Evaluation of Psychiatric History and Symptom Discordance in Neuro-PASC Patients: A Cross-Sectional Study
Lina Al Qadi1, Josiane Stadler1, Dominique Comeau2, Véronique Landry3, Mahée Cote1, Marie-Claire Losier4, Emilie Laplante5, Gilles Robichaud7, Luc Boudreau7, Robert Laforce8, Ludivine Chamard Witkowski6
1Centre de formation médicale du Nouveau-Brunswick, 2Vitalité Health Network, 3Département de psychiatrie, Centre hospitalier universitaire Dr-Georges-L.-Dumont, 4Hôpital de Tracadie, 5Centre hospitalier universitaire Dr-Georges-L.-Dumont, 6Département de neurologie, clinique MAPR, Centre hospitalier universitaire Dr-Georges-L.-Dumont, 7Département de chimie et biochimie, Université de Moncton, 8CHU De Quebec
Objective:

Compare self-reported psychiatric symptoms in Neuro-PASC patients to standardized tools.

Background:

Studies regarding COVID-19 have been ongoing, as patients continue to present with various cognitive-psychiatric symptoms for more than 12 weeks post-infection—a condition known as Neuro-PASC. While literature points out to past psychiatry history as a risk factor to long covid development, there were gaps in literature regarding evaluating the clinical accuracy in self-reported symptoms. Hence, this left an unanswered question whether long COVID is over or under diagnosed based solely on self-reported symptoms.

Design/Methods:

Through a cross-sectional design, controls and patients underwent various health questionnaires, notably the Patient Health Questionnaire-9 (PHQ-9) and Generalized Anxiety Disorder-7 (GAD-7), to scale depression and anxiety intensity. Anxiety and depression were specifically questioned when taking participants health and long COVID symptoms history.

Results:

The patient group (n=26) had a prevalence of 38% for a history of depression and 35% for a history of anxiety, while controls group (n=15) had 20% and 7%, respectively. There was a statistically significant increase in PHQ-9 and GAD-7 scores in patients who had a pre-COVID history of depression or anxiety. Qualitative analyses showed a large proportion of patients with no self-reported depression had moderate-severe depression scores. Similarly, in the case of anxiety, it was noted that 40% of patients with severe anxiety scores had not reported this finding, and a bit less than 20% of patients who reported anxiety had none according to the GAD-7 scale.

Conclusions:

This study supports the literature findings that pre-covid psychiatric history is a risk factor for long COVID development and severity. This study also highlights the discordance between self-reported symptoms and validated scales. It would be interesting to explore further whether the presence of current psychiatric symptoms in patients is secondary to COVID-19, requiring a pathological trigger to surge, or were rather omnipresent before the infection.

10.1212/WNL.0000000000212381
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