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Schwartz SE, Ross SG, Bryant JA, Duncan JD. Mental and physical health among students at a private university that held in-person classes during the COVID-19 pandemic. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2024; 72:587-597. [PMID: 35298366 DOI: 10.1080/07448481.2022.2052074] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/08/2020] [Revised: 09/14/2021] [Accepted: 03/07/2022] [Indexed: 06/14/2023]
Abstract
OBJECTIVE The COVID-19 pandemic is expected to have serious negative consequences on mental and physical health, which may disproportionally affect young adults. The aim of this study was to understand short-term impacts on a population of students at a college that held in-person classes during the pandemic. PARTICIPANTS This study was conducted at a moderately-sized private university in the southeastern United States where approximately 75% of students were enrolled in undergraduate degree programs and 25% in graduate degree programs. METHODS A survey was created to assess anxiety and depression symptoms, psychotherapeutic medication use, healthy living, and coping skills. Links to the electronic form were distributed to students via email in Spring 2020 and Fall 2020. Participation was completely voluntary and responses were collected anonymously. RESULTS The rate of anxiety symptoms in the study cohort was higher than the national average (31%) and increased between Spring 2020 (39%) and Fall 2020 (50%). Rates of psychotherapeutic medication use also rose, with benzodiazepine use increasing from 6% to 11% and antidepressant use increasing from 16% to 20%. Compared to the national average, fewer students in the study cohort rated their overall health as "good" or better (72-76% vs. 82%). Physical exercise, nutrition, and alcohol use worsened between Spring and Fall 2020. Problem-focused engagement was associated with significantly fewer anxiety and depression symptoms. Demographic factors such as gender, race, and sexual orientation interacted with several outcomes studied. CONCLUSIONS Students at a private university that held in-person classes during the COVID-19 pandemic reported high rates of anxiety that increased between Spring and Fall 2020. Self-reported physical health was below average in Spring 2020 but improved in Fall 2020. Appropriate identification and management of the effects of pandemic-related stressors is critical during this uncertain time. Supplemental data for this article can be accessed online at https://doi.org/10.1080/07448481.2022.2052074 .
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Affiliation(s)
- Shaina E Schwartz
- Department of Clinical Sciences, High Point University Fred Wilson School of Pharmacy, One University Parkway, High Point, North Carolina, USA
| | - Sarah G Ross
- Department of Psychology, High Point University David R. Hayworth College of Arts and Sciences, One University Parkway, High Point, North Carolina, USA
| | - Joseph A Bryant
- Department of Clinical Sciences, High Point University Fred Wilson School of Pharmacy, One University Parkway, High Point, North Carolina, USA
| | - Jenna D Duncan
- Department of Psychology, High Point University David R. Hayworth College of Arts and Sciences, One University Parkway, High Point, North Carolina, USA
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2
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Sürme Y, Özmen N, Ertürk Arik B. Fear of COVID-19 and Related Factors in Emergency Department Patients. Int J Ment Health Addict 2023; 21:28-36. [PMID: 34220384 PMCID: PMC8241404 DOI: 10.1007/s11469-021-00575-2] [Citation(s) in RCA: 13] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/15/2021] [Indexed: 02/07/2023] Open
Abstract
This study was aimed to determine the fear of COVID-19 and related factors in patients. This study was conducted with 639 patients who were admitted to the emergency department. Data were collected using the sociodemographic characteristics form, Fear of COVID-19 scale (FCV-19S). The data were evaluated with Student's t-test to compare two groups and one-way ANOVA and post hoc Tukey's honestly significant difference (HSD) more than two groups. Multiple linear regression analysis was used to determine the relationship between dependent and independent variables. The mean age of patients was 46.12 ± 17.02, 53.4% were male, 70.7% were married, 42.4% had a chronic disease, 18.3% stated that they had symptoms of COVID-19, and 38.0% stated that they experienced economic difficulties due to COVID-19. The COVID-19 fear scores were significantly higher in 57 ages and over, female, had lung disease, had COVID-19 symptoms, and had children. Having a lung disease, female gender, and fear of COVID-19 were statistically significantly correlated with FCV-19S scores. As a result, it was determined that patients admitted to the emergency department had fear of COVID-19. Further research is recommended to support our study findings. As an emergency nurse, strategies must be developed to cope with these fears.
