The Change of Mental Health Status and Health-Seeking Behaviors of Psychiatric Outpatients in General Hospital During the COVID-19 Outbreak in China: A Retrospective Study from Unaware of the Outbreak Till Control

Background: The aim of current study was to retrospectively compare the change of mental health status and health-seeking behaviors among psychiatric outpatients during the period of three months from January till March, 2020 when the epidemic developed from beginning till the stability phase in China. Methods: A retrospective cross-sectional, hospital-based survey of registered psychiatric outpatients was conducted from January 1, 2020, to March 31, 2020. Outcomes: There were a total of 3027 registered psychiatric outpatients included. Major depressive disorder (MDD), general anxiety disorder (GAD), insomnia, and panic disorder (PD) were the main disorders in the psychiatric clinic in the three months, accounted for respectively 97.2%, 98.6%, 97.5%. The percentage of PD increased gradually from February, and reached the highest level significantly in March. The percentages of both remission and mild patients in MDD or GAD were significantly decreased in February and March. The severe percentages of MDD in February and March were increased dramatically and significantly, even it was doubled in March. The percentages of moderate and severe patients with GAD since February were increased significantly. The percentages of relapse in GAD in February and March were significant higher than that in January. Correlation analysis showed time was positively related to the severity of MDD or GAD. Interpretation: The longer the duration of COVID, the worse the status of MDD and GAD. The mental health status of psychiatric outpatients has worsened during the COVID outbreak. Secondly, health-seeking behavior of psychiatric outpatients in general hospital has changed during the outbreak. Funding Statement: This work was supported by Grant 2018YFC 1314400 from National Key R&D Program of China, Grant 81660235, 81971288 from the National Natural Scientific Foundation of China. Declaration of Interests: The authors declare no competing interests. Ethics Approval Statement: Approval from the clinical research ethics committee of the Second Affiliated Hospital of Kunming Medical University was received before the initiation of this study. The survey was anonymous, and confidentiality of information was assured. This retrospective study followed the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) reporting guideline.