EMERGENCY DEPARTMENT PATTERNS IN PSYCHIATRIC VISITS DURING THE HOLIDAY SEASON

Study objective: To determine the prevalence of psychopathology during the holiday season and which subpopulations are at greatest risk for holiday decompensation. Design: A retrospective analysis of emergency department records. Setting: ED of a university-affiliated hospital lo cated in a mixed urban-agricultural catchment area in North Carolina. Participants: Eight thousand seven hundred fifty-six patient visits to the ED, with subsequent triage for psychiatric evaluation, for a 6-ye ar period (1987 to 1993), were analyzed. Results: We observed seasonal patterns in visits, with a general decrease in visits preceding holid ays followed by an increase afterward. Substance abusers, men, and bla ck patients were more likely to visit the ED than expected, particular ly during the weeks surrounding Christmas. Conclusion: These results s upport the existence of a ''Christmas effect'' on ED visitations by pa tients with psychiatric symptoms. Understanding of these patterns may help emergency physicians predict the seasonal variation of such patie nt visits and apply preventive measures accordingly.