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Affiliation(s)
- Yeliz Sürme
- Department of Nursing, Faculty of Health Sciences, Erciyes University, Kayseri, Turkey
| | - Nurten Özmen
- Emergency Room Nurse, Tomarza Yaşar Karayel State Hospital, Kayseri, Turkey
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3
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Karl S, Schönfeldt-Lecuona C, Sartorius A, Grözinger M. Provision of Electroconvulsive Therapy During the COVID-19 Pandemic: A Survey Among Clinics in Germany, Austria, and Switzerland. J ECT 2022; 38:205-210. [PMID: 35462387 PMCID: PMC9426313 DOI: 10.1097/yct.0000000000000846] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/04/2021] [Accepted: 01/29/2022] [Indexed: 11/25/2022]
Abstract
ABSTRACT The coronavirus disease 2019 (COVID-19) pandemic has had a marked impact on psychiatry. Capacity reductions also affected electroconvulsive therapy (ECT), even though ECT is an essential rather than an elective procedure. We sent a survey to all 197 clinics in Germany, Austria, and Switzerland with an ECT service between March and May 2021 to provide an overview of the changes made to ECT services in these countries during the acute phase of the COVID-19 pandemic. More than a quarter of the clinics (27.0%) reported a temporary suspension of all ECT treatments, and 28.2% of the clinics reported reductions of up to 75%. Maintenance ECT was suspended in 46.7% of the clinics and reduced by up to 75% in 30.6% of the clinics. At the time of the survey, 40.8% of the clinics still reported lower numbers of ECT treatments compared with the prepandemic situation. Reasons for the reduced number of ECT treatments included patient safety and testing measures, personnel shortages in the anesthesiology departments, and limited availability of rooms. The COVID-19 pandemic had and continues to have a marked negative impact on the provision of ECT in clinics in Germany, Austria, and Switzerland. To avoid negative consequences for patients, ECT clinics should urgently take steps to provide ECT services without disruptions.
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Affiliation(s)
- Sebastian Karl
- From the Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim
| | | | - Alexander Sartorius
- From the Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim
| | - Michael Grözinger
- Department of Psychiatry, Psychotherapy and Psychosomatics, Faculty of Medicine, RWTH Aachen, Aachen, Germany
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4
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Penner F, Rajesh A, Kinney KL, Mabus KL, Barajas KG, McKenna KR, Lim CS. Racial and demographic disparities in emergency department utilization for mental health concerns before and during the COVID-19 pandemic. Psychiatry Res 2022; 310:114442. [PMID: 35219262 PMCID: PMC8840823 DOI: 10.1016/j.psychres.2022.114442] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/20/2021] [Revised: 02/06/2022] [Accepted: 02/11/2022] [Indexed: 11/29/2022]
Abstract
This study investigated whether emergency department (ED) visits for mental health concerns increased during the COVID-19 pandemic, taking a health disparities lens. ED encounters from the only academic medical center in Mississippi were extracted from March-December 2019 and 2020, totaling 2,842 pediatric (ages 4-17) and 17,887 adult (ages 18-89) patients. Visits were coded based on primary ED diagnosis. For adults, there were fewer depression/anxiety ED visits during the pandemic, not moderated by any demographic factor, but no differences for serious mental illness or alcohol/substance use. For youth, there were significantly fewer ED visits for behavior problems during the pandemic among children in the lower socioeconomic status (SES) category; there were no differences for depression/anxiety. Regardless of year, adults in the lower SES category were more likely to visit the ED for mental health, Black adults were less likely to visit the ED for depression/anxiety or alcohol/substance use, and Black children were less likely to visit the ED for behavioral concerns. Results suggest that access to outpatient and telehealth services remains critical for mental health care during the pandemic and underline the importance of race- and SES-related factors in use of the ED for mental health concerns beyond the pandemic.
