The influence of the COVID‑19 pandemic and the first UK lockdown on older age presentations to a regional psychiatric liaison service: A retrospective observational study

Abstract

Background: Loneliness and social isolation may have increased during the coronavirus disease 2019 (COVID-19) pandemic, possibly increasing mental health problems. However, due to fears of contracting COVID-19, patients may not have presented to hospitals. Aims: We assessed the impact of the COVID-19 pandemic measures and lockdown on elderly (≥65 years) presentations to a psychiatric liasion service. Settings and Design: A UK regional liasion psychiatry service. Materials and Methods: Mixed methods methodologies were used to assess data between 01/01/20 and 31/08/20, which were compared to data from the same time period in 2019. Statistical and thematic analyses were conducted to understand drivers of presentations. Statistical Analysis: Nonparametric testing and analysis of variance (ANOVA). Results: Presentations to liaison psychiatry reduced by 13% for 01–08/2020 compared to 01–08/2019, with a 42% reduction during lockdown. Average weekly presentations significantly decreased during the main lockdown months only (April 2019 vs. 2020: 213.0 [12.3] vs. 110.3 [22.9] [adjusted P = 0.006], May 2019 vs. 2020: 209.5 [14.6] vs. 148.8 [12.3] [adjusted P = 0.006]). There was only a trend toward reduced elderly presentations from January to August 2020 and during lockdown. Lockdown pressures did not drive significantly more new elderly presentations. However, we still found a highly significant difference in the distribution of causal factors for the elderly presentations affected by the pressures of lockdown compared to those who were not. Conclusions: A trend toward reduced elderly presentations during lockdown and the pandemic was found. Thematic analysis supported by further statistical analysis of the drivers of elderly presentations showed that the pressures of lockdown clearly affected older age liaison psychiatry presentations.