Skip to main content
Intended for healthcare professionals
Restricted access
Research article
First published online August 7, 2023

The impact of COVID-19 on acute psychiatric admissions for first and repeated episode psychosis

Abstract

Background:

There is limited evidence of the longer-term impact of the COVID-19 pandemic on acute admissions for psychosis in the UK.

Aims:

We examined the impact of COVID-19 on rates of admissions for first and repeated episode psychosis, and changes in patient profile and seasonal patterns, over a period of 12 months.

Method:

We conducted a retrospective case note review of all patients admitted with a primary psychosis (F20-29 ICD 10 diagnosis) to an NHS psychiatric inpatient unit. We compared the 12 months pre-COVID-19 period between 1 March 2019 and 28 February 2020, and the 12 months post-COVID-19 period between 1 March 2020 and 28 February 2021.

Results:

The results showed increase rates of admissions post-COVID-19 in both first and repeated episode psychosis, the patient profile had more females and older age in the repeated episode group, with increased employment rates. Combined group data for both pre- and post-COVID-19 periods showed an increased trend in spring and summer admissions, and even though not statistically significant, more pronounced post-COVID-19.

Conclusions:

Our findings highlight the effect of the COVID-19 pandemic on acute psychosis admissions over a 12-month period. The results provide evidence for the ‘stress-pathogenesis’ in the context of genetic vulnerability in psychosis. Preventative strategies in the context of the ‘stress-pathogenesis model’, improved access to and responsiveness within NHS transformation efforts needs to be adjusted to fit local need and environmental changes.

Get full access to this article

View all access and purchase options for this article.

