Does COVID-19 related symptomatology indicate a transdiagnostic neuropsychiatric disorder? - Multidisciplinary implications

Sari Goldstein Ferber; Gal Shoval; Gil Zalsman; Aron Weller

doi:10.5498/wjp.v12.i8.1004

Does COVID-19 related symptomatology indicate a transdiagnostic neuropsychiatric disorder? - Multidisciplinary implications

World J Psychiatry. 2022 Aug 19;12(8):1004-1015. doi: 10.5498/wjp.v12.i8.1004.

Authors

Sari Goldstein Ferber¹, Gal Shoval^{2

3}, Gil Zalsman^{2

4}, Aron Weller⁵

Affiliations

¹ Department of Psychology and Gonda Brain Research Center, Bar Ilan University, Ramat Gan 5317000, Israel. sari.goldstein@biu.ac.il.
² Department of Psychiatry, Tel Aviv University, Tel Aviv 6997801, Israel.
³ Department of Neuroscience, Princeton University, Princeton, NJ 08544, United States.
⁴ Department of Psychiatry, Columbia University, New York, NY 10032, United States.
⁵ Department of Psychology and Gonda Brain Research Center, Bar Ilan University, Ramat Gan 5317000, Israel.

Abstract

The clinical presentation that emerges from the extensive coronavirus disease 2019 (COVID-19) mental health literature suggests high correlations among many conventional psychiatric diagnoses. Arguments against the use of multiple comorbidities for a single patient have been published long before the pandemic. Concurrently, diagnostic recommendations for use of transdiagnostic considerations for improved treatment have been also published in recent years. In this review, we pose the question of whether a transdiagnostic mental health disease, including psychiatric and neuropsychiatric symptomology, has emerged since the onset of the pandemic. There are many attempts to identify a syndrome related to the pandemic, but none of the validated scales is able to capture the entire psychiatric and neuropsychiatric clinical presentation in infected and non-infected individuals. These scales also only marginally touch the issue of etiology and prevalence. We suggest a working hypothesis termed Complex Stress Reaction Syndrome (CSRS) representing a global psychiatric reaction to the pandemic situation in the general population (Type A) and a neuropsychiatric reaction in infected individuals (Type B) which relates to neurocognitive and psychiatric features which are part (excluding systemic and metabolic dysfunctions) of the syndrome termed in the literature as long COVID. We base our propositions on multidisciplinary scientific data regarding mental health during the global pandemic situation and the effects of viral infection reviewed from Google Scholar and PubMed between February 1, 2022 and March 10, 2022. Search in-clusion criteria were "mental health", "COVID-19" and "Long COVID", English language and human studies only. We suggest that this more comprehensive way of understanding COVID-19 complex mental health reactions may promote better prevention and treatment and serve to guide implementation of recommended administrative regulations that were recently published by the World Psychiatric Association. This review may serve as a call for an international investigation of our working hypothesis.

Keywords: Comorbidity; Fatigue; Long COVID; Mental health; Symptoms; Transdiagnostic.

Publication types

Review