4 ms·

> Researchers who conducted the analysis said it was not clear how the virus was linked to psychiatric conditions such as anxiety and depression, but that these

> Researchers who conducted the analysis said it was not clear how the virus was linked to psychiatric conditions such as anxiety and depression, but that these were the most common diagnoses among the 14 disorders they looked at. Could it have something to do with being locked up for the last 6 months or worry about ones future career maybe?

tablespoon 6y ago
> Could it have something to do with being locked up for the last 6 months or worry about ones future career maybe? So you're saying the study is so shoddy that they didn't have a control group of people who went through the same lockdowns but didn't get COVID? Otherwise, your comment doesn't make sense.
- rriepe 6y ago
  The proper control group would be people with COVID who didn't go through the lockdowns.
  - happytoexplain 6y ago
    They both seem like useful control groups - can you explain the difference to an amateur on statistics?
    - rriepe 6y ago
      Covid and the lockdowns both might be causing the effect. So you have one group that has just Covid and then one group that has both. Then you compare the outcomes and see if the just-Covid group has the effect too. But my comment was kinda tongue-in-cheek: How do you even find people not affected by this doom-n-gloom global news story?
  - tablespoon 6y ago
    > The proper control group would be people with COVID who didn't go through the lockdowns. No, they were studying the effects of COVID, not the effects of lockdowns. Your suggestion is controlling for the wrong variable.
  - kkoncevicius 6y ago
    Best control group would be people who went through the lockdowns, had flu but suspected themselves to have COVID.
    - rriepe 6y ago
      I like this one too.
- taldo 6y ago
  Their control group was people that had influenza and other respiratory conditions in the same timeframe. The hazard ratios for COVID survivors (over influenza or others) were in the 1-2% range. Meh.
  - kazinator 6y ago
    That's not a credible control, because influenza and respiratory conditions are not a plausible placebo for Covid-19. The subjects knew that they are not having Covid-19, which makes them different from subjects which got Covid-19 and knew it.
    - Barrin92 6y ago
      I'm not really sure what you're trying to say, that if you control for covid-19, the effect of covid-19 goes away? Duh What you want to control for is the lockdown effects or general disease stress, not covid-19 itself. That's what you're trying to measure.
      - necovek 6y ago
        I think the GP has a point: ideally, you'd have unaware Covid19 patients as a control group, to see if this is psychological or physiological. Those aware they had Covid19 will fear all the known-unknowns around Covid19. Those who don't think they had it wouldn't have stressed about it at all.
    - c6401 6y ago
      Wow people do incredible mental hymnastics to prove themselves they are safe and all these studies are flawed. No matter how much effort have been put into research it will never be good enough.
- kazinator 6y ago
  You cannot control for that. You can't give a control group a "placebo illness" such that they don't know whether it's Covid-19 or not (and make it double-blind so that the people administering this illness also don't know). The people who overcame Covid-19 had an experience that members of a control group who did not overcome Covid-19 do not have. That's an obvious source of bias, which is inherent to the study. What would be credible would be data about people who had Covid-19 but did not know it (due to mild symptoms and no hospitalization), showing that those people have mental problems compared to a control group of those who didn't have Covid-19. However, if there is a real physiological effect there, it could be tied to the severity of the illness: i.e. how much damage it caused to the body. In that case, those secondary effects could be expected to be next to nonexistent in the mild group.
  - loopz 6y ago
    You can never really rely on just one study anyways. You then need metastudies and comparative studies where such flaws get weeded out or corrected for. So there will be significant lag in certainty, thus not suitable for much of decisionmaking now.
  - necovek 6y ago
    The effect might not even be physiological yet still be this prominent: having COVID-19 makes you doubly scared for your loved-ones, worry about your perception in the society (was I not careful enough?), worry about lingering side-effects, worry about missing extended time from work, etc. While this depends on the individual, you can notice effects of increased stress in large numbers. Your suggestion of another control group with Covid-19-but-no-symptoms would help answer that question too, though ideally we'd want those who had Covid19 but didn't know it at all. But anyway, this paper is only establishing correlation: getting to causation in medicine is the harder task and takes years or decades and even then it's usually inconclusive!
happytoexplain 6y ago
Did something in the article make you think they didn't control for something that obvious?
- crocodiletears 6y ago
  The article does nothing to mention the general population beyond suggesting that the difference between the incidence of psychiatric orders in covid vs cold/flu patients was 'significant'. It provides neither the title nor a link to the original study. The significance and quality of the study are both impossible to elucidate from the article's text.
