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Research Trends

Psychiatric Emergencies and Suicide Attempts Before and During COVID-19 Lockdown in Spain

Published Online:January 13, 2023https://doi.org/10.1027/0227-5910/a000896

Abstract

Abstract:Background: The COVID-19 pandemic had a significant impact on the mental health of the population. The lockdown period in Spain – from March 14 to June 21, 2020 – was particularly stressful. This study aims to examine the differences in visits to the emergency department for psychiatric reasons before and during the lockdown period in a hospital in the province of Lleida (Catalonia, Spain), which has a catchment area of 431,183 inhabitants. We hope that this study can contribute to the understanding of this difficult period in our recent history and help us to be prepared in case of new social emergencies that may affect the mental health of the general population. Aims: This study aims to examine the differences in ER visits due to psychiatric reasons before and during the COVID-19 lockdown period in a province hospital in Spain. Methods: We compared the n = 1,599 visits to the emergency room and their characteristics before (June 13 to March 13, 2020) and during (March 14 to June 21, 2020) the lockdown period in the province of Lerida, Spain. Data were obtained from the electronic health records. Information collected included sociodemographic variables, reason for consultation, previous diagnosis, and characteristics of suicidal ideation and attempts – including history of previous suicidal behavior, method, days spent in the ER, suicide reattempts at 6-month follow-up. Results: Before lockdown, there were an average of 11.2 psychiatric emergencies per day compared with 9.2 psychiatric emergencies per day during lockdown. Regarding suicidal behavior, before lockdown, there were an average of 0.9 suicide attempts before lockdown compared with 0.7 attempts per day during lockdown. Limitations: Since the data came from the electronic health records, we have relied on the clinical diagnosis made by different psychiatrists. Also, we did not record psychiatric comorbidities, but instead only registered one main Axis I diagnosis and one main Axis II diagnosis. Conclusions: We observed a decrease in the number of visits to the ER in general, as well as a lower frequency of patients with suicidal behavior during the first and only lockdown period in Spain, which occurred during the initial months of the pandemic. This is consistent with previous studies showing a reduction of suicidal behavior during periods of social emergency. However, this decrease could be only temporary, and several authors predict an increase of suicidal behavior in the aftermath of the COVID-19 crisis. Ensuring access to mental healthcare during periods of crisis is crucial for the population.

References

  • American Psychiatric Association. (1994). Diagnostic and statistical manual of mental disorder (DSM-IV). American Psychiatric Publishing. First citation in articleGoogle Scholar

  • Batty, G. D., Kivimäki, M., Bell, S., Gale, C. R., Shipley, M., Whitley, E., & Gunnell, D. (2018). Psychosocial characteristics as potential predictors of suicide in adults: An overview of the evidence with new results from prospective cohort studies. Translational Psychiatry, 8(1), Article 22. 10.1038/s41398-017-0072-8 First citation in articleCrossref Medline, Google Scholar

  • Borbás, R., Fehlbaum, L. V., Dimanova, P., Negri, A., Arudchelvam, J., Schnider, C. B., & Raschle, N. M. (2021). Mental well-being during the first months of Covid-19 in adults and children: Behavioral evidence and neural precursors. Scientific Reports, 11(1), Article 17595. 10.1038/s41598-021-96852-0 First citation in articleCrossref Medline, Google Scholar

  • Chevance, A., Gourion, D., Hoertel, N., Llorca, P. M., Thomas, P., Bocher, R., Moro, M. R., Laprévote, V., Benyamina, A., Fossati, P., Masson, M., Leaune, E., Leboyer, M., & Gaillard, R. (2020). Ensuring mental health care during the SARS-CoV-2 epidemic in France: A narrative review. Encephale, 46(3), 193–201. 10.1016/j.encep.2020.04.005 First citation in articleCrossref Medline, Google Scholar

  • Claassen, C. A., Carmody, T., Stewart, S. M., Bossarte, R. M., Larkin, G. L., Woodward, W. A., & Trivedi, M. H. (2010). Effect of 11 September 2001 terrorist attacks in the USA on suicide in areas surrounding the crash sites. British Journal of Psychiatry, 196(5), 359–364. 10.1192/bjp.bp.109.071928 First citation in articleCrossref Medline, Google Scholar

  • Cobo, A., Porras-Segovia, A., Pérez-Rodríguez, M. M., Artés-Rodríguez, A., Barrigón, M. L., Courtet, P., & Baca-García, E. (2021). Patients at high risk of suicide before and during a COVID-19 lockdown: Ecological momentary assessment study. BJPsych Open, 7(3), Article e82. 10.1192/bjo.2021.43 First citation in articleCrossref Medline, Google Scholar

