Center to Improve Veteran Involvement in Care (CIVIC)
Psychiatric Disorders Newly Diagnosed After Hospitalization for COVID-19
Written by Alison Eckhardt
If the COVID era has been marked by anything, it’s uncertainty. From the beginning of the pandemic, public health messaging changed rapidly as new information came to light, and the broader population understandably struggled to keep up. Although many experts predicted negative mental health outcomes from the pandemic more broadly, there have been fewer studies looking at the potential mental health impacts of COVID infection itself. In collaboration with Dr. Denise Hynes, Dr. Jason Chen and colleagues evaluated the development of new mental health diagnoses following hospitalization for COVID-19 in VA patients. They presented their findings in a paper titled “Psychiatric disorders newly diagnosed among veterans subsequent to hospitalization for COVID-19,” published in Psychiatry Research in June 2022. In the population studied, approximately 8% of patients developed a new mental health diagnosis following hospitalization with COVID-19. Patients who developed a new mental health diagnosis were more likely to be younger, male, and live in a rural area. Of those, 64% already had an existing comorbid mental health diagnosis.
As this was an observational study, the authors did not suggest a direct cause of specific health outcomes. However, clinicians can still use the results of this study to prioritize making mental health resources available to potentially vulnerable populations. When asked how this research could inform clinical practice, Dr. Chen said, “I think providers may wish to be aware of the possibility of developing new mental health conditions following COVID hospitalization with special attention for those who have not had prior mental health care or are seeking continuous mental health support, live in rural areas, or are in certain age groups.”
Biostatistician Alex Hickok, who performed the analysis for the study, also expressed hope that this research could improve future mental health outcomes. “I think that continuity of care and follow up care for those individuals already using mental health care resources will be important. We saw in this article that people who were already using mental health care prior to COVID… were still at risk of developing new mental health conditions. The COVID-19 pandemic has put more strain on individuals and society than any other event in the last decade and this translates often to poorer mental health outcomes. I think being able to understand how the pandemic has affected mental health can help inform where we need more resources.”
One of the more surprising findings from this study was that people with more medical comorbidities were less likely to develop a new mental health diagnosis following COVID-19 hospitalization. This could be because psychiatric illness generally starts before age 50, and people with more medical comorbidities are likely to be older on average. It could also reflect a disparity in availability or utilization of care among different populations (for patients who have never engaged with mental health care before, a new diagnosis does not necessarily mean the condition itself is new). Alex Hickok suggests further research is needed in this area: “I think we are just beginning to scratch the surface of how this pandemic has impacted people’s mental health. Some of these issues might not manifest for months or years after the pandemic has subsided and we are still in the pandemic! I would like to see how overall pandemic ‘burnout’ is affecting Veterans and what consequences that might have beyond surviving a COVID infection.”
When asked about key takeaways from this research, Dr. Chen offered a hopeful message. “I think more broadly my hope from our COVID and mental health outcomes research is that we can convey that having a thriving life after COVID is possible and to identify some of the key elements that might help support a positive recovery trajectory.” As the pandemic enters its third year, it’s important to remember that we are still learning about the long-term impacts of COVID-19. The more research comes out to guide clinical practice, the more capable we become of providing better care in the future.
