PSYCHIATRIC HOSPITALIZATIONS AND IMPLEMENTATION OF CAPS IN RIO GRANDE DO SUL

The CAPS was created with the objective of offering care that prioritizes the rehabilitation and psychosocial reintegration of the mentally ill individual. However, psychiatric hospitalization remains a widely used resource. This study aims to evaluate the rates of psychiatric hospitalizations and the implementation of CAPS in the state of Rio Grande do Sul, from 2008 to 2018. The study has an ecological time series design. As a result, we found a 42% increase in psychiatric hospitalizations. The CAPS coefficient was 0.64 in 2008 and increased to 0.85 (34% higher). The correlation between the CAPS coverage coefficient and the rate of psychiatric hospitalizations in RS exhibited a positive and statistically significant coefficient. These data diverge from what is found in the literature, which indicates a reduction in psychiatric hospitalizations in recent years. Thus, it is possible to conclude that there was an increase in hospitalizations and an increase in CAPS during the study period.

Repetitive Suicidal Behaviors in a Case With a New Mutation of Wolfram Syndrome; A Jump From the Gene to The Behavior

Wolfram syndrome (WS) is a rare autosomal recessive neurodegenerative disease with variable symptoms including neuropsychiatric manifestations. A 26-year-old man was reported with classic symptoms of WS and repetitive psychiatric hospitalizations and at least 16 suicidal attempts. The genetic study demonstrated a novel homozygous stop-codon mutation on the WFS1 gene. This special type of mutation may be related to repetitive suicidal behaviors in this case of WS. Psychological support should be a routine practice in patients with WS.

A Retrospective Study on the Factors Associated with Long-Stay Hospitalization in a Child Neuropsychiatry Unit

The past twenty years have seen a rapid increase in acute psychiatric symptoms in children and adolescents, with a subsequent rise in the number of psychiatric hospitalizations. This paper aims to: (a) describe the epidemiology of hospitalizations and some of the clinical and sociodemographic characteristics of pediatric patients admitted to a regional referral Complex Operative Child Neuropsychiatry Hospital Unit in Northeast Italy and (b) identify potential factors correlated with the length of hospital stay. Methods: 318 (M = 12.8 years; SD = 3.11; 72% Female) patients hospitalized for mental health disorders from 2013 to 2019. Results: Around 60% of hospital admissions occurred via the emergency room, mostly due to suicidal ideation and/or suicide attempts (24%). Affective disorders were the most frequent discharge diagnosis (40%). As for factors correlated with length of hospital stay, we found significant links with chronological age, way of hospital admission, cause of admission, discharge diagnosis, presence of psychiatric comorbidity, family conflict, and psychiatric family history. Conclusions: These results provide information about global characteristics associated with the length of psychiatric hospital stays in pediatric patients and provide a basis on which specific precautions can be hypothesized with the aim of developing more focused treatments.

A-127 The Interplay of Social Perception and Psychiatric Symptoms in a Case of Traumatic Brain Injury

Objective Acquired impairment in social perception (SP) is relatively common following moderate to severe traumatic brain injury (TBI), with up to 39% of these individuals experiencing deficient facial affect recognition. Formal assessment of SP is not common practice, despite evidence of this as a predictor of social functioning. We present the case of a 35-year-old, Caucasian male with new onset paranoid/delusional (P/D) thought processes in the context of prior TBI. Method The patient’s TBI (unknown severity) occurred 17 years prior and resulted in prolonged (>1 year) hospitalization, followed by intensive rehabilitation services. He reported residual, stable difficulties with attention, processing speed, executive functioning, and memory. Post-TBI, he was living independently with few external supports. Following a traumatic encounter with a family member (nine months prior), the patient developed P/D thought processes and a marked decline in functioning, resulting in three psychiatric hospitalizations. Brain MRI (Figure 1) revealed encephalomalacia and gliosis in the bilateral inferior frontal lobes anteriorly, high frontoparietal lobes, and bilateral (L > R) temporal lobes. Neuropsychology was consulted to clarify diagnosis/etiology and assess functional status. Results (Table 1). Evaluation results revealed non-amnestic memory impairment and variable language and processing speed. Performances on measures of SP revealed a notable weakness in the context of current intellectual performances. Conclusions This case highlights the importance of formally assessing SP in cases of TBI. Underlying SP difficulties in the context of a traumatic event may have increased vulnerability to psychiatric decompensation. Evaluation of SP allowed for enhanced understanding of the interplay between cognitive and psychiatric symptoms.

