Mental disorders may be associated with an increased risk of severe COVID-19
In the fall, the CDC identified mental disorders as underlying health conditions that could result in more severe cases of COVID-19 or even die from the virus. To be clear, this differs from studies suggesting that COVID-19 cases have led to increased diagnoses of mental illness. POPSUGAR talked to two doctors about how some mental illness can increase your likelihood of serious or fatal COVID-19 – here’s what we know.
What mental illnesses may mean that you are at higher risk for severe COVID-19?
The CDC writes: “If you have mood disorders, including depression and schizophrenia spectrum disorders, it may make you more likely to become seriously ill with COVID-19.” When the CDC updated its list of underlying medical conditions associated with higher risk of severe COVID-19, the CDC cited two meta-analyzes published in Journal of the American Medical Association (JAMA) as evidence. One who reviewed 21 studies suggested that individuals with pre-existing mood disorders such as depression or bipolar disorder were more likely to be hospitalized for and die of COVID-19 compared to those without mood disorders. It did not find a link between “serious incidents” (oxygen treatment, ventilation, hospitalization in the intensive care unit, etc.) and pre-existing mood disorders. Another meta-analysis, which reviewed 16 studies, identified serious mental disorders, namely schizophrenia and / or bipolar disorder, which pose the greatest risk of COVID-19 death.
Katlyn Nemani, MD, research assistant at NYU Langone Health’s Department of Psychiatry, stressed that in her opinion, people with serious mental illness, especially schizophrenia, are at greatest risk. “The CDC bases its guidance on the data available; hopefully future research will help refine this list of issues,” she told POPSUGAR.
Dr. Nemani was the lead author of a NYU study Langone that specifically linked schizophrenia to increased mortality in COVID-19 patients, second only to age as the major risk factor for COVID-19 deaths. The study, published in JAMA and included in both meta-analyzes mentioned above, showed that COVID-19 patients with schizophrenia had approximately 2.7-fold increased odds of dying when evaluating 45-day mortality and adjusting for demographic and medical risk factors. Mood disorders and anxiety disorders were not associated with higher risk of death in this one study (Dr. Nemani pointed out that discrepancies in results between her study and others could be due to how different mental disorders are grouped together).
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Chronic mental illness can affect your immune function
Dr. Nemani stressed that mental illness can affect one’s immune system, which is one of the reasons why people with severe cases of mental illness may be more prone to advanced cases of COVID-19. Christine Crawford, MD, MPH, associate medical director at the National Alliance on Mental Illness, told similarly New York Times that chronic mental health conditions can “wreak havoc on the body’s immune system,” making people more vulnerable.
Researcher and authorized clinical psychologist Raquel Martin, PhD, explained to POPSUGAR that although mental disorders affect everyone’s body differently, they can be chronic stressors, and chronic stressors cause a reduction in T cells that help fight infection. Your body also releases catecholamines (dopamine, adrenaline and norepinephrine, for example) as a stress response, but having high levels of catecholamines for long periods can lead to complications such as high blood pressure, digestive problems and headaches (she explains this more on TikTok). Such complications make your body less protected and again more vulnerable.
Dr. Nemani said a potential explanation for the escalating risk she and her team observed in people with schizophrenia is an abnormal immune response to infection. She explained, “There are at least two immune-mediated mechanisms that contribute to the COVID-19 mortality risk: an ineffective response to the virus shortly after exposure and a harmful inflammatory response later in the course of infection when the immune system develops an overexuberant response that can damage the body’s own tissues. . ” She noted that there is a wealth of evidence to suggest that people with schizophrenia may be less effective at fending off viruses and increasingly prone to damage inflammatory responses that may be “related to genetic and other environmental risk factors.” “
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Other factors may affect the severity of COVID-19 in people with mental illness
Comorbidities of mental disorders – other mental or physical illnesses that occur at the same time – can affect a person’s overall health. Dr. Nemani explained that those with schizophrenia, for example, are more likely to experience heart disease and obesity, which are “established risk factors for COVID-19 mortality.” CEO of the American Psychological Association Arthur Evans, Jr., PhD, told NOW Aside from the pandemic, people with severe mental illness are generally expected to live 10 to 25 years less than people who do not.
Dr. Martin stressed that overarching practices for promoting physical health such as nutrition, hydration, and exercise could be affected by mental illness, take a toll on the body, and further affect a person’s susceptibility to illness. Dr. Nemani mentioned a few other potential factors for higher COVID-19 mortality rates in people with severe mental illness, including “socio-environmental factors such as overcrowded housing, barriers to receiving health care, and lack of social support.” In addition, she said that “psychiatric symptoms such as apathy, disinhibition or cognitive deficits” may interfere with a person’s willingness to follow or commit to preventive safety measures and seek medical attention.
Dr. Nemani stated that being vaccinated “is probably the most effective thing people can do to protect themselves,” and that it should be a priority.
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