Adults With Long COVID Are Twice as Likely to Report Psychiatric Symptoms

Adults with long COVID are about twice as likely to experience psychiatric symptoms than their peers without long COVID, according to study results published in JAMA Network Open. However, patients with long COVID report cost-related barriers to accessing mental health care.

Previous research indicates that individuals with long COVID can experience psychiatric symptoms like depression, anxiety, sleep difficulties, fatigue, cognitive difficulties, and post-traumatic stress disorder. However, it has been difficult to establish the prevalence of these conditions thus far, given how recently the condition was identified.

To evaluate the prevalence of psychiatric symptoms, uptake of mental health treatment, and barriers to treatment among people experiencing long COVID, researchers analyzed data from the National Health Interview Study (NHIS) – a nationwide cross-sectional survey conducted between October 2023 and February 2024. Respondents were classified as having symptomatic long COVID if they reported a previous SARS-CoV-2 infection, had new symptoms that persisted for more than 3 months following infection, and had active symptoms at the time of the survey. The researchers used self-reported answers to survey questions to evaluate mental health treatment, cost-related barriers to care, and secondary psychiatric outcomes (ie, sleep difficulties, cognitive difficulties, fatigue), while the primary psychiatric symptoms of interest (ie, depression and anxiety) were measured using the 8-item Patient Health Questionnaire (PHQ-8).

A total of 25,122 respondents were included for analysis. The median age of participants was 46 years, 50.2% were women, and 19.3% had long COVID. Individuals with long COVID were more likely to be women, non-Hispanic White, and have multiple comorbidities, but less likely to have been vaccinated.

Relative to adults without long COVID, individuals experiencing long COVID were significantly more prone to:

• moderate to severe depression symptoms (adjusted odds ratio [aOR], 1.96; 95% CI, 1.51-2.55),
• anxiety symptoms (aOR, 2.21; 95% CI, 1.53-3.19),
• sleep difficulties (aOR, 1.95; 95% CI, 1.65-2.29),
• cognitive issues (aOR, 2.04; 95% CI, 1.66-2.50),
• and disabling fatigue (aOR, 1.85; 95% CI, 1.20-2.86).

Despite the increased burden of these psychiatric symptoms, treatment uptake for mental health concerns within the previous 12 months did not significantly differ between individuals with long COVID and those without (28.2% vs 34.9%; AOR, 1.02; 95% CI, 0.66-1.57). Furthermore, individuals with long COVID who were experiencing symptoms of depression or anxiety were more likely to cite cost-related barriers to accessing mental health counseling or therapy (AOR, 2.12; 95% CI, 1.65-2.73). Sensitivity analyses reaffirmed these findings across various subgroups and measures, emphasizing the need to address mental health challenges, particularly among individuals with long COVID.

The researchers concluded, “At the individual level, clinicians should be aware that people with [long COVID] are about twice as likely to report psychiatric symptoms and consider routine screening for these symptoms. At the health system level, it may be useful for health care leaders to prioritize the inclusion of affordable mental health supports when designing care pathways for [long COVID].”

Study limitations include a lack of information regarding the timing or duration of participants’ psychiatric symptoms relative to COVID-19 diagnosis and an inability to determine whether psychiatric distress is a risk factor for long COVID due to the cross-sectional study design.

This article originally appeared on Psychiatry Advisor