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October 29, 2021

CDC: Mental illness is tied to worse Covid-19 outcomes

Daily Briefing

    CDC earlier this month added "mood disorders, including depression, and schizophrenia spectrum disorders" to its list of medical conditions associated with a higher risk of severe Covid-19.

    The move makes millions of Americans diagnosed with mental health conditions eligible for booster shots.

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    The link between mental health disorders and severe Covid-19 

    The addition comes as two meta-analyses published in the Journal of the American Medical Association demonstrated the link between mental health conditions and more severe Covid-19.

    For one study, researchers analyzed data from seven countries and discovered that individuals with schizophrenia were one of the groups likeliest to die from Covid-19—second only to the elderly.

    The second study, a meta-analysis that assessed 21 studies with more than 91 million participants, identified a strong correlation between preexisting mood disorders and rates of hospitalization and death. The correlation held even after researchers controlled for factors such as health care and housing insecurity, smoking, and various comorbidities such as heart disease, according to Roger McIntyre, a study author who serves as scientific advisory board chair at the Depression and Bipolar Support Alliance.

    "Taken together, we've got reasons to be hypervigilant for people who have depression. They've got to get in front of the queue to get their vaccines," said McIntyre.

    Separately, Bill Petri, a professor of infectious diseases at the University of Virginia, said, "There truly could be a biologic link between being anxious and having worse Covid-19." He added, "Someone who is in a good state of mental health, it's easier to manage all these chronic underlying illnesses, and stress can directly and biologically impact your response to things."

    What this means for people with mental health conditions

    While many clinicians and advocates already suspected a link between mental health conditions and severe Covid-19, CDC's official "scientific seal of approval" was a critical step in protecting individuals with mental health conditions from Covid-19, the Post reports.

    Specifically, CDC says individuals from 18 to 49 years old who received the Pfizer-BioNTech or Moderna vaccine more than six months ago and who have an underlying medical condition "may get a booster shot based on their individual risks and benefits." Those between 50 and 64 with such a condition "should get a booster shot" after six months, CDC says, as should all older adults even if they don't have underlying medical conditions.

    Mary Giliberti, EVP of policy at Mental Health America, praised CDC's decision to add mental health disorders to the list of high-risk conditions, saying, "This is very significant because I think it will make a tremendous difference to people who have these mental health conditions, their families, and their providers."

    Separately, Miriam Delphin-Rittmon, assistant secretary for mental health and substance abuse at HHS, said, "CDC's recent inclusion of certain mental health conditions that can contribute to the severity of a Covid-19 infection reinforces the plight faced by Americans with behavioral health issues, including substance use disorders."

    According to Lisa Dailey, executive director of the Treatment Advocacy Center, "This is a population [who] is really, really at risk due to the way that Covid-19 interacts with the diagnoses." She added, "Until the CDC put this group of disorders on their list, they would not have known that."

    Moving forward, Dailey said, "We basically need to figure out where this population is likely to be and address concerns they might have about the vaccine." She added, "It isn't rocket science." (Portnoy, Washington Post, 10/27; American Hospital Association, 10/18; Church, WHSV 3, 10/20; Frias, Insider, 10/27; CDC, 10/14)

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    The Covid-19 pandemic is rapidly increasing the need for behavioral health services. But there are significant gaps and barriers that stand in the way of people getting the help they need. Download our take to learn how health systems can prioritize addressing the immediate needs of both staff and patients, especially those with preexisting behavioral health needs or comorbid conditions.

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