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COVID-19 and Psychiatric Disorders
Q: What do we know about COVID-19, depression and psychiatric disorders?
A: We know that the pandemic has had a profound effect on the mental health of infected individuals and on the community in general, and that the impact and psychological effects of the COVID-19 crisis differs for each generation. A study by the CDC in the spring of 2020 revealed that about one-third of Americans have clinically significant anxiety or depression, a three- to four-fold increase compared to the same time last year; the youngest age groups (18-29 years) and those from minority communities had the highest rates.
From prior studies of MERS and SARS, we know there is an increased incidence of cognitive impairment, depression, anxiety and insomnia in the acute phase of infection and of PTSD in the post-infection phase. While the acute mental health effects of COVID-19 are beginning to be clear, the long-term impacts on the central nervous system will take time to uncover; neuropsychiatric manifestations may emerge long after the virus has been contained.
There are several reasons why severe infections might have psychiatric consequences, including direct effects of the virus itself on the central nervous system; the impact of the human immune response to the infection (inflammatory cytokines, post-infectious autoimmunity); and the impact of interventions (prolonged intubation and use of sedatives).
But there are other factors to consider. For example: How much of the increase in anxiety and depression are due to the effects of the virus itself versus the collateral effects of the pandemic—social isolation, personal loss, economic insecurity, fear of infection and death and uncertainty about the future?
Columbia researchers are attempting to learn more from neuropsychiatric and immunologic studies that will track the health of COVID-19 survivors from childhood to old age. In the meantime, clinicians must be alert for both the acute and potential long-term mental health effects of the virus, such as depression, fatigue, cognitive problems and PTSD. Mental health systems throughout the country have set up rapid response and outreach teams. CopeColumbia, for example, provides mental health services and resilience training to all members of the Columbia University Irving Medical Center community.
Brian A. Fallon, Professor of Clinical Psychiatry and Director of the Lyme and Tick-Borne Diseases Research Center at Columbia University Irving Medical Center
Michael Novakhov – SharedNewsLinks℠