Fluctuation of Danish psychiatric admission rates in World War II: initial decrease and subsequent increase; trends in psychiatric hospital admissions 1939-1948

Effects of lockdown on emergency room admissions for psychiatric evaluation: an observational study from the AUSL Romagna, Italy

OBJECTIVES

An observation of the admissions to the emergency room (ER) requiring psychiatric evaluation during the lockdown and investigation of the demographic and clinical variables.

METHODS

Retrospective longitudinal observational study of ER accesses for psychiatric evaluation was performed, comparing two periods (9 March-3 May 2020 vs. 9 March-3 May 2019). Data (number of admissions, key baseline demographic and clinical variables) were extracted from the ER databases of referral centres in a well-defined geographic area of North-Eastern Italy (Cesena, Ravenna, Forlì, and Rimini).

RESULTS

A 15% reduction of psychiatric referrals was observed, together with a 17% reduction in the total number of patients referring to the ER. This reduction was most evident in the first month of the lockdown period (almost 25% reduction of both referrals and patients). Female gender (OR: 1.52: 95%, CI: 1.12-2.06) and being a local resident (OR: 1.54: 95%CI: 1.02-2.34) were factors associated with the decrease.

CONCLUSIONS

Lockdown changed dramatically health priorities in the local population, including people with mental health. We speculate that our observations do not only refer to the confinement due to the lockdown regime but also to fear of contagion and adoption of different coping strategies, especially in women.Key-pointsDuring lockdown 15% reduction of psychiatric visits and >17% reduction in the number of psychiatric patients referring to the ER was observed.in the first four weeks of the lockdown almost 25% reduction of both visits and patients was observedFemale gender and being a local resident were factors associated with the decrease.

Psychiatric hospitalization rates in Italy before and during COVID-19: did they change? An analysis of register data

OBJECTIVES.

To assess admission rates to seven General Hospital Psychiatric Wards (GHPWs) located in the Lombardy Region in the 40 days after the start of Coronavirus disease 2019 (COVID-19) epidemic, compared to similar periods of 2020 and 2019.

METHODS.

Anonymized data from the regional psychiatric care register have been obtained and analyzed. The seven GHPWs care for approximately 1.4 million inhabitants and have a total of 119 beds.

RESULTS.

In the 40-day period (February 21-March 31, 2020) after the start of the COVID-19 epidemic in Italy, compared to a similar 40-day period prior to February 21, and compared to two 40-day periods of 2019, there has been a marked reduction in psychiatric admission rates. The reduction was explained by voluntary admissions, while there was not a noticeable reduction for involuntary admissions. The reduction was visible for all diagnostic groups, except for a group of 'Other' diagnoses, which includes anxiety disorders, neurocognitive disorders, etc.

CONCLUSIONS.

Large-scale pandemics can modify voluntary admission rates to psychiatric facilities in the early phases following pandemic onset. We suggest that the reduction in admission rates may be due to fear of hospitals, seen as possible sites of contagion, as well as to a change in thresholds of behavioral problems acting as a trigger for admission requests from family relatives or referrals from treating clinicians. It is unclear from the study whether the reduction in admissions was contributed to most by the current pandemic or the lockdown imposed due to the pandemic.

Internet addiction and psychopathology in a community before and during an economic crisis

Background. Internet addiction disorder (IAD) is a novel concept under scrutiny for a definite inclusion in the psychiatric taxonomy, after showing correlations with overt expressions of psychopathology. This study aims to assist the scientific dialogue concerning IAD while presenting comparative data on adolescent psychopathology before and during a major economic crisis that has affected Greece from 2010 onwards. Methods. This is a cross-sectional study of a high school student population, aged 12-18, on IAD which follows-up a 2006 survey, and is carried out 5 years later at the same school classes. A comparison on psychopathological symptoms between the two samples is carried out to confirm any underlying correlations with IAD while providing some first insight on any effects of the economic crisis on adolescent psyche. Results. Results indicate that Internet addiction is increased in this population paralleling the increase in Internet availability at home. Adolescents affected with IAD present with more psychopathological symptoms. A comparison between the 2006 and 2011 samples reveals lower rates of general psychopathology but similar burden of reported symptoms. Conclusions. Those findings are discussed in the framework of adolescent coping to adversity, individual reactions to major crises, as well as the general debate regarding the value of IAD as a distinct diagnosis. The effects of the economic crisis may have triggered an adaptive response in the adolescent population although IAD as a distinct nosological entity is clearly linked to more symptoms of overt psychopathology. Directions are offered for further research in countries affected by crises.