• Tommaso Boldrini, Paolo Girardi, Massimo Clerici, Andreas Conca, Chiara Creati, Giuseppe Di Cicilia, Giuseppe Ducci, Federico Durbano, Carlo Maci, Antonio Maone, Giuseppe Nicolò, Osmano Oasi, Mauro Percudani, Gian Marco Polselli, Maurizio Pompili, Alessandro Rossi, Silvia Salcuni, Federica Tarallo, Antonio Vita, Vittorio Lingiardi, and Italian Network for Research on Mental Health during COVID-19 Pandemic.
• Department of Developmental Psychology and Socialization, University of Padova, Padova, Italy.
• Prog. Neuropsychopharmacol. Biol. Psychiatry. 2021 Aug 30; 110: 110304.

AimsThe present investigation aimed at evaluating differences in psychiatric hospitalizations in Italy during and after the lockdown due to the novel coronavirus disease 2019 (COVID-19), compared to the same periods in 2018 and 2019.MethodsWe obtained and analyzed anonymized data on psychiatric admissions (n = 4550) from 12 general hospital psychiatric wards (GHPWs) in different Italian regions (catchment area = 3.71 millions of inhabitants). Using a mixed-effects Poisson regression model, we compared admission characteristics across three periods: (a) March 1-June 30, 2018 and 2019; (b) March 1-April 30, 2020 (i.e., lockdown); and (c) May 1-June 30, 2020 (i.e., post-lockdown).ResultsDuring the COVID-19 lockdown, there was a 41% reduction (IRR = 0.59; p < 0.001, CI: 0.45-0.79) in psychiatric admissions in the enrolled GHPWs with respect to the 2018 and 2019 control period. Conversely, admission rates in the post-lockdown period were similar to those observed in the control period. Notably, a consistent and significant reduction in psychiatric hospitalizations of older patients (aged >65 years) was observed in the lockdown (40%; IRR = 0.60; 95% CI: 0.44-0.82) and post-lockdown (28%; IRR = 0.72; 95% CI: 0.54-0.96) periods. Long-stay admissions (>14 days) increased (63%; IRR = 1.63; 95% CI: 1.32-2.02) during the lockdown and decreased by 39% thereafter (IRR = 0.61; 95% CI: 0.49-0.75). A significant 35% increase in patients reporting suicidal ideation was observed in the post-lockdown period, compared to the rate observed in the 2018 and 2019 control period (IRR = 1.35; 95% CI: 1.01-1.79).ConclusionThe COVID-19 lockdown was associated with changes in the number of psychiatric admissions, particularly for older patients and long-stay hospitalizations. Increased admission of patients reporting suicidal ideation in the post-lockdown period merits special attention. Further studies are required to gain insight into the observed phenomena.Copyright © 2021 Elsevier Inc. All rights reserved.

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