The mental health toll of COVID-19: significant increase in admissions to ICU for voluntary self-inflicted injuries after the beginning of the pandemic.

COVID-19 Self-harm Self-inflicted injuries Suicidal behaviours Suicide attempts

Journal

International journal of mental health systems
ISSN: 1752-4458
Titre abrégé: Int J Ment Health Syst
Pays: England
ID NLM: 101294224

Informations de publication

Date de publication:
15 Jul 2023
Historique:
received: 26 08 2022
accepted: 27 06 2023
medline: 16 7 2023
pubmed: 16 7 2023
entrez: 15 7 2023
Statut: epublish

Résumé

COVID-19 outbreak deeply impacted on mental health, with high rate of psychological distress in healthcare professionals, patients and general population. Current literature on trauma showed no increase in ICU admissions for deliberate self-inflicted injuries in the first weeks after the beginning of COVID-19. We tested the hypothesis that self-inflicted injuries/harms of any method requiring ICU admission increased in the year following COVID-19 outbreak. Retrospective cohort single-center study comparing admissions to ICU the year before and the year after the pandemic start. All patients admitted to polyvalent ICUs-Fondazione IRCCS Policlinico S. Matteo, Pavia, Italy from February 21st, 2019 to February 21st, 2020 (pre-COVID) and from February 22nd, 2020 to February 22nd, 2021 (post-COVID) were enrolled. We enrolled 1038 pre-COVID and 854 post-COVID patients. In post-COVID, the incidence of self-inflicted injuries was 32/854 (3.8% [2.5-5.1]), higher than in pre-COVID (23/1038, 2.2%-p = 0.0014-relative increase 72.7%). The increase was more relevant when excluding COVID-19 patients (suicide attempts 32/697 (4.6% [3.0-6.2])-relative increase 109.1%; p < 0.0001). Both in pre-COVID and post-COVID, the most frequent harm mean was poisoning [15 (65.2%) vs. 25 (78.1%), p = 0.182] and the analysed population was younger than general ICU population (p = 0.0015 and < 0.0001, respectively). The distribution of admissions for self-inflicted injuries was homogeneous in pre-COVID along the year. In post-COVID, no admissions were registered during the lockdown; an increase was observed in summer with pandemic curve at minimal levels. An increase in ICU admissions for self-inflicted injuries/harms was observed in the year following COVID-19 outbreak.

Sections du résumé

BACKGROUND BACKGROUND
COVID-19 outbreak deeply impacted on mental health, with high rate of psychological distress in healthcare professionals, patients and general population. Current literature on trauma showed no increase in ICU admissions for deliberate self-inflicted injuries in the first weeks after the beginning of COVID-19.
OBJECTIVES OBJECTIVE
We tested the hypothesis that self-inflicted injuries/harms of any method requiring ICU admission increased in the year following COVID-19 outbreak.
METHODS METHODS
Retrospective cohort single-center study comparing admissions to ICU the year before and the year after the pandemic start. All patients admitted to polyvalent ICUs-Fondazione IRCCS Policlinico S. Matteo, Pavia, Italy from February 21st, 2019 to February 21st, 2020 (pre-COVID) and from February 22nd, 2020 to February 22nd, 2021 (post-COVID) were enrolled.
RESULTS RESULTS
We enrolled 1038 pre-COVID and 854 post-COVID patients. In post-COVID, the incidence of self-inflicted injuries was 32/854 (3.8% [2.5-5.1]), higher than in pre-COVID (23/1038, 2.2%-p = 0.0014-relative increase 72.7%). The increase was more relevant when excluding COVID-19 patients (suicide attempts 32/697 (4.6% [3.0-6.2])-relative increase 109.1%; p < 0.0001). Both in pre-COVID and post-COVID, the most frequent harm mean was poisoning [15 (65.2%) vs. 25 (78.1%), p = 0.182] and the analysed population was younger than general ICU population (p = 0.0015 and < 0.0001, respectively). The distribution of admissions for self-inflicted injuries was homogeneous in pre-COVID along the year. In post-COVID, no admissions were registered during the lockdown; an increase was observed in summer with pandemic curve at minimal levels.
CONCLUSIONS CONCLUSIONS
An increase in ICU admissions for self-inflicted injuries/harms was observed in the year following COVID-19 outbreak.

Identifiants

pubmed: 37454115
doi: 10.1186/s13033-023-00590-x
pii: 10.1186/s13033-023-00590-x
pmc: PMC10349498
doi:

Types de publication

Journal Article

Langues

eng

Pagination

22

Informations de copyright

© 2023. The Author(s).

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Auteurs

Silvia Mongodi (S)

Anesthesia and Intensive Care 1St, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy. silvia.mongodi@libero.it.

Giulia Salve (G)

Anesthesia and Intensive Care 1St, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy.
Department of Clinical-Surgical, Diagnostic and Pediatric Sciences, Università Di Pavia, Pavia, Italy.

Marta Ravasi (M)

Department of Clinical-Surgical, Diagnostic and Pediatric Sciences, Università Di Pavia, Pavia, Italy.

Damiano Rizzi (D)

Psychology department, Fondazione Soleterre, Milan, Italy.
Emergency Room, Department of Intensive Medicine, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy.

Matteo Mangiagalli (M)

Department of Clinical-Surgical, Diagnostic and Pediatric Sciences, Università Di Pavia, Pavia, Italy.
Psychology department, Fondazione Soleterre, Milan, Italy.

Valeria Musella (V)

Clinical Epidemiology and Biometrics, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy.

Catherine Klersy (C)

Clinical Epidemiology and Biometrics, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy.

Luca Ansaloni (L)

Department of Clinical-Surgical, Diagnostic and Pediatric Sciences, Università Di Pavia, Pavia, Italy.
General Surgery, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy.

Francesco Mojoli (F)

Anesthesia and Intensive Care 1St, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy.
Department of Clinical-Surgical, Diagnostic and Pediatric Sciences, Università Di Pavia, Pavia, Italy.

Classifications MeSH