COVID-19 may have consequences for mental health

Summary: 96% of patients hospitalized for coronavirus infections report experiencing PTSD as a result of their illness. Researchers also found an increased risk of depression, anxiety, and other mental health disorders in those hospitalized for COVID-19.

Source: University of Copenhagen

The global COVID-19 pandemic has affected the physical lives of most people. But now there are also indications that the pandemic has negative consequences for the mental health of the people being infected, the healthcare professionals and the population as a whole.

This is shown in a new Danish review of 43 scientific articles that have studied the subject. The review was produced by researchers from the University of Copenhagen and the Mental Health Centre Copenhagen, Mental Health Services in the Capitol Region of Denmark.

‘It is known from the previous SARS epidemic in 2002-2003, also called the bird flu, that mental health was affected among patients who survived the disease and among the healthcare professionals, treating the patients. Our recently published article systematically reviews current knowledge on symptoms among healthcare professionals and patients, and the same appears to be the case for the COVID-19 pandemic’, says Professor Michael Eriksen Benros at the Department of Immunology and Microbiology at the University of Copenhagen and the Mental Health Centre Copenhagen.

Post-Traumatic Stress, Depression and Anxiety

The article is a review of 43 scientific studies. Of these, 20 studies have examined the mental health among healthcare professionals. An overweight of the studies found higher levels of anxiety and depression as well as mental stress and poor quality of sleep. 19 studies examined the mental health of the population as a whole. Here, too, it is the overall picture that the COVID-19 pandemic seems to be having a negative impact.

Only two studies have so far examined mental symptoms among patients with SARS-CoV-2 infection. The studies showed that 96% of seriously ill hospitalised patients with COVID-19 infection exhibited symptoms of post-traumatic stress. They also found an increased risk of developing depression after hospitalisation with COVID-19.

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An overweight of the studies found higher levels of anxiety and depression as well as mental stress and poor quality of sleep. Image is in the public domain.

‘Many more and better studies are needed, but the results are still relevant. The numerous reports of decreased sense of smell and taste during a COVID-19 infection might indicate an effect on the nervous system. It is therefore worrying that mental symptoms have been detected during and immediately after the infection. One contributing factor might be that the infection has affected the brain and caused the symptoms, either directly or through the induced immune response’, says Michael Eriksen Benros.

Need for Better and More Studies

The researchers behind the review emphasise that significant reservations must be made because the included studies are of varying quality. The urgent societal and health crisis has led to faster than usual publication of scientific articles. In addition, most of the studies have been performed as online questionnaires and therefore do not have the same quality as thorough, clinical studies. Also, most studies are from Asia, and it is unclear whether the results can be transferred to a European context.

‘We need more high-quality studies to make any final conclusions about a link between mental symptoms and COVID-19. However, our results indicate that COVID-19 may have an impact on the brain of those infected, and that there are derived effects of the pandemic on the mental health among both healthcare professionals and the population. Given that the previous SARS epidemic was also associated with mental symptoms, we believe that research in this area is extremely important, as knowledge is a prerequisite for dealing with any mental consequences of COVID-19’, says PhD student and first author, Nina Vindegaard Sørensen, from the Department of Immunology and Microbiology at the University of Copenhagen and the Mental Health Centre Copenhagen

The previous SARS epidemic spread to 28 countries and sickened around 8,000 people, while eight million people in over 180 countries and regions have already been infected with SARS-CoV-2.

About this neuroscience research article

Source:
University of Copenhagen
Media Contacts:
Michael Eriksen Benros – University of Copenhagen
Image Source:
The image is in the public domain.

Original Research: Open access
“COVID-19 pandemic and mental health consequences: Systematic review of the current evidence”. by Nina Vindegaard, Michael Eriksen Benros.
Brain, Behavior and Immunity doi:10.1016/j.bbi.2020.05.048

Abstract

COVID-19 pandemic and mental health consequences: Systematic review of the current evidence

Background
During the COVID-19 pandemic general medical complications have received the most attention, whereas only few studies address the potential direct effect on mental health of SARS-CoV-2 and the neurotropic potential. Furthermore, the indirect effects of the pandemic on general mental health are of increasing concern, particularly since the SARS-CoV-1 epidemic (2002–2003) was associated with psychiatric complications.

Methods
We systematically searched the database Pubmed including studies measuring psychiatric symptoms or morbidities associated with COVID-19 among infected patients and among none infected groups the latter divided in psychiatric patients, health care workers and non-health care workers.

Results
A total of 43 studies were included. Out of these, only two studies evaluated patients with confirmed COVID-19 infection, whereas 41 evaluated the indirect effect of the pandemic (2 on patients with preexisting psychiatric disorders, 20 on medical health care workers, and 19 on the general public). 18 of the studies were case-control studies/compared to norm, while 25 of the studies had no control groups. The two studies investigating COVID-19 patients found a high level of post-traumatic stress symptoms (PTSS) (96.2%) and significantly higher level of depressive symptoms (p = 0.016). Patients with preexisting psychiatric disorders reported worsening of psychiatric symptoms. Studies investigating health care workers found increased depression/depressive symptoms, anxiety, psychological distress and poor sleep quality. Studies of the general public revealed lower psychological well-being and higher scores of anxiety and depression compared to before COVID-19, while no difference when comparing these symptoms in the initial phase of the outbreak to four weeks later. A variety of factors were associated with higher risk of psychiatric symptoms and/or low psychological well-being including female gender, poor-self-related health and relatives with COVID-19.

Conclusion
Research evaluating the direct neuropsychiatric consequences and the indirect effects on mental health is highly needed to improve treatment, mental health care planning and for preventive measures during potential subsequent pandemics.

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