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Abstract The pandemic has gotten a high impact in mental health including general population and patients with mental illness before the pandemic, who has seen increase their symptoms and/or their treatment interrupted. This letter aims to describe the sociodemographic and clinical variables that converge in patients who come to the psychiatry emergency department during the pandemic without being under prior follow-up at least the previous six months. The database was obtained through a retrospective review of digital medical record, which registers sociodemographic, diagnosis, reason for consultation and hospital admissions. The observatory periods were: 1) Before the lockdown, from 13th of January, 2020 to 14th of March, 2020; 2) During the lockdown by the first alarm state, from the beginning of the alarm state in Spain (15th of March, 2020) until its end (20th of June, 2020) and 3) while the second state of alarm in Spain (from the 25th of October, 2020 to 9th of May, 2021). In the first state of alarm the psychotic decompensations increased from 5.1% before the pandemic to 12.5% (p=0.015), and the unipolar depression decreased from 15.3% to 9.3% (p=0.026). About the therapeutic decision, stands out that in the first alarm state the hospitalizations increased to 30.6% while before the lockdown the income was 21% (p=0.039). During the second state of alarm the number of pacients without previous follow-up increased from 22.4% to 29.4% (p