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Associations of Depression, Anxiety, Worry, Perceived Stress, and Loneliness Prior to Infection With Risk of Post–COVID-19 Conditions, 2022, Wang et a

Discussion in 'Psychosomatic research - ME/CFS and Long Covid' started by Wyva, Sep 7, 2022.

  1. Wyva

    Wyva Senior Member (Voting Rights)

    Messages:
    1,368
    Location:
    Budapest, Hungary
    Key Points

    Question Is psychological distress before SARS-CoV-2 infection associated with risk of COVID-19–related symptoms lasting 4 weeks or longer, known as post–COVID-19 conditions?

    Findings This cohort study found that among participants who did not report SARS-CoV-2 infection at baseline (April 2020) and reported a positive SARS-CoV-2 test result over 1 year of follow-up (N = 3193), depression, anxiety, perceived stress, loneliness, and worry about COVID-19 were prospectively associated with a 1.3- to 1.5-fold increased risk of self-reported post–COVID-19 conditions, as well as increased risk of daily life impairment related to post–COVID-19 conditions.

    Meaning In this study, preinfection psychological distress was associated with risk of post–COVID-19 conditions and daily life impairment in those with post–COVID-19 conditions.

    ----

    Abstract

    Importance Few risk factors for long-lasting (≥4 weeks) COVID-19 symptoms have been identified.

    Objective To determine whether high levels of psychological distress before SARS-CoV-2 infection, characterized by depression, anxiety, worry, perceived stress, and loneliness, are prospectively associated with increased risk of developing post–COVID-19 conditions (sometimes called long COVID).

    Design, Setting, and Participants This prospective cohort study used data from 3 large ongoing, predominantly female cohorts: Nurses’ Health Study II, Nurses’ Health Study 3, and the Growing Up Today Study. Between April 2020 and November 2021, participants were followed up with periodic surveys. Participants were included if they reported no current or prior SARS-CoV-2 infection at the April 2020 baseline survey when distress was assessed and returned 1 or more follow-up questionnaires.

    Exposures Depression, anxiety, worry about COVID-19, perceived stress, and loneliness were measured at study baseline early in the pandemic, before SARS-CoV-2 infection, using validated questionnaires.

    Main Outcomes and Measures SARS-CoV-2 infection was self-reported during each of 6 monthly and then quarterly follow-up questionnaires. COVID-19–related symptoms lasting 4 weeks or longer and daily life impairment due to these symptoms were self-reported on the final questionnaire, 1 year after baseline.

    Results Of 54 960 participants, 38.0% (n = 20 902) were active health care workers, and 96.6% (n = 53 107) were female; the mean (SD) age was 57.5 (13.8) years. Six percent (3193 participants) reported a positive SARS-CoV-2 test result during follow-up (1-47 weeks after baseline). Among these, probable depression (risk ratio [RR], 1.32; 95% CI = 1.12-1.55), probable anxiety (RR = 1.42; 95% CI, 1.23-1.65), worry about COVID-19 (RR, 1.37; 95% CI, 1.17-1.61), perceived stress (highest vs lowest quartile: RR, 1.46; 95% CI, 1.18-1.81), and loneliness (RR, 1.32; 95% CI, 1.08-1.61) were each associated with post–COVID-19 conditions (1403 cases) in generalized estimating equation models adjusted for sociodemographic factors, health behaviors, and comorbidities. Participants with 2 or more types of distress prior to infection were at nearly 50% increased risk for post–COVID-19 conditions (RR, 1.49; 95% CI, 1.23-1.80). All types of distress were associated with increased risk of daily life impairment (783 cases) among individuals with post–COVID-19 conditions (RR range, 1.15-1.51).

    Conclusions and Relevance The findings of this study suggest that preinfection psychological distress may be a risk factor for post–COVID-19 conditions in individuals with SARS-CoV-2 infection. Future work should examine the biobehavioral mechanism linking psychological distress with persistent postinfection symptoms.

    Open access: https://jamanetwork.com/journals/jamapsychiatry/fullarticle/2796097
     
    Peter Trewhitt and Lilas like this.
  2. John Mac

    John Mac Senior Member (Voting Rights)

    Messages:
    905
    Didn't take long for the usual suspects to chip in.

    https://www.spectator.co.uk/article/who-s-most-likely-to-report-long-covid-

    "The study looked at 3,193 people – mostly women"

    "In short, the most typical long Covid sufferer is a well-educated, obese white woman with a history of poor mental health. A less-educated non-white man is less likely to report having persistent symptoms."

