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疫情前后移民的精神科住院情况:意大利博洛尼亚急性精神科病房的回顾性研究。

Psychiatric Admission Among Migrants Before and During Pandemic: a Retrospective Study in Acute Psychiatric Ward in Bologna, Italy.

机构信息

Department of Medical and Surgical Sciences (DIMEC), University of Bologna, Bologna, Italy.

Department of Mental Health and Pathological Addictions, Bologna Local Health Authority, Bologna, Italy.

出版信息

J Immigr Minor Health. 2023 Jun;25(3):507-521. doi: 10.1007/s10903-023-01464-7. Epub 2023 Mar 23.

Abstract

Previous evidence showed significant discrepancies in psychiatric services utilization between migrants and reference populations. Our study aims were to evaluate incidence and characteristics of psychiatric hospitalizations of migrant patients compared with reference populations and to assess how the COVID-19 pandemic affected admissions. All patients admitted to the psychiatric ward "SPDC-Malpighi" of the Bologna Mental Health Department from 01/01/2018 to 31/12/2020 were included. Differences in sociodemographic and clinical characteristics were tested by migrant status. Incidence rate ratios of hospital admissions by migrant status were estimated via Poisson regression considering population-at-risk, gender, and age-group. Migrants had higher hospitalization rates due to any psychiatric disorder (IRR = 1.16). The risk was especially pronounced among women (IRR = 1.25) and within the youngest age-group (IRR = 3.24). Young migrants had also a greater risk of compulsory admission (IRR = 3.77). Regarding admissions due to a specific diagnosis, we found relevant differences in hospitalization rates for psychosis, mood disorders, and personality disorders. Finally, migrants were more likely to be admitted via Emergency Department and less likely to be referred from a specialist. During the year of pandemic (2020) we observed an increase in the proportion of migrants admitted voluntarily or compulsorily. Migrants, especially those from the youngest age-group, had higher hospitalization rates for any disorder. Younger migrants were also at higher risk of compulsory treatment. The distribution of psychiatric admissions during the pandemic period seemed to have further increased discrepancies in mental healthcare needs and provision between migrants and the reference population. Tailored interventions and policies are urgently needed to address this issue.

摘要

先前的证据表明,移民与参照人群在精神卫生服务利用方面存在显著差异。我们的研究目的是评估与参照人群相比,移民患者的精神病住院情况的发生率和特征,并评估 COVID-19 大流行如何影响入院率。所有于 2018 年 1 月 1 日至 2020 年 12 月 31 日期间入住博洛尼亚心理健康部门精神科病房“SPDC-Malpighi”的患者均被纳入研究。通过移民身份测试了社会人口统计学和临床特征的差异。通过考虑风险人群、性别和年龄组,使用泊松回归估计移民身份对住院的发病率比值。由于任何精神障碍而住院的移民的住院率更高(IRR=1.16)。这种风险在女性中尤为明显(IRR=1.25),在最年轻的年龄组中(IRR=3.24)更为明显。年轻移民也有更高的强制入院风险(IRR=3.77)。关于特定诊断的入院情况,我们发现精神病、心境障碍和人格障碍的住院率存在相关差异。最后,移民更有可能通过急诊部入院,而较少通过专科医生转介。在大流行期间(2020 年),我们观察到自愿或强制入院的移民比例增加。由于任何障碍,移民,尤其是来自最年轻年龄组的移民,其住院率更高。年轻移民也有更高的强制治疗风险。大流行期间的精神科入院分布似乎进一步增加了移民和参照人群之间在精神卫生需求和服务提供方面的差异。迫切需要采取有针对性的干预措施和政策来解决这个问题。

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