Admissions to psychiatric inpatient services and use of coercive measures in 2020 in a Swiss psychiatric department : An interrupted time-series analysis

Article Article scientifique Article Admissions to psychiatric inpatient services and use of coercive measures in 2020 in a Swiss psychiatric department : An interrupted time-series analysis eng 2023-07-27 2023-07-27 author Wullschleger Alexandre 0000-0001-9282-8064 Department of Psychiatry, Geneva University Hospitals, Geneva, Switzerland. 595667 Département de psychiatrie (PSYAT) author Da Cunha Goncalves Léonel Division of Prison Health, Geneva University Hospitals & University of Geneva, Geneva, Switzerland. 909239 author Royston Maya Department of Psychiatry, Geneva University Hospitals, Geneva, Switzerland. 818154 author Sentissi El Idrissi Othman 0000-0001-6280-2197 Department of Psychiatry, Geneva University Hospitals, Geneva, Switzerland. 711790 Département de psychiatrie (PSYAT) author Ambrosetti Julia 0000-0002-5775-4589 Department of Acute Medicine, Geneva University Hospitals, Geneva, Switzerland. 864890 author Kaiser Stefan 0000-0002-3013-2034 Department of Psychiatry, Geneva University Hospitals, Geneva, Switzerland. 868946 Département de psychiatrie (PSYAT) author Baggio Stéphanie 0000-0002-5347-5937 Institute of Primary Health Care (BIHAM), University of Bern, Bern, Switzerland.,Population Health Laboratory (#PopHealthLab), University of Fribourg, Fribourg, Switzerland. 706989 e0289310 10.1371/journal.pone.0289310 37498908 1932-6203 PMC10374153 https://dx.plos.org/10.1371/journal.pone.0289310 Background: The CoVID pandemic and the associated lockdown had a significant impact on mental health services. Inpatient services faced the challenge of offering acute psychiatric while implementing strict infection control measures. There is, however, a lack of studies investigating the use of coercive measures during the pandemic and their relation to hospitalizations and symptom severity. Aims: To investigate the effects of the CoVID outbreak on psychiatric admissions, use of seclusion and symptom severity. Method: Using routine data from 2019 and 2020 gathered in the Department of Psychiatry at the Geneva University Hospitals, we performed an interrupted time series analysis. This included the number of psychiatric hospitalizations, the proportion of people who experienced seclusion and the average severity of symptoms as measured by the Health of Nations Outcome Scale (HoNOS). Dependent variables were regressed on the time variable using regression model with bootstrapped standard errors. Results: Hospitalizations decreased over time ( b = -0.57, 95% CI: -0.67; -0.48, p < .001). A structural break in the data (supremum Wald test: p < .001) was observed in the 12 th week of 2020. There was an inverse relationship between the number of admissions and the proportions of people subject to seclusion ( b = 0.21, 95% CI: -0.32; -0.09, p < .001). There was a statistically marginally significant inverse relationship between HoNOS scores at admission and the number of psychiatric hospitalizations ( b = -1.28, 95% CI: -2.59, 0.02, p = .054). Conclusion: Our results show that the CoVID pandemic in 2020 was associated with a significant decrease in the number of hospital admissions. This decrease was correlated with a greater use of seclusion. The higher burden of symptoms and the difficult implementation of infection control measures might explain this higher use of coercion. COVID-19 / epidemiology Coercion Hospitalization Hospitals, Psychiatric Humans Infection Control Inpatients / psychology Interrupted Time Series Analysis Mental Disorders / epidemiology Mental Disorders / psychology Mental Disorders / therapy Restraint, Physical Switzerland / epidemiology Dewey 616.89 Dewey 613 Dewey 617 Fondation Privée des HUG 135- COVID LIBERTE PSY 60 Département de psychiatrie 225 64 Département de santé et médecine communautaires 22A 63 Département d'anesthésiologie, pharmacologie, soins intensifs et urgences 229 false 1236 Psychopathologie clinique et expérimentale 987 PloS one 18 7 6ce19b18-9d0e-4223-8b27-e20f50f2b71c Article (Published version) Public Article_scientifique_from_unpaywall.pdf 768534 application/pdf CC BY-4.0 d8f139283a1e71f551bc006ea2f5b0b4e51a1ac04f1ee7cf1a16859a399e185a 9c3a5bc6-a0f4-4568-a4cb-75f7faf27f3c Supplemental data Public 10_1371_journal_pone_0289310.zip 38570 application/zip 79653d5ae89e92563d5de66d7c8f7819694650ef04486f9b83319cd9a38eed15 openAccess Faculté de médecine / Section de médecine clinique / Département de psychiatrie Faculté de médecine / Section de médecine clinique / Département de santé et médecine communautaires Faculté de médecine / Section de médecine clinique / Département d'anesthésiologie, pharmacologie, soins intensifs et urgences

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Admissions to psychiatric inpatient services and use of coercive measures in 2020 in a Swiss psychiatric department : An interrupted time-series analysis	PloS one	2023	94	315
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