Evolution of Paris' public hospital psychiatrics outpatients from 2019 to 2023: a retrospective cohort study

The COVID-19 pandemic increased the prevalence of psychiatric disorders, especially in young people. The University Hospital Group Paris Psychiatry and Neurosciences (also known as the Paris Psychiatry Hospital Group, PPHG) provides psychiatric care for 2.2 million Parisians. We aimed to study the evolution of the psychiatric outpatients' characteristics in the PPHG between 2019 and 2023.

We used data from the PPHG's electronic health record database. We assessed the trend in the number of patients per year between 2019 and 2023 and the number of newly admitted outpatients. We conducted both analyses by sex, age group and clinical diagnoses.

The number of ambulatory patients treated at the PPHG remained stable between 2019 and 2023 (n = 30,000). The proportion of new patients among outpatients per year dropped (-20%). We observed a significant increase in young patients (+ 200% for those aged 15-18 and + 40% for those aged 18-25) and a decrease in patients older than 60 (-20%). These evolutions were more important for personality disorders and mood disorders than schizophrenia spectrum disorders, which could explain why the increase was more pronounced in women than men for young people.

It is one of the most extensive studies on the evolution of psychiatric outpatient care before and after the COVID-19 pandemic. This study highlighted the lack of capacity in public psychiatry, characterised by a decline in the proportion of new patients and delays between hospital discharge or emergency unit consultation and the first consultation at a public psychiatric centre.