Consequences of the COVID-19 pandemic on admissions to general hospital psychiatric wards in Italy: Reduced psychiatric hospitalizations and increased suicidality,Progress in Neuro-Psychopharmacology and Biological Psychiatry

当前位置： X-MOL 学术 › Prog. Neuropsychopharmacol. Biol. Psychiatry › 论文详情

Our official English website, www.x-mol.net, welcomes your feedback! (Note: you will need to create a separate account there.)

Consequences of the COVID-19 pandemic on admissions to general hospital psychiatric wards in Italy: Reduced psychiatric hospitalizations and increased suicidality
Progress in Neuro-Psychopharmacology and Biological Psychiatry ( IF 5.6 ) Pub Date : 2021-03-16 , DOI: 10.1016/j.pnpbp.2021.110304
Tommaso Boldrini ₁ , Paolo Girardi ₁ , Massimo Clerici ₂ , Andreas Conca ₃ , Chiara Creati ₄ , Giuseppe Di Cicilia ₄ , Giuseppe Ducci ₅ , Federico Durbano ₆ , Carlo Maci ₇ , Antonio Maone ₅ , Giuseppe Nicolò ₈ , Osmano Oasi ₉ , Mauro Percudani ₁₀ , Gian Marco Polselli ₅ , Maurizio Pompili ₁₁ , Alessandro Rossi ₁₂ , Silvia Salcuni ₁ , Federica Tarallo ₈ , Antonio Vita ₁₃ , Vittorio Lingiardi ₄ ,

Affiliation

Department of Developmental Psychology and Socialization, University of Padova, Padova, Italy.
Department of Mental Health and Addiction, ASST of Monza; Psychiatric Clinic, University of Milan Bicocca, Italy.
General Hospital of Bolzano, Department of Psychiatry, Bolzano, Italy.
Department of Dynamic and Clinical Psychology, Faculty of Medicine and Psychology, Sapienza University of Rome, Rome, Italy.
Mental Health Department, ASL Roma 1, S.Spirito Hospital, Rome, Italy.
Department of Mental Health and Addiction, ASST of Melegnano and Martesana, Italy.
Psychiatric Unit, Sandro Pertini Hospital, ASL Roma2, Rome, Italy.
Department of Mental Health and Addiction, ASL Roma5, Rome, Italy.
Department of Psychology, Catholic University of Milan, Milan, Italy.
Department of Mental Health and Addiction Services, Niguarda Hospital, Milan, Italy.
Department of Neuroscience, Mental Health and Sensory Organs, S. Andrea Hospital, Sapienza University of Rome, Rome, Italy.
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.
Department of Mental Health and Addiction, ASST of Brescia, Psychiatric Clinic, University of Brescia, Italy.

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.

中文翻译：

COVID-19 大流行对意大利综合医院精神病房入院的影响：精神病住院率下降和自杀率上升

宗旨

本调查旨在评估与 2018 年和 2019 年同期相比，意大利因 2019 年新型冠状病毒病 (COVID-19) 而在封锁期间和之后因精神病住院的差异。

方法

我们从意大利不同地区（集水区 = 371 万居民）的 12 个综合医院精神病房 (GHPW)获取并分析了精神病院入院的匿名数据 ( n = 4550)。我们使用混合效应泊松回归模型，比较了三个时期的录取特征：(a) 2018 年 3 月 1 日至 6 月 30 日和 2019 年；(b) 2020 年 3 月 1 日至 4 月 30 日（即封锁）；(c) 2020 年 5 月 1 日至 6 月 30 日（即封锁后）。

结果

在 COVID-19 封锁期间，减少了 41%（IRR = 0.59；p < 0.001，CI：0.45–0.79）在 2018 年和 2019 年控制期间登记的 GHPW 中的精神病院入院。相反，锁定后时期的入学率与对照时期的入学率相似。值得注意的是，在封锁期间（40%；IRR = 0.60；95% CI：0.44–0.82）和封锁后（28%；IRR = 0.72；95% CI：0.54–0.96) 周期。长期住院（>14 天）在锁定期间增加（63%；IRR = 1.63；95% CI：1.32-2.02），此后下降 39%（IRR = 0.61；95% CI：0.49-0.75）。与 2018 年和 2019 年对照期观察到的比率相比，在封锁后时期观察到报告自杀意念的患者显着增加了 35%（IRR = 1.35；95% CI：1.01-1.79）。