{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,1]],"date-time":"2026-04-01T06:58:48Z","timestamp":1775026728034,"version":"3.50.1"},"reference-count":37,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,4,1]],"date-time":"2026-04-01T00:00:00Z","timestamp":1775001600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Public Health"],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>This study examined whether the COVID-19 pandemic produced diagnosis-specific and cross-nationally reproducible alterations in psychiatric admissions, or whether observed variations primarily reflected organizational responses. We compared psychiatric inpatient services from Austria and Germany\u2014two hospital-centered systems with similar pre-pandemic structures\u2014and used Italy as a contrasting community-based model.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a retrospective multicenter observational study including all psychiatric hospitalizations between 2017 and 2020. Temporal admission trends were analyzed bi-weekly for each ICD-10 diagnostic group. Generalized Linear Models (Poisson family) were used to model the effects of Diagnosis, Year (2020 vs. pre-2020), Week, and Country, and their interactions. Diagnostic categories were grouped following ICD-10, with F10 (alcohol-related disorders) analyzed separately from other substance-use disorders to capture differences between planned and emergency admissions.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Across Austria and Germany, 2020 was associated with a marked temporal distortion in admission patterns compared with previous years (Week \u00d7 Year interaction,\n                      <jats:italic>p<\/jats:italic>\n                      \u202f&amp;lt;\u202f0.05), consistent across diagnoses except for F10. Alcohol-related disorders showed country-specific trajectories, reflecting service reorganization\u2014bed closures in Austria versus stable capacity in Germany. No other diagnosis exhibited reproducible temporal deviations across countries, indicating that the pandemic affected admission organization rather than disorder-specific psychopathology. A supplementary comparison including Italy showed that, while Austria and Germany experienced a decline in total hospitalizations (\u221216 and \u221210%, respectively), Italy remained stable (+12%), suggesting greater resilience of its community-based system.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The pandemic did not induce diagnosis-specific increases in acute psychiatric admissions but substantially altered their temporal organization. Differences across countries highlight how healthcare structure\u2014particularly the integration of territorial and inpatient services\u2014modulates system resilience under crisis conditions.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fpubh.2026.1516371","type":"journal-article","created":{"date-parts":[[2026,4,1]],"date-time":"2026-04-01T05:02:33Z","timestamp":1775019753000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Lockdown COVID\u201119: a stress test revealing more about the mental health system than psychopathology\u2014A comparative analysis between Austria, Germany, and Italy"],"prefix":"10.3389","volume":"14","author":[{"given":"Francesco","family":"de Bertoldi","sequence":"first","affiliation":[{"name":"Department of Psychiatry, General Hospital of Bolzano, Sanitary Agency of South Tyrol","place":["Bolzano, Italy"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Livio","family":"Finos","sequence":"additional","affiliation":[{"name":"Department of Statistical Sciences, University of Padova","place":["Padova, Italy"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pascale","family":"Roux","sequence":"additional","affiliation":[{"name":"Vorarlberg University of Applied Sciences, Empirical Social Sciences Research Group","place":["Dornbirn, Austria"]},{"name":"Regional Hospital of Rankweil, Adult Psychiatry","place":["Rankweil, Austria"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Davide","family":"Gaspari","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, General Hospital of Bolzano, Sanitary Agency of South Tyrol","place":["Bolzano, Italy"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jan","family":"Di Pauli","sequence":"additional","affiliation":[{"name":"Regional Hospital of Rankweil, Adult Psychiatry","place":["Rankweil, Austria"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Heiko","family":"Ullrich","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, Psychotherapy and Psychosomatics, Siegen Hospital","place":["Siegen, Germany"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nicolas","family":"Benedetti","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, General Hospital of Bolzano, Sanitary Agency of South Tyrol","place":["Bolzano, Italy"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jacopo","family":"Bizzarri","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, General Hospital of Bolzano, Sanitary Agency of South Tyrol","place":["Bolzano, Italy"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Johanna","family":"Neugebauer","sequence":"additional","affiliation":[{"name":"Regional Hospital of Rankweil, Adult Psychiatry","place":["Rankweil, Austria"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"P.","family":"Peter Plum","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, Psychotherapy and Psychosomatics, Siegen Hospital","place":["Siegen, Germany"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mariateresa","family":"Nitti","sequence":"additional","affiliation":[{"name":"Geriatrics Department, General Hospital of Bolzano, Sanitary Agency of South Tyrol","place":["Bolzano, Italy"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andreas","family":"Conca","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, General Hospital of Bolzano, Sanitary Agency of South Tyrol","place":["Bolzano, Italy"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2026,4,1]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"100145","DOI":"10.1016\/j.patter.2020.100145","article-title":"A machine learning-aided global diagnostic and comparative tool to assess effect of quarantine control in COVID-19 spread","volume":"1","author":"Dandekar","year":"2020","journal-title":"Patterns (N Y)"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"912","DOI":"10.1016\/S0140-6736(20)30460-8","article-title":"The psychological impact of quarantine and how to reduce it: rapid review of the evidence","volume":"395","author":"Brooks","year":"2020","journal-title":"Lancet"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"113193","DOI":"10.1016\/j.psychres.2020.113193","article-title":"The psychological impact of quarantine on coronavirus disease 2019 (COVID-19)","volume":"291","author":"Luo","year":"2020","journal-title":"Psychiatry Res"},{"key":"ref4","volume-title":"Mental health and COVID-19: early evidence of the pandemic\u2019s impact","year":"2022"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"1107560","DOI":"10.3389\/fpsyt.2023.1107560","article-title":"A hidden pandemic? 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