{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,13]],"date-time":"2026-01-13T16:56:23Z","timestamp":1768323383143,"version":"3.49.0"},"reference-count":11,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2021,7,20]],"date-time":"2021-07-20T00:00:00Z","timestamp":1626739200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Psychiatry"],"abstract":"<jats:p><jats:bold>Background:<\/jats:bold> During the spread of coronavirus disease (COVID-19), mandatory quarantines increased social isolation and anxiety, with inevitable consequences on mental health and health seeking behavior. We wished to estimate those trends.<\/jats:p><jats:p><jats:bold>Methods:<\/jats:bold> We examined all psychiatric visits to the emergency department (ED) during March, April 2020, compared to identical months in 2018, 2019. We evaluated both number and nature of referrals.<\/jats:p><jats:p><jats:bold>Results:<\/jats:bold> Throughout the years, psychiatric referrals comprised about 5% of the total number of ED visits. In March-April 2020, 30% decreases were observed in overall ED visits and in psychiatric referrals in the ED. Compared to 2018\u20132019, in 2020, the proportions of these diagnoses were higher: anxiety disorders (14.5 vs. 5.4%, <jats:italic>p<\/jats:italic> &amp;lt; 0.001), personality disorders (6.7 vs. 3.2%, <jats:italic>p<\/jats:italic> = 0.001), psychosis (9.5 vs. 6.7%, <jats:italic>p<\/jats:italic> = 0.049), post-traumatic stress disorder (3.2 vs. 1.5%, <jats:italic>p<\/jats:italic> = 0.023). Compared to 2018\u20132019, in 2020, proportions were lower for adjustment disorder (5.8 vs. 8.9%, <jats:italic>p<\/jats:italic> = 0.036) and for consultation regarding observation (11.7 vs. 31.6%, <jats:italic>p<\/jats:italic> &amp;lt; 0.001). Differences were not observed between 2018-2019 and 2020 in the proportions of other diagnoses including suicide and self-harm disorders. Referrals concerning suicide and self-harm in a rural hospital and community clinic were 30% lower in the COVID-19 lockdown than in the same months in 2018, 2019.<\/jats:p><jats:p><jats:bold>Conclusion:<\/jats:bold> Psychiatric ED visits decreased by the same proportion as overall visits to the ED, apparently driven by fears of COVID-19. Referrals relating suicidality and self-harm shown nominal decrease, but their proportioned share remained constant. Increased anxiety and delayed care may eventually lead to increased mental health needs.<\/jats:p>","DOI":"10.3389\/fpsyt.2021.603318","type":"journal-article","created":{"date-parts":[[2021,7,20]],"date-time":"2021-07-20T06:00:21Z","timestamp":1626760821000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":19,"title":["Trends in Psychiatric Emergency Department Visits in Northern Israel During the COVID-19 Outbreak"],"prefix":"10.3389","volume":"12","author":[{"given":"Yael","family":"Pikkel 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