Tommaso Boldrini1, Paolo Girardi2, Massimo Clerici3, Andreas Conca4, Chiara Creati5, Giuseppe Di Cicilia5, Giuseppe Ducci6, Federico Durbano7, Carlo Maci8, Antonio Maone6, Giuseppe Nicolò9, Osmano Oasi10, Mauro Percudani11, Gian Marco Polselli6, Maurizio Pompili12, Alessandro Rossi13, Silvia Salcuni1, Federica Tarallo9, Antonio Vita14, Vittorio Lingiardi5, Arianna Schiano Lomoriello15. 1. Department of Developmental Psychology and Socialization, University of Padova, Padova, Italy. 2. Department of Developmental Psychology and Socialization, University of Padova, Padova, Italy. Electronic address: paolo.girardi@unipd.it. 3. Department of Mental Health and Addiction, ASST of Monza; Psychiatric Clinic, University of Milan Bicocca, Italy. 4. General Hospital of Bolzano, Department of Psychiatry, Bolzano, Italy. 5. Department of Dynamic and Clinical Psychology, Faculty of Medicine and Psychology, Sapienza University of Rome, Rome, Italy. 6. Mental Health Department, ASL Roma 1, S.Spirito Hospital, Rome, Italy. 7. Department of Mental Health and Addiction, ASST of Melegnano and Martesana, Italy. 8. Psychiatric Unit, Sandro Pertini Hospital, ASL Roma2, Rome, Italy. 9. Department of Mental Health and Addiction, ASL Roma5, Rome, Italy. 10. Department of Psychology, Catholic University of Milan, Milan, Italy. 11. Department of Mental Health and Addiction Services, Niguarda Hospital, Milan, Italy. 12. Department of Neuroscience, Mental Health and Sensory Organs, S. Andrea Hospital, Sapienza University of Rome, Rome, Italy. 13. Section of Psychiatry, Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, Mental Health Department ASL 1 Abruzzo, Psychiatric Unit, L'Aquila, Italy. 14. Department of Mental Health and Addiction, ASST of Brescia, Psychiatric Clinic, University of Brescia, Italy. 15. Section for Cognitive Systems, DTU Compute, Technical University of Denmark.. Electronic address: arilom@dtu.dk.
Abstract
AIMS: The present investigation aimed at evaluating differences in psychiatric hospitalizations in Italy during and after the lockdown due to the novel coronavirus disease 2019 (COVID-19), compared to the same periods in 2018 and 2019. METHODS: We obtained and analyzed anonymized data on psychiatric admissions (n = 4550) from 12 general hospital psychiatric wards (GHPWs) in different Italian regions (catchment area = 3.71 millions of inhabitants). Using a mixed-effects Poisson regression model, we compared admission characteristics across three periods: (a) March 1-June 30, 2018 and 2019; (b) March 1-April 30, 2020 (i.e., lockdown); and (c) May 1-June 30, 2020 (i.e., post-lockdown). RESULTS: During the COVID-19 lockdown, there was a 41% reduction (IRR = 0.59; p < 0.001, CI: 0.45-0.79) in psychiatric admissions in the enrolled GHPWs with respect to the 2018 and 2019 control period. Conversely, admission rates in the post-lockdown period were similar to those observed in the control period. Notably, a consistent and significant reduction in psychiatric hospitalizations of older patients (aged >65 years) was observed in the lockdown (40%; IRR = 0.60; 95% CI: 0.44-0.82) and post-lockdown (28%; IRR = 0.72; 95% CI: 0.54-0.96) periods. Long-stay admissions (>14 days) increased (63%; IRR = 1.63; 95% CI: 1.32-2.02) during the lockdown and decreased by 39% thereafter (IRR = 0.61; 95% CI: 0.49-0.75). A significant 35% increase in patients reporting suicidal ideation was observed in the post-lockdown period, compared to the rate observed in the 2018 and 2019 control period (IRR = 1.35; 95% CI: 1.01-1.79). CONCLUSION: The COVID-19 lockdown was associated with changes in the number of psychiatric admissions, particularly for older patients and long-stay hospitalizations. Increased admission of patients reporting suicidal ideation in the post-lockdown period merits special attention. Further studies are required to gain insight into the observed phenomena.
AIMS: The present investigation aimed at evaluating differences in psychiatric hospitalizations in Italy during and after the lockdown due to the novel coronavirus disease 2019 (COVID-19), compared to the same periods in 2018 and 2019. METHODS: We obtained and analyzed anonymized data on psychiatric admissions (n = 4550) from 12 general hospital psychiatric wards (GHPWs) in different Italian regions (catchment area = 3.71 millions of inhabitants). Using a mixed-effects Poisson regression model, we compared admission characteristics across three periods: (a) March 1-June 30, 2018 and 2019; (b) March 1-April 30, 2020 (i.e., lockdown); and (c) May 1-June 30, 2020 (i.e., post-lockdown). RESULTS: During the COVID-19 lockdown, there was a 41% reduction (IRR = 0.59; p < 0.001, CI: 0.45-0.79) in psychiatric admissions in the enrolled GHPWs with respect to the 2018 and 2019 control period. Conversely, admission rates in the post-lockdown period were similar to those observed in the control period. Notably, a consistent and significant reduction in psychiatric hospitalizations of older patients (aged >65 years) was observed in the lockdown (40%; IRR = 0.60; 95% CI: 0.44-0.82) and post-lockdown (28%; IRR = 0.72; 95% CI: 0.54-0.96) periods. Long-stay admissions (>14 days) increased (63%; IRR = 1.63; 95% CI: 1.32-2.02) during the lockdown and decreased by 39% thereafter (IRR = 0.61; 95% CI: 0.49-0.75). A significant 35% increase in patients reporting suicidal ideation was observed in the post-lockdown period, compared to the rate observed in the 2018 and 2019 control period (IRR = 1.35; 95% CI: 1.01-1.79). CONCLUSION: The COVID-19 lockdown was associated with changes in the number of psychiatric admissions, particularly for older patients and long-stay hospitalizations. Increased admission of patients reporting suicidal ideation in the post-lockdown period merits special attention. Further studies are required to gain insight into the observed phenomena.
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