The importance of psychiatry in the care and research of Post-COVID 2026 Walter et al

[Andy]

Summary​

Post-infectious syndromes such as post-COVID have come into focus as a result of the COVID-19 pandemic. In addition to headaches and limb pain, palpitations, skin changes and shortness of breath, the wide spectrum of complaints also includes neuropsychiatric symptoms such as fatigue, memory and concentration disorders, as well as anxiety and affective symptoms. The etiology and pathophysiology of symptoms are still largely unknown. The experience of a difficult to treat and potentially chronic disease places a considerable burden on those affected, especially for people with pre-existing mental health conditions. It is essential to make a careful delimitation to other mental illnesses. In order to adequately support those affected in coping with the consequences of post-COVID, psychiatric expertise is absolutely necessary. This article shows how psychiatry can contribute to the diagnosis and treatment of post-COVID and how it contributes to a better understanding of the clinical picture. Treatment approaches and research opportunities are discussed. Specialist and social demands for a holistic approach that requires an interdisciplinary approach and includes both clinical and scientific expertise and the perspective of those affected are explained.

Open access (in German)

 

[rvallee]

So weak that by comparison water is extra spicy.

Similar to medications, there are currently no approved psychotherapeutic approaches for post-COVID. A randomized trial suggests that cognitive behavioral therapy may have a beneficial effect on post-COVID fatigue, but most studies are uncontrolled [ 22 ]. In the absence of effective causal treatment strategies, coping with the illness and, in the case of post-COVID fatigue, learning pacing techniques are therefore important therapeutic goals.

I don't know what they refer to by such "psychotherapeutic approaches" being 'approved'. There is no such approval process. Doing a bunch of small, biased pilot trials, summing up a few of them in 'systematic' reviews, then asserting it's good enough for a guideline is not an approval process. There is no authority that 'approves' anything here, not for alternative medicine.

It's also telling that they speak of "a" randomized trial that 'suggests' something about CBT. There have been far more than one, but they keep pretending that it has both never-been-tried while also benefiting from extensive experience with it.

Psychiatry has completely dominated this issue, and has not contributed a single useful thing. Nothing has stopped them from contributing anything, they just haven't. The idea that they have a place just because they could have is ridiculous.

Therefore, the pandemic-related simultaneous occurrence of large numbers of post-COVID cases also presents an opportunity to investigate the pathomechanisms of the early phase of post-infectious syndromes.

It did represent an opportunity. 6 years ago. We tried, but no one was listening because they were listening to you all along. So it passed, mainly thanks to your decades of miserable failure.

The symptom of post-COVID-19 (PEM) is of particular importance, as it is a unique characteristic of ME/CFS and distinguishes the disease from symptomatically overlapping syndromes.

The "symptom" of PEM? The thing that has been controversially dismissed to even exist for decades? By you? Do go on about how you have a lot to contribute here, when you have opposed everything that could have made any progress.

The demand for measures to combat the stigmatization of post-COVID individuals is therefore a crucial issue that touches upon not only the medical but also the societal dimension of the COVID-19 pandemic

The entire 'stigmatization' is the false assertion of this being psychological or biopsychosocial. YOU are the whole controversy.

Reducing stigma surrounding mental illness and preventing the stigmatizing, hasty, incorrect, or one-sided categorization of symptoms as mental disorders are not contradictory.

Good grief they never learn anything. Like a dog eating its own vomit in an infinite loop.

Psychiatry and psychotherapy, as key players, can thus contribute important experience and resources to multidisciplinary collaboration on post-infectious conditions, both within and beyond the context of post-COVID, and actively participate in their development.

You will never contribute anything. Never. Go away. You are ruin.

 

[OrganicChilli]

"The Role of Psychiatry in Post-COVID Care and Research" – that's the title of a new consensus paper in the journal Nervenarzt. The summary states: "Distinguishing it from other mental illnesses." This establishes the frame of reference.

Post-COVID is thus situated within the context of mental illness. There is no explicit clarification that it is a somatic illness. The diagnostic perspective is therefore already pre-structured.

The text continues in this vein: Fatigue, along with cognitive impairments, concentration difficulties and anxiety, is categorized as "neuropsychiatric symptoms".

This is not a neutral description. It is a framework that defines responsibilities – for diagnosis, treatment, and care. Whoever sets the category also claims and determines access to care.

It also states that psychiatric expertise is "absolutely essential" to provide adequate support to those affected. This, too, is not merely an addition – but a clearly formulated demand for competence.

