Consequences of the COVID-19 pandemic on admissions to general hospital psychiatric wards in Italy: Reduced psychiatric hospitalizations and increased suicidality

• Published in: Progress in neuro-psychopharmacology & biological psychiatry 2021-08, Vol.110, p.110304-110304, Article 110304
• Main Authors: Boldrini, Tommaso, Girardi, Paolo, Clerici, Massimo, Conca, Andreas, Creati, Chiara, Di Cicilia, Giuseppe, Ducci, Giuseppe, Durbano, Federico, Maci, Carlo, Maone, Antonio, Nicolò, Giuseppe, Oasi, Osmano, Percudani, Mauro, Polselli, Gian Marco, Pompili, Maurizio, Rossi, Alessandro, Salcuni, Silvia, Tarallo, Federica, Vita, Antonio, Lingiardi, Vittorio
• Format: Article
• Language: English
• Subjects: Adult; Age Factors; Aged; Communicable Disease Control; COVID-19; COVID-19 - complications; COVID-19 - epidemiology; COVID-19 - psychology; Emergency psychiatric department; Female; General hospital psychiatric ward; Hospital admission; Hospitalization - statistics & numerical data; Humans; Italy - epidemiology; Length of Stay - statistics & numerical data; Male; Middle Aged; Psychiatric Department, Hospital - statistics & numerical data; Psychiatric hospitalization; Suicidal Ideation; Suicidality; Young Adult
• ISSN: 0278-5846; 1878-4216; 1878-4216
• DOI: 10.1016/j.pnpbp.2021.110304

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. 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). During the COVID-19 lockdown, there was a 41% reduction (IRR = 0.59; p 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). 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. •Admissions to General Hospital Psychiatric Wards during the COVID-19 pandemic in Italy were analyzed.•The COVID-19 lockdown led to a 41% reduction of psychiatric hospitalizations.•Significant changes in duration of hospital admissions and age of inpatients were observed.•In May-June 2020, a 35% increase in patients reporting suicidal ideation was observed.•Suicide prevention strategies are critically needed in the current scenario.