References

Abbas M. J., Kronenberg G., McBride M., Chari D., Alam F., Mukaetova-Ladinska E., Al-Uzri M., Brugha T. (2021). The early impact of the COVID-19 pandemic on acute care mental health services. Psychiatric Services, 72(3), 242–246. https://doi.org/10.1176/appi.ps.202000467
Almeida M., Shrestha A. D., Stojanac D., Miller L. J. (2020). The impact of the COVID-19 pandemic on women’s mental health. Archives of Women’s Mental Health, 23(6), 741–748. https://doi.org/10.1007/s00737-020-01092-2
Bassiony M. M., Sehlo M. G., Ibrahim E. F., Zayed A. E., Atwa S. A. (2023). Assessment of compliance and relapse in patients with schizophrenia before and after the onset of COVID-19 pandemic. International Journal of Psychiatry in Clinical Practice, 27(2), 127–133. https://doi.org/10.1080/13651501.2022.2124175
Boldrini T., Girardi P., Clerici M., Conca A., Creati C., Di Cicilia G., Ducci G., Durbano F., Maci C., Maone A., Nicolò G., Oasi O., Percudani M., Polselli G. M., Pompili M., Rossi A., Salcuni S., Tarallo F., Vita A., Lingiardi V. (2021). Consequences of the COVID-19 pandemic on admissions to general hospital psychiatric wards in Italy: Reduced psychiatric hospitalizations and increased suicidality. Progress in Neuro-Psychopharmacology and Biological Psychiatry, 110, 110304. https://doi.org/10.1016/j.pnpbp.2021.110304
Brahmi L., Ben Ammar H., Hamdi G., Khelifa E., Felhi R., Mnif L. (2021). COVID-19 pandemic and first episode of psychosis: Clinical characteristics. European Psychiatry, 64(S1), S675–S676. https://doi.org/10.1192/j.eurpsy.2021.1793
Brahmi L., Ben Ammar H., Khelifa E., Hamdi G., Felhi R., Mnif L. (2021). Psychotic relapse from COVID-19 pandemic: Clinical features. European Psychiatry, 64(S1), S677–S677. https://doi.org/10.1192/j.eurpsy.2021.1797
Casanovas F., Trabsa A., Bergé D., Sánchez-Gistau V., Moreno I., Sanchez J., Montalvo I., Tost M., Labad J., Pérez-Solà V., Mané A. (2022). Incidence rate and distinctive characteristics of first episode psychosis during the COVID-19 pandemic: A multicenter observational study. Scientific Reports, 12(1), 22036. https://doi.org/10.1038/s41598-022-26297-6
Chatterjee S. S., Malathesh B. C., Mukherjee A. (2020). Impact of COVID-19 pandemic on pre-existing mental health problems. Asian Journal of Psychiatry, 51, 102071. https://doi.org/10.1016/j.ajp.2020.102071
Clarke M., Moran P., Keogh F., Morris M., Kinsella A., Larkin C., Walsh D., O’Callaghan E. (1999). Seasonal influences on admissions for affective disorder and schizophrenia in Ireland: A comparison of first and readmissions. European Psychiatry, 14(5), 251–255. https://doi.org/10.1016/S0924-9338(99)00174-1
Clerici M., Durbano F., Spinogatti F., Vita A., de Girolamo G., Micciolo R. (2020). Psychiatric hospitalization rates in Italy before and during COVID-19: Did they change? An analysis of register data. Irish Journal of Psychological Medicine, 37(4), 283–290. https://doi.org/10.1017/ipm.2020.29
Connor J., Madhavan S., Mokashi M., Amanuel H., Johnson N. R., Pace L. E., Bartz D. (2020). Health risks and outcomes that disproportionately affect women during the COVID-19 pandemic: A review. Social Science & Medicine, 266, 113364. https://doi.org/10.1016/j.socscimed.2020.113364
D’Agostino A., D’Angelo S., Giordano B., Cigognini A. C., Chirico M. L., Redaelli C., Gambini O. (2021). Brief psychotic disorder during the national lockdown in Italy: An emerging clinical phenomenon of the COVID-19 pandemic. Schizophrenia Bulletin, 47(1), 15–22. https://doi.org/10.1093/schbul/sbaa112
Davies M., Hogarth L. (2021). The effect of COVID-19 lockdown on psychiatric admissions: Role of gender. BJPsych Open, 7(4), e112. https://doi.org/10.1192/bjo.2021.927
Dionisie V., Ciobanu A. M., Moisa E., Manea M. C., Puiu M. G. (2022). The impact of the COVID-19 pandemic on inpatient admissions for psychotic and affective disorders: The experience of a large psychiatric teaching hospital in Romania. Healthcare, 10(8), 1570. https://doi.org/10.3390/healthcare10081570
Dziwota E., Stepulak M., Włoszczak-Szubzda A., Olajossy M. (2018). Social functioning and the quality of life of patients diagnosed with schizophrenia. Annals of Agricultural and Environmental Medicine, 25(1), 50–55. https://doi.org/10.5604/12321966.1233566
Emsley R., Chiliza B., Asmal L., Harvey B. H. (2013). The nature of relapse in schizophrenia. BMC Psychiatry, 13(1), 50. https://doi.org/10.1186/1471-244X-13-50
Esposito C. M., D’Agostino A., Dell Osso B., Fiorentini A., Prunas C., Callari A., Oldani L., Fontana E., Gargano G., Viscardi B., Giordano B., D’Angelo S., Wiedenmann F., Macellaro M., Giorgetti F., Turtulici N., Gambini O., Brambilla P. (2021). Impact of the first COVID-19 pandemic wave on first episode psychosis in Milan, Italy. Psychiatry Research, 298, 113802. https://doi.org/10.1016/j.psychres.2021.113802
Hinterbuchinger B., König D., Gmeiner A., Listabarth S., Fellinger M., Thenius C., Baumgartner J. S., Vyssoki S., Waldhoer T., Vyssoki B., Pruckner N. (2020). Seasonality in schizophrenia—an analysis of a nationwide registry with 110,735 hospital admissions. European Psychiatry, 63(1), e55. https://doi.org/10.1192/j.eurpsy.2020.47
Iosifescu D. V. (2012). The relation between mood, cognition and psychosocial functioning in psychiatric disorders. European Neuropsychopharmacology, 22, S499–S504. https://doi.org/10.1016/j.euroneuro.2012.08.002