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Affiliation(s)
- Francesca Penner
- Department of Psychiatry and Human Behavior, University of Mississippi Medical Center, Jackson, MS, United States; Child Study Center, Yale School of Medicine, New Haven, CT, United States.
| | - Aishwarya Rajesh
- Department of Psychiatry and Human Behavior, University of Mississippi Medical Center, Jackson, MS, United States,Department of Radiology, Washington University School of Medicine, St. Louis, MO, United States
| | - Kerry L. Kinney
- Department of Psychiatry and Human Behavior, University of Mississippi Medical Center, Jackson, MS, United States
| | - Kara L. Mabus
- Department of Psychiatry and Human Behavior, University of Mississippi Medical Center, Jackson, MS, United States
| | - Kimberly G. Barajas
- Department of Psychiatry and Human Behavior, University of Mississippi Medical Center, Jackson, MS, United States,Psychiatry and Behavioral Medicine, Seattle Children's Hospital, Seattle, WA, United States
| | - Kevin R. McKenna
- Department of Psychiatry and Human Behavior, University of Mississippi Medical Center, Jackson, MS, United States,VA Palo Alto Health Care System, Palo Alto, CA, United States
| | - Crystal S. Lim
- Department of Psychiatry and Human Behavior, University of Mississippi Medical Center, Jackson, MS, United States
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5
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Lam KKW, Ho KY, Wu CST, Tong MN, Tang LN, Mak YW. Exploring Factors Contributing to the Smoking Behaviour among Hong Kong Chinese Young Smokers during COVID-19 Pandemic: A Qualitative Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19074145. [PMID: 35409831 PMCID: PMC8998443 DOI: 10.3390/ijerph19074145] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/10/2022] [Revised: 03/29/2022] [Accepted: 03/29/2022] [Indexed: 02/04/2023]
Abstract
COVID-19 has significant impacts on young smokers in their smoking behaviors. This qualitative study summarises the lived experience of young smokers during COVID-19. Moreover, through their lived experience, we aim to understand how the COVID-19 pandemic influence tobacco use behaviours in this population. A purposive sampling of 48 smokers aged between 17–25 years old is individually interviewed for 30 to 45 min. All interviews are transcribed in verbatim and analysed by two researchers separately using Colaizzi’s method of descriptive phenomenology. The results reveal the following six important themes, which could explain the mixed pattern of smoking behaviour changes in young smokers: (1) perceptions of COVID-19 and its association with smoking, (2) more time at home, (3) taking masks off to smoke, (4) the effects of COVID-19 on smokers’ financial status and academic performance, (5) reduced social gatherings, and (6) restricted access to tobacco products. To conclude, this pandemic and the anti-pandemic measures, i.e., mask mandates, stay-at-home and work-from-home orders, and class suspension, result in both new obstacles and new advantages for smoking cessation among young people. More studies should be performed to monitor any transition of tobacco products and the trajectory of use in this population during this pandemic, thus informing public health policy making.
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Affiliation(s)
| | - Ka-Yan Ho
- Correspondence: ; Tel.: +852-27666417
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6
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Kim J, Rim SJ, Jo M, Lee MG, Park S. The Trend of Psychiatric Visits and Psychiatric Medication Prescription Among People Tested for SARS-CoV-2 During the Initial Phase of COVID-19 Pandemic in South Korea. Psychiatry Investig 2022; 19:61-71. [PMID: 35086193 PMCID: PMC8795598 DOI: 10.30773/pi.2021.0247] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2021] [Accepted: 11/27/2021] [Indexed: 11/27/2022] Open
Abstract
OBJECTIVE The objective of this study was to monitor the trend of psychiatric visits and medication prescriptions among people tested for SARS-CoV-2 during the initial phase of coronavirus disease 2019 (COVID-19) pandemic in South Korea. METHODS We conducted a population-based cohort study using data from the National Health Insurance Service (NHIS) linked to the Korea Disease Control and Prevention Agency (KDCA) data. The overall trend of psychiatric visits during COVID-19 for each month was compared to the month prior to COVID-19. The number of psychiatric medication prescription records was monitored from January 2019 to May 2020. RESULTS A total of 212,678 individuals were tested for SARS-CoV-2 between January 2020 and May 2020. Among these individuals, 72.1% (n=153,309) did not have pre-existing mental illness, and 27.9% (n=59,369) had pre-existing mental illness. We found that most psychiatric visits were made in March, and patients without pre-existing mental illness significantly increased in psychiatric outpatients during the COVID-19 pandemic (p trend<0.001). In addition, psychiatric medication prescriptions were the most prescribed between March and April 2020. CONCLUSION We identified a rising trend in psychiatric visits and medication prescriptions among people who were tested for SARSCoV-2 during the initial phase of COVID-19 pandemic in South Korea.
