Covid-19 is associated with an increased risk of mental health disorders, including anxiety, depression, substance use and sleep disorders, up to one year after initial infection, a new study suggests.

Irish psychiatrists say the findings have implications for mental health services here and suggest tackling disorders among survivors of Covid-19 should be a priority.

Dr Brendan Kelly, professor of psychiatry at Trinity College Dublin, said the risks of mental illness following Covid-19 infection were becoming clearer with each month that passes. "Although we are not looking at a pandemic of mental illness, the added risk is substantial and requires an immediate response."

Hospital Report

The study found people with the virus showed a 60 per cent higher risk of any mental health diagnosis or prescription one year after infection, compared with a control group of uninfected people – equivalent to an additional 64 per 1,000 people.

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When the researchers examined mental health disorders separately, they found the disease was associated with an additional 24 per 1,000 people with sleep disorders at one year, 15 per 1,000 with depressive disorders, 11 per 1,000 with neuro-cognitive decline, and four per 1,000 with any non-opioid substance use disorder.

Previous studies have suggested people with the virus might be at increased risk of anxiety and depression, but they included only a small selection of mental health outcomes and tracked patients over a maximum of six months.

The latest research tracked outcomes one year after infection and examined the massive database of the US Department of Veterans Affairs between March 2020 and January of last year.

Researchers found risks were highest in people admitted to hospital during the initial phase of coronavirus, but were evident even among those who were not admitted to hospital.

Additional trauma

People with the disease also showed higher risks of mental health disorders than people with seasonal flu, while people admitted to hospital for the virus showed increased risks of mental health disorders compared to those admitted to hospital for any other reason.

“This paper shows the risk of depression in the year following hospitalisation with Covid-19 is 24 per cent greater than the risk of depression in the year following hospitalisation with influenza prior to the pandemic,” said Prof Kelly.

He suggested this might be due to the additional trauma of being hospitalised during a pandemic, or the long-term neuro-biological effects of the virus, “which are now undeniable”.

“The sheer numbers infected with Covid-19 mean that even an increase of 24 per cent in risk of depression among those hospitalised with Covid compared to influenza will present a significant challenge to mental health services.”

Dr Eric Kelleher of the College of Psychiatrists said the study pointed to the "enduring" nature of Covid-related mental health issues for some.

“It’s important therefore we have a well-funded and robust mental health service to deal with this.”

The study is observational, so it cannot establish cause. As it included mostly older white men, the results may not apply to other groups.

Pointing out that long Covid appears to affect women more than men, Dr Kelleher said it was important a cross-specialty approach was taken in patient care, dealing with both the mental and physical symptoms.