Trends in Emergency Department Visits for Mental Health Disorder Diagnoses Before and During the COVID-19 Pandemic: A Retrospective Cohort Study 2016-2021

Abstract

Background: As the pandemic started, Saudi Arabia applied extreme measures in responses to the public health crises. These control measures have adversely affected individuals with reported psychological illnesses such as depression, and anxiety. We aimed to describe trends, and gender-age differences in proportions of psychiatric Emergency department (ED) visits from 2016 to 2021 in two large hospitals in Saudi Arabia.Methods: This is a retrospective cohort study using data from electronic health records in the Ministry of National Guard Health Affairs’ (MNG-HA) in two major hospitals in Saudi Arabia. Individuals aged ≥12 years diagnosed with mental disorder from January 2016 to May 31, 2021, registered in MNG-HA hospitals system were included in the study.Outcomes: A total of 1171 ED psychiatric visits (52% female, 48% male). A constant annual increase in the number of psychiatric ED visits before the pandemic from 2016 to 2019 (2.91%, 6.17%, 9.64%, and 15.25%) was observed. While nearly 42% of total psychiatric visits for the study period occurred during the pandemic 2020-2021. During the pandemic, psychiatric ED visits were significantly higher in females (adjusted OR 1.46; CI 1.14, 1.86) than males. During the pandemic, generalized anxiety disorder was the most common psychiatric ED disorder with reported increase of visits by 48.44% (p-value 0.007).Interpretation: ED psychiatric visit rates have consistently increased before and during the pandemic. During the pandemic, female at greater risk of seeking psychiatric ED services than male. Interventions for mental health related disorders are urgently needed for preventing mental health problems.Funding: None to declare. Declaration of Interest: None to declare. Ethical Approval: Biomedical ethics committee of King Abdullah International Medical Research Center (KAIMRC) approved this study (JED-21-427780-99596)