Understanding the psychiatric symptoms of COVID-19: a meta-analysis of studies assessing psychiatric symptoms in Chinese patients with and survivors of COVID-19 and SARS by using the Symptom Checklist-90-Revised

Abstract

Understanding the psychiatric symptoms of COVID-19 could facilitate the clinical management of COVID-19 patients. However, the profile of psychiatric symptoms among COVID-19 patients has been understudied. We performed a meta-analysis of studies assessing psychiatric symptoms of COVID-19 and SARS patients and survivors by using the Symptom Checklist-90-Revised (SCL-90-R), an instrument covering a wide spectrum of psychiatric symptoms. Studies reporting SCL-90-R subscale scores among patients with and survivors of COVID-19 and SARS were retrieved from major English and Chinese literature databases. Patients’ pooled SCL-90-R subscale scores were compared to the Chinese normative SCL-90-R data, and Cohen’s d values were calculated to indicate the severity of psychiatric symptoms. The Joanna Briggs Institute Critical Appraisal Checklist for Studies Reporting Prevalence Data was used to assess the quality of the included studies. The search yielded 25 Chinese studies with 1675 acute COVID-19 and 964 acute SARS patients, 30 COVID-19 and 552 SARS survivors during very early recovery (up to 1 month since discharge), 291 SARS survivors during early recovery (1–6 months after discharge), and 48 SARS survivors during late recovery (12 months after discharge). None of the included studies were rated as good quality. The ten SCL-90-R-defined psychiatric symptoms, which were of medium-to-severe severity (d = 0.68–3.01), were all exhibited in acute COVID-19 patients, and the severity of these symptoms decreased to mild-to-medium during very early recovery (d = 0.17–0.73). SARS patients presented eight psychiatric symptoms with mild-to-severe severity during the acute stage (d =0.43–1.88), and thereafter, the severity of symptoms decreased over the follow-up period. However, somatization (d = 0.30) and anxiety (d = 0.28) remained at mild levels during late recovery. A wide variety of severe psychiatric symptoms have been reported by acute COVID-19 patients, and these symptoms, despite decreasing in severity, persist in very early recovery. The changing trajectory observed with SARS suggests that psychiatric symptoms of COVID-19 may persist for a long time after discharge, and therefore, periodic monitoring of psychiatric symptoms, psychosocial support, and psychiatric treatment (when necessary) may be necessary for COVID-19 patients from the acute to convalescent stages.

Impact of the COVID-19 pandemic on temporal patterns of mental health and substance abuse related mortality in Michigan: An interrupted time series analysis

“…While the patterns of mortality incidence in this study could be attributed to exogenous societal and economic factors, it is possible that endogenous factors of COVID-19 infection also played a role. SARS-CoV-2 can cross the blood brain barrier and increase the risk of neurological and psychiatric outcomes, 58 especially among those with more severe forms of COVID-19 (e.g., hospitalization, intubation). 59 Patterns within demographic groups might represent disparate levels of infection.…”

Association of Psychopathology Symptoms, Self-Compassion, and Forgiveness in Patients With Pulmonary Embolism

“…Studies have previously suggested that medical patients suffering from acute life-threatening diseases may exhibit moderate to severe psychiatric symptoms [ 8 ]. A significant proportion (36.4%) of our cohort exhibit signs and symptoms of obsessive-compulsive disorder, 22.7% demonstrated signs of depression and hostility, and 18.2% presented high interpersonal sensitivity.…”

“…A large number of psychiatric symptoms are present in acute medical patients suffering from potentially lethal diseases [ 8 ]. The psychological characteristics may relate to physical symptoms and influence how patients manage their disease.…”

“…The psychological characteristics may relate to physical symptoms and influence how patients manage their disease. For example, the presence of psychotic symptoms has been related to poor drug adherence [ 8 ] while self-compassion is associated with self-management behaviors [ 7 ]. The term self-compassion as described by Neff [ 9 ] includes the idea that one should treat himself/herself as he/she would treat others and is defined by three components: common humanity versus isolation, self-kindness versus self-judgment, and mindfulness versus over-identification.…”

Predictors of the Development of Mental Disorders in Hospitalized COVID-19 Patients without Previous Psychiatric History: A Single-Center Retrospective Study in South Korea

“…By the end of 2021, 278,714,484 cases of COVID-19 had been reported worldwide [1]. As the coronavirus disease 2019 (COVID-19) has rapidly spread worldwide, mental health among patients with COVID-19 is an emerging and important public health issue [2][3][4].…”