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One in five COVID-19 patients are diagnosed with a psychiatric disorder such as anxiety or depression within 3 months of testing positive for the virus, new research suggests.
“People are concerned that COVID-19 survivors will be at greater risk of psychiatric disorders, and our findings in a large and detailed study show this to be true,” lead investigator Paul Harrison, BM, DM, professor of psychology, The University of Oxford, United Kingdom of Oxford said in a statement.
“Health services need to be prepared to provide care, especially since our results can be underestimated by the number of actual cases,” Harrison said.
The study also showed that independently of having a psychiatric disorder increases the risk of having COVID-19 – a finding that is consistent with research published earlier this month.
“Having a mental illness should be added to the list of risk factors for COVID-19,” said co-author Maxime Taquet, PhD at the University of Oxford.
The study was published online on 9 November The Lancet Psychiatry.
Double the risk
The investigators took advantage of the Trinetex Analytics Network, which captured de-identified data from electronic health records of a total of 69.8 million patients from 54 health organizations in the United States.
Of those patients, 62,354 adults were diagnosed with COVID-19 between January 20 and August 1, 2020.
To assess the psychiatric order of COVID-19, investigators constructed a tendency score-matched peers of patients who had received diagnoses of other conditions that represented a range of normal acute presentations.
In 14 to 90 days after diagnosis of COVID-19, 5.8% of patients received their first recorded diagnosis of psychiatric illness. Among patients with health problems other than COVID, 2.5% to 3.4% of patients received a psychiatric diagnosis, the authors report. The risk for anxiety disorders, depression, and insomnia was greatest.
Table. Disorders that were first followed 14–90 days by psychiatric diagnosis
|Other respiratory tract infections||3.4%|
Older COVID-19 patients had a two to three times higher risk for first dementia diagnosis, a finding that supports an earlier UK study.
Some of this additional risk may indicate inaccurate cases of delirium or transient cognitive impairment due to reversible neurological events, the authors note.
The study also revealed a bidirectional relationship between mental illness and COVID-19. Individuals with a psychiatric diagnosis were 65% more likely to be diagnosed with COVID-19 than their counterparts who did not have mental illness, independently of known physical health risk factors for COVID-19.
“We did not anticipate that psychiatric history would be an independent risk factor for COVID-19. This finding appears strong, observed in all ages and both sexes, and was substantial,” the authors write.
Currently, we do not understand what the explanation for the linkage between COVID and mental illness is. We are trying to learn and understand in more detail what subgroups are particularly vulnerable in this regard, ”Harrison pointed out. Medscape medical news.
Commenting on the findings of Medscape medical newsRoy H. Perlis, MD, Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, stated that this is “an ambitious attempt to understand the short-term consequences of COVID in the context of brain diseases.”
Perlis said he is not particularly surprised by the rise in psychiatric diagnoses in COVID-19 patients.
“After COVID infection, people are more likely to receive close medical follow-up in general. They are more likely to reach the healthcare system. After all, they already have COVID, so they might be less likely to see Scared. Their doctors. But, perhaps it also means that they are more likely to get a new diagnosis of something like depression.
Perimis said that dementia may be the clearest portrayal of it. “It is less likely that dementia develops one month after COVID; more likely, something happens during the course of the disease that makes someone more likely to be diagnosed with dementia later,” he said.
Perlis warned against being “unnecessarily nervous” by the findings of this study.
“We know that the rate of depression in the UK and the US, in most parts of the world, has just increased. Much of it is the result of stress and disruption that accompanies the epidemic,” Perelis.
The study was funded by the National Institutes of Health Research. Harrison has not disclosed any relevant financial relationships. One writer is an employee of TriNetX. Perlis has received consulting fees for service on the scientific advisory boards of Belle Artificial Intelligence, Burrage Capital, Genomind, Psy Therapeutics, Outermost Therapeutics, RID Ventures, and Takeda. He holds equity in Psy Therapeutics and Outermost Therapeutics.
Lancet Psychiatry. Published online on November 9, 2020. full Text
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