Dinsenbacher L, Krückl J S, Imfeld L, Helfenstein F, Moeller J, Lieb R, Lang U E, Huber C G
Faculty of Medicine, University of Basel, Klingelbergstr. 6, CH-4056, Basel, Switzerland.
University Psychiatric Clinics Basel (UPK), University of Basel, Wilhelm Klein-Str. 27, CH-4002, Basel, Switzerland; Division of Clinical Psychology and Epidemiology, Department of Psychology, University of Basel, Missionsstr. 60/62, CH-4055, Basel, Switzerland.
J Psychiatr Res. 2025 Sep;189:64-70. doi: 10.1016/j.jpsychires.2025.05.076. Epub 2025 May 29.
The outbreak of COVID-19 in 2020 presented a major challenge to mental health care. Due to the risk of infection and the restrictions during the lockdown, outpatient treatment services were scaled down. This may have been particularly challenging for patients with Personality Disorders (PD), for which a stable outpatient treatment setting is especially important. The aim of the study was to investigate if PD patients have experienced longer inpatient stays and more coercive measures during the COVID-19 pandemic.
In this multi-year, hospital-wide, longitudinal observational study, we compared the period before the outbreak of COVID-19 (until December 2019) and the period after (from January 2020) by means of an interrupted time series analysis including all adult inpatient cases with PD (N = 1170) admitted to the Adult Psychiatry, UPK, Basel, Switzerland, between October 2016 and December 2021 (for the median length of stay) and between January 2012 and December 2021 (for coercive measures). Outcome variables were the occurrence rate of coercive measures and the median length of stay.
Both the occurrence rate of coercive measures (OR = 15.32, p = >.001) and the median length of stay (E = 244.016, p = .028) increased in PD patients after the COVID-19 outbreak.
Our findings suggest that PD patients are specifically vulnerable to a changing and stressful psychosocial context such as that of a pandemic. Strategies to maintain outpatient care services and opportunities for short-term crisis intervention are essential for this group, especially to prevent a rise in coercive measures and unnecessarily prolonged inpatient treatment.
2020年新冠疫情的爆发给精神卫生保健带来了重大挑战。由于感染风险和封锁期间的限制，门诊治疗服务规模缩减。这对人格障碍（PD）患者可能尤其具有挑战性，因为稳定的门诊治疗环境对他们尤为重要。本研究的目的是调查在新冠疫情期间，人格障碍患者的住院时间是否更长，以及是否受到更多强制性措施的约束。
在这项多年度、全院范围的纵向观察性研究中，我们通过中断时间序列分析，比较了新冠疫情爆发前（截至2019年12月）和爆发后（从2020年1月起）两个时间段。研究对象包括2016年10月至2021年12月期间（用于中位住院时间分析）以及2012年1月至2021年12月期间（用于强制性措施分析）入住瑞士巴塞尔大学精神病学系成人精神科的所有成年人格障碍住院患者（N = 1170）。结局变量为强制性措施的发生率和中位住院时间。
新冠疫情爆发后，人格障碍患者的强制性措施发生率（OR = 15.32，p = >.001）和中位住院时间（E = 244.016，p = .028）均有所增加。
我们的研究结果表明，人格障碍患者特别容易受到大流行等不断变化且充满压力的社会心理环境的影响。对这一群体而言，维持门诊护理服务和短期危机干预机会的策略至关重要，尤其是要防止强制性措施的增加和不必要的长期住院治疗。
