New Research Details Links Between COVID and Mental Health
Several new studies highlight links between mental health disorders and COVID-19. People with mental health disorders and intellectual disabilities are more at risk for contracting COVID and people who have had COVID are at greater risk for developing mental disorders. Understanding these risks can potentially help health professionals and individuals to improve prevention, assessment, and treatment.
One study, led by Nora Volkow, M.D., Director of the National Institute on Drug Abuse, looked at the health histories of more than 61 million adults in the U.S. and found that people with a recent diagnosis of a mental disorder have a significantly increased risk for COVID-19 infection. Individuals diagnosed with depression or schizophrenia were at greater risk than those diagnosed with other mental disorders. The study also found that among those with a recent mental health diagnosis, Black Americans had a higher risk of COVID-19 infection than whites, and women were at greater risk than men.
Volkow and colleagues note several factors that may contribute to the increased risk. People with mental illness have life circumstances that often place them where infection can spread, such as being in hospitals or group residences or having unstable housing. People with mental illness also have an increased likelihood of having a major co-existing medical condition, such as heart disease or diabetes. The study results emphasize “the need to recognize and address modifiable vulnerability factors and to prevent delays in health care provision in this population,” Volkow and colleagues conclude.
Another analysis has found that people with intellectual disabilities (such as Down syndrome) and developmental disorders* (such as developmental disorders of speech and language and academic skills) are especially vulnerable to COVID-19. They are three times more likely to die of COVID-19, compared to patients without the conditions, according to the report from Fair Health, a nonprofit focused on health care costs and health coverage. Researchers reviewed a database of insurance claims of more than 460,000 patients diagnosed with COVID-19 from April 1 through Aug. 31, 2020.
The report suggests several factors contributing to the increased vulnerability in this population, including the higher risk associated with living in group homes and with receiving direct personal care from aides or therapists. People with developmental disorders and intellectual disabilities are also more likely to have underlying chronic medical conditions, such as respiratory and metabolic disorders. The study also points to other potential economic and social factors such as greater likelihood of working in service occupations and relying on public transportation. Wearing a mask or following other guidelines may be challenging for some in this population.
A third study, reported in The Lancet, found that people who have been diagnosed with COVID-19 are at greater risk of developing mental health disorders compared to people recovering from other acute health events. Researchers Maxime Taquet, Ph.D., and colleagues found that after a diagnosis of COVID-19, nearly one in five people were diagnosed with a mental disorder within three months, including nearly 6% with no previous psychiatric history. The study looked at electronic health records of more than 62,000 people diagnosed with COVID-19 between January and August 2020. This study also found that people with a pre-existing diagnosis of a mental disorder are 65% more likely to be diagnosed with COVID-19, independent of known physical health risk factors.
The study authors recommend mental health history be discussed during assessment for COVID-19 and there is increased mental health follow up following a diagnosis.
More information at the APA COVID Information Hub.
*Autism was not included in either category.
- Makaray, M., et. Al. Risk Factors for COVID-19 Mortality among Privately Insured Patients: A FAIR Health White Paper in Collaboration with the West Health Institute and Marty Makary, MD, MPH, from Johns Hopkins University School of Medicine, November 11, 2020
- Wang, Q., et. Al. Increased risk of COVID‐19 infection and mortality in people with mental disorders: analysis from electronic health records in the United States. World Psychiatry. October 7, 2020.
- Volkow, N. Study Reveals Adults With Mental Disorders Are At Significantly Higher Risk of COVID-19 and Have Poorer Outcomes. Brain and Behavior Research Foundation. November 12, 2020
- Wamsley, L. After COVID-19 Diagnosis, Nearly 1 In 5 Are Diagnosed With Mental Disorder. NPR, November 11, 2020
- Rabin, R.C. Developmental Disabilities Heighten Risk of COVID Death. New York Times, Nov. 10, 2020
- Taquet, M., et al. Bidirectional associations between COVID-19 and psychiatric disorder: retrospective cohort studies of 62 354 COVID-19 cases in the USA. The Lancet Psychiatry. Nov. 9, 2020.