The heterogeneity of cognitive profiles among psychiatric patients has been reported to carry significant clinical information. However, how to best characterize such cognitive heterogeneity is still a matter of debate. Despite being well suited for clinical data, cluster analysis techniques, like the Two-Step and the Latent Class, received little to no attention in the literature. The present study aimed to test the validity of the cluster solutions obtained with Two-Step and Latent Class cluster analysis on the cognitive profile of a cross-diagnostic sample of 387 psychiatric inpatients. Two-Step and Latent Class cluster analysis produced similar and reliable solutions. The overall results reported that it is possible to group all psychiatric inpatients into Low and High Cognitive Profiles, with a higher degree of cognitive heterogeneity in schizophrenia and bipolar disorder patients than in depressive disorders and personality disorder patients.

Purpose The aim of our study is to evaluate the number and the features of admissions to the emergency room (ER) requiring psychiatric consultation, in the period between May 4th and August 31st 2020. Methods We carried out a retrospective longitudinal observational study examining the 4 months following the initial lockdown imposed during the COVID-19 outbreak (May 4th and August 31st 2020). More specifically, the ER admissions leading to psychiatric referral were reviewed at all seven public hospitals of AUSL Romagna (Emilia Romagna region, Italy). Socio-demographic variables, history of medical comorbidities or psychiatric disorders, reason for ER admission, psychiatric diagnosis at discharge, and actions taken by the psychiatrist were collected. Results An 11.3% ( p = 0.007) increase in psychiatric assessments was observed when compared with the same period of the previous year (2019). A positive personal history of psychiatric disorders (OR:0.68, CI: 0.53–0.87) and assessments leading to no indication for follow-up (OR: 0.22, CI: 0.13–0.39) were significantly less frequent, while there was a significant increase of cases featuring organic comorbidities (OR: 1.24, CI: 1.00–1.52) and suicidal ideation/self-harm/suicide attempt (OR: 1,71, CI: 1.19–2.45) or psychomotor agitation (OR: 1.46, CI: 1.02–2.07) as reason for admission. Conclusions Our results showed an increase in ER psychiatric consultations compared to the previous year, underlying the increased psychological distress caused by the lockdown.

IntroductionRecent findings demonstrated significant overlaps among major psychiatric disorders on multiple neurocognitive domains. However, it is not clear which are the cognitive functions that contribute to this phenomenon.ObjectivesTo find the optimal clustering solution using the two-step cluster analysis on a sample of psychiatric patients.AimsTo classify into subgroups a cross-diagnostic sample of psychiatric inpatients on the basis of their neurocognitive profiles.MethodsSeventy-one patients with psychotic, bipolar, depressive and personality disorders hospitalised at Psychiatric Diagnosis and Care Service of Bufalini Hospital of Cesena participated in the study. The symptomatology was assessed using Health of the Nation Outcome Scales-Roma and Brief Psychiatric Rating Scale. Cognitive functions were evaluated using Tower of London, Modified Wisconsin Card Sorting Test, Judgment and Verbal Abstract Tasks test, Raven matrices, Attentional Matrices, Stroop Test and Mini Mental State Examination. Two-step cluster analysis was conducted using the standardized scores of each neurocognitive test.ResultsTwo groups were obtained:– group 1, with good cognitive performances;– group 2, with almost all subjects having impaired cognitive performances.Executive functions and attention are the major determinants of the cluster solution. The clusters did not differ on socio-demographic correlates. Different diagnoses were equally distributed amongst the clusters.ConclusionsTwo-step cluster analysis was useful in identifying subgroups of psychiatric inpatients with different cognitive functioning, overcoming other cluster techniques limitations. According to former literature, these results confirm a continuum of severity in cognitive impairment across different psychiatric disorders.Disclosure of interestThe authors have not supplied their declaration of competing interest.

The aim was to study the number of accesses to the Emergency Room (ER) requiring psychiatric evaluation in the four months following the lockdown period for the COVID-19 outbreak (May 4th, 2020-August 31th, 2020). The study is a retrospective longitudinal observational study of the ER admissions of the Hospitals of Cesena and Forlì (Emilia Romagna region) leading to psychiatric assessment. Sociodemographic variables, history for medical comorbidities or psychiatric disorders, reason for ER admission, psychiatric diagnosis at discharge and measures taken by the psychiatrist were collected. An increase of 9.4% of psychiatric assessments was observed. The difference was more pronounced in the first two months after lockdown, with a 21.7% increase of number of ER accesses, while after two months numbers were the same as those of the year before. Admission with anxiety symptoms and history of psychiatric disorder decreased significantly. Moreover, there is an age trend with an increasing age of admission.

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