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Mental health and alcohol use among patients attending a post-COVID-19 follow-up clinic: a cohort study, 2022, Broughan et al.

Discussion in 'Psychosomatic news - ME/CFS and Long Covid' started by Dolphin, Jun 8, 2022.

  1. Dolphin

    Dolphin Senior Member (Voting Rights)

    Messages:
    4,990
    This research has got some coverage in the Irish media

    Free:
    https://hrbopenresearch.org/articles/5-16/v1

    Research Article
    Mental health and alcohol use among patients attending a post-COVID-19 follow-up clinic: a cohort study
    [version 1; peer review: 1 approved]

    John Broughan
    https://orcid.org/0000-0002-5084-8507
    1, Geoff McCombe
    https://orcid.org/0000-0003-4898-3459
    1, Brendan O’Kelly1,2, Gordana Avramovic1,2, Ronan Fawsitt3,4, Shannon Glaspy
    https://orcid.org/0000-0001-7455-0978
    1,2, Mary Higgins1,5, Tina McHugh1,2, Louise Vidal2, James Woo2, John S Lambert
    https://orcid.org/0000-0001-5404-2415
    1,2, Walter Cullen1
    Author details

    Abstract
    Background: Ongoing mental health problems following COVID-19 infection warrant greater examination. This study aimed to investigate psychiatric symptoms and problematic alcohol use among Long COVID patients.

    Methods: The study was conducted at the Mater Misericordiae University Hospital’s post-COVID-19 follow-up clinic in Dublin, Ireland. A prospective cohort study design was used encompassing assessment of patients’ outcomes at 2-4 months following an initial clinic visit (Time 1), and 7–14-month follow-up (Time 2). Outcomes regarding participants’ demographics, acute COVID-19 healthcare use, mental health, and alcohol use were examined.

    Results: The baseline sample’s (n = 153) median age = 43.5yrs (females = 105 (68.6%)). Sixty-seven of 153 patients (43.8%) were admitted to hospital with COVID-19, 9/67 (13.4%) were admitted to ICU, and 17/67 (25.4%) were readmitted to hospital following an initial COVID-19 stay. Sixteen of 67 (23.9%) visited a GP within seven days of hospital discharge, and 26/67 (38.8%) did so within 30 days. Seventeen of 153 participants (11.1%) had a pre-existing affective disorder. The prevalence of clinical range depression, anxiety, and PTSD scores at Time 1 and Time 2 (n = 93) ranged from 12.9% (Time 1 anxiety) to 22.6% (Time 1 PTSD). No statistically significant differences were observed between Time 1 and Time 2 depression, anxiety, and PTSD scores. Problematic alcohol use was common at Time 1 (45.5%) and significantly more so at Time 2 (71.8%). Clinical range depression, anxiety, and PTSD scores were significantly more frequent among acute COVID-19 hospital admission and GP attendance (30 days) participants, as well as among participants with lengthy ICU stays, and those with a previous affective disorder diagnosis.

    Conclusions: Ongoing psychiatric symptoms and problematic alcohol use in Long COVID populations are a concern and these issues may be more common among individuals with severe acute COVID-19 infection and /or pre-existing mental illness.

    Keywords
    COVID-19; Long COVID; Mental Health; Alcohol Abuse; Cohort Studies
     
  2. Dolphin

    Dolphin Senior Member (Voting Rights)

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    Peter Trewhitt likes this.
  3. Dolphin

    Dolphin Senior Member (Voting Rights)

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    cfsandmore and Peter Trewhitt like this.
  4. LarsSG

    LarsSG Senior Member (Voting Rights)

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    As far as I can tell, a person drinking a glass of wine with dinner twice per week would qualify as having problematic alcohol use in this study (as would someone who was drinking to excess daily). The data is available, so someone could actually do a more detailed analysis.

    Is alcohol intolerance common in LC as it is in ME? I wonder if people drinking more after 7-14 months actually correlates with increased alcohol tolerance / recovery.
     
  5. Wonko

    Wonko Senior Member (Voting Rights)

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    So, obviously, the official treatment for long covid will now be 'stop drinking' as 'research' has shown that people who consume 'problematic' levels of alcohol have long covid.

    Ergo - alcohol causes long covid.

    (anyone who says they don't consume alcohol is obvious lying, or delusional)

    ETA - I suppose i should mention that the above is a 'parody' of the way that medicine, at least in the UK, seems to operate, in many, if not all, areas.
     
  6. Wyva

    Wyva Senior Member (Voting Rights)

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    I don't know how common it is but at least on Reddit a decent number of people seem to have it, based on these threads.
     
  7. LarsSG

    LarsSG Senior Member (Voting Rights)

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    Also the depression scores went down very slightly and the anxiety scores went down significantly between 3 months and a year post-Covid, while alcohol use went up. So probably not the case that worsening mental health is driving more drinking.
     
  8. Hutan

    Hutan Moderator Staff Member

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    Screen Shot 2022-06-08 at 10.25.12 am.png

    Screen Shot 2022-06-08 at 10.28.30 am.png

    A score of 3 does seem extraordinarily low as a threshold for problematic alcohol intake.

