Consequences of the COVID-19 pandemic on admissions to general hospital psychiatric wards in Italy: reduced psychiatric hospitalizations and increased suicidality
Open accessAbstract
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.
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A study of 4550 inpatients reported more psychopathology, including suicidal ideation, and longer hospital stays in the COVID-19 era than before it (Boldrini et al., 2021).
“In a study of 4550 inpatients, researchers found evidence of increased psychopathology (i.e., suicidal ideation) and the need for longer hospital stays during the COVID-19 era, as compared to the pre-COVID-19 era (Boldrini et al., 2021).”
From Prevalence rates of anxiety, depressive, and eating pathology symptoms between the pre- and peri-COVID-19 eras: A meta-analysis (2022) · cites this paper as Boldrini et al., 2021
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“, suicidal ideation) and the need for longer hospital stays during the COVID-19 era, as compared to the pre-COVID-19 era (Boldrini et al., 2021).”
- Authors
- Boldrini, T., Girardi, P., Clerici, M., Conca, A., Creati, C., Di Cicilia, G., Ducci, G., Durbano, F., Maci, C., Maone, A., Nicolò, G., Oasi, O., Percudani, M., Polselli, G. M., Pompili, M., Rossi, A., Salcuni, S., Tarallo, F., Vita, A., & Lingiardi, V.
- Affiliations
- University of Padua (IT)
- University of Milan (IT)
- Ospedale di Bolzano (IT)
- Sapienza University of Rome (IT)
- ASL Roma (IT)
- ASST Melegnano e della Martesana (IT)
- Università Cattolica del Sacro Cuore (IT)
- Azienda Socio Sanitaria Territoriale Grande Ospedale Metropolitano Niguarda (IT)
- Azienda Ospedaliera Sant'Andrea (IT)
- University of L'Aquila (IT)
- University of Brescia (IT)
- Corresponding author
- Girardi, Paolo
- ORCID
- Venue
- Progress in Neuro-Psychopharmacology and Biological Psychiatry
- Publisher
- Elsevier BV
- Published
- 2021-08
- Volume
- 110
- Pages
- 110304
- ISSN
- 0278-5846 (ISSN-L)
- PMC
- PMC8569419
- OpenAlex
- W3138057172
- Cited by
- 90
- References
- 38
- Citations by year
- 2026: 7 · 2025: 7 · 2024: 12 · 2023: 26 · 2022: 30 · 2021: 8
- FWCI
- 12.96
- Type
- journal article
- Language
- en
- Open access
- green
- europepmc.org
- Licence
- Locations
- Progress in Neuro-Psychopharmacology and Biological Psychiatry (publishedVersion)
- Europe PMC (PubMed Central) (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- BOA (University of Milano-Bicocca) (submittedVersion)
- Institutional Research Information System (Università degli Studi di Brescia) (submittedVersion)
- Institutional Research Information System (Università degli Studi di Brescia) (submittedVersion, other-oa)
- IRIS Research product catalog (Sapienza University of Rome) (submittedVersion)
- ARCA (Università Ca' Foscari Venezia) (submittedVersion)
- Archivio Istituzionale della Ricerca - Università degli Studi dell Aquila (submittedVersion, public-domain)
- Padua Research Archive (University of Padova) (submittedVersion)
- Topics
- Social Sciences › Psychology › Clinical Psychology › COVID-19 and Mental Health
- Health Sciences › Medicine › Oncology › COVID-19 and healthcare impacts
- Social Sciences › Psychology › Clinical Psychology › Psychiatric care and mental health services
- Keywords
- COVID-19 pandemic, lockdown, psychiatric hospitalization, psychiatric hospital admissions, suicidality, suicidal ideation, older adults, mental health services, Italy
- MeSH terms
- COVID-19, Adult, Age Factors, Aged, Communicable Disease Control, Female, Hospitalization, Humans, Italy, Length of Stay, Male, Middle Aged, Psychiatric Department, Hospital, Young Adult, Suicidal Ideation
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