vinni2 6y ago
I would presume the mental disorders are statistically significant in COVID survivors compared to the general population. Otherwise it’s not publication worth!
- merb 6y ago
  > Anxiety, at 17%, and mood disorders, at 14%, were the most common, and did not appear to be related to how mild or severe the patient’s COVID-19 infection had been.
  - happytoexplain 6y ago
    I don't follow your implication in the context of the parent post.
- isolli 6y ago
  They actually compare it to other respiratory diseases survivors. The results are a lot milder than the headline implies. This, by contrast to the shoddy Reuters article, is a good reference, with a chart that neatly summarizes the results (pay attention to the different values on the y-axes): https://medicalxpress.com/news/2021-04-largest-date-link-covid-infection.html https://medicalxpress.com/news/2021-04-largest-date-link-cov...
taldo 6y ago
For all the effects, having had COVID-19 means about 1-2% higher chance of each of the disorders they were looking at, except for one that was like 5%. IOW, sure, about a third of COVID-19 survivors have some conditions in the following 6 months, but so do Influenza and other respiratory disease survivors.
jariel 6y ago
So they controlled with 2 other groups, those diagnosed with the flu and those with respiratory trace infections. Some things stick out: 1) That we are all locked up in a state of anxiety is a little bit hard to control for especially because those factors alone may not trigger things, but those factors + COVID may actually amplify. 2) The big loophole that's nary impossible to nail down is the psychological impact of being told you have something that 'might kill you and has killed 550 000 Americans and the cause of a pandemic' vs. 'You have the normal flu go hoe you'll be fine in two days'. I once had an ailment that was actually something not so severe (lack of sleep, too much redbull and stress) and was fine a few months after adjusting, by my symptoms were so varied and odd I was sure I had the 'start of something worse'. The fact the doctors could not nail it down with a straight diagnosis sent me into kind of a panic. The 'real control group' would be people that 'Had actual COVID' but were actually told that 'They just have the regular flu' - which would be obviously next to impossible. Because the symptoms identified are common and indirect things like 'Depression and Anxiety' - it speaks even more to the mental aspects of the side effects. If for example COVID patients had '50% higher likelihood of Iron deficiency' or something like that, well, it would be easier to absorb as a straight up side effect. It might be possible to do the same kind of survey in other countries to see if the same thing holds up. It'd be interesting to see if they can normalize for things like neuroticism, and general attitudes towards the virus, deaths in the family due to COVID etc. to see if depression is more common in those who naturally tend to worry, or have more of a reason to be afraid.
gremlinsinc 6y ago
Who's been locked up? I've gone to the gas station daily to get fountain drinks, I've gone to grocery stores, etc... I have NOT gone to movie theaters or crowded in-door places, but I mostly avoided those before lockdowns. The only change is masks. In fact my daily life is mostly the same as it was before lockdown, except I had covid last march, have severe anxiety, depression, weakness in my hands/feet and severe neuropathy, as well as a standing heart rate of 130, sitting at 90, constant shortness of breath, fatigue that's only sort of in check when I take 3-4oz of energy shots per day plus my vyvanse, and two antihistamines (loratadine/pepcid). At night I have severe insomnia, but that could be the pain as my pain level seems to be 2x at night as it is during the day. I'm pretty sure there's a very valid effect of covid on the brain/body/etc. If you doubt it just go to reddit.com/r/covidlonghaulers
- necovek 6y ago
  I am sorry to hear of your experience with Covid! It makes total sense for you to be depressed after surviving with so many lingering side-effects: I only hope it improves for you going forward (and sooner, rather than later)! However, we need more papers like the OP to establish how many people are in the same boat as you, and out of all the "newly" depressed people, how many are due to actual lingering health issues, and how many are due to psychological stress caused by going through the illness that's so influential on the world today. During the lockdowns, I've messed up my back. While I originally went for physical therapy over the summer 2020, I don't feel comfortable doing that today because of COVID. The fact that I am not doing enough to "fix myself" is making me depressed. "Lockdowns" are a spectrum, and have also stopped people from potentially making changes they need to make: I don't think it's fair for you to discount it as a non-variable here. I am sure you are wondering aloud if you'll ever be "back to normal". So am I. But separating out all of these will help us understand COVID19 and its consequences, and help us adapt treatment to the actual causes.
stmfreak 6y ago
Ding ding ding! Also being told repeatedly that covid causes long hauler syndrome might cause people recovering from covid to worry if that will happen to them.

