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The impact of the first UK COVID‐19 lockdown on presentations with psychosis to mental health services for older adults: An electronic health records study in South London

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Lauren Simkin, Paul Yung, Flora Greig, Gayan Perera, Konstantinos Tsamakis, Emmanouil Rizos, Robert Stewart, Latha Velayudhan, Christoph Mueller

Original languageEnglish
JournalInternational Journal of Geriatric Psychiatry
Accepted/In press17 Oct 2022


King's Authors


Social distancing restrictions in the COVID-19 pandemic may have had adverse effects on older adults’ mental health. Whereby the impact on mood is well-described, less is known about psychotic symptoms. The aim of this study was to compare characteristics associated with psychotic symptoms during the first UK lockdown and a pre-pandemic comparison period.
In this retrospective observational study we analysed anonymised records from patients referred to mental health services for older adults in South London in the 16-week period of the UK lockdown starting in March 2020, and in the comparable pre-pandemic period in 2019. We used logistic regression models to compare the associations of different patient characteristics with increased odds of presenting with any psychotic symptom (defined as hallucinations and/or delusion), hallucinations or delusions, during lockdown and the corresponding pre-pandemic period.
1,991 referrals were identified. There were fewer referrals during lockdown but a higher proportion of presentations with any psychotic symptoms (48.7% vs. 42.8%, p=0.018), particularly hallucinations (41.0% vs. 27.8%, pConclusions:
During lockdown, referrals to mental health services for adults decreased, but contained a higher proportion with psychotic symptoms. The stronger association with psychotic symptoms in non-White ethnic groups and patients with dementia during lockdown suggests that barriers in accessing care might have increased during the COVID-19 pandemic.

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