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Affiliation(s)
- Jungeun Kim
- Department of Research Planning, Mental Health Research Institute, National Center for Mental Health, Seoul, Republic of Korea
| | - Soo Jung Rim
- Department of Research Planning, Mental Health Research Institute, National Center for Mental Health, Seoul, Republic of Korea
| | - Minkyung Jo
- Department of Research Planning, Mental Health Research Institute, National Center for Mental Health, Seoul, Republic of Korea
| | - Min Geu Lee
- Department of Research Planning, Mental Health Research Institute, National Center for Mental Health, Seoul, Republic of Korea
| | - Subin Park
- Mental Health Research Institute, National Center for Mental Health, Seoul, Republic of Korea
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7
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Hoorelbeke K, Sun X, Koster EHW, Dai Q. Connecting the dots: A network approach to post‐traumatic stress symptoms in Chinese healthcare workers during the peak of the Coronavirus Disease 2019 outbreak. Stress Health 2021; 37:692-705. [PMID: 33434296 PMCID: PMC8013316 DOI: 10.1002/smi.3027] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/30/2020] [Revised: 12/17/2020] [Accepted: 12/31/2020] [Indexed: 12/29/2022]
Abstract
Healthcare workers are at elevated risk to develop symptoms of post-traumatic stress disorder (PTSD) in response to an outbreak of a highly infectious disease. The current study set-out to model the complex interrelations between PTSD symptoms during the peak of the Coronavirus Disease 2019 outbreak in 291 Chinese healthcare workers and 291 matched control cases that were selected from the general population. For this purpose, we estimated regularized partial correlation networks. Within the network of healthcare workers, we observed a central role for avoidance of reminders of the traumatic event, physiological cue reactivity, anger/irritability, re-experiencing, and startle. We identified three clusters of closely interconnected PTSD symptoms in healthcare workers, consisting of (a) symptoms of re-experiencing and anxious arousal, (b) symptoms of avoidance and amnesia and (c) symptoms of emotional numbing and dysphoric arousal. Respectively, startle, avoidance of reminders and feeling detached emerged as bridging nodes in these communities. Although yielding highly similar network models, the PTSD symptom structure of healthcare workers showed several unique features compared to the matched control sample. This is informative for interventions aimed at targeting PTSD symptoms in healthcare workers in the context of a public health emergency.
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Affiliation(s)
- Kristof Hoorelbeke
- Department of Experimental Clinical and Health PsychologyGhent UniversityGhentBelgium
| | - Xiaoxiao Sun
- Educational Center of Mental HealthArmy Medical UniversityChongqingChina
| | - Ernst H. W. Koster
- Department of Experimental Clinical and Health PsychologyGhent UniversityGhentBelgium
| | - Qin Dai
- Educational Center of Mental HealthArmy Medical UniversityChongqingChina
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8
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McDowell MJ, Fry CE, Nisavic M, Grossman M, Masaki C, Sorg E, Bird S, Smith F, Beach SR. Evaluating the association between COVID-19 and psychiatric presentations, suicidal ideation in an emergency department. PLoS One 2021; 16:e0253805. [PMID: 34191850 PMCID: PMC8244888 DOI: 10.1371/journal.pone.0253805] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2021] [Accepted: 06/13/2021] [Indexed: 12/24/2022] Open
Abstract
OBJECTIVE To estimate the association between COVID-19 and Emergency Department (ED) psychiatric presentations, including suicidal ideation. METHODS Using an interrupted time series design, we analyzed psychiatric presentations using electronic health record data in an academic medical center ED between 2018 and 2020. We used regression models to assess the association between the onset of the COVID-19 outbreak and certain psychiatric presentations. The period February 26-March 6, 2020 was used to define patterns in psychiatric presentations before and after the coronavirus outbreak. RESULTS We found a 36.2% decrease (unadjusted) in ED psychiatric consults following the coronavirus outbreak, as compared to the previous year. After accounting for underlying trends, our results estimate significant differential change associated with suicidal ideation and substance use disorder (SUD) presentations following the outbreak. Specifically, we noted a significant differential increase in presentations with suicidal ideation six weeks after the outbreak (36.4 percentage points change; 95% CI: 5.3, 67.6). For presentations with SUD, we found a differential increase in the COVID-19 time series relative to the comparison time series at all post-outbreak time points and this differential increase was significant three weeks (32.8 percentage points; 95% CI: 4.0, 61.6) following the outbreak. Our results estimate no differential changes significant at the P value < 0.05 level associated with affective disorder or psychotic disorder presentations in the COVID-19 time series relative to the comparator time series. CONCLUSIONS The COVID-19 outbreak in Boston was associated with significant differential increases in ED presentations with suicidal ideation and SUD.
