Impact of COVID-19 on psychiatric assessment in emergency and outpatient settings measured using electronic health records

Victor M. Castro; Roy H Perlis

is the (which was not peer-reviewed) The copyright holder for this preprint . https://doi.org/10.1101/2020.03.30.20048207 doi: medRxiv preprint individual, and included only those which occurred at or before time of testing. (Sensitivity analysis considering one randomly-selected note per individual, or index note, did not yield meaningfully different results and are not presented here, consistent with previous work using narrative notes in this health system; see, e.g., McCoy 14 .) All analyses utilized R 3.6.0 16 . provide insight regarding magnitude of subsequent decrease in visit frequency. Notes with mentions of anxiety dropped 75% for outpatient and 45% for ED from a weekly average in January and February, excluding holidays, to the week spanning 3/19/2020-3/25/2020 (decrease from 96,280 to 24,113 outpatient notes and 3,533 to 1,940, respectively). A similar decrease was observed for mentions of depression with a drop of 81% for outpatient and 44% for ED (decrease from 49,132 to 9,315 outpatient notes and 1,446 to 816, respectively). Similarly, Figure 1 (C) shows references to suicide, overdose, and violence, illustrating a similar pattern. For comparison, Figure 2 shows relative stability of age by week.