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Is ... COVID-19 causing an increased risk of psychological distress, psychotropic prescribing or sleep and fatigue problems? 2021, Abel, Chalder et al

Discussion in 'Psychosomatic research - ME/CFS and Long Covid' started by Dolphin, Oct 9, 2021.

  1. Dolphin

    Dolphin Senior Member (Voting Rights)


    Is infection with COVID-19 causing an increased risk of psychological distress, psychotropic prescribing or sleep and fatigue problems? A study of patients in English primary care
    Contribution to journal › Article › peer-review

    Kathryn M Abel, Matthew J Carr, Darren M Ashcroft, Trudie Chalder, Carolyn Chew-Graham, Holly Hope, Navneet Kapur, Sally McManus, Sarah Steeg, Roger T Webb, Matthias Pierce

    Original language English
    Journal JAMA Network open
    Accepted/In press 23 Sep 2021
    King's Authors

    Importance Infection with COVID-19 is linked to fatigue and sleep problems, long after the acute phase of the illness. In addition, there are concerns of COVID-19 infection causing psychiatric illness; however, evidence of a direct effect is inconclusive.


    The primary hypothesis was: there is an increased risk of incident or repeat psychiatric illness, fatigue and sleep problems following COVID-19 infection.

    The secondary hypotheses were that the increase was largest for anxiety, those from deprived areas and women.

    The analysis plan was pre-registered (https://osf.io/n2k34/).


    Matched cohorts were assembled using a UK primary care registry (the CPRD-Aurum database). Patients were followed-up for up to 10 months, from 1st February 2020 to 9th December 2020.


    Primary care database of 11,923,499 adults (>16 years).

    Participants From 232,780 adults with a positive COVID-19 test (after excluding those with <2 years historical data or <1 week follow-up), 86,922 without prior mental illness, 19,020 with anxiety or depression, 1,036 with psychosis, 4,152 with fatigue and 4,539 with sleep problems were matched to up to four controls based on gender, general practice and year of birth.

    A negative control used patients who tested negative for COVID-19. Main Outcomes and Measures Cox proportional hazard models estimated the association between a COVID-19 positive test and subsequent psychiatric morbidity (depression, anxiety, psychosis, or self-harm), sleep problems, fatigue or psychotropic prescribing.

    Models adjusted for comorbidities, ethnicity, smoking and BMI. Results 232,780 patients with a COVID-19 positive test were identified, 56.2% were female, their median age was 42 and 20.5% were from ethnic minority groups.

    After adjusting for observed confounders, there was an association between testing positive for COVID-19 and almost all markers of psychiatric morbidity, fatigue and sleep problems.

    The adjusted hazard ratio (aHR) for incident psychiatric morbidity was 1.75 (95% CI 1.56-1.96).

    However, there was a similar risk of incident psychiatric morbidity for those with a negative COVID-19 test (aHR 1.57, 95% CI 1.51-1.63) and a larger increase associated with influenza (aHR 2.97, 95% CI 1.36-6.48).

    Conclusion and Relevance

    In this study of adults registered at an English primary care practice during the pandemic, there was consistent evidence that COVID-19 infection elevates risk of fatigue and sleep problems.

    However the results from the negative control analysis suggests that unobserved confounding may be responsible for at least some of the positive association between COVID-19 and psychiatric morbidity.
  2. Trish

    Trish Moderator Staff Member

    Is it just me, or does that abstract make no sense. Why give the numbers for premorbid symptoms but not for post infection symptoms?
    The data seems very badly set out and the conclusion about a positive association between Covid and psychiatric morbidity seems to contradict the fact that a bigger association was found in those without covid and those with flu.

    Maybe it's just me. I'll go back to watching Strictly come dancing. It makes more sense.
    MEMarge, Mithriel, Simon M and 9 others like this.
  3. alktipping

    alktipping Senior Member (Voting Rights)

    same old copy paste cherry picked tripe .got to stay on that gravy train .
    Sean, TigerLilea, EzzieD and 3 others like this.
  4. Creekside

    Creekside Senior Member (Voting Rights)

    If the goal of a study is a desired outcome, for whatever benefits to the authors, it's all a matter of choosing experiments or carefully selected data that supports the outcome.

    A well designed study of something silly, such as whether slugs move more erratically during a full moon, is probably of more benefit to society than badly done studies of important subjects. :grumpy:
    Solstice, Wyva, Sean and 4 others like this.
  5. rvallee

    rvallee Senior Member (Voting Rights)

    All over the place with nothing to conclude out of it, so a typical Chalder/Chew-Graham study. Using negative tests as controls is obviously absurd at this point (and any point frankly). Who keeps wasting money on this and how does no one care that this money is just burned without anything to show for it?

    Oh, yeah, my bad, this is just a jobs program for people who can't handle their actual job. Nevermind, it serves its purpose.
    Last edited by a moderator: Oct 10, 2021
    Solstice, Amw66, Sean and 3 others like this.

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