Schizophrenia cases in emergency went up during lockdown, reveals PGIMER study

There was an increase in the proportion of patients diagnosed with schizophrenia in emergency settings during the lockdown, a study conducted by the Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, has revealed. Schizophrenia is a type of mental illness characterised by distortions in thinking, perception, emotions, language, sense of self, and behaviour.

For the purpose of the study, records of all patients attending Psychiatry Emergency Services from January 1 to July 25, 2020 were retrieved. Comparisons were made between the patient profile before the imposition of the nationwide lockdown from January 1, 2020 to March 23, 2020 (83 days) and after the imposition of the lockdown from March 24, 2020, to July 25, 2020 (123 days). A longer duration was considered for the lockdown period to ensure an equal sample size in both groups.

Reduction in proportion of patients diagnosed with delirium

The study found that during the pre-lockdown period, delirium (an acute state of confusion due to underlying physical illnesses) was the most common psychiatric diagnosis in emergency settings. Previous studies from the same centre had also found delirium to be the most common psychiatric diagnosis in such settings.

However, when the diagnostic profile of patients attending emergency services during the lockdown period was evaluated, it was seen that there was a significant reduction in the proportion of patients diagnosed with delirium.

“This significant reduction, possibly reflects, reduction in the number of patients with severe physical illnesses, attending the emergency services, as delirium is usually seen in the background of a physical decompensation,” the study states.

Many patients experience a relapse

The study suggests that there was an increase in the proportion of patients with a diagnosis of schizophrenia, availing the emergency services, during the lockdown period. This finding suggests that, in the absence of routine regular services, possibly many patients with schizophrenia experienced a relapse of symptoms and presented to the emergency services.

“There could be many reasons for relapse, such as difficulty in procuring, purchasing the medication, an increase in the level of stress, and an adverse household environment,” the study evaluated.

The Psychiatry Emergency Services caters to patients attending medical, surgical, trauma, as well as paediatric services. Before the Covid-19 pandemic, patients referred from the out-patient services for urgent care, other hospitals, as well as those coming by self-referrals were seen in the emergency services. During the lockdown period, after the onset of the Covid-19 pandemic, mostly only those patients requiring emergency care, referred from other hospitals, or those who attended on their own, or those initially seen in the telepsychiatry services and considered to require emergency care were attended.

Source: Read Full Article