Psychiatric treatment outcomes of travelers admitted to a psychiatric hospital: a retrospective analysis

Travel-related psychiatric disorders range from anxiety disorders to mood disorders, substance abuse, and psychosis. Various travel-associated factors such as dehydration, time shifts, changes in social structures or stress factors are discussed for these disorders. There is a lack of knowledge concerning the quality and outcome of psychiatric treatment in travelers hospitalized abroad. This study is the first to compare outcome of treatment in psychiatric travelers to domestic patients. We analyzed electronic health records of travelers in the Psychiatric University Hospital Zurich from January 2013 to December 2020. Each traveler was matched with one Swiss national and one migrant using propensity score matching. Travelers showed inferior CGI-I scores at discharge (F(2,969) = 5.72; p = 0.003). The length of stay was shorter (F(2,969) = 38.74:p < 0.001) for travelers (9.69 ± 14.31) than for Swiss nationals (24.69 ± 29.42) and migrants (24.74 ± 28.62). The transfer rate to another hospital was higher (X(2,972) = 50.85: p < 0.001) for travelers (79, 29.4%) than for Swiss nationals (25, 7.7%) or migrants (26, 8.0%). Psychiatric treatments of hospitalized travelers showed a lower symptom improvement while presenting a more severe overall condition at discharge. Length of stay was shorter compared to domestic patients. Admission of travelers was initiated involuntarily more frequently. This most closely reflects the theory that travelers are typically hospitalized in severe emergencies and are promptly discharged or repatriated after an initial treatment response has been achieved.