Acute Psychiatric Admissions 2017-2024: are we back to pre-pandemic patterns?

Background The COVID-19 pandemic lead to changes concerning access and type of clinical care available in healthcare systems and facilities around the world. This study aims to understand the changes in patterns of acute psychiatric admissions in the periods before, during and now after the virus hit. Methods In this retrospective study, all episodes of admissions in acute psychiatric wards in Hospital Júlio de Matos (age 18 or older) were obtained from January 2017 until March 2024. Three time frames were considered: pre-pandemic (until March 17th, 2020), pandemic (until April 30th, 2021), and post-pandemic (from that date forward); comparing gender, age, diagnosis at discharge, length of stay (LOS), number of daily admissions and number of patients occupying psychiatric hospital beds. Results 11146 admissions were identified (5706 during the pre-pandemic, 1283 during the pandemic, and 4157 in the post-pandemic period), with a median age of 47 years old, median LOS of 15 days; 4 daily admissions and occupation of 103 beds. Statistical significance was found for every variable between the three groups. Post-hoc analysis identified a higher rate of males during the post-pandemic compared to the pre-pandemic period, a higher median of age in the pre-pandemic period compared to the others; a higher median of previous admissions in the pandemic compared to the post-pandemic, a lower median LOS in the pre-pandemic period compared to the others. The proportion of patients with primary psychotic disorders was significantly lower in the pre-pandemic period compared to other diagnoses and significantly higher in the post-pandemic group. These patients were younger, with longer LOS and bed occupation. The proportion of substance use disorders was significantly lower than any other diagnosis during the pandemic period. Conclusions The profile of acute psychiatric patients in the post-pandemic period presents as being more male, younger and with a higher proportion of primary psychotic disorders. Further debate is needed towards the development of community and hospital services better adapted to this new reality. Trial registration: The current study was approved by the hospital’s scientific and ethics committees (CCP number 0060/2021 and CES 09/2021)