TY - JOUR

T1 - Psychiatric Admissions, Referrals and Suicidal Behavior Before and During the COVID-19 Pandemic in Denmark

T2 - A Time-Trend Study

AU - Rømer, Troels Boldt

AU - Christensen, Rune Haubo Bojesen

AU - Blomberg, Stig Nikolaj

AU - Folke, Fredrik

AU - Christensen, Helle Collatz

AU - Benros, Michael E

N1 - This article is protected by copyright. All rights reserved.

PY - 2021

Y1 - 2021

N2 - OBJECTIVE: To assess the patterns in psychiatric admissions, referrals and suicidal behavior before and during the COVID-19 pandemic.METHODS: This study utilized health records from hospitals and Emergency Medical Services (EMS) covering 46 % of the Danish population (n=2,693,924). In an time-trend study, we compared the number of psychiatric in-patients, referrals to mental health services and suicidal behavior in years prior to the COVID-19 pandemic to levels during the first lockdown (March 11 - May 17, 2020), inter-lockdown period (May 18 - December 15, 2020) and second lockdown (December 16, 2020 - February 28, 2021).RESULTS: During the pandemic, the rate of psychiatric in-patients declined compared to pre-pandemic levels (RR = 0.95, 95 % CI = 0.94 - 0.96, p < 0.01), with the largest decrease of 19 % observed three weeks into the first lockdown. Referrals to mental health services were not significantly different (RR = 1.01, 95 % CI = 0.92 - 1.10, p = 0.91) during the pandemic; neither was suicidal behavior among hospital contacts (RR = 1.04, 95 % CI = 0.94 - 1.14, p = 0.48) nor EMS contacts (RR = 1.08, 95 % CI = 1.00 - 1.18, p = 0.06). Similar trends were observed across nearly all age groups, sexes and types of mental disorders examined. In the age group <18, an increase in the rate of psychiatric inpatients (RR = 1.11, 95 % CI = 1.07 - 1.15, p < 0.01) was observed during the pandemic; however, this did not exceed the pre-pandemic, upwards trend in psychiatric hospitalizations in the age group <18 (p = 0.78).CONCLUSION: The COVID-19 pandemic has been associated with a decrease in psychiatric hospitalizations, while no significant change was observed in referrals to mental health services and suicidal behavior. Psychiatric hospitalizations amongst children and adolescents increased during the pandemic; however, this appears to be a continuation of a pre-pandemic trend.

AB - OBJECTIVE: To assess the patterns in psychiatric admissions, referrals and suicidal behavior before and during the COVID-19 pandemic.METHODS: This study utilized health records from hospitals and Emergency Medical Services (EMS) covering 46 % of the Danish population (n=2,693,924). In an time-trend study, we compared the number of psychiatric in-patients, referrals to mental health services and suicidal behavior in years prior to the COVID-19 pandemic to levels during the first lockdown (March 11 - May 17, 2020), inter-lockdown period (May 18 - December 15, 2020) and second lockdown (December 16, 2020 - February 28, 2021).RESULTS: During the pandemic, the rate of psychiatric in-patients declined compared to pre-pandemic levels (RR = 0.95, 95 % CI = 0.94 - 0.96, p < 0.01), with the largest decrease of 19 % observed three weeks into the first lockdown. Referrals to mental health services were not significantly different (RR = 1.01, 95 % CI = 0.92 - 1.10, p = 0.91) during the pandemic; neither was suicidal behavior among hospital contacts (RR = 1.04, 95 % CI = 0.94 - 1.14, p = 0.48) nor EMS contacts (RR = 1.08, 95 % CI = 1.00 - 1.18, p = 0.06). Similar trends were observed across nearly all age groups, sexes and types of mental disorders examined. In the age group <18, an increase in the rate of psychiatric inpatients (RR = 1.11, 95 % CI = 1.07 - 1.15, p < 0.01) was observed during the pandemic; however, this did not exceed the pre-pandemic, upwards trend in psychiatric hospitalizations in the age group <18 (p = 0.78).CONCLUSION: The COVID-19 pandemic has been associated with a decrease in psychiatric hospitalizations, while no significant change was observed in referrals to mental health services and suicidal behavior. Psychiatric hospitalizations amongst children and adolescents increased during the pandemic; however, this appears to be a continuation of a pre-pandemic trend.

U2 - 10.1111/acps.13369

DO - 10.1111/acps.13369

M3 - Journal article

C2 - 34525216

VL - 144

SP - 553

EP - 562

JO - Acta Psychiatrica Scandinavica

JF - Acta Psychiatrica Scandinavica

SN - 0001-690X

IS - 6

ER -