tablespoon 6y ago

> Could it have something to do with being locked up for the last 6 months or worry about ones future career maybe? So you're saying the study is so shoddy that they didn't have a control group of people who went through the same lockdowns but didn't get COVID? Otherwise, your comment doesn't make sense.

rriepe 6y ago
The proper control group would be people with COVID who didn't go through the lockdowns.
- happytoexplain 6y ago
  They both seem like useful control groups - can you explain the difference to an amateur on statistics?
  - rriepe 6y ago
    Covid and the lockdowns both might be causing the effect. So you have one group that has just Covid and then one group that has both. Then you compare the outcomes and see if the just-Covid group has the effect too. But my comment was kinda tongue-in-cheek: How do you even find people not affected by this doom-n-gloom global news story?
- tablespoon 6y ago
  > The proper control group would be people with COVID who didn't go through the lockdowns. No, they were studying the effects of COVID, not the effects of lockdowns. Your suggestion is controlling for the wrong variable.
- kkoncevicius 6y ago
  Best control group would be people who went through the lockdowns, had flu but suspected themselves to have COVID.
  - rriepe 6y ago
    I like this one too.
taldo 6y ago
Their control group was people that had influenza and other respiratory conditions in the same timeframe. The hazard ratios for COVID survivors (over influenza or others) were in the 1-2% range. Meh.
- kazinator 6y ago
  That's not a credible control, because influenza and respiratory conditions are not a plausible placebo for Covid-19. The subjects knew that they are not having Covid-19, which makes them different from subjects which got Covid-19 and knew it.
  - Barrin92 6y ago
    I'm not really sure what you're trying to say, that if you control for covid-19, the effect of covid-19 goes away? Duh What you want to control for is the lockdown effects or general disease stress, not covid-19 itself. That's what you're trying to measure.
    - necovek 6y ago
      I think the GP has a point: ideally, you'd have unaware Covid19 patients as a control group, to see if this is psychological or physiological. Those aware they had Covid19 will fear all the known-unknowns around Covid19. Those who don't think they had it wouldn't have stressed about it at all.
  - c6401 6y ago
    Wow people do incredible mental hymnastics to prove themselves they are safe and all these studies are flawed. No matter how much effort have been put into research it will never be good enough.
kazinator 6y ago
You cannot control for that. You can't give a control group a "placebo illness" such that they don't know whether it's Covid-19 or not (and make it double-blind so that the people administering this illness also don't know). The people who overcame Covid-19 had an experience that members of a control group who did not overcome Covid-19 do not have. That's an obvious source of bias, which is inherent to the study. What would be credible would be data about people who had Covid-19 but did not know it (due to mild symptoms and no hospitalization), showing that those people have mental problems compared to a control group of those who didn't have Covid-19. However, if there is a real physiological effect there, it could be tied to the severity of the illness: i.e. how much damage it caused to the body. In that case, those secondary effects could be expected to be next to nonexistent in the mild group.
- loopz 6y ago
  You can never really rely on just one study anyways. You then need metastudies and comparative studies where such flaws get weeded out or corrected for. So there will be significant lag in certainty, thus not suitable for much of decisionmaking now.
- necovek 6y ago
  The effect might not even be physiological yet still be this prominent: having COVID-19 makes you doubly scared for your loved-ones, worry about your perception in the society (was I not careful enough?), worry about lingering side-effects, worry about missing extended time from work, etc. While this depends on the individual, you can notice effects of increased stress in large numbers. Your suggestion of another control group with Covid-19-but-no-symptoms would help answer that question too, though ideally we'd want those who had Covid19 but didn't know it at all. But anyway, this paper is only establishing correlation: getting to causation in medicine is the harder task and takes years or decades and even then it's usually inconclusive!

happytoexplain 6y ago

Did something in the article make you think they didn't control for something that obvious?

crocodiletears 6y ago
The article does nothing to mention the general population beyond suggesting that the difference between the incidence of psychiatric orders in covid vs cold/flu patients was 'significant'. It provides neither the title nor a link to the original study. The significance and quality of the study are both impossible to elucidate from the article's text.