  • Courtet, P., Olié, E., Debien, C., & Vaiva, G. (2020). Keep socially (but not physically) connected and carry on: Preventing suicide in the age of COVID-19. Journal of Clinical Psychiatry, 81(3), Article 20com13370. 10.4088/JCP.20com13370 First citation in articleCrossref, Google Scholar

  • Durkheim, E. (1966). Suicide. The Free Press. First citation in articleGoogle Scholar

  • EXPANSION. (2022). España es el país más afectado por la caída de la productividad en la pandemia [Spain is the country most affected by the drop in productivity in the pandemic]. https://www.expansion.com/economia/2020/11/10/5faa5d47468aebf41b8b468f.html First citation in articleGoogle Scholar

  • Finlay, I., & Gilmore, I. (2020). Covid-19 and alcohol-a dangerous cocktail. BMJ, 369, Article m1987. 10.1136/bmj.m1987 First citation in articleCrossref Medline, Google Scholar

  • Hawkley, L. C., & Cacioppo, J. T. (2010). Loneliness matters: A theoretical and empirical review of consequences and mechanisms. Annals of Behavioral Medicine, 40(2), 218–227. 10.1007/s12160-010-9210-8 First citation in articleCrossref Medline, Google Scholar

  • Henríquez, J., Gonzalo-Almorox, E., García-Goñi, M., & Paolucci, F. (2020). The first months of the COVID-19 pandemic in Spain. Health Policy Technol, 9(4), 560–574. 10.1016/j.hlpt.2020.08.013 First citation in articleCrossref Medline, Google Scholar

  • Irigoyen-Otiñano, M., Puigdevall-Ruestes, M., Prades-Salvador, N., Salort-Seguí, S., Gaybuo, L., de León, J., & Blasco-Fontecilla, H. (2018). Más evidencias de que los grandes repetidores se comportan como un subgrupo en la conducta suicida [Further evidence for major repeaters as a subgroup of suicide attempters]. Revista de Psiquiatria y Salud Mental, 11(1), 60–61. 10.1016/j.rpsm.2017.04.004 First citation in articleCrossref Medline, Google Scholar

  • Jeffery, M. M., D'Onofrio, G., Paek, H., Platts-Mills, T. F., Soares, W. E., Hoppe, J. A., Genes, N., Nath, B., & Melnick, E. R. (2020). Trends in emergency department visits and hospital admissions in health care systems in 5 states in the first months of the COVID-19 pandemic in the US. JAMA Internal Medicine, 180(10), 1328–1333. 10.1001/jamainternmed.2020.3288 First citation in articleCrossref Medline, Google Scholar

  • Kang, J. H., Lee, S. W., Ji, J. G., Yu, J. K., Jang, Y. D., Kim, S. J., & Kim, Y. W. (2021). Changes in the pattern of suicide attempters visiting the emergency room after COVID-19 pandemic: An observational cross sectional study. BMC Psychiatry, 21(1), Article 571. 10.1186/s12888-021-03570-y First citation in articleCrossref, Google Scholar

  • Kawohl, W., & Nordt, C. (2020). COVID-19, unemployment, and suicide. Lancet Psychiatry, 7(5), 389–390. 10.1016/S2215-0366(20)30141-3 First citation in articleCrossref Medline, Google Scholar

  • Leigh-Hunt, N., Bagguley, D., Bash, K., Turner, V., Turnbull, S., Valtorta, N., & Caan, W. (2017). An overview of systematic reviews on the public health consequences of social isolation and loneliness. Public Health, 152, 157–171. 10.1016/j.puhe.2017.07.035 First citation in articleCrossref Medline, Google Scholar

  • Liu, S., Yang, L., Zhang, C., Xiang, Y. T., Liu, Z., Hu, S., & Zhang, B. (2020). Online mental health services in China during the COVID-19 outbreak. Lancet Psychiatry, 7(4), e17–e18. 10.1016/S2215-0366(20)30077-8 First citation in articleCrossref Medline, Google Scholar

  • Marsden, J., Darke, S., Hall, W., Hickman, M., Holmes, J., Humphreys, K., Neale, J., Tucker, J., & West, R. (2020). Mitigating and learning from the impact of COVID-19 infection on addictive disorders. Addiction, 115(6), 1007–1010. 10.1111/add.15080 First citation in articleCrossref Medline, Google Scholar

  • Marshall, J. R. (1981). Political integration and the role of war in suicide. Social Forces, 59(3), 771–785. 10.2307/2578193 First citation in articleCrossref, Google Scholar