    Well if you look mostly at women then you are going to find more women with long Covid.
    And I wonder how many "less-educated non-white men" they had in the study?


    https://www.theguardian.com/society...ink-between-poor-mental-health-and-long-covid
     
    Last edited: Sep 7, 2022
  3. Andy

    Andy Committee Member

    Messages:
    21,813
    Location:
    Hampshire, UK
    From the paper, the woeful questionnaires that they used to 'measure' levels of 'distress':

    Types of Distress

    Distress was measured at baseline. Frequency of depressive and anxiety symptoms in the past 2 weeks was assessed with the 4-item Patient Health Questionnaire (PHQ-4), which consists of a 2-item depression measure (PHQ-2) and a 2-item anxiety measure (2-item Generalized Anxiety Disorder scale [GAD-2]).30 Responses ranged from 0 (not at all) to 3 (nearly every day). Scores of 3 or higher on the PHQ-2 or GAD-2 indicated probable depression or probable anxiety.30-33 Worry about COVID-19 was assessed with the item, “How worried are you about COVID-19?” Response options were not at all, not very worried, somewhat worried, and very worried.34 The reference was not at all or not very worried.

    Two additional types of distress were assessed only among participants who were not active health care workers. The 4-item Perceived Stress Scale (PSS-4) queries frequency of past-month feelings of stress (eg, “difficulties piling up so high that you could not overcome them”).35,36 Response options ranged from never to very often (0-4). The summed score was divided into quartiles for analysis.

    The 3-item UCLA Loneliness Scale queried the frequency of feeling lack of companionship, left out, and isolated from others (hardly ever [1], some of the time [2], or often [3]).37 We divided the score into 3 levels for analysis: hardly ever lonely (3 points, reference), less than some of the time (4-5 points), and some of the time or often (≥6 points).

    For each participant, we calculated the number of distress types experienced at a high level,30-37 including probable depression, probable anxiety, somewhat or very worried about COVID-19, the top quartile of perceived stress, and lonely some of the time or more often (coded as 0, 1, or 2 or more types of distress).
     
  4. Charles B.

    Charles B. Senior Member (Voting Rights)

    Messages:
    247
    This is like injecting some otherworldly steroid into the veins of long Covid denIalists and paychologizers. The typical refrains will echo throughout the desolate wasteland that is social media. Ultimately, these pieces have a cumulative effect. They’ll reduce interest in genuine biomedical research and divert patients to the hinterlands where BPS functionaries stand at the ready.

    Anyone who criticizes the quality of the research will be subjected to the usual litany of recriminations: stigmatizing mental illness; militant; activists; small vocal minority; etc. A major mistake was ceding the realm of public opinion and just hoping that facts would prevail. We need an incisive, adaptable media strategy that incorporates our scientific stalwarts to rebut harmful narratives. A benevolent Science Media Center if you would.
     
  5. rvallee

    rvallee Senior Member (Voting Rights)

    Messages:
    12,299
    Location:
    Canada
    Says everything about how all of this psychosomatic nonsense is pseudoscience. If people want to see something they'll find it, even if it's not there.

    In the end, almost all psychological research can be ignored on the basis that correlation is not causation. People are doing the rest, finding crooked noses or beady criminal-looking eyes or whatever if they feel like it. It's simply not a legitimate discipline, I've seen enough of this nonsense.
     
  6. Sid

    Sid Senior Member (Voting Rights)

    Messages:
    1,054
    Pretty funny study if not for the fact that it will be used as a weapon against ME/CFS patients. These marginal associations don’t exceed the ambient noise / crud factor that afflicts this sort of questionnaire research and can easily be explained by the common method bias. They measured exposures and outcome using self-report questionnaires. People tend to have a response style so what you typically find in studies of this type is that every construct is correlated to one another to some extent.
     
    Snow Leopard, Ariel, EzzieD and 3 others like this.
  7. Arnie Pye

    Arnie Pye Senior Member (Voting Rights)

    Messages:
    6,048
    Location:
    UK
    A problem I have with doctors is that if I tell them I'm not depressed, anxious, stressed or worried about something they never believe me.
     
    rvallee, shak8, Ariel and 3 others like this.
  8. rvallee

    rvallee Senior Member (Voting Rights)

    Messages:
    12,299
    Location:
    Canada
    That's why atypical depression, depression without depression, and generalized anxiety, anxiety without anxiety, were invented.

    Heads you're anxious. Tails you're also anxious. Refuse to toss the coin? Clearly anxious about the outcome. The magic of circular evidence.
     

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