A Systematic Review on the Impact of Seasonality on Severe Mental Illness Admissions: Does Seasonal Variation Affect Coercion?

Rizavas, Ioannis; Gournellis, Rossetos; Douzenis, Phoebe; Efstathiou, Vasiliki; Bali, Panagiota; Lagouvardos, Kostas; Douzenis, Athanasios

doi:10.3390/healthcare11152155

Cited by 6 publications

(3 citation statements)

References 112 publications

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“…According to the literature, there is a correlation between seasonality and admissions for serious mental illness. The findings suggest a strong indication of a positive spring/summer correlation due to high environmental temperature [20][21][22][23]. Furthermore, during the summer period, as well as in January, professionals' leaves of absence are common.…”

Section: Discussionmentioning

confidence: 84%

Outcome of Involuntary Mental Health Assessment in a Psychiatric Department in Greece

Papadopoulou,

Arvaniti,

Kalamara

et al. 2023

Healthcare

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Despite their controversiality, involuntary admissions in psychiatric departments remain a central issue in mental health care. The present study aims to identify demographic and clinical factors possibly associated with emergency involuntary psychiatric assessment and its outcome in Greece. This study was carried out in the psychiatric department of the University General Hospital of Alexandroupolis (UGHA) from 1 March 2018 to 28 February 2019. The sample included 191 individuals who had been psychiatrically assessed without their consent following a prosecutorial order. The majority of the involuntary assessments resulted in hospitalization (71%), with 51% of them resulting in involuntary hospitalization. Almost all patients diagnosed with “F20–29 schizophrenia, schizotypal and delusional disorders” were subsequently admitted to the psychiatric department of the UGHA (77 of 81, 66 of them involuntarily). Higher admission rates were recorded among those who had been referred from the Prosecutor’s Office of regions that are located far from the psychiatric department of UGHA (Fisher’s exact test, p-value = 0.045). In multivariate logistic regression, prior contact with psychiatric services and having an “F20–29 schizophrenia, schizotypal and delusional disorders” diagnosis was statistically significant with admission to the hospital as an outcome variable. Our study suggests an increased risk of involuntary admission among patients with psychosis, patients who had visited a psychiatric service prior to their assessment as well as those living further away from the main psychiatric services of the hospital. Better organization of community psychiatric services in remote places from hospital central services may lead to fewer prosecutorial referrals and coercive measures.

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Section: Discussionmentioning

confidence: 84%

Outcome of Involuntary Mental Health Assessment in a Psychiatric Department in Greece

Papadopoulou,

Arvaniti,

Kalamara

et al. 2023

Healthcare

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“…Differently from other authors, we could not observe any seasonal trend which may have had a significant effect on the onset and exacerbation of psychopathology of severe mental illness and, therefore, on the need for psychiatric admissions, violence and the risk of mental health coercion. 56,57 We can explain this different result with the relatively short duration of our observation period or with the particular occurrence of the pandemic epidemic, which may have distorted this possible correlation. Individuals involuntarily hospitalized in our sample were more frequently unemployed, living alone, and were more frequently treated by MHCS and social services, compared to those voluntarily hospitalized, probably due to more severe psychopathological conditions with negative impact on individual's daily life.…”

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confidence: 85%

Involuntary Hospitalizations in an Italian Acute Psychiatric Ward: A 6-Year Retrospective Analysis

