The COVID-19 pandemic has affected mental health globally, but the impact on referrals and admissions to mental health services remains understudied.

To assess patterns in psychiatric admissions, referrals, and suicidal behavior before and during the COVID-19 pandemic in Denmark.

Utilizing hospital and Emergency Medical Services (EMS) health records covering 46% of the Danish population, we compared psychiatric in-patients, referrals to mental health services and suicidal behavior in years prior to the COVID-19 pandemic to levels during the first lockdown (March 11 – May 17, 2020), inter-lockdown period (May 18 – December 15, 2020), and second lockdown (December 16, 2020 – February 28, 2021) using negative binomial models.

The rate of psychiatric in-patients declined compared to pre-pandemic levels (RR = 0.95, 95% CI = 0.94 – 0.96, p < 0.01). Referrals were not significantly different (RR = 1.01, 95% CI = 0.92 – 1.10, p = 0.91) during the pandemic; neither was suicidal behavior among hospital contacts (RR = 1.04, 95% CI = 0.94 – 1.14, p = 0.48) nor EMS contacts (RR = 1.08, 95% CI = 1.00 – 1.18, p = 0.06). In the age group <18, an increase in the rate of psychiatric in-patients (RR = 1.11, 95% CI = 1.07 – 1.15, p < 0.01) was observed during the pandemic; however, this did not exceed the pre-pandemic, upwards trend in psychiatric hospitalizations in the age group <18 (p = 0.78).

The pandemic was associated with a decrease in psychiatric hospitalizations. No significant change was observed in referrals and suicidal behavior.

No significant relationships.

This study aimed to describe the impact of the coronavirus disease (COVID-19) pandemic on emergency department (ED) admissions for urgent diagnoses.

From January 1, 2019, until December 31, 2020, patients older than 18 years who attended the ED at University Hospital of Leuven (UZ Leuven, Belgium) were included. Urgent diagnoses selected in the First Hour Quintet were collected. The periods of the pandemic waves in 2020 were analyzed and compared with the same time period in 2019.

During the first wave of the pandemic, 16 075 patients attended the ED compared with 16 893 patients during the comparison period in 2019. The proportion of patients having one of the diagnoses of the First Hour Quintet was similar between the periods (4.4% vs 4.5%). During the second wave, 14 739 patients attended the ED compared with 18 704 patients during the same period in 2019; 5.6% of patients had a diagnosis of the First Hour Quintet compared with 4.3% of patients in the comparison period.

This study showed a decrease in the number of patients attending the ED during the COVID-19 pandemic. Further studies are needed to determine for which conditions patients visited the ED less.

The UK went into nationwide lockdown on 24 March 2020, in response to COVID-19. The direct psychiatric effects of this are relatively unknown.

We examined whether the first UK lockdown changed the demographics of patients admitted to psychiatric hospitals (to include gender, legality, route of admission and diagnoses), independent of seasonal variation..

We conducted an anonymous review of psychiatric admissions aged ≥18 years in the 6-month period after the announcement of the first UK lockdown (March to August 2020), and in the previous year (March to August 2019), in Kent and Medway NHS and Social Care Partnership Trust in-patient facilities. The number of admissions were compared, along with factors that may help to explain the psychological effects of national lockdown.

There was no significant increase in total number of admissions or the gender percentage. However, there was a 11.8% increase in formal sectioning under the Mental Health Act 1983. This increase was sustained and statistically significant across all 6 months. A sustained decrease in admissions via the crisis team was also observed as being statistically significant. Separate diagnoses saw changes in percentage of admissions between March and May. The most statistically significant was schizophrenia admissions for men in April (18.7%), and women in March (18.4%).

Our findings highlight the effect of COVID-19 on the legal status of psychiatric admissions, and emphasise the importance of having a robust, adaptable and open psychiatric service that caters to the ongoing needs of patients, regardless of government restrictions.

Lay opinions and published papers alike suggest mood varies with the seasons, commonly framed as higher rates of depression mood in winter. Memory and confirmation bias may have influenced previous studies. We therefore systematically searched for and reviewed studies on the topic, but excluded study designs where explicit referrals to seasonality were included in questions, interviews or data collection.

Systematic literature search in Cochrane database, DARE, Medline, Embase, PsychINFO and CINAHL, reporting according to the PRISMA framework, and study quality assessment using the Newcastle-Ottawa scale. Two authors independently assessed each study for inclusion and quality assessment. Due to large heterogeneity, we used a descriptive review of the studies.

Among the 41 included studies, there was great heterogeneity in regards to included symptoms and disorder definitions, operationalisation and measurement. We also observed important heterogeneity in how definitions of ‘seasons’ as well as study design, reporting and quality. This heterogeneity precluded meta-analysis and publication bias analysis. Thirteen of the studies suggested more depression in winter. The remaining studies suggested no seasonal pattern, seasonality outside winter, or inconclusive results.

The results of this review suggest that the research field of seasonal variations in mood disorders is fragmented, and important questions remain unanswered. There is some support for seasonal variation in clinical depression, but our results contest a general population shift towards lower mood and more sub-threshold symptoms at regular intervals throughout the year. We suggest future research on this issue should be aware of potential bias by design and take into account other biological and behavioural seasonal changes that may nullify or exacerbate any impact on mood.

