Objectives: The objective of this study was to determine the characteristics of psychological distress among populations impacted by the COVID-19 pandemic in a high-incidence area in southern Thuringia, Germany. The study aimed to assess the prevalence and severity of psychological distress in patients who came for planned inpatient therapy and in patients who were admitted as an acute emergency due to crisis intervention. Material and methods: A retrospective, non-interventional study was conducted from the first of February until the 30th of November 2021 in Hildburghausen, south Thuringia, Germany, a city with outstandingly high COVID-19 incidences. Two questionnaires, the PASA, and the SSQ-25, were administered to measure the level of psychological discomfort. The questionnaires were answered and filled out by a total of 258 psychiatric inpatients at the beginning of their inpatient admission. Results: The study findings revealed the prevalence and severity of psychological distress among psychiatric inpatients in a high-incidence area during the COVID-19 pandemic. The results showed significant levels of psychological symptoms, including increased stress appraisals and experienced stress, in both patients who came for planned inpatient therapy and those who were admitted as an acute emergency due to crisis intervention. The results showed that females had significantly higher depression and stress levels than males and that there were differences in the primary diagnoses between the two genders. Moreover, patients with recurrent depressive disorder were admitted more frequently as regular cases, while in emergencies, more diagnoses of depressive episodes were found. Conclusion: This retrospective study provides important insights into the characteristics of psychological distress among populations impacted by the COVID-19 pandemic in a highincidence area in southern Thuringia, Germany. The findings highlight the significant burden of psychological symptoms, including stress appraisals and experienced stress, in psychiatric inpatients during the pandemic. These findings may have implications for the development of interventions and support strategies to address the mental health needs of individuals in similar settings during and after the COVID-19 pandemic. Further research is warranted to better understand the long-term impact of the pandemic on mental health and inform appropriate interventions.