Emergency Psychiatric Consultations During and After the COVID-19 Lockdown in Italy. A Multicentre Study

Aims: The aim was to analyse the psychiatric consultations in nine Italian hospital emergency departments, by comparing the lockdown and post-lockdown periods of 2020 with the equivalent periods of 2019.Methods: Characteristics of psychiatric consultations, patients, and drug prescriptions were analyzed. Joinpoint models were used to identify changes in the weekly trend of consultations.Results: A 37.5% decrease in the number of consultations was seen during the lockdown period and 17.9% after the lockdown. The number of individual patients seen decreased by 34.9% during the lockdown and 11.2% after the lockdown. A significant change in the number of consultations from week 11 to week 18 occurred, followed by a gradual increase. There was a higher percentage of patients with previous psychiatric hospitalizations during the lockdown period (61.1 vs. 56.3%) and a lower percentage after the lockdown (59.7 vs. 64.7%). During the lockdown there was a large increase in psychiatric consultations for substance use disorders, whereas more consultations for manic episodes occurred after the lockdown. A 3.4% decrease was observed in consultations for suicidal ideation and planning during the lockdown, followed by an upward rebound after the lockdown, along with an increase in consultations for suicide attempts. During lockdown antipsychotic and benzodiazepine prescriptions increased by 5.2 and 4.1%, respectively. After the lockdown, the number of compulsory hospitalizations was higher than in 2019.Conclusions: We observed a decrease of psychiatric consultations during and after the lockdown. There was an increase in consultations for manic episodes and suicidality after the lockdown. The focus of psychiatric services must remain high particularly in this latter period.

The Invisible Enemy that Stopped the World: The Impact of the COVID‑19 Pandemic on Psychiatric Hospitalizations in a Portuguese Department

Introduction: The World The World Health Organization declared the coronavirus outbreak a pandemic on March 11th 2020. Since then, the containment measures are leading to increasing mental health problems in the general population and worsening of some pre‑existing psychiatric conditions. To our knowledge, there are no studies characterizing the impact of the COVID‑19 pandemic on psychiatric hospitalizations across the world. We aim to compare the number and characteristics of the hospitalizations in the mental health department of a Portuguese psychiatric hospital from March 2nd 2019 to October 31st 2019 with those that occurred in the same period in 2020. Methods: We conducted a retrospective observational study including all patients admitted to hospital during these periods (n=805). Sociodemographic data, clinical characteristics and information about the context of hospitalization were collected. Statistical analysis was performed using t Student Test, Mann‑Whitney and Chi‑square. Results: In the pandemic period there was a marked reduction in the number of psychiatric hospitalizations. There was a statistically significant difference in the median length of stay and in the percentage of involuntary hospitalizations between the two periods. In 2019, the most frequent International Classification of Diseases (10th Revision) diagnostic categories were F30‑F39 (mood disorders) and in 2020 were F20‑F29 (schizophrenia, schizotypal and delusional disorders). Conclusion: The reorganization of services and the decrease in admissions through the emergency department may explain these results.

Trends in admissions to a child and adolescent neuropsychiatric inpatient unit in the 2007–2017 decade: how contemporary neuropsychiatry is changing in Northwestern Italy

Purpose Rising levels of psychopathology in the adolescent population have been evidenced in the last few years throughout the Western world. We aim to examine how contemporary neuropsychiatry is changing in Northwestern Italy and how this impacts inpatient services. Methods The present research considered the 1177 admissions to a public neuropsychiatric inpatient service in the 2007–2017 decade. The annual percentual change (APC) was analysed for the total admissions, the number of the neurological vs psychiatric admissions, the length of inpatient stay, and the mean age at admission, also accounting for sex differences. The annual trend was also calculated for each diagnosis. Results The overall number of inpatient admissions decreased significantly (APC = − 5.91), in particular for children under 12 years of age (APC = − 7.23). The rate of neurologic diagnoses significantly decreased (APC = − 26.44), while the length of the inpatient stay (APC = 6.98) and the mean age at admission (APC = 6.69) increased. Among the psychiatric diagnoses, depression significantly rose (APC = 41.89), in particular among female adolescents (APC = 40.30). Conclusions These data document a substantial change in the utilization of inpatient neuropsychiatric services for children and adolescents, with a major increase in psychiatric hospitalizations and a parallel decrease in neurological ones. These trends call for greater attention to early preventive intervention in mental healthcare system.