Patients with clinical depression ‘stop se

Patients in hospital due to depression, Germany 2020

Photo: Depressed patients, Germany 2020
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Credit: Marek Eichholzer

In the first study of its kind, German researchers show that the COVID pandemic has seen a significant decrease in the number of patients admitted to hospital due to clinical depression. Regardless of these national statistics, the researchers found that the number of outpatients they treated increased during the same period in their departments. Because inpatient treatment provides more levels of intensive care, this means that many patients have not received appropriate care for their condition. It is not yet known whether this shift in treatment has also been observed in other countries.

The researchers, from the University Hospital in Frankfurt, studied German national databases. They found that during the first COVID wave, the number of patients hospitalized for the first time for clinical depression decreased by 57.5%, from 13,457 in January 2020 to 5,723 in April 2020. In the same period, the number of patients hospitalized for recurrent depression decreased by 56.3%, from 22,188 down to 9698.

Dr Marek Eichholzer, principal investigator, said:We also saw a reduction in inpatient treatment for recurrent depression at our hospital in Frankfurt. In addition to stricter admission rules, this appears to be due to lower demand from patients themselves“.

In contrast, the number of outpatients treated for clinical depression at the University Hospital in Frankfurt remained stable, and the number of patients with recurrent depression showed a significant increase between 2019 and 2021. “This is data from one center, so we need to wait and see what other centers say“.

she continued,The results suggest that patients who had frequently experienced depression during their lifetime were less likely to be hospitalized during the epidemic. However, these patients are often so severely affected by depression that outpatient treatment alone is not sufficient to achieve satisfactory improvement in symptoms. The result is that patients lose their quality of life in the long term. The real reason for this observation is not clear. Although our study was not designed to identify the causes of these changes, we suspect that clinically depressed patients in particular often withdraw from society/friends/family and that this behavior was more common during times of lockdown and strict hygiene guidelines. Furthermore, we suspect that clinically depressed patients avoided hospitalization, because they were afraid of contracting COVID-19 on the ward.

Data from our hospital in Frankfurt indicate that patients with clinical depression seem to have withdrawn, rather than seek adequate mental health help. To prepare for winter with the potential for increased numbers of COVID, we need to provide easily accessible assistance and raise awareness of this topic.”

Clinical depression, also known as major depressive disorder (MDD), is a serious mental illness that affects more than 6% of Europeans at any given time. The majority of sufferers can be treated with medication and/or counseling, although a minority of patients do not respond to treatment.

Commenting, Professor Brenda Benincks, Professor of Psychiatric Epidemiology in the Department of Psychiatry, University Medical Centre, Amsterdam said:

“The numbers that the Frankfurt team found confirm a familiar pattern. We have recently found that a good number of countries started reporting a low pattern of mental health care use during the early years of the epidemic. It is very important to see in the next few years whether deferred treatments have been effective. It leads to an increase in mental health problems. This also shows that mental health care deserves appropriate clinical attention during future epidemics.”

This is an independent comment, Professor Benincks was not involved in this research.

Notes

Poster p 0127 Impact of COVID-19 on German treatment numbers for patients with depression – a gap in mentally ill care? (researchers M. Eichholzer, bad. Schwick, C. Uckermark, T.; Hamsehloya, C. Reeve; Leonhard, A.; Reeve, S.; Edwin Thanrajah) at 35The tenth Annual Conference of the European College of Neuropsychiatry, to be held in Vienna and online from 15-18 October, see https://www.ecnp.eu/Congress2022/ECNPcongress. Up to 5,000 delegates are expected to attend. ECNP is the main European organization working in applied neuroscience.


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