Department of Developmental Psychology and Socialization, University of Padova, Padova, Italy.
Department of Developmental Psychology and Socialization, University of Padova, Padova, Italy.
Prog Neuropsychopharmacol Biol Psychiatry. 2021 Aug 30;110:110304. doi: 10.1016/j.pnpbp.2021.110304. Epub 2021 Mar 16.
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 < 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).
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.
本研究旨在评估意大利在因新型冠状病毒病 2019（COVID-19）而封锁期间和之后与 2018 年和 2019 年同期相比，精神病院住院治疗的差异。
我们从意大利不同地区的 12 个综合医院精神病病房（GHPW）获得并分析了 4550 名精神病住院患者的匿名数据（患者人数=3710 万）。使用混合效应泊松回归模型，我们比较了三个时期的入院特征：（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（即封锁期）；和（c）2020 年 5 月 1 日至 6 月 30 日（即封锁后）。
在 COVID-19 封锁期间，与 2018 年和 2019 年的对照期相比，登记的 GHPW 中的精神病入院率下降了 41%（IRR=0.59；p<0.001，CI：0.45-0.79）。然而，封锁后时期的入院率与对照期相似。值得注意的是，在封锁期（40%；IRR=0.60；95%CI：0.44-0.82）和封锁后（28%；IRR=0.72；95%CI：0.54-0.96），老年患者（>65 岁）的精神病住院率显著且持续下降。长期住院治疗（>14 天）在封锁期间增加了 63%（IRR=1.63；95%CI：1.32-2.02），此后减少了 39%（IRR=0.61；95%CI：0.49-0.75）。与 2018 年和 2019 年的对照期相比，封锁后时期报告自杀意念的患者人数增加了 35%（IRR=1.35；95%CI：1.01-1.79）。
COVID-19 封锁与精神病入院人数的变化有关，特别是与老年患者和长期住院治疗有关。封锁后时期报告自杀意念的患者入院人数增加值得特别关注。需要进一步研究以深入了解观察到的现象。