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Affiliation(s)
- Michal J. McDowell
- Department of Psychiatry, Massachusetts General Hospital, Boston, MA, United States of America
- McLean Hospital, Belmont, MA, United States of America
| | - Carrie E. Fry
- Department of Health Policy, Vanderbilt University School of Medicine, Nashville, TN, United States of America
| | - Mladen Nisavic
- Department of Psychiatry, Massachusetts General Hospital, Boston, MA, United States of America
| | - Mila Grossman
- Department of Psychiatry, Massachusetts General Hospital, Boston, MA, United States of America
- McLean Hospital, Belmont, MA, United States of America
| | - Charles Masaki
- Department of Psychiatry, Massachusetts General Hospital, Boston, MA, United States of America
- McLean Hospital, Belmont, MA, United States of America
| | - Emily Sorg
- Department of Psychiatry, Massachusetts General Hospital, Boston, MA, United States of America
| | - Suzanne Bird
- Department of Psychiatry, Massachusetts General Hospital, Boston, MA, United States of America
| | - Felicia Smith
- Department of Psychiatry, Massachusetts General Hospital, Boston, MA, United States of America
| | - Scott R. Beach
- Department of Psychiatry, Massachusetts General Hospital, Boston, MA, United States of America
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The Perceived Impact of COVID-19 among Treatment-Seeking Smokers: A Mixed Methods Approach. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18020505. [PMID: 33435462 PMCID: PMC7826630 DOI: 10.3390/ijerph18020505] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/30/2020] [Revised: 01/04/2021] [Accepted: 01/06/2021] [Indexed: 12/11/2022]
Abstract
The consequences of the COVID-19 pandemic on behavioral health, including tobacco use, are not fully known. The current study sought to measure the perceived impact of COVID-19 and the resulting stay-at-home orders in Philadelphia, Pennsylvania and Buffalo, New York on smokers enrolled in four smoking cessation trials between March 2020 and July 2020. The survey collected quantitative data regarding life changes due to COVID-19, health/exposure status, and the impact on their cessation attempt (e.g., motivation to quit, change in triggers). The questionnaire collected qualitative data to better understand how such changes could explain changes in smoking behavior. Of the 42 participants surveyed, approximately half indicated that COVID-19 changed their motivation and ability to quit or remain quit. Among those who reported that it was easier to quit following the stay-at-home orders (n = 24), most attributed this to concerns regarding the severity of COVID-19 among smokers. Among those who reported more difficulty quitting (n = 15), most attributed this to their increased stress due to the pandemic and the inability to access activities, places, or people that could help them manage triggers. Given public health warnings of continued surges in COVID-19, these data provide insight into who may benefit from further smoking cessation support should existing restrictions or new stay-at-home orders be enacted.