    A major problem with this study is the lumping of people with all sorts of post-Covid issues together.
     
  9. Wonko

    Wonko Senior Member (Voting Rights)

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    I don't drink (scoring 1, 0, and 1, so 2 - but it could have been 1,1,1 if I was 'socialising', which mostly doesn't happen as I live alone and don't like people much, but if forced to 'socialise' about the only thing that makes it even slightly tolerable, is alcohol).

    So, I, who drinks maybe once or twice a year, up to a couple of pints a time, am very nearly a problem drinker, according to these 'people'?
     
  10. Hutan

    Hutan Moderator Staff Member

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    With a different mindset, the headline on this study could have been 'Pre-existing mood disorders not related to the onset of post-Covid symptoms'.

    Only 11.1% of the participants had 'a pre-existing affective disorder'. That's probably not remarkable given prevailing rates in the population
    I don't think there is evidence here for a pre-existing affective disorder being a risk factor for post-Covid symptoms.


    There's actually quite a low prevalence of depression after Covid-19 in this sample - around 50% had no signs of depression and another nearly 30% had only mild signs, as measured by the PHQ. These percentages look to be consistent with the scores found in the general population Anxiety and depression in the Republic of Ireland during the COVID-19 pandemic using the same survey tools:
     
    Last edited: Jun 8, 2022
    lycaena, CRG, Sean and 4 others like this.
  11. Hutan

    Hutan Moderator Staff Member

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    Given the foregoing, the conclusion of this paper seems to unfairly characterise people turning up at the post-Covid clinics (some of whom have symptoms consistent withME/CFS, and some of whom will have other health and psychological issues (PTSD from the experience of being very ill may be a valid problem).

    Of course, concern is warranted about psychiatric symptoms and problematic alcohol use in anyone, but this paper does not seem to provide good evidence for being more concerned about depression and anxiety and alcohol use in Long Covid populations as a whole.
     
    Last edited: Jun 8, 2022
  12. LarsSG

    LarsSG Senior Member (Voting Rights)

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    I downloaded their data and had a look at some of the details and the drinking data definitely doesn't add up. I don't think we can trust any of their alcohol conclusions and I'd want to look very carefully at the other data as well before believing it (but I've gone past my limit for this kind of mental effort).

    https://twitter.com/user/status/1534378448508133376


    [Edit: Corrected tweet and reposted.]
     
    Last edited: Jun 8, 2022
    rvallee, Missense, CRG and 12 others like this.
  13. LarsSG

    LarsSG Senior Member (Voting Rights)

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    It is very easy to score mild or moderate on the PHQ-9 if you have Long Covid without being depressed at all. Being tired and having some brain fog puts you in the mild category, add in some difficulty sleeping and a little moving slowly and you're moderate.
     
  14. Mithriel

    Mithriel Senior Member (Voting Rights)

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    If you have a glass of wine 4 days a week you score 4 then having 6 drinks every Christmas day gives you another point to be classed as a problematic drinker. The question then is what a control group would score. It may be that people with longcovid drink much less than the normal population and maybe they have cut back drastically on their previous levels.
     
    Peter Trewhitt and Wonko like this.
  15. CRG

    CRG Senior Member (Voting Rights)

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    AUDIT-C has been around since 1989 - AUDIT-C for Alcohol Use and is the basis for the current NHS Primary Care questionnaire: Alcohol Questionnaire - NHS

    AUDIT-C limitations:

    • "AUDIT-C is a 3-item alcohol screen that can help identify persons who are hazardous drinkers or have active alcohol use disorders.
    • The AUDIT-C is a modified, shortened version of the 10-question AUDIT instrument. Its briefer design makes it more practical for incorporation into routine patient interviews or health history questionnaires in a primary care setting.
    • AUDIT-C is a screening tool. An abnormal or positive screening result may thus “raise suspicion” about the presence of an alcohol use problem, while a normal or negative result should suggest a low probability of an alcohol use problem. Assessment for purposes of diagnosis occurs in subsequent stages of evaluation."
    my bolding.

    UK Chief Medical Officers' advice is that no one should drink more than 14 units of alcohol in a week, but it seems improbable that amount could fit with the non problematic levels as defined by AUDIT-C so there's clearly a mismatch between AUDIT-C and and official advice on alcohol, at least in the UK.
     
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  16. Arnie Pye

    Arnie Pye Senior Member (Voting Rights)

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    I can imagine that this "research" was supported by government and insurance companies so that they can claim anyone with Long Covid is a drunk, secret or otherwise. If it becomes common knowledge then sufferers saying that they have Long Covid are at risk of being accused of being mad drunks.
     
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  17. LarsSG

    LarsSG Senior Member (Voting Rights)

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    They say in the paper that the 45.5% they observed at 3 months is similar to the general population in Ireland (which is actually 52%). The one year data is just wrong and I'm in touch with them to get it corrected.
     
    Mithriel, CRG, Peter Trewhitt and 3 others like this.

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