Hospital Admissions for Personality Disorders Increased During the COVID-19 Pandemic

Patten, Scott B.; Dimitropoulos, Gina; Williams, Jeanne V.A.; Rao, Sandy; Fahim, Mina; Sharifi, Vandad; Pedram, Pardis; Bulloch, Andrew G. M.

doi:10.1177/07067437231155999

Cited by 2 publications

(2 citation statements)

References 5 publications

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“…Several previous contributions pointed to the detrimental effect of COVID-19 related restrictions on the mental health of patients with borderline personality disorder. They displayed an increase of distress and depressive feelings, and non-suicidal self-injuries ( 28–32 ) but also increased rate of admission for inpatient care ( 33 ). Reports on antisocial personality mostly focused on the poor compliance with the COVID-19 rules of protection among these patients, in particular in case of lack of empathy and callous behavior ( 34–36 ).…”

Section: Discussionmentioning

confidence: 99%

Patterns of admission in forensic units during the COVID-19 pandemic: a process analysis

D’Orta,

Herrmann,

Giannakopoulos

2024

Front. Psychiatry

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IntroductionThe impact of COVID-19 pandemic on forensic service practice remains matter of debate. Increased rates of anxiety, depression, and exacerbation of psychotic symptoms were reported in the early phases of the pandemic among detained persons. However, longitudinal analyses in medium-security hospitals taking into account the whole pandemic period led to mitigated results.MethodsThis report examines the evolution of the type (voluntary versus involuntary) and reason of admissions, length of stay, history of outpatient care, short-term seclusion hours for aggressive behaviors, and clinical diagnoses for detainees needing acute psychiatric care during the COVID-19 pandemic in the sole secure ward located in the central prison of Geneva, Switzerland. To determine the general trend of the processes over time we applied a combination of process analysis with run chart plotting, and fractional polynomial regression.ResultsRun tests showed that the proportion of cases with personality disorders, substance use disorders (SUD), and previous outpatient care tended to increase during the COVID pandemic with subsequent decrease to reach the pre-COVID values. This was also the case for depressive symptoms as reason for admission. The proportion of involuntary admission showed a steady increase both during the COVID and post-COVID time periods. In contrast, short-term seclusion hours decreased during the COVID pandemic followed by a return to their pre-COVID values. Regression models revealed that the COVID pandemic was associated with a significant increase in the rates of inmates with personality disorders and SUD admitted for forensic care explaining 36 and 41% of their variance.DiscussionThese data support the idea that, in terms of acute care needs, the COVID-19 pandemic was associated with increased needs for acute forensic care that concerned detainees with personality disorders characterized by increased levels of impulsiveness, decreased tolerance to frustrations, loss of control, increased extraversion and frequent SUD comorbidity.

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Section: Discussionmentioning

confidence: 99%

Patterns of admission in forensic units during the COVID-19 pandemic: a process analysis

D’Orta,

Herrmann,

Giannakopoulos

2024

Front. Psychiatry

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“…Across Canada, mental health and substance use service utilization during the pandemic has mostly suggested a decline in emergency department and hospital visits ( 18 , 19 ) with hospitalization rates returning to pre-pandemic levels by March 2021 ( 20 ). Evidence from Ontario, Canada using population-level administrative data found psychiatric-related hospital admissions did not return to pre-restriction rates ( 21 ) and while overall volumes may have decreased, monthly increases were observed for specific mental disorders post pandemic ( 22 , 23 ). In British Columbia (BC), Canada COVID-19 mental-health related service use rose sharply during 2020, but quickly stabilized; however, other types of mental health service use and drug dispensation continued to rise significantly into 2021 ( 24 ).…”

Section: Introductionmentioning

confidence: 99%

Adult psychiatric inpatient admissions and length of stay before and during the COVID-19 pandemic in a large urban hospital setting in Vancouver, British Columbia

Russolillo,

Carter,

Guan

et al. 2024

Front. Health Serv.

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IntroductionDuring the COVID-19 pandemic individuals with mental illnesses faced challenges accessing psychiatric care. Our study aimed to describe patient characteristics and compare admissions and length of stay (LOS) for psychiatric-related hospitalizations before and during the COVID-19 pandemic.MethodsWe conducted a retrospective analysis using health administrative data comparing individuals with an acute psychiatric admission between two time periods: 1st March 2019 to 31st December 2019 (pre-COVID) and 1st March 2020 to 31st December 2020 (during-COVID). Multivariable negative binomial regression was used to model the association between most responsible diagnosis type and the two-time periods to hospital LOS, reporting the Rate Ratio (RR) as the measure of effect.ResultsThe cohort comprised 939 individuals who were predominately male (60.3%) with a severe mental illness (schizophrenia or mood-affective disorder) (72.7%) and a median age of 38 (IQR: 28.0, 52.0) years. In the multivariable analysis, anxiety disorders (RR: 0.63, CI: 0.4, 0.99) and personality disorders (RR: 0.52, CI: 0.32, 0.85) were significantly associated with a shorter LOS when compared to individuals without those disorders. Additionally, when compared to hospital admissions for non-substance related disorders the LOS for patients with substance-related disorders were significantly shorter during the COVID period (RR: 0.45, CI: 0.30, 0.67) and pre-COVID period (RR: 0.31, CI: 0.21, 0.46).ConclusionsWe observed a significant difference in the type and length of admissions for various psychiatric disorders during the COVID-19 period. These findings can support systems of care in adapting to utilization changes during pandemics or other global health events.

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Hospital Admissions for Personality Disorders Increased During the COVID-19 Pandemic

Cited by 2 publications

References 5 publications

Patterns of admission in forensic units during the COVID-19 pandemic: a process analysis

Patterns of admission in forensic units during the COVID-19 pandemic: a process analysis

Adult psychiatric inpatient admissions and length of stay before and during the COVID-19 pandemic in a large urban hospital setting in Vancouver, British Columbia

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