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Aims <p>Following Italy’s psychiatric reform, national inpatient numbers declined, but how the age at admission has changed across sex, diagnostic, and admission-type subgroups remains unclear. This study examined 17 consecutive years (2006–2022) of psychiatric admissions to the sole ward serving L’Aquila, assessing temporal trends in age at admission by diagnosis, sex, and admission status (voluntary vs. compulsory).</p> Methods <p>All adult admissions (≥ 18 years) were extracted from hospital discharge records (Schede di Dimissione Ospedaliera, SDO). Analyses were conducted at the admission-episode level. Primary diagnoses were grouped into four ICD-9 categories: schizophrenia spectrum, major depressive disorder, bipolar disorder, and alcohol/substance use disorder. Multiple linear models tested time-related changes in mean age at admission, including interactions for time × diagnosis × sex × admission type.</p> Results <p>Across 5,207 admission episodes, the Trimester × Diagnosis interaction showed a marked decline in age at admission for major depression (<i>B</i> = − 0.20 per trimester, <i>p</i> &lt; 0.001) and bipolar disorder (<i>B</i> = − 0.09, <i>p</i> = 0.03), equivalent to approximately − 0.80 and − 0.36 years per year, yielding total reductions of ~ 13.6 and ~ 6.1 years over 2006–2022. The Trimester × Diagnosis × Sex interaction indicated that the decline in depression was driven by men (<i>B</i> = − 0.32, <i>p</i> &lt; 0.001; ≈ −1.28 years/year; −21.76 over 17 years), while in bipolar disorder it was driven by women (<i>B</i> = − 0.14, <i>p</i> = 0.03; ≈ −0.56 years/year; −9.52 over 17 years). The Trimester × Admission type interaction showed the reduction was specific to voluntary admissions (<i>B</i> = − 0.10, <i>p</i> &lt; 0.001; ≈ −0.40 years/year), while compulsory admissions were stable (<i>B</i> = − 0.01, <i>p</i> = 0.87). No significant age change occurred in schizophrenia spectrum disorders or in alcohol/substance use disorders.</p> Conclusions <p>Between 2006 and 2022, we observed a progressive rejuvenation of voluntary and affective-disorder inpatient admissions, with the clearest subgroup-specific reductions detected in men with major depression and women with bipolar disorder, while remaining stable in schizophrenia spectrum, alcohol/substance use disorder, and compulsory admissions. These findings underscore the need to balance youth-focused outreach with adequate capacity for chronic psychosis and substance use disorder.</p>

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Long-term trends in age at psychiatric admission (2006–2022): influence of sex, diagnosis, and admission type in a single Italian catchment

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  • 发表日期：

    2026年5月31日

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  • Tommaso Barlattani,
  • Federico Salfi,
  • Valentina Socci,
  • Giulio Renzi,
  • Antony Bologna,
  • Silvia Tamanti,
  • Edoardo Trebbi,
  • Alessandro Rossi,
  • Ferdinando Romano,
  • Francesca Pacitti

摘要

Aims

Following Italy’s psychiatric reform, national inpatient numbers declined, but how the age at admission has changed across sex, diagnostic, and admission-type subgroups remains unclear. This study examined 17 consecutive years (2006–2022) of psychiatric admissions to the sole ward serving L’Aquila, assessing temporal trends in age at admission by diagnosis, sex, and admission status (voluntary vs. compulsory).

Methods

All adult admissions (≥ 18 years) were extracted from hospital discharge records (Schede di Dimissione Ospedaliera, SDO). Analyses were conducted at the admission-episode level. Primary diagnoses were grouped into four ICD-9 categories: schizophrenia spectrum, major depressive disorder, bipolar disorder, and alcohol/substance use disorder. Multiple linear models tested time-related changes in mean age at admission, including interactions for time × diagnosis × sex × admission type.

Results

Across 5,207 admission episodes, the Trimester × Diagnosis interaction showed a marked decline in age at admission for major depression (B = − 0.20 per trimester, p < 0.001) and bipolar disorder (B = − 0.09, p = 0.03), equivalent to approximately − 0.80 and − 0.36 years per year, yielding total reductions of ~ 13.6 and ~ 6.1 years over 2006–2022. The Trimester × Diagnosis × Sex interaction indicated that the decline in depression was driven by men (B = − 0.32, p < 0.001; ≈ −1.28 years/year; −21.76 over 17 years), while in bipolar disorder it was driven by women (B = − 0.14, p = 0.03; ≈ −0.56 years/year; −9.52 over 17 years). The Trimester × Admission type interaction showed the reduction was specific to voluntary admissions (B = − 0.10, p < 0.001; ≈ −0.40 years/year), while compulsory admissions were stable (B = − 0.01, p = 0.87). No significant age change occurred in schizophrenia spectrum disorders or in alcohol/substance use disorders.

Conclusions

Between 2006 and 2022, we observed a progressive rejuvenation of voluntary and affective-disorder inpatient admissions, with the clearest subgroup-specific reductions detected in men with major depression and women with bipolar disorder, while remaining stable in schizophrenia spectrum, alcohol/substance use disorder, and compulsory admissions. These findings underscore the need to balance youth-focused outreach with adequate capacity for chronic psychosis and substance use disorder.