Jagadheesan K., Danivas V., Itrat Q., Sekharan L., Lakra A. P. V. (2021). COVID-19 and psychiatric admissions: An observational study of the first six months of lockdown in Melbourne. Psychiatry Research, 300, 113902. https://doi.org/10.1016/j.psychres.2021.113902
Jahan S., Wraith D., Dunne M. P., Naish S., McLean D. (2020). Seasonality and schizophrenia: A comprehensive overview of the seasonal pattern of hospital admissions and potential drivers. International Journal of Biometeorology, 64(8), 1423–1432. https://doi.org/10.1007/s00484-020-01910-3
Jongsma H. E., Turner C., Kirkbride J. B., Jones P. B. (2019). International incidence of psychotic disorders, 2002–17: A systematic review and meta-analysis. The Lancet Public Health, 4(5), e229–e244. https://doi.org/10.1016/S2468-2667(19)30056-8
Kozloff N., Mulsant B. H., Stergiopoulos V., Voineskos A. N. (2020). The COVID-19 global pandemic: Implications for people with schizophrenia and related disorders. Schizophrenia Bulletin, 46(4), 752–757. https://doi.org/10.1093/schbul/sbaa051
Michalak E. E., Yatham L. N., Maxwell V., Hale S., Lam R. W. (2007). The impact of bipolar disorder upon work functioning: A qualitative analysis. Bipolar Disorders, 9(1–2), 126–143. https://doi.org/10.1111/j.1399-5618.2007.00436.x
Mondelli V. (2014). From stress to psychosis: Whom, how, when and why? Epidemiology and Psychiatric Sciences, 23(3), 215–218. https://doi.org/10.1017/S204579601400033X
Murray R. M., Mondelli V., Stilo S. A., Trotta A., Sideli L., Ajnakina O., Ferraro L., Vassos E., Iyegbe C., Schoeler T., Bhattacharyya S., Marques T. R., Dazzan P., Lopez-Morinigo J., Colizzi M., O’Connor J., Falcone M. A., Quattrone D., Rodriguez V., . . . Di Forti M. (2020). The influence of risk factors on the onset and outcome of psychosis: What we learned from the GAP study. Schizophrenia Research, 225, 63–68. https://doi.org/10.1016/j.schres.2020.01.011
NHS England. (2019, January 7). The NHS Long Term Plan. www.longtermplan.nhs.uk.
O’Donoghue B., Collett H., Boyd S., Zhou Y., Castagnini E., Brown E., Street R., Nelson B., Thompson A., McGorry P. (2022). The incidence and admission rate for first-episode psychosis in young people before and during the COVID-19 pandemic in Melbourne, Australia. Australian & New Zealand Journal of Psychiatry, 56(7), 811–817. https://doi.org/10.1177/00048674211053578
Pelayo-Terán J. M., Gajardo Galán V. G., de la Ortiz-García de la Foz V., Martínez-García O., Tabarés-Seisdedos R., Crespo-Facorro B., Ayesa-Arriola R. (2017). Rates and predictors of relapse in first-episode non-affective psychosis: A 3-year longitudinal study in a specialized intervention program (PAFIP). European Archives of Psychiatry and Clinical Neuroscience, 267(4), 315–323. https://doi.org/10.1007/s00406-016-0740-3
Power K. (2020). The COVID-19 pandemic has increased the care burden of women and families. Sustainability: Science, Practice and Policy, 16(1), 67–73. https://doi.org/10.1080/15487733.2020.1776561
Stilo S. A., Murray R. M. (2019). Non-genetic factors in schizophrenia. Current Psychiatry Reports, 21(10), 100. https://doi.org/10.1007/s11920-019-1091-3
Takei N., O’Callaghan E., Sham P., Glover G., Tamura A., Murray R. (1992). Seasonality of admissions in the psychoses: Effect of diagnosis, sex, and age at onset. British Journal of Psychiatry, 161(4), 506–511. https://doi.org/10.1192/bjp.161.4.506
Törmälehto S., Svirskis T., Partonen T., Isometsä E., Pirkola S., Virtanen M., Sund R. (2022). Seasonal effects on hospitalizations due to mood and psychotic disorders: A nationwide 31-year register study. Clinical Epidemiology, 14, 1177–1191. https://doi.org/10.2147/CLEP.S372341
Valdés-Florido M. J., López-Díaz Á., Palermo-Zeballos F. J., Garrido-Torres N., Álvarez-Gil P., Martínez-Molina I., Martín-Gil V. E., Ruiz-Ruiz E., Mota-Molina M., Algarín-Moriana M. P., Guzmán-Del Castillo A. H., Ruiz-Arcos Á., Gómez-Coronado R., Galiano-Rus S., Rosa-Ruiz A., Prados-Ojeda J. L., Gutierrez-Rojas L., Crespo-Facorro B., Ruiz-Veguilla M. (2022). Clinical characterization of brief psychotic disorders triggered by the COVID-19 pandemic: A multicenter observational study. European Archives of Psychiatry and Clinical Neuroscience, 272(1), 5–15. https://doi.org/10.1007/s00406-021-01256-w
Valdés-Florido M. J., López-Díaz Á., Palermo-Zeballos F. J., Martínez-Molina I., Martín-Gil V. E., Crespo-Facorro B., Ruiz-Veguilla M. (2020). Reactive psychoses in the context of the COVID-19 pandemic: Clinical perspectives from a case series. Revista de Psiquiatría y Salud Mental, 13(2), 90–94. https://doi.org/10.1016/j.rpsm.2020.04.009
van Winkel R., Stefanis N. C., Myin-Germeys I. (2008). Psychosocial stress and psychosis. A review of the neurobiological mechanisms and the evidence for gene-stress interaction. Schizophrenia Bulletin, 34(6), 1095–1105. https://doi.org/10.1093/schbul/sbn101
Zhand N., Joober R. (2021). Implications of the COVID-19 pandemic for patients with schizophrenia spectrum disorders: Narrative review. BJPsych Open, 7(1), e35. https://doi.org/10.1192/bjo.2020.157
Zwicker A., Denovan-Wright E. M., Uher R. (2018). Gene–environment interplay in the etiology of psychosis. Psychological Medicine, 48(12), 1925–1936. https://doi.org/10.1017/S003329171700383X