The article itself addresses the stigmatization caused by attributing psychological factors. And it carries out precisely this attribution linguistically – consistently and systematically.

An inherent contradiction: Stigmatization is named – and simultaneously reproduced. The authors recognize the problem, but cling to their framing ("there is no contradiction here").

This will not be without consequences. It will shape the distribution of research funding – and above all, the care provided to those affected. The fact that the German Center for Mental Health (DZPG) is specifically mentioned as a suitable research initiative speaks volumes.

 

[Utsikt]

Fatigue, along with cognitive impairments, concentration difficulties and anxiety, is categorized as "neuropsychiatric symptoms".

And they are neuropsychiatric symptoms. But that doesn’t mean that psychiatry or psychology is a suitable home for LC.

 

[rvallee]

And they are neuropsychiatric symptoms. But that doesn’t mean that psychiatry or psychology is a suitable home for LC.

Fatigue? I don't see how. I can't even imagine what psychiatry could possibly even have to do with fatigue, unless it's defined as low motivation, which is usually why it gets miscategorized this way.

 

[Utsikt]

Fatigue? I don't see how. I can't even imagine what psychiatry could possibly even have to do with fatigue, unless it's defined as low motivation, which is usually why it gets miscategorized this way.

I guess it depends on how you define «neuropsychiatric».

If it’s symptoms caused by changes to the brain, brain fog probably fits but fatigue might not depending on the cause. Anxiety would be the same - dependent on the cause.

So I agree that it’s a mistake to outright assume those a neuropsychiatric - thanks for the correction.

 

[rvallee]

Anxiety would be the same - dependent on the cause.

Yup. Even that in most cases barely seems to fit. If being jittery from taking too much caffeine gets called the same, among many other situations, then the whole concept is basically both useless and meaningless. I really doubt much of the current nomenclature in mental health will stand the test of time. Seems similar to how before telescopes telling planets apart from stars wasn't really possible.

 

[bobbler]

And they are neuropsychiatric symptoms. But that doesn’t mean that psychiatry or psychology is a suitable home for LC.

Fatigue? I don't see how. I can't even imagine what psychiatry could possibly even have to do with fatigue, unless it's defined as low motivation, which is usually why it gets miscategorized this way.

I agree - I know there in the past few decades has been certain individuals successfully managing to push things even like Alzheimer’s under ‘mental health’ once they rejigged it to become that (rather than dept of psychiatry) by conning GP s that ‘cos anything that looks like it’s the thinking can be sent there’ when it used to and should be about cause

Headaches shouldn’t be ‘mental health ‘ for example but I wouldn’t put it past them

And much of my brain fog is in sure an extreme version of what people get at the end of an extreme week of working that involved lots of noise and talking and you then ‘just need peace’ and can’t even form words. Albeit yes there is more mixed in

And albeit I’ve often got other not at all brain symptoms too

I’ve always hated the term brain fog because of this and it really gets up my nose with the bucketing of symptoms that have very clear terms in psychology - like specific errors in word finding vs forgetting to turn off the oven are clearly defined - in order that they are better understood as to the cause/how to avoid (as eg they need to be understood for healthy people in jobs like truck driving and air traffic control too)

I’ve really noticed the real difference with when long covid came along was how much they wanted to call so much neuropsychiatric and really stick it and I never knew whether it was a new special thing some long covid but not me/cfs type had (like there’s a lung version) or if it was a ‘move’ on the me/cfs type and was them trying to pathologist what I see as part of the ‘overall exhaustion’ package and not ‘a neuropsychiatric disease’ (which is almost where they seemed to bill it)

This is significant particularly for the more severe if they are trying to pull this one and I sort of feel it anyway in the ‘there’s some forces making those in the profession think this way’ feels that you get when you have to interact with as well as read about the health services a lot. Because I will always get exhausted after a short time of conversation even when I’ve saved up to have a good day to talk (so worse when it’s ad hoc) but as it’s obvious if they see me the rest of my body is curling up too you’d expect a human being to realise it’s exhaustion - yet the terms some of them (allied not really medical ones more commonly the worst and younger lower down the scale ones so I guess it’s what’s being taught being worse not better these days in that) instead jump to I find offensive because I’ve a bsc psychology and know they aren’t qualified often to be doing that or using those terms and that there are instead these descriptive terms they aren’t qualified often being handed but refusing to use instead of these fake insinuating diagnostics terms (and what’s an equipment person doing changing ‘I’m cognitively exhausted’ to their own term??)