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Natafgi N, Childers C, Pollak A, Blackwell S, Hardeman S, Cooner S, Bank R, Ratliff B, Gooch V, Rogers K, Narasimhan M. Beam Me Out: Review of Emergency Department Telepsychiatry and Lessons Learned During COVID-19. Curr Psychiatry Rep 2021; 23:72. [PMID: 34613436 PMCID: PMC8493776 DOI: 10.1007/s11920-021-01282-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/28/2021] [Indexed: 02/06/2023]
Abstract
PURPOSE OF REVIEW The aim of this review is to critically evaluate recent literature on the use of telepsychiatry in emergency departments (EDTP) and synthesize the evidence on telepsychiatry during public health emergencies. We also report on experiences and success stories from a state-wide EDTP program in South Carolina during the COVID-19 pandemic. RECENT FINDINGS We identified 12 peer-reviewed articles published between January 2019 and February 2021 that evaluated EDTP interventions and their impact on patient outcomes. The recent evidence on EDTP shows a significant association between EDTP implementation or use and decreased patients' wait time in emergency department (ED), shorter length of stay in certain settings, reduced ED revisit rates, improved ED patient disposition (e.g., more discharge to home, less observational stays, and decreased inpatient admissions), and reduced follow-up encounters involving self-harm diagnosis. The EDTP virtual delivery model can help healthcare systems reduce burden of public health emergencies on providers, staff, and patients alike. While a disruption of magnitude seen by COVID-19 may be infrequent, strategies used during the pandemic may be implemented to enhance care in rural settings, and/or enhance preparedness of communities and healthcare systems during more commonly occurring natural disasters.
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Affiliation(s)
- Nabil Natafgi
- grid.254567.70000 0000 9075 106XHealth Services Policy & Management, Arnold School of Public Health, University of South Carolina, Columbia, SC USA
| | - Casey Childers
- grid.254567.70000 0000 9075 106XDepartment of Neuropsychiatry and Behavioral Science, School of Medicine, University of South Carolina, Columbia, SC USA ,grid.413319.d0000 0004 0406 7499Prisma Health - Midlands, SC Columbia, USA
| | - Amanda Pollak
- grid.254567.70000 0000 9075 106XDepartment of Neuropsychiatry and Behavioral Science, School of Medicine, University of South Carolina, Columbia, SC USA ,grid.413319.d0000 0004 0406 7499Prisma Health - Midlands, SC Columbia, USA
| | - Shanikque Blackwell
- grid.254567.70000 0000 9075 106XHealth Services Policy & Management, Arnold School of Public Health, University of South Carolina, Columbia, SC USA
| | - Suzanne Hardeman
- Department of Neuropsychiatry and Behavioral Science, School of Medicine, University of South Carolina, Columbia, SC, USA. .,Prisma Health - Midlands, SC, Columbia, USA.
| | - Stewart Cooner
- grid.414236.60000 0004 0604 0521South Carolina Department of Mental Health, Columbia, SC USA
| | - Robert Bank
- grid.414236.60000 0004 0604 0521South Carolina Department of Mental Health, Columbia, SC USA
| | - Brenda Ratliff
- grid.414236.60000 0004 0604 0521South Carolina Department of Mental Health, Columbia, SC USA
| | - Victoria Gooch
- grid.414236.60000 0004 0604 0521South Carolina Department of Mental Health, Columbia, SC USA
| | - Kenneth Rogers
- grid.414236.60000 0004 0604 0521South Carolina Department of Mental Health, Columbia, SC USA
| | - Meera Narasimhan
- grid.254567.70000 0000 9075 106XDepartment of Neuropsychiatry and Behavioral Science, School of Medicine, University of South Carolina, Columbia, SC USA ,grid.413319.d0000 0004 0406 7499Prisma Health - Midlands, SC Columbia, USA
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11
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Munich J, Dennett L, Swainson J, Greenshaw AJ, Hayward J. Impact of Pandemics/Epidemics on Emergency Department Utilization for Mental Health and Substance Use: A Rapid Review. Front Psychiatry 2021; 12:615000. [PMID: 33716818 PMCID: PMC7943839 DOI: 10.3389/fpsyt.2021.615000] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/07/2020] [Accepted: 01/25/2021] [Indexed: 12/31/2022] Open
Abstract
Background: A prolonged COVID-19 pandemic has the potential to trigger a global mental health crisis increasing demand for mental health emergency services. We undertook a rapid review of the impact of pandemics and epidemics on emergency department utilization for mental health (MH) and substance use (SU). Objective: To rapidly synthesize available data on emergency department utilization for psychiatric concerns during COVID-19. Methods: An information specialist searched Medline, Embase, Psycinfo, CINAHL, and Scopus on June 16, 2020 and updated the search on July 24, 2020. Our search identified 803 abstracts, 7 of which were included in the review. Six articles reported on the COVID-19 pandemic and one on the SARS epidemic. Results: All studies reported a decrease in overall and MH related ED utilization during the early pandemic/epidemic. Two studies found an increase in SU related visits during the same period. No data were available for mid and late stage pandemics and the definitions for MH and SU related visits were inconsistent across studies. Conclusions: Our results suggest that COVID-19 has resulted in an initial decrease in ED visits for MH and an increase in visits for SU. Given the relative paucity of data on the subject and inconsistent analytic methods used in existing studies, there is an urgent need for investigation of pandemic-related changes in ED case-mix to inform system-level change as the pandemic continues.
