New Delhi: Schizophrenia could be the second biggest risk factor contributing to Covid-19 mortality, according to a study by US researchers.
Published in Jama Psychiatry on 27 January, the study also found that people suffering from schizophrenia could face a higher risk of severe Covid-19.
In comparison to Covid-19 patients without psychiatric disorders, the study — conducted by researchers at New York University Langone Medical Center — found that those diagnosed with schizophrenia spectrum disorder had 2.7 times higher risk of mortality.
It aimed to evaluate the association of schizophrenia spectrum disorder, mood disorder, ad anxiety disorder with mortality in Covid-19 patients.
Schizophrenia is a chronic brain disorder, which causes distortions in thinking and perception. Some symptoms of the illness include delusions, hallucinations, disorganised speech, lack of motivation. People with schizophrenia are two to three times more likely to die early than the general population.
The study defined mortality as death or discharge to hospice within 45 days from a positive test result of coronavirus.
Researchers evaluated health records from 260 clinics and four hospitals in New York. Out of 26,540 patients who were tested, 7,348 adults tested positive for Covid-19 between 3 March and 31 May 2020.
Out of the 7,348 adults who tested positive, 75 patients had a history of schizophrenia, 564 had a history of mood disorder and 360 had a history of anxiety disorder.
From all the patients who tested positive for Covid-19, 864 patients died or were discharged to hospice within 45 days. The study didn’t find an association between anxiety or mood disorders from Covid-19.
However, it was found that people with schizophrenia were 2.7 times more likely to die from Covid-19 than people without the mental illness.
“The most notable finding from this study is the high risk of mortality associated with schizophrenia spectrum diagnoses, ranking second behind age in strength of an association among all demographic and medical risk factors examined in the sample,” the study said.
It stressed the need for “targeted interventions” for patients with severe mental illnesses to prevent “worsening health disparities”.
Also read: Depression, OCD, loss of sleep — Covid has made everything worse, but there are ways to cope
What links Schizophrenia to Covid-19?
The study noted that a higher risk with schizophrenia to Covid-19 mortality was expected based on previous studies on mortality. However, the “magnitude” of the increase in mortality was “unexpected”.
Considering that schizophrenia is a chronic mental illness, experts believed it may not have a “direct biological correlation” to Covid-19 mortality.
The study also predicted that delay in treatment or reduced access to care could have contributed to this outcome.
Speaking to ThePrint, Dr B.N. Gangadhar, director and vice-chancellor of the National Institute of Mental Health and Neuro Sciences (NIMHANS), Bengaluru, said, “Any comorbidity with Covid increases the mortality, schizophrenia itself is a comorbidity.”
Dr Gangadhar further said research has revealed that schizophrenia “accelerates ageing” and that he was “hardly surprised” that schizophrenia showed a high risk of mortality.
‘People with schizophrenia end up getting neglected’
Dr Soumitra Pathare, psychiatrist and director of the Centre for Mental Health Law and Policy at the Indian Law Society’s Law College, Pune, said the mortality may not have a direct correlation with schizophrenia.
“People with schizophrenia as it is have a higher mortality as compared to their peers and that is frequently linked to various conditions. They end up getting neglected much more, so they don’t get their physical health checked. There is evidence of discrimination in physical healthcare provisions,” he explained.
He also said there is evidence of poor quality of care meted out to people with schizophrenia and often their concerns are neglected.
Medicines used for treating schizophrenic patients are associated with metabolic syndrome.
“This may not have a direct relationship to Covid-19, but the indirect relationship being that they anyway get poor quality of care, they are on higher risk factors, diabetes is more likely to present in people with schizophrenia,” he explained.
Further, high risk factors, which are undiagnosed like cardiac conditions, metabolic conditions, are prevalent because they get poor quality of care.
This might have to do with why their mortality from Covid-19 is higher as opposed to a direct physical relationship between schizophrenia and Covid-19, said Pathare.
Also read: Mental health issues like depression, stress could make Covid vaccines less effective — report