Anxiety, depression, insomnia and other psychiatric disorders in the former months following the diagnosis of Covid-19 have been widely predicted, less so the inverse relationship.
Researchers used anonymised data from electronic health records in 54 health-care organisations in the USA, totalling 69·8 million patients, 62?354 of whom had a diagnosis of COVID-19, to asses whether the diagnosis (compared with other health events) was associated with increased rates of subsequent psychiatric diagnoses, and whether patients with a history of psychiatric illness are at a higher risk of being diagnosed with COVID-19.
Scientists measured the incidence of and hazard ratios (HRs) for psychiatric disorders, dementia, and insomnia, during the first 14 to 90 days after a diagnosis of COVID-19.
In patients with no previous psychiatric history, a diagnosis of COVID-19 was associated with increased incidence of a first psychiatric diagnosis in the following 14 to 90 days compared with six other health events.
The hazard ratios (HRs) was greatest for anxiety disorders, insomnia, and dementia.
Researchers observed similar findings, although with smaller hazard ratios (HRs), when relapses and new diagnoses were measured.
The incidence of any psychiatric diagnosis in the 14 to 90 days after COVID-19 diagnosis was 18·1%, including 5·8% that were a first diagnosis.
The incidence of a first diagnosis of dementia in the 14 to 90 days after COVID-19 diagnosis was 1·6% in people older than 65 years.
A psychiatric diagnosis in the previous year was associated with a higher incidence of COVID-19 diagnosis.
This risk was independent of known physical health risk factors for COVID-19, but researchers cannot exclude possible residual confounding by socioeconomic factors.
Survivors of COVID-19 appear to be at increased risk of psychiatric sequelae, and a psychiatric diagnosis might be an independent risk factor for COVID-19.
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THE LANCET PSYCHIATRY
Bidirectional associations between COVID-19 and psychiatric disorder: retrospective cohort studies of 62?354 COVID-19 cases in the USA
The Department of Psychiatry at the University of Oxford
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