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Affiliation(s)
- Julie Munich
- Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada
| | - Liz Dennett
- Scott Health Sciences Library, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada
| | - Jennifer Swainson
- Department of Psychiatry, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada
| | - Andrew J Greenshaw
- Department of Psychiatry, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada
| | - Jake Hayward
- Department of Emergency Medicine, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada
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12
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Davis SE, Greevy RA, Lasko TA, Walsh CG, Matheny ME. Detection of calibration drift in clinical prediction models to inform model updating. J Biomed Inform 2020; 112:103611. [PMID: 33157313 PMCID: PMC8627243 DOI: 10.1016/j.jbi.2020.103611] [Citation(s) in RCA: 45] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2020] [Revised: 10/21/2020] [Accepted: 10/29/2020] [Indexed: 10/23/2022]
Abstract
Model calibration, critical to the success and safety of clinical prediction models, deteriorates over time in response to the dynamic nature of clinical environments. To support informed, data-driven model updating strategies, we present and evaluate a calibration drift detection system. Methods are developed for maintaining dynamic calibration curves with optimized online stochastic gradient descent and for detecting increasing miscalibration with adaptive sliding windows. These methods are generalizable to support diverse prediction models developed using a variety of learning algorithms and customizable to address the unique needs of clinical use cases. In both simulation and case studies, our system accurately detected calibration drift. When drift is detected, our system further provides actionable alerts by including information on a window of recent data that may be appropriate for model updating. Simulations showed these windows were primarily composed of data accruing after drift onset, supporting the potential utility of the windows for model updating. By promoting model updating as calibration deteriorates rather than on pre-determined schedules, implementations of our drift detection system may minimize interim periods of insufficient model accuracy and focus analytic resources on those models most in need of attention.
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Affiliation(s)
- Sharon E Davis
- Department of Biomedical Informatics, Vanderbilt University Medical Center, Nashville, TN, USA.
| | - Robert A Greevy
- Department of Biostatistics, Vanderbilt University Medical Center, Nashville, TN, USA.
| | - Thomas A Lasko
- Department of Biomedical Informatics, Vanderbilt University Medical Center, Nashville, TN, USA.
| | - Colin G Walsh
- Department of Biomedical Informatics, Vanderbilt University Medical Center, Nashville, TN, USA; Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, USA; Department of Psychiatry, Vanderbilt University Medical Center, Nashville, TN, USA.
| | - Michael E Matheny
- Department of Biomedical Informatics, Vanderbilt University Medical Center, Nashville, TN, USA; Department of Biostatistics, Vanderbilt University Medical Center, Nashville, TN, USA; Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, USA; Geriatrics Research, Education, and Clinical Care, Tennessee Valley Healthcare System VA, Nashville, TN, USA.
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13
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Affiliation(s)
- Dost Öngür
- McLean Hospital, Belmont, Massachusetts
- Editor
| | - Roy Perlis
- McLean Hospital, Belmont, Massachusetts
- Associate Editor
| | - Donald Goff
- Department of Psychiatry, NYU Medical Center, New York, New York
- Associate Editor
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