key: cord-0910402-lgyo45wb authors: Funayama, Michitaka; Kurose, Shin; Kudo, Shun; Shimizu, Yusuke; Takata, Taketo title: New information technology (IT)-related approaches could facilitate psychiatric treatments in general hospital psychiatry during the COVID-19 pandemic date: 2020-06-18 journal: Asian J Psychiatr DOI: 10.1016/j.ajp.2020.102239 sha: a0dc8c8fb27b290dfefaa65d3a442abe49128bdf doc_id: 910402 cord_uid: lgyo45wb • Impact of the COVID-19 pandemic on psychiatric conditions has been increasing. • “Tablet visit” for inpatients has been introduced. • For outpatients, an online visit system has been used. There have been two fatal cases owing to psychiatric conditions that were closely related to the COVID-19 pandemic among outpatients and inpatients in our psychiatric department in Ashikaga Red Cross Hospital during the first 2-month period (March 10 to May 9, 2020) after the Japanese government categorized the COVID-19 pandemic in Japan as an emergency situation. More specifically, the causes of death were a suicide for one patient and extreme malnutrition for the other, both of which were associated with the delusional belief of being infected with COVID-19. In contrast, in the same department, there were no fatal cases due to psychiatric conditions after the Great East Japan Earthquake and its related nuclear accident during the 2-month period after the earthquake, although mental conditions of some psychiatric outpatients deteriorated, especially those with affective disorders (Funayama et al., 2013) . Over this same 2-month period, we note that the number of new outpatients had significantly decreased from 65 patients during the preceding 2-month period (Jan 10 to March 9, 2020) to 36 patients (55.4%), even though psychiatric patients are experiencing more psychiatric symptoms during the COVID-19 pandemic and lockdown than healthy control subjects (Hao et al., 2020) . Similar circumstances were also seen in Italy, where a marked reduction in psychiatric admission rates was recorded. This was explained by a fear of hospitals, which were seen as possible sites of contagion, as well as a change in thresholds of behavioral problems acting as a trigger for admission requests from family relatives or referrals from treating clinicians (Clerici et al., 2020) . behaviors of patients, which allows the psychiatrists to easily judge their mental conditions and also can give patients relief and facilitate consultation. In one instance, a patient with a slight fever was unable to enter our hospital because of the risk of having COVID-19. He used this online visit system instead, which allowed him to receive the treatment he needed and minimized our anxiety about being infected. We publicized this online visiting system via our hospital homepage and also via the local public health center. As patients with COVID-19 frequently have symptoms of mental illness (Marazziti et al., 2020) and the effects of society's response (e.g., quarantine, lock-down, etc.) are considered to be substantial (Tandon, 2020) , it is likely that our psychiatric unit will be required to admit a psychiatric patient with COVID-19 infection in the near future. In this case, an online medical interview might decrease the amount of time during which health care providers interact with this patient in person, if this system functions easily enough for the patient to manipulate independently. Thus, an online examination system, together with training on standard precautions with personal protective equipment and use of a negative pressure room, might be the key for preventing our psychiatrists and medical staff from being infected in our psychiatric unit. In addition to the effects of quarantine or lock-down, the upcoming economic recession could have a profound effect on people's mental health (Tandon, 2020) . As the impact of the COVID-19 pandemic and its related social change on psychiatric conditions has been increasing across the world, initiatives to protect undesirable consequences in psychiatric conditions have attracted great attention. The introduction of additional IT tools into psychiatric practices might provide a solution to these issues. The authors assert that all procedures contributing to this work comply with the ethical standards of the relevant national and institutional committees on human experimentation and with the Helsinki Declaration of 1975, as revised in 2008. The datasets generated and/or analyzed during the current study are available from the J o u r n a l P r e -p r o o f corresponding author (MF) upon request. All the authors declare that they have no competing interests. We have neither financial relationships, nor funding sources in connection with this manuscript. Psychiatric hospitalization rates in Italy before and during COVID-19: Did they change? An analysis of register data Severity of pre-existing psychiatric illness and response to the Great East Japan Earthquake Do psychiatric patients experience more psychiatric symptoms during COVID-19 pandemic and lockdown? A case-control study with service and research implications for immunopsychiatry The relevance of COVID-19 pandemic to psychiatry Internet-based cognitive behavioral therapy with real-time therapist support via videoconference for patients with obsessive-compulsive disorder, panic disorder, and social anxiety disorder: Pilot single-arm trial The COVID-19 Pandemic Remote Neuropsychological Assessment of Elderly Japanese Population Using the Alzheimer's Disease Assessment Scale: A Validation Study 1357633X19845278 We thank all the medical staff in the psychiatric unit in Ashikaga Red Cross Hospital.