vinni2 6y ago

I would presume the mental disorders are statistically significant in COVID survivors compared to the general population. Otherwise it’s not publication worth!

merb 6y ago
> Anxiety, at 17%, and mood disorders, at 14%, were the most common, and did not appear to be related to how mild or severe the patient’s COVID-19 infection had been.
- happytoexplain 6y ago
  I don't follow your implication in the context of the parent post.
isolli 6y ago
They actually compare it to other respiratory diseases survivors. The results are a lot milder than the headline implies. This, by contrast to the shoddy Reuters article, is a good reference, with a chart that neatly summarizes the results (pay attention to the different values on the y-axes): https://medicalxpress.com/news/2021-04-largest-date-link-covid-infection.html https://medicalxpress.com/news/2021-04-largest-date-link-cov...

taldo 6y ago

For all the effects, having had COVID-19 means about 1-2% higher chance of each of the disorders they were looking at, except for one that was like 5%. IOW, sure, about a third of COVID-19 survivors have some conditions in the following 6 months, but so do Influenza and other respiratory disease survivors.

jariel 6y ago

So they controlled with 2 other groups, those diagnosed with the flu and those with respiratory trace infections. Some things stick out: 1) That we are all locked up in a state of anxiety is a little bit hard to control for especially because those factors alone may not trigger things, but those factors + COVID may actually amplify. 2) The big loophole that's nary impossible to nail down is the psychological impact of being told you have something that 'might kill you and has killed 550 000 Americans and the cause of a pandemic' vs. 'You have the normal flu go hoe you'll be fine in two days'. I once had an ailment that was actually something not so severe (lack of sleep, too much redbull and stress) and was fine a few months after adjusting, by my symptoms were so varied and odd I was sure I had the 'start of something worse'. The fact the doctors could not nail it down with a straight diagnosis sent me into kind of a panic. The 'real control group' would be people that 'Had actual COVID' but were actually told that 'They just have the regular flu' - which would be obviously next to impossible. Because the symptoms identified are common and indirect things like 'Depression and Anxiety' - it speaks even more to the mental aspects of the side effects. If for example COVID patients had '50% higher likelihood of Iron deficiency' or something like that, well, it would be easier to absorb as a straight up side effect. It might be possible to do the same kind of survey in other countries to see if the same thing holds up. It'd be interesting to see if they can normalize for things like neuroticism, and general attitudes towards the virus, deaths in the family due to COVID etc. to see if depression is more common in those who naturally tend to worry, or have more of a reason to be afraid.

gremlinsinc 6y ago

Who's been locked up? I've gone to the gas station daily to get fountain drinks, I've gone to grocery stores, etc... I have NOT gone to movie theaters or crowded in-door places, but I mostly avoided those before lockdowns. The only change is masks. In fact my daily life is mostly the same as it was before lockdown, except I had covid last march, have severe anxiety, depression, weakness in my hands/feet and severe neuropathy, as well as a standing heart rate of 130, sitting at 90, constant shortness of breath, fatigue that's only sort of in check when I take 3-4oz of energy shots per day plus my vyvanse, and two antihistamines (loratadine/pepcid). At night I have severe insomnia, but that could be the pain as my pain level seems to be 2x at night as it is during the day. I'm pretty sure there's a very valid effect of covid on the brain/body/etc. If you doubt it just go to reddit.com/r/covidlonghaulers

necovek 6y ago
I am sorry to hear of your experience with Covid! It makes total sense for you to be depressed after surviving with so many lingering side-effects: I only hope it improves for you going forward (and sooner, rather than later)! However, we need more papers like the OP to establish how many people are in the same boat as you, and out of all the "newly" depressed people, how many are due to actual lingering health issues, and how many are due to psychological stress caused by going through the illness that's so influential on the world today. During the lockdowns, I've messed up my back. While I originally went for physical therapy over the summer 2020, I don't feel comfortable doing that today because of COVID. The fact that I am not doing enough to "fix myself" is making me depressed. "Lockdowns" are a spectrum, and have also stopped people from potentially making changes they need to make: I don't think it's fair for you to discount it as a non-variable here. I am sure you are wondering aloud if you'll ever be "back to normal". So am I. But separating out all of these will help us understand COVID19 and its consequences, and help us adapt treatment to the actual causes.

stmfreak 6y ago

Ding ding ding! Also being told repeatedly that covid causes long hauler syndrome might cause people recovering from covid to worry if that will happen to them.