  • Moreno, C., Wykes, T., Galderisi, S., Nordentoft, M., Crossley, N., Jones, N., Cannon, M., Correll, C. U., Byrne, L., Carr, S., Chen, E. Y. H., Gorwood, P., Johnson, S., Kärkkäinen, H., Krystal, J. H., Lee, J., Lieberman, J., López-Jaramillo, C., Männikkö, M., & Arango, C. (2020). How mental health care should change as a consequence of the COVID-19 pandemic. Lancet Psychiatry, 7(9), 813–824. 10.1016/S2215-0366(20)30307-2 First citation in articleCrossref Medline, Google Scholar

  • Morselli, H. (1882). Suicide: An essay on comparative moral statistics. D. Appleton and Company, (Originally published 1881) First citation in articleGoogle Scholar

  • Osman, M., & Parnell, A. C. (2015). Effect of the first world war on suicide rates in Ireland: An investigation of the 1864-1921 suicide trends. BJPsych Open, 1(2), 164–165. 10.1192/bjpo.bp.115.000539 First citation in articleCrossref Medline, Google Scholar

  • Oyesanya, M., Lopez-Morinigo, J., & Dutta, R. (2015). Systematic review of suicide in economic recession. World Journal of Psychiatry, 5(2), 243–254. 10.5498/wjp.v5.i2.243 First citation in articleCrossref Medline, Google Scholar

  • Pirkis, J., John, A., Shin, S., Del Pozo-Banos, M., Arya, V., Analuisa-Aguilar, P., Appleby, L., Arensman, E., Bantjes, J., Baran, A., Bertolote, J. M., Borges, G., Brecic, P., Caine, E., Castelpietra, G., Chang, S. S., Colchester, D., Crompton, D., Curkovic, M., & Spittal, M. J. (2021). Suicide trends in the early months of the COVID-19 pandemic: An interrupted time-series analysis of preliminary data from 21 countries. Lancet Psychiatry, 8(7), 579–588. 10.1016/S2215-0366(21)00091-2 First citation in articleCrossref Medline, Google Scholar

  • Ramalho, R. (2020). Alcohol consumption and alcohol-related problems during the COVID-19 pandemic: A narrative review. Australasian Psychiatry, 28(5), 524–526. 10.1177/1039856220943024 First citation in articleCrossref Medline, Google Scholar

  • RTVE. (2022). Mapa del coronavirus en el mundo: casos, muertes y los últimos datos de su evolución [Map of the coronavirus in the world: Cases, deaths and the latest data on its evolution]. https://www.rtve.es/noticias/20220519/mapa-mundial-del-coronavirus/1998143.shtml First citation in articleGoogle Scholar

  • Sher, L. (2020). COVID-19, anxiety, sleep disturbances and suicide. Sleep Medicine, 70, 124. 10.1016/j.sleep.2020.04.019 First citation in articleCrossref Medline, Google Scholar

  • Steeg, S., John, A., Gunnell, D. J., Kapur, N., Dekel, D., Schmidt, L., Knipe, D., Arensman, E., Hawton, K., Higgins, J. P. T., Eyles, E., Macleod-Hall, C., McGuiness, L. A., & Webb, R. T. (2022). The impact of the COVID-19 pandemic on presentations to health services following self-harm: Systematic review. British Journal of Psychiatry, 221(4), 603–612. 10.1192/bjp.2022.79 First citation in articleCrossref Medline, Google Scholar

  • Swerdlow, B. A., Johnson, S. L., Timpano, K. R., Porter, P. A., & Dev, A. (2021). Longitudinal associations between internalizing symptoms, social behavior, and social perceptions in the initial months of the COVID-19 pandemic: Findings from a transdiagnostic community sample. Journal of Affective Disorders, 294, 805–812. 10.1016/j.jad.2021.07.093 First citation in articleCrossref Medline, Google Scholar

  • Tanaka, T., & Okamoto, S. (2021). Increase in suicide following an initial decline during the COVID-19 pandemic in Japan. Nature Human Behaviour, 5(2), 229–238. 10.1038/s41562-020-01042-z First citation in articleCrossref Medline, Google Scholar

  • Tran, T. D., Hammarberg, K., Kirkman, M., Nguyen, H. T. M., & Fisher, J. (2020). Alcohol use and mental health status during the first months of COVID-19 pandemic in Australia. Journal of Affective Disorders, 277, 810–813. 10.1016/j.jad.2020.09.012 First citation in articleCrossref Medline, Google Scholar

  • World Health Organization. (2020). Mental health and psychosocial considerations during COVID-19 outbreak. https://www.who.int/docs/default-source/coronaviruse/mental-health-considerations.pdf First citation in articleGoogle Scholar

  • World Medical Association. (2013). World Medical Association Declaration of Helsinki: Ethical principles for medical research involving human subjects. JAMA, 310(20), 2191–2194. 10.1001/jama.2013.281053 First citation in articleCrossref Medline, Google Scholar