The mandatory clinical radiotherapy department visit undertaken by potential applicants aims to provide understanding of the profession and therefore reduce attrition. Increasing pressure on clinical departments makes visits a logistical challenge. This additional step may also present as an unnecessary barrier to applicants. With no evidence relating to visits, this study aimed to explore the perceptions of both students and clinical educators concerning potential benefits and challenges.

A focus group interview method was used to gather in-depth qualitative data concerning the clinical department visit experiences from first-year undergraduate students and clinical educators.

Three themes emerged from the student focus groups: the perceived purpose of the clinical visit, the visit content and the outcomes and impact arising from the visit. Clinical educator data also followed these themes in addition to ‘logistical impact’ theme.

The clinical visit has value to applicants in affirming their decision to study radiotherapy. There is variation in expectation and content for these visits and they are logistically challenging. Nationally agreed guidelines for visit structure and content could improve visit efficiency and effectiveness. A national clinical visit form may reduce workload for educators and applicants.

The purpose of this paper has been to identify and describe the demographic, social and clinical characteristics of persons admitted to an Irish district lunatic asylum in the late 19th century as exemplified by the records of the Sligo District Lunatic Asylum. Some 21st century comparisons and epidemiological considerations from the same catchment area have been attempted.

The register entries and case books of a series of consecutive admissions to Sligo District Asylum during the decade 1892–1901 were surveyed in the Irish National Archive.

Most admitted patients were of lower socio-economic status, the majority male, poorly literate, unmarried and described as suffering from mania or melancholia. Most were first admissions. The predominant (62.5%) reason given for admission was for assault or threat of assault. These admissions were by order of the Lord Lieutenant as ‘dangerous lunatics’. Although it may be maintained that this admission process was a device of social convenience to maintain the peace and integrity of local communities and the convenience of families, clinical information indicates that the majority of admissions had symptoms of mental disorder recognisable in terms of 21st century psychiatric diagnostics.

Traditional strategies to determine hospital bed surge capacity have relied on cross-sectional hospital census data, which underestimate the true surge capacity in the event of a mass-casualtyincident.

To determine hospital bed surge capacity for the County more accurately using physician and nurse manager assessments for the disposition of all in-patients at multiple facilities.

Overnight- and day-shift nurse managers from each in-patient unit at four different hospitals were approached to make assessments for each patient as to their predicted disposition at 2, 24, and 72 hours post-event in the case of a mass-casualty incident, including transfer to a hypothetical, onsite nursing facility. Physicians at the two academic institutions also were approached for comparison. Age, gender, and admission diagnosis also were recorded for each patient.

A total of 1,741 assessments of 788 patients by 82 nurse managers aabnd 25 physicians from the four institutions were included. Nurse managers assessed approximately one-third of all patients as dischargeable at 24 hours and approximately one-half at 72 hours; one-quarter of the patients were assessed as being transferable to a hypothetical, on-site nursing facility at both time points. Physicians were more likely than werenurse managers to send patients to such a facility or discharge them, but less likely to transfer patients outof the intensive care unit (ICU). Inter-facility variability was explained by differences in the distribution of patient diagnoses.

A large proportion of in-patients can be discharged within 24 and 72 hours in the event of a mass-casualty incident (MCI). Additional beds can be made available if an on-site nursing facility is made available. Both physicians and nurse managers should be included on the team that makes patient dispositions in the event of a MCI.

This article characterizes the epidemiological outcomes, resource utilization, and time course of emergency needs in mass-casualty, terrorist bombings producing 30 or more casualties.

Eligible bombings were identified using a MEDLINE search of articles published between 1996 and October 2002 and a manual search of published references. Mortality, injury frequency, injury severity, emergency department (ED) utilization, hospital admission, and time interval data were abstracted and relevant rates were determined for each bombing. Median values for the rates and the inter-quartile ranges (IQR) were determined for bombing subgroups associated with: (1) vehicle delivery; (2) terrorist suicide; (3) confined-space setting; (4) open-air setting; (5) structural collapse sequela; and (6) structural fire sequela.

Inclusion criteria were met by 44 mass-casualty, terrorist bombings reported in 61 articles. Median values for the immediate mortality rates and IQRs were: vehicle-delivery, 4% (1–25%); terrorist-suicide, 19% (7–44%); confined-space 4% (1–11%); open-air, 1% (0–5%); structural-collapse, 18% (5–26%); structural fire 17% (1–17%); and overall, 3% (1–14%). A biphasic pattern of mortality and unique patterns of injury frequency were noted in all subgroups. Median values for the hospital admission rates and IQRs were: vehicle-delivery, 19% (14–50%); terrorist-suicide, 58% (38–77%); confined-space, 52% (36–71%); open-air, 13% (11–27%); structural-collapse, 41% (23–74%); structural-fire, 34% (25–44%); and overall, 34% (14–53%). The shortest reported time interval from detonation to the arrival of the first patient at an ED was five minutes. The shortest reported time interval from detonation to the arrival of the last patient at an ED was 15 minutes. The longest reported time interval from detonation to extrication of a live victim from a structural collapse was 36 hours.

Epidemiological outcomes and resource utilization in mass-casualty, terrorist bombings vary with the characteristics of the event.