From the Guidelines
Yes, COVID long haul patients can experience psychiatric problems, including anxiety, depression, and post-traumatic stress disorder, with estimated incidences of 17% and 1.2%, respectively, for the entire cohort. These mental health issues are common among those with long COVID and may include depression, anxiety, post-traumatic stress disorder (PTSD), brain fog, and cognitive impairment 1. Some patients report mood changes, irritability, and sleep disturbances that persist for months after the initial infection. The underlying mechanisms likely involve a combination of direct viral effects on the nervous system, inflammatory responses, immune system dysregulation, and psychological reactions to chronic illness.
Key Points to Consider
- The incidence of psychological sequelae of COVID-19 is substantial, even in patients with mild acute infections 1.
- Treatment typically involves a multidisciplinary approach, potentially including antidepressants like SSRIs, cognitive behavioral therapy, and support groups specifically for long COVID patients.
- Regular physical activity, adequate sleep, stress management techniques, and maintaining social connections may also help manage these psychiatric symptoms.
- Healthcare practitioners should be aware of the substantial incidence of psychological sequelae of COVID-19 and refer patients for assessment and therapy when relevant 1.
Management and Treatment
- A multidisciplinary approach to treatment is recommended, including psychological counseling, mental health education, cognitive behavioral therapy, mindfulness therapy, group intervention, and potentially traditional Chinese medicine decoctions 1.
- Patients experiencing psychiatric symptoms should discuss them with healthcare providers who can develop appropriate treatment plans and monitor for improvement.
From the Research
Psychiatric Problems in COVID Long Haul Patients
- COVID long haul patients can experience various psychiatric problems, including anxiety, depression, post-traumatic stress disorder (PTSD), poor sleep qualities, somatic symptoms, and cognitive deficits 2.
- The most prevalent reported psychiatric symptoms in long COVID patients are anxiety, depression, PTSD, poor sleep qualities, somatic symptoms, and cognitive deficits, with being female and having previous psychiatric diagnoses being risk factors for the development of these symptoms 2.
- Long-COVID patients have reported new and worsening mental health symptoms, with the most frequently reported being depression, anxiety, PTSD, and insomnia 3.
Mental Health Symptoms and Treatment Needs
- Veterans with long COVID have significant impairments in functioning, as well as feelings of isolation and loneliness, highlighting the need for a psychotherapeutic intervention that can facilitate interpersonal connection, improve functioning, and decrease psychiatric symptoms 4.
- The mental health burden of long-COVID stress symptoms is essential to providing efficient and effective mental health treatment, supporting physicians treating long-COVID patients, and enhancing access to and utilization of medical services 3.
Interactions between COVID-19 Treatments and Psychotropic Drugs
- There is a potential risk of drug-drug interactions between COVID-19 treatments and antidepressants, mood stabilizers/anticonvulsants, and benzodiazepines, highlighting the need for clinicians to be aware of these interactions to ensure patient safety 5.
- Selective serotonin reuptake inhibitor (SSRI) antidepressants have been found to reduce COVID-19 infection, with fluoxetine and fluvoxamine showing promise against SARS-CoV-2 6.