The impact of the COVID-19 pandemic on hospital admissions for psychiatric disorders: results from the multicentre study on the Italian population "COVID-19 and Mental Health" (CoMeH).

aimTo evaluate the impact of the COVID-19 pandemic on hospital admissions for psychiatric disorders, with a focus on the patients’ socioeconomic and demographic characteristics and/or the diagnostic group and type of admission.

methodsOpen cohort of individuals aged ≥ 10 years resident for at least two years in one of three large areas of Italy, covering about 6 million inhabitants (nearly 10% of the entire population). The outcome was the first admission for a psychiatric disorder (First Mental Health Admission: FMHA) during the study period (January 2018–December 2021). Municipality of residence, sex, census tract deprivation index, citizenship, type of admission and the diagnostic group were considered as covariates of interest. Incidence rate ratios (IRR) of FMHAs were estimated via an interrupted time series (ITS) analysis using a step-change negative binomial model. Moreover, an ITS analysis was conducted on the monthly number of FMHAs to evaluate the impact of COVID-19 on the temporal trend of FMHAs.

resultsOf the 5,159,363 subjects enrolled, 11,171 had an FMHA in the study period. The incidence of FMHAs decreased after the outbreak of the pandemic, overall (from 0.169/100,000 to 0.147/100,000) and by sex, deprivation level and citizenship. Immigrants from high migration pressure countries (HMPCs) had a greater reduction in FMHAs during COVID-19 (IRR: 0.91, p < 0.01). A decrease in FMHAs was observed for all diagnoses, the only exceptions being for post-traumatic stress and related disorders, which increased. Involuntary admissions also increased abruptly at the outbreak of the pandemic (from pre-COVID IRR 0.98 to 1.32). Younger age (< 34) and high deprivation level were associated with higher risk of hospitalization. In the following post-outbreak period (March 2020-December 2021), a moderate but significant growing trend of FMHAs was observed, although not reaching the pre-pandemic levels. A more robust increase was found especially for patients with eating disorders, while FMHAs for patients with post-traumatic stress and related disorders decreased to the low pre-pandemic levels. Involuntary FMHAs also decreased in the post-outbreak period.

conclusionsThe pandemic had a considerable impact on hospitalizations for psychiatric disorders. Hospitalization rates generally decreased, especially among immigrants. Younger people and those with high socioeconomic deprivation had a higher risk of hospitalization. PTSD diagnoses increased but only for a short period, while eating disorders tended to increase in the post-COVID period. In general, the effect of COVID on mental health hospitalizations appeared temporary. Longer follow-up surveys are needed. CLINICAL TRIAL NUMBER: Not applicable.