The risk of hospitalization for psychotic disorders following hospitalization for COVID-19: a French nationwide longitudinal study

Abstract

Abstract COVID-19, like other infectious diseases, may be a risk factor for a first episode of psychosis or psychotic relapse. We aimed to compare the proportions of hospitalizations for psychotic disorders in the 12 months following discharge from hospital for either COVID-19 or for another reason in the adult general population in France during the first wave of the pandemic. We conducted a retrospective longitudinal nationwide study using the national French administrative healthcare database. Psychotic disorders were first studied as a whole, and then chronic and acute disorders separately. The role of several adjustment factors, including sociodemographics, a history of psychotic disorder, the duration of the initial hospitalization, and the level of care received during that hospitalization, were also analyzed. Between 1 January 2020 and 30 June 2020, a total of 14,622 patients were hospitalized for psychotic disorders in the 12 months following discharge from hospital for either COVID-19 or another reason. Initial hospitalization for COVID-19 (vs. another reason) was associated with a lower rate of subsequent hospitalization for psychotic disorders (0.31 % vs. 0.51 %, OR = 0.60, 95% CI [0.53-0.67]). This was true for both chronic and acute disorders, even after adjusting for the various study variables. Importantly, a history of psychotic disorder was a major determinant of hospitalization for psychotic disorders (aOR = 126.56, 95% CI [121.85-131.46]). Our results suggest that individuals initially hospitalized for COVID-19 (vs. another reason) present a lower risk of hospitalization for first episodes of psychotic symptoms/disorders or for psychotic relapse in the 12 months following discharge. This finding contradicts invalidates the hypothesis that there is a higher risk of psychotic disorders after a severe COVID-19.