CDC adds mental health disorders to list of conditions linked to higher risk of severe COVID-19. Here's why.
Research during the pandemic has shown those with mental health disorders are more vulnerable to COVID-19, but it wasn't until last week that the Centers for Disease Control and Prevention added them to the list of underlying medical conditions associated with a higher risk of severe disease.
Although mental health experts say the addition should have come sooner, they applaud the agency’s update as the Food and Drug Administration authorizes COVID-19 boosters for millions of vulnerable Americans.
“For too long, public programs and federal agencies have continued to not pay attention to the importance of mental health,” said Benjamin Miller, president of Well Being Trust, a nonprofit health foundation. “This is a good course correction on the part of the CDC.”
Under the list of underlying conditions that are supported by at least one meta-analysis or systematic review, the CDC included mood disorders and schizophrenia spectrum disorders.
The Mayo Clinic defines mood disorders as one's general emotional state or mood being distorted or inconsistent with circumstances, interfering with the person’s ability to function. The most common examples of mood disorders include major depressive disorder and bipolar disorders, said Dr. Dost Ongur, head of the McLean Hospital’s division of psychotic disorders and professor of psychiatry at Harvard Medical School.
Previous research has shown mental health disorders are associated with a higher risk of other health problems like diabetes, stroke, and cardiovascular disease, Miller said, which the CDC lists as conditions that put people at risk for severe COVID-19 disease and death.
People with mental health disorders are also more likely to smoke and to be incarcerated, he said. A study published Oct. 6 in JAMA found nearly 400,000 COVID-19 cases and more than 2,500 deaths occurred among the U.S. prison population.
But recent data suggests mental health disorders may also be independently linked to a higher risk of developing severe disease from COVID-19.
A study published January in JAMA Psychiatry found patients with a schizophrenia spectrum disorder who were diagnosed with COVID-19 in a large New York medical system were associated with an increased risk for death after adjusting for age, sex, race and known medical risk factors.
Another report published in July in JAMA Psychiatry reviewed 21 studies involving 91 million people and found “significantly higher odds” of COVID-19 hospitalization and death among people with preexisting mood disorders compared to those without. Another systematic review and meta-analysis of mood disorders found similar results and was published in The Lancet Psychiatry.
With so much compounding evidence, mental health advocates wondered why it took so long for health officials to name mental health disorders as an underlying medical condition associated with higher risk of severe COVID-19.
“This is a reflection of an essential bias and stigma,” said Schroeder Stribling, president and CEO of Mental Health America, a nonprofit promoting mental health awareness and services. “It’s very hard to overcome this false dichotomy that we have about mental health and physical health.”
Although it may have taken longer than experts would have liked, they’re glad mental health disorders made the list in time for COVID-19 boosters.
The CDC has approved booster shots for all three FDA authorized vaccines in the U.S. with the agency’s director, Dr. Rochelle Walensky, signing off on allowing clinics, doctors and pharmacies to mix-and-match shots.
“We’re living in a world where protection from vaccines is a big tool for preventing community spread and circulation,” Ongur said. “If you prioritize the people who are at higher risk, you’ll actually protect the people getting the boosters (as well as) the communities they’re coming in contact with.”
But mental health experts say more must be done to increase access to quality care beyond the pandemic.
“We should not stop screaming from the rooftops,” Stribling said. “We know the mental health effects of this pandemic are going on right now, and will continue to go on, and may even have a longer tail than the primary health effects.”
Follow Adrianna Rodriguez on Twitter: @AdriannaUSAT.
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