Review
Copyright ©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Psychiatry. Aug 19, 2022; 12(8): 1004-1015
Published online Aug 19, 2022. doi: 10.5498/wjp.v12.i8.1004
Does COVID-19 related symptomatology indicate a transdiagnostic neuropsychiatric disorder? - Multidisciplinary implications
Sari Goldstein Ferber, Gal Shoval, Gil Zalsman, Aron Weller
Sari Goldstein Ferber, Aron Weller, Department of Psychology and Gonda Brain Research Center, Bar Ilan University, Ramat Gan 5317000, Israel
Gal Shoval, Gil Zalsman, Department of Psychiatry, Tel Aviv University, Tel Aviv 6997801, Israel
Gal Shoval, Department of Neuroscience, Princeton University, Princeton, NJ 08544, United States
Gil Zalsman, Department of Psychiatry, Columbia University, New York, NY 10032, United States
Author contributions: Goldstein Ferber S developed the hypothesis and wrote the first draft of this paper; Weller A reviewed and added to the first draft; Goldstein Ferber S wrote the revised manuscript; Shoval G and Zalsman G reviewed the various drafts of the paper and contributed to its content.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Sari Goldstein Ferber, PhD, Additional Professor, Department of Psychology and Gonda Brain Research Center, Bar Ilan University, Geha Road, Ramat Gan 5317000, Israel. sari.goldstein@biu.ac.il
Received: March 11, 2022
Peer-review started: March 11, 2022
First decision: April 18, 2022
Revised: April 28, 2022
Accepted: July 25, 2022
Article in press: July 25, 2022
Published online: August 19, 2022
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: Mental health, Symptoms, Comorbidity, Long COVID, Fatigue, Transdiagnostic

Core Tip: This Review asks a question shown in its title and hidden to date in the scientific literature on coronavirus disease 2019 (COVID-19) pandemic. It integrates the immense COVID-19 and long COVID literature on psychiatric and neuropsychiatric reactions to the pandemic in the general population. It also derives a working hypothesis on Type A and Type B of a hypothesized syndrome to be termed Complex Stress Reaction Syndrome. This working hypothesis is elaborated in the manuscript and supports the need to ask the transdiagnostic question in a timely manner based on a novel interdisciplinary and genuine integration of the relevant scientific literature.