical School. Patients presenting during the same timeframe in 2019 served as a control group. A decrease in PED visits was observed during the COVID-19 pandemic with an increase in repeat visits within 1 month (30.2 vs. 20.4%, pBA = 0.001). Fewer patients with affective disorders utilized the PED (15.2 vs. 22.2%, pBA = 0.010). Suicidal ideation was stated more frequently among patients suffering from substance use disorders (47.4 vs. 26.8%, pBA = 0.004), while patients with schizophrenia more commonly had persecutory delusions (68.7 vs. 43.5%, pBA = 0.023) and visual hallucinations (18.6 vs. 3.3%, pBA = 0.011). Presentation rate of patients with neurotic, stress-related, and somatoform disorders increased. These patients were more likely to be male (48.6 vs. 28.9%, pBA = 0.060) and without previous psychiatric treatment (55.7 vs. 36.8%, pBA = 0.089). Patients with personality/behavioral disorders were more often inhabitants of psychiatric residencies (43.5 vs. 10.8%, pBA = 0.008). 20.1% of patients stated an association between psychological well-being and COVID-19. Most often patients suffered from the consequences pertaining to social measures or changes within the medical care system. By understanding how patients react to such a crisis situation, we can consider how to improve care for patients in the future and which measures need to be taken to protect these particularly vulnerable patients.

Keywords: COVID-19; Mental health; Pandemic; Psychiatric emergency department; Psychological burden.

MeSH terms

  • Adult
  • Aged
  • COVID-19*
  • Cost of Illness
  • Emergencies / psychology*
  • Female
  • Germany
  • Humans
  • Male
  • Mental Disorders / classification
  • Mental Disorders / therapy*
  • Middle Aged
  • Mood Disorders / epidemiology
  • Mood Disorders / therapy
  • Neurotic Disorders / epidemiology
  • Neurotic Disorders / psychology
  • Pandemics*
  • Psychiatry / statistics & numerical data*
  • Schizophrenia / epidemiology
  • Schizophrenic Psychology
  • Sex Factors
  • Somatoform Disorders / epidemiology
  • Somatoform Disorders / psychology
  • Substance-Related Disorders / epidemiology
  • Suicidal Ideation