Topline
People with Covid-19 are much more likely to be diagnosed with a mental health disorder or be prescribed a mental health-related drug up to one year after infection, according to a new peer reviewed study in the British Medical Journal, another worrying set of findings as researchers learn more about the long-term impact of Covid.
Key Facts
People with Covid-19 had a 46% higher chance of being diagnosed with a mental health disorder and were 86% more likely to have been prescribed a mental health related drug up to one year after infection, according to an analysis of healthcare records from the U.S. Department of Veterans Affairs.
The increased risk—which would mean an extra 36 people per 1,000 being diagnosed with a mental illness and an extra 48 per 100,000 people being prescribed a mental health-related drug up to a year after Covid-19—was calculated by comparing more than 150,000 veterans with Covid-19 to two control groups, which consisted of nearly six million people with no signs of Covid-19 at the same time as the study and a similarly sized group using historical data from before the pandemic.
When the researchers examined various mental health disorders separately, they found Covid-19 was linked to a 40% high risk of being diagnosed with a depressive disorder (equivalent to an additional 15 per 100,000 people), 35% higher risk of anxiety disorder (11 per 100,000 people), 30% higher risk of a stress disorder like PTSD (13 per 100,000 people) and a 41% higher risk of a sleep disorder (24 per 1,000 people).
Though the researchers said the mental health risks of Covid-19 were higher among patients hospitalized with the disease, they were “evident even among those who were not admitted to hospital” and the findings were relevant to “most people with Covid-19.”
The researchers also compared groups of people with seasonal influenza or who had been hospitalized for non-Covid causes, and found the risk of mental health disorders to be “consistently higher in the Covid-19 group.”
The study did not consider whether vaccinated people with Covid-19 are affected in the same way.
Key Background
The study adds to a growing pile of research demonstrating the mental toll of the pandemic and extends previous research which examined the incidence of mental health conditions after much shorter periods of time (90 days and 6 months). The impact of the disease itself on mental health is made worse by reduced availability of mental healthcare during the pandemic as usual support networks reduced their services, closed or moved online. General pandemic life, including the shift to working from home, lockdowns and social restrictions, also had a marked impact on peoples’ lives and mental health, creating new stresses, amplifying existing ones and destroying valuable routines. Those already with mental health disorders are also much more likely to die from Covid-19, studies suggest, particularly those with schizophrenia or bipolar disorder.
What We Don’t Know
Why Covid-19 is linked with an increased risk of mental health disorders. The researchers said the precise mechanism or mechanisms behind the increased risk of mental illness following Covid-19 “are not entirely clear,” but said possible mechanisms include brain inflammation, immune cells getting into the brain, the immune system acting on the central nervous system and non-biological issues like grief, trauma and isolation. The researchers said the study was observational and therefore cannot establish cause and noted its findings may not apply universally as most subjects were white older men.
Big Number
415 million. That’s how many cases of Covid-19 have been reported around the world, according to data collated by Johns Hopkins University. That’s around 5% of the world’s population, though the overall figure does not account for people being infected more than once, those who subsequently died from the disease (nearly 6 million people) or other causes, and the many cases that are not identified. Given this figure, the researchers said there are likely large numbers of people dealing with the mental health impact of Covid-19. Health systems, national governments and international groups should “develop and implement strategies” to identify and treat affected individuals as a matter of urgency, the researchers said.
Crucial Quote
“We do not yet know the true incidence and consequences of long Covid, and we are still witnessing the unfolding toll of the pandemic on healthcare staff, wrote Dr. Scott Weich, a professor of mental health at the University of Sheffield, in a linked editorial. We also don’t have an “effective response to the devastating disruption to health, social care, and voluntary sector services on the lives of people with serious mental illness,” Weich added, criticizing the failure to prepare for the mental health impacts of the pandemic. “While epidemiological research has flourished… We are guilty of failing to prioritize evaluations of mental healthcare interventions, including clinical trials, just when these are most needed.”
Further Reading
COVID’s mental-health toll: how scientists are tracking a surge in depression (Nature)
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