Psychiatric hospitalization during the two SARS-CoV-2 pandemic waves: New warnings for acute psychotic episodes and suicidal behaviors

Abstract

Informed consent statement:The informed consent statement was waived.

Psychiatric ward admissions during the COVID-19 pandemic in Canton of Ticino (Swiss Confederation) and the province of Como (Italy): a comparison between two different systems of care and outbreak response strategies

“…6,13,18 More specifically, in the province of Como, the psychiatric ward in the Hospital of Cantù was temporary closed, with reduction of the beds in the entire province, and consequently, along with the fear of the contagion, a reduction of availability for new admissions. 12 In fact, in line with other studies carried out in Italy; 6,15,17 we found a significant reduction in voluntary admissions while the number of compulsory admissions remained stable; that mean an "increased threshold" for inpatient admissions and only the more severe patients keep being admitted to the psychiatric wards. 16 Moreover, compulsory admissions did not either show any autocorrelation or seasonality, nor seemed to be significantly influenced by any covariates.…”

“…Then, we did not consider any data about length of stay, sociodemographic variables (age, ethnicity, marital, housing and economic status), diagnosis and disorder severity or pharmacological treatment. We expect, in line with the current literature, a significant reduction in elderly, 6,21,40 addiction disorders 21,23,39 and in mood disorders 14,17 and a general increase of length of stay. 6,14…”

“…9,10 However, to evaluate the more severe burden of pandemic and lockdown on mental health status, the investigation of psychiatric hospitalizations is an essential index, since it is well known that patients with psychiatric comorbidity are linked with longer hospitalization also in internal medicine wards. 11 Surveys carried out during the first wave of the pandemic 3,6,[12][13][14][15][16][17][18][19] showed a reduction in the overall number of psychiatric ward admissions, but not for compulsory admissions 3,6,[12][13][14][15]17,20 and in high acuity units; 16 by contrast, in a survey carried out in Sweden (where lockdown measures were lighter), 21 In studies investigating the post-lockdown period and the following waves of the pandemic (with the consequent of new restrictions), the number of admissions either reached (without exceeding) the numbers of pre-pandemic period, 6,15,17,21,22 or remained slightly lower. 19,20,23 However, none of these studies compared data from two or more different countries.…”

The effects of COVID-19 on European healthcare provision for working-age adults with major depressive disorder

“…These studies are summarised in Table 2. Across these articles, there was a general tendency for a decrease in access to care during the COVID-19 pandemic: several studies reported changes in the number of clinical interactions relevant to MDD care, including number of psychiatric presentations to acute mental health assessment centres in London [27], number of admissions to emergency psychiatric care in Barcelona [28], number of hospitalisations to a psychiatric ward in Bologna [29], and number of referrals to inpatient and liaison psychiatry services in London [30]. There was consistency in the findings, with number of clinical interactions being reduced in all instances, to varying degrees.…”