Trends in psychiatric diagnoses by COVID-19 infection and hospitalization among patients with and without recent clinical psychiatric diagnoses in New York city from March 2020 to August 2021

Abstract

Determining emerging trends of clinical psychiatric diagnoses among patients infected with the SARS-CoV-2 virus is important to understand post-acute sequelae of SARS-CoV-2 infection or long COVID. However, published reports accounting for pre-COVID psychiatric diagnoses have usually relied on self-report rather than clinical diagnoses. Using electronic health records (EHRs) among 2,358,318 patients from the New York City (NYC) metropolitan region, this time series study examined changes in clinical psychiatric diagnoses between March 2020 and August 2021 with month as the unit of analysis. We compared trends in patients with and without recent pre-COVID clinical psychiatric diagnoses noted in the EHRs up to 3 years before the first COVID-19 test. Patients with recent clinical psychiatric diagnoses, as compared to those without, had more subsequent anxiety disorders, mood disorders, and psychosis throughout the study period. Substance use disorders were greater between March and August 2020 among patients without any recent clinical psychiatric diagnoses than those with. COVID-19 positive patients (both hospitalized and non-hospitalized) had greater post-COVID psychiatric diagnoses than COVID-19 negative patients. Among patients with recent clinical psychiatric diagnoses, psychiatric diagnoses have decreased since January 2021, regardless of COVID-19 infection/hospitalization. However, among patients without recent clinical psychiatric diagnoses, new anxiety disorders, mood disorders, and psychosis diagnoses increased between February and August 2021 among all patients (COVID-19 positive and negative). The greatest increases were anxiety disorders (378.7%) and mood disorders (269.0%) among COVID-19 positive non-hospitalized patients. New clinical psychosis diagnoses increased by 242.5% among COVID-19 negative patients. This study is the first to delineate the impact of COVID-19 on different clinical psychiatric diagnoses by pre-COVID psychiatric diagnoses and COVID-19 infections and hospitalizations across NYC, one of the hardest-hit US cities in the early pandemic. Our findings suggest the need for tailoring treatment and policies to meet the needs of individuals with pre-COVID psychiatric diagnoses.

COVID-19 Policies, Pandemic Disruptions, and Changes in Child Mental Health and Sleep in the United States

“…Some survey responses were incomplete, with some differences between survey responders and nonresponders (eTable 3 in Supplement 1). Details of the ABCD study are available in eMethods in Supplement 1 and elsewhere . Eligibility criteria for study inclusion were any survey fielded and returned in 2020, with available sociodemographics.…”

“…Adopting rapidly developing techniques that allow for more efficient and biascorrected estimation using multilevel and other models is also needed. 117,118 Third, we recognize there are other types of disruptions (eg, COVID-19 deaths of family members) 39 and COVID-19related outcomes 119,120 that may impact mental health and sleep. While our estimates of family financial and school disruptions were designed to correct bias, this does not mean no other relevant disruptions exist.…”

“…However, such policies may have unintended consequences for child mental health . It is important to evaluate psychological sequelae and sleep deterioration of pandemic-related economic crises and disrupted schooling on children . Yet, to date, rigorous quantitative information is lacking.…”

“…[4][5][6] It is important to evaluate psychological sequelae 2,3,7,8 and sleep deterioration [9][10][11] of pandemic-related economic crises 12 and disrupted schooling 13,14 on children. [15][16][17][18][19][20][21] Yet, to date, rigorous quantitative information is lacking.…”

Risk of Fracture and Complications Following Fixation in Patients with Pre-injury Psychiatric Illness: A Propensity-Matched Cohort Study

“…1 With the response to COVID-19, the burden of psychiatric illness has increased, especially in those patients who had a previous diagnosis of a psychiatric condition and especially among patients with orthopaedic trauma. [2][3][4] A growing body of literature has exposed the detrimental effects of psychiatric disorders on postoperative outcomes in several unique medical and surgical domains, such as colorectal surgery, 5 stroke management, 6 total knee arthroplasties, 7 lung cancer, 8 and several more, 9 including orthopaedic trauma. [10][11][12] Recently, more emphasis has been placed on socioeconomic barriers and mental illness among patients with orthopaedic trauma.…”