Not all the same in the face of mental disorders caused by Covid-19



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Since the start of the health crisis, psychiatric emergencies have been called into question like never before. Even traumatic events such as terrorist attacks have not overwhelmed their services. Of course, confinement has something to do with this, with reduced social contacts, a less healthy lifestyle, etc. But it seems that that’s not the only reason.

This is the conclusion reached in an Oxford study published in The Lancet. Based on medical data from 69 million Americans, including 62,000 patients with Covid-19, the researchers concluded that one in five Covid patients develops a mental disorder within 90 days of being diagnosed with the disease. This mainly leads to cases of anxiety, depression or even insomnia. A troubling and anxious statistic in itself. But it should be noted that some people are much more sensitive to this phenomenon than others.

Hospitalizations and crisis context: yes but …

To further analyze their findings, the psychiatrists divided their data into cohorts. Comparing them, they observed that different scenarios could favor a mental disorder. Logically, they thought that hospitalization could be such an ordeal as to be a potential factor. Unsurprisingly, this has been confirmed in practice, but there is a downside. If we exclude people in hospital, the data shows that Covid patients are even more likely to develop this complication. We must therefore also look elsewhere.

Contrary to what one might think, the severity of the disease does not really explain this phenomenon. The researchers then tried to see the influence of context by dividing those diagnosed with Covid-19 before and after April 1. Here too there is a correlation. It seems that getting sick in the heart of the crisis, in a more stressful environment, has a more deleterious effect on mental health. But, again, this is not enough to explain everything.

The hellish circle of psychiatric disorders

Scientists therefore went even further in the analysis, dividing patients according to multiple criteria. And among the various possibilities there is a population that stands out much more than the others: that which has already been diagnosed with a psychiatric disorder in the year preceding the health crisis. The risk of a Covid-19-related mental disorder has increased by 65% ​​for them. In other words, these initially fragile people are even more exposed to the pathologies they have already known. On the other hand, there are only a few differences between psychiatric illnesses, with the exception of patients suffering from mood disorders who would be even more concerned.

But that doesn’t mean other Covid patients are at risk. For example, the older a person is, the more exposed they are, not only to the disease itself, but also to the risk of developing a mental disorder. If a man is over 76 and developed a psychiatric disorder in the previous year, the risk explodes to + 94%. If that person has further economic or housing problems, it only exacerbates this threat.

The devastation of the cytokine storm

To understand why these different people are so exposed to mental disorders after a Covid-19 infection, we can do a study conducted at the University of Paris-Est Créteil. Again, the 402 Covid patients followed had 28% more PTSD (post-traumatic stress disorder), 31% depression, 42% anxiety, 20% obsessive disorder and 40% insomnia in the months following the infection. Context plays a role, for example due to the fear of developing an even more severe form of the disease, especially in the elderly. But we must also look for an explanation on a purely biological level “,both by the direct action of the infection on the brain but also as a consequence of the immune-inflammatory response to the infection, in particular the cytokine storm that follows the infection and that the triggering effect on mental illness can be anticipated», Please specify the researchers. Questioned on the subject by RTBF, psychiatrist Gérald Deschietere clarified this phenomenon: “Inflammation degrades the structure of some neurons, decreases the number of synapses and dendrites, and the inflammatory response can cause neuron death“.

Faced with this real public health problem, scientists sound the alarm. Paul Harrison, professor of psychiatry in charge of the Oxford study, says it is urgent to continue to investigate the causes of these mental illnesses and appropriate treatments. “Health services need to be prepared to provide care, especially as our results are likely to be underestimatedHe told Reuters. The WHO for its part believes that it is generally necessary to strengthen psychiatric services, which suffer not only from chronic underfunding but also from their partial closure during the crisis. A necessity while mental illnesses are not only favored by Covid-19 but also by childbirth.

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