Researchers have confirmed one of our worst fears. The pandemic does play a significant role in increasing the risk of mental health disorders.
A study published by The BMJ on Wednesday has revealed that COVID-19 infection is associated with an increased risk of mental health disorders, including anxiety, depression, substance use, and sleep disorders, up to one year after initial infection.
Though there were studies that illustrated people with COVID-19 at an increased risk of anxiety and depression, they were limited to a short follow-up—less than six months—and a small selection of mental health outcomes.
Keeping this in mind, researchers obtained data from the US Department of Veterans Affairs national healthcare databases to assess the risks of mental health outcomes in people who survived at least 30 days after a positive polymerase chain reaction (PCR) test result between March 2020 and January 2021.
A 60 percent higher risk
Data for 153,848 individuals, mostly white men with an average age of 63 years, were identified and matched to two control groups without COVID-19: a contemporary controls group comprising 5,637,840 users of the US Department of Veterans Health Care System (Veterans Health Administration) with no evidence of SARS-CoV-2 and a historical control group (predating the COVID-19 pandemic) consisting of 5,859,251 users of the healthcare system during 2017.
The COVID-19 group was then further divided into those who were or were not admitted to the hospital during the acute phase of infection. Information was collected on potentially influential factors such as age, race, sex, lifestyle, and medical history.
The researchers tracked all three groups for one year to estimate the risks of a list of predefined mental health outcomes, that include anxiety, depression and stress disorders, substance use disorders, neurocognitive decline, and sleep disorders.
In comparison with the non-infected control group, people who tested positive for COVID-19 showed a 60 percent higher risk of any mental health diagnosis or prescription in one year.
When the mental health disorders were examined separately, the researchers also found out that COVID-19 was associated with sleep disorders at one year in an additional 24 per 1,000 people, depressive disorders in 15 per 1,000 , neurocognitive decline in 11 per 1,000, and any (non-opioid) substance use disorders in 4 per 1,000. The historical control group also revealed similar results.
Though the risks were highest in people admitted to the hospital during the acute phase of COVID-19, they were also evident among those who were not admitted to the hospital.
Mental health must be prioritized
The researchers have acknowledged that the study was purely observational and may contain some misclassification bias. Also, the results may not apply to the other groups as the study included mostly older white men.
"The worst of the pandemic might be behind us in terms of mortality and social restrictions. Taking stock, it could be argued that much of the research concerned with the mental health impacts of COVID-19 represents more hindsight," says Weich.
He also explains that COVID and lockdown caused transient distress for the general public and those who contracted COVID-19 were at moderately increased risk of anxiety and depression, for the first 6 months or so.
"While epidemiological research has flourished—at least in terms of scientific publications—we are guilty of them failing to prioritize evaluations of mental healthcare interventions, including clinical trials, just when these are most needed," adds Weich.
Nevertheless, the study's findings reveal that people who survive the initial phase of COVID-19 are at increased risk of a cluster of incident mental health disorders and that tackling them must be a priority.