People with a history of certain psychiatric conditions such as psychosis and anxiety are at increased risk of COVID-19 breakthrough, a finding that may be related to impaired immune responses as well as risky behaviors associated with certain disorders.
Researchers from the University of California-San Francisco said the finding was also consistent with people who had been vaccinated with SARS-CoV-2.
The team found that patients over the age of 65 with substance abuse, psychotic disorders, bipolar disorder, adjustment disorders, and anxiety faced an up to 24 percent risk of breakthrough COVID.
For people under 65, the risk was 11 percent higher than for those who had no mental history.
“Our research suggests that increased infections among people with psychiatric disorders cannot be fully explained by socio-demographic factors or pre-existing conditions,” said Aoife O’Donovan of the UCSF Weill Institute for Neurosciences.
“It is possible that post-vaccination immunity decreases more quickly or more strongly for people with mental disorders and/or that they may have less protection against new forms.”
In the study, published in JAMA Network Open, researchers tracked data from 263,697 US patients who had completed their vaccine regimen and had at least one test for SARS-CoV-2.A.
Surprisingly, given the higher incidence of breakthrough infections in younger people, this study showed a significantly lower effect in the younger age group.
In addition, the risk was 10 percent lower in participants with psychotic disorders compared to those without a psychiatric diagnosis “a decrease that O’Donovan attributed to potentially reduced socialization among younger people with psychiatric disorders compared to older people”. “May be less socially isolated” because of their ill health and the greater burden of contact with caregivers.
However, the risks of breakthrough transitions associated with substance abuse, adjustment disorders, anxiety, and post-traumatic stress disorder were all higher in the youth group than their peers without a psychiatric diagnosis — 11 percent, 9 percent, 4 percent, and 4 percent. 3 percent, respectively.
According to Kristen Nishimi of the UCSF Weill Institute, the higher incidence of breakthrough infections in older participants may be due to the “decreased immunological response to vaccines” that have been associated with certain psychiatric disorders, which may be more significant in older adults.
It is also possible that older adults with mental disorders “may require more frequent individualized care, which may increase their interactions with the health care system”, she said.
“It is important to consider mental health in conjunction with other risk factors, and some patients should be prioritized for boosters and other important preventive efforts,” O’Donovan said.