Di Lorenzo,

Reami,

Dragone

et al. 2023

PPA

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We evaluated the differences between demographic (age, sex, nationality, employment, housing, schooling, support administrator), clinical (hospitalization reason, aggressive behaviour, length of hospitalization, psychiatric diagnosis and comorbidities, psychiatric medications, discharge destination, "revolving door" hospitalizations) and environmental (pre-and pandemic period) variables in voluntary (VHs) and involuntary hospitalizations (IHs) in an acute psychiatric ward during a 6-year period. Patients and Methods: We retrospectively collected the selected variables concerning the hospitalizations of subjects over 18 years of age in the Service for Psychiatric Diagnosis and Care of Mental Health and Drug Abuse Department in Modena from 01/01/2017 to 31/12/2022. Results: We observed a progressive and sharp reduction in the number of VHs (n = 1800; 61.41%) during the pandemic and a stability of IHs (n = 1131; 38.59%), which in 2022 became prevalent. We highlighted the following differences between VHs and IHs: an increase in hospitalization length in IHs (14.25 mean days ± 15.89 SD) in comparison with VHs (8.78 mean days ± 13.88 SD), which increased more during the pandemic; an increase in aggressive behavior in IHs, especially during the pandemic (Pearson Chi2 = 90.80; p = 0.000); a prevalence of schizophrenia and bipolar disorders (Pearson Chi2 = 283.63; p = 0.000) and more frequent maladaptive social conditions among subjects in IHs. Conclusion:During the 6-year observation period, we underscored a trend of increasingly reduced recourse to VHs, whereas IHs increased even in the pandemic. Our results suggest that IHs in Psychiatry represented an extreme measure for treating the most severe psychopathological situations such as schizophrenia and bipolar disorders, characterized by aggressive behaviour and precarious social conditions, which needed longer stay than VHs, especially during the pandemic.

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“…21 The seasonal pattern of ED psychiatric visits should also be considered given higher rates of psychiatric hospitalizations and suicide in spring and summer. 22,23 Another factor to consider is a general increase in youth psychiatric ED visits worldwide. 6 Over the past 10 years, the proportion of pediatric ED visits for mental health reasons has approximately doubled, with a 5-fold increase in suicide-related visits.…”

Section: Introductionmentioning

confidence: 99%

COVID-19 Pandemic School Disruptions and Acute Mental Health in Children and Adolescents

Davico,

Marcotulli,

Abbracciavento

et al. 2024

JAMA Netw Open

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ImportanceThere are suggestions that school pressure may be stressful and a factor in child and adolescent mental health disturbances, but data about this association are scarce and inconclusive.ObjectiveTo assess whether varying degrees of school interruption were associated with changes in emergency department (ED) psychiatric visits of children and adolescents before and after the COVID-19 outbreak.Design, Setting, and ParticipantsA cross-sectional observational study was conducted at 9 urban university hospitals in Italy. All ED visits from January 1, 2018, to December 31, 2021, for psychiatric reasons of patients younger than 18 years were examined for demographic characteristics and type of psychopathologic factors. Data analysis was conducted from July 1 to August 31, 2023.ExposureThe disruption in the usual succession of school and holiday periods brought on by the COVID-19 pandemic at different times and with various degrees of intensity.Main Outcomes and MeasuresTotal number of pediatric ED visits, psychiatric ED visits, and psychiatric ED visits categorized by specific reasons (eg, psychomotor agitation, suicide ideation [SI] or suicide attempt [SA], and eating disorders) on a weekly basis.ResultsA total of 13 014 psychiatric ED visits (1.3% of all pediatric ED visits) were recorded (63.2% females; mean [SD] age, 13.8 [3.8] years). The number of ED psychiatric visits increased over time (incidence rate ratio [IRR], 1.19; 95% CI, 1.16-1.22 for each year). Significant increases in ED visits were observed for eating disorders (294.8%), SI (297.8%), and SA (249.1%). School opening, but not social lockdown restriction, was associated with an increase in the number of ED psychiatric visits (IRR, 1.29; 95% CI, 1.23-1.34), which was evident for females and for SI with SA. Socioeconomic status was associated with an increase in psychiatric visits for males (IRR, 1.12; 95% CI, 1.04-1.20) but not females (IRR, 1.04; 95% CI, 0.98-1.10).Conclusions and RelevanceIn this study, school opening was associated with an increased incidence of acute psychiatric emergencies among children and adolescents, suggesting that school can be a substantial source of stress with acute mental health implications.

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A Systematic Review on the Impact of Seasonality on Severe Mental Illness Admissions: Does Seasonal Variation Affect Coercion?

Cited by 6 publications

References 112 publications

Outcome of Involuntary Mental Health Assessment in a Psychiatric Department in Greece

Outcome of Involuntary Mental Health Assessment in a Psychiatric Department in Greece

Involuntary Hospitalizations in an Italian Acute Psychiatric Ward: A 6-Year Retrospective Analysis

COVID-19 Pandemic School Disruptions and Acute Mental Health in Children and Adolescents

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