Cite article

Cite article

Cite article

OR

Download to reference manager

If you have citation software installed, you can download article citation data to the citation manager of your choice

Share options

Share

Share this article

Share with email
EMAIL ARTICLE LINK
Share on social media

Share access to this article

Sharing links are not relevant where the article is open access and not available if you do not have a subscription.

For more information view the Sage Journals article sharing page.

Information, rights and permissions

Information

Published In

Article first published online: August 7, 2023
Issue published: December 2023

Keywords

  1. COVID-19
  2. acute psychiatric admissions
  3. psychosis

Rights and permissions

© The Author(s) 2023.
Request permissions for this article.
PubMed: 37548342

Authors

Affiliations

Marlene Kelbrick
Northamptonshire Healthcare NHS Foundation Trust, Kettering, UK
Ksenija da Silva
Coventry University, Coventry, UK
Chris Griffiths
Northamptonshire Healthcare NHS Foundation Trust, Kettering, UK
Saba Ansari
Northamptonshire Healthcare NHS Foundation Trust, Kettering, UK
Gabriela Paduret
Northamptonshire Healthcare NHS Foundation Trust, Kettering, UK
James Tanner
Northamptonshire Healthcare NHS Foundation Trust, Kettering, UK
Nick Mann
Northamptonshire Healthcare NHS Foundation Trust, Kettering, UK
Sara Johnson
Northamptonshire Healthcare NHS Foundation Trust, Kettering, UK

Notes

Marlene Kelbrick, Northamptonshire Healthcare NHS Foundation Trust, St Mary’s Hospital, NSTEP, Carey Block, 77 London Road, Kettering NN15 7PW, UK. Email: [email protected]

Metrics and citations

Metrics

Journals metrics

This article was published in International Journal of Social Psychiatry.

VIEW ALL JOURNAL METRICS

Article usage*

Total views and downloads: 134

*Article usage tracking started in December 2016


Articles citing this one

Receive email alerts when this article is cited

Web of Science: 1 view articles Opens in new tab

Crossref: 1

  1. Relationship of Anxiety, Depression, Stress, and Post-Traumatic Stress...
    Go to citation Crossref Google Scholar

Figures and tables

Figures & Media

Tables

View Options

Get access

Access options

If you have access to journal content via a personal subscription, university, library, employer or society, select from the options below:


Alternatively, view purchase options below:

Purchase 24 hour online access to view and download content.

Access journal content via a DeepDyve subscription or find out more about this option.

View options

PDF/ePub

View PDF/ePub

Full Text

View Full Text