ArticleFrontiers in psychiatry2026
COVID-19 and psychiatric inpatient admissions at a Saudi tertiary hospital, 2017-2024: an interrupted time-series study.
Article in Frontiers in psychiatry, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Introduction: Psychiatric inpatient admissions decreased in many countries during the COVID-19 pandemic. Most studies used a year or less of pre-pandemic data and compared the two periods directly, which cannot separate a pandemic effect from the increase that predated it, and evidence from the Middle East is limited. This study examined changes in psychiatric admission volume across the COVID-19 pandemic, with diagnostic case-mix and length of stay (LOS) examined as secondary outcomes. Methods: This interrupted time-series analysis used eight years of inpatient records from Prince Sultan Military Medical City, a tertiary hospital in Riyadh, Saudi Arabia. All 1551 adult psychiatric admissions between January 2017 and November 2024 were assigned to pre-COVID (January 2017 to February 2020), during-COVID (March 2020 to December 2021), and post-COVID (January 2022 to November 2024) periods. Monthly admission counts were modeled by segmented Poisson regression. Diagnostic case-mix was assessed by chi-square tests and length of stay by a linear mixed-effects model. Results: Before the pandemic, admissions were increasing by 1.7% per month (IRR 1.017; 95% CI 1.009-1.024), a trend concentrated in the first recording year (2017). With the baseline restricted to 2018 onward, this trend was flat. At onset admissions decreased by 31.5% (IRR 0.685; 95% CI 0.564-0.831), a reduction that persisted across baseline specifications. Monthly volume then remained near the pre-pandemic mean of 16 to 17 through 2024. Diagnostic composition differed across periods. Admissions for substance use disorders increased from 9.0% to 14.3% in the post-COVID period (absolute difference 5.3 percentage points; 95% CI 1.6-9.0), and admissions for mood disorders decreased from 37.4% to 30.5%. Length of stay showed no significant change. Conclusion: At this single center, admissions fell at onset and then remained near their pre-pandemic level through 2024. The diagnostic and sociodemographic differences were small and should be regarded as exploratory. Multicenter studies are needed to confirm these findings and to inform mental health service planning for future public health emergencies.
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