Covid linked to increased risk of mental health disorders

Covid-19 is associated with an increased risk of mental health conditions, including anxiety, depression, substance misuse and sleep disorders, up to one year after initial infection, research suggests. The findings come days after an Age UK report proclaimed a hidden mental crisis among the elderly, and indicate that tackling psychiatric illness among Covid patients should be prioritised.

The US study, published by The BMJ on Wednesday, is the first comprehensive assessment of the mental health manifestations of Covid one year after infection. Researchers used data from the US Department of Veterans Affairs national healthcare databases to estimate the risks of poor mental health outcomes in people who survived at least 30 days after a positive PCR test result between March 2020 and January 2021.

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They identified data for 153,848 people and matched them to two control groups with no history of Covid-19. Participants were mostly white men with an average age of 63 years. The Covid-19 group was further divided into those who were or were not admitted to hospital during the acute phase of infection, and information was collected on potentially influential factors including age, race, sex, lifestyle and medical history.

The researchers then followed all three groups for one year to estimate the risks of a set of specified mental health outcomes, including anxiety, depression and stress disorders, substance misuse, sleep disorders and neurocognitive decline.

Compared with the non-infected control group, people with Covid-19 showed a 60 per cent higher risk of any mental health diagnosis or prescription at one year, equivalent to an additional 64 per 1,000 people.

When the researchers examined mental health disorders separately, they found that Covid-19 was associated with an additional 24 per 1,000 people with sleep disorders at one year, 15 per 1,000 with depressive disorders, 11 per 1,000 with neurocognitive decline and 4 per 1,000 with any non-opioid substance use disorders.

The risks were highest in people admitted to hospital during the initial, acute phase of Covid-19, but were evident even among those who were not admitted to hospital. People with Covid-19 also showed higher risks of mental health disorders than people with seasonal influenza.

The same held true for hospital admissions. Those admitted to hospital with Covid-19 showed increased risk of mental health disorders compared with those in hospital for any other reason.

We now have a clearer picture of the mental health impacts of the Covid-19 pandemic, said Scott Weich, professor of mental health at the University of Sheffield.

He said for the general population, Covid and lockdown caused transient distress – related to threat – and those who contracted the virus were at moderately increased risk of anxiety and depression for the first six months or so, with the risk greatest in the first month.

“Taking stock, it could be argued that much of the research concerned with the mental health impacts of Covid-19 represents more hindsight than insight,” he said. He believes the focus must now be placed on advancing our understanding of the causes of mental illness and undertaking research that evaluates treatments for psychiatric disorders generally.

The study authors said the report is observational and did not identify cause, and that some misclassification bias may have occurred. Because the study included mostly older white men, the results may not apply to other groups, they said.