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Substance Use and Addiction Medicine

Mental Health Disorders Related to COVID-19–Related Deaths

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To identify the key insights or developments described in this article
1 Credit CME
JAMA
Published Online: October 12, 2020
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Naomi M. Simon, MD, MSc1;
Glenn N. Saxe, MD2;
Charles R. Marmar, MD3
Author Affiliations
  • 1Anxiety and Complicated Grief Program, Department of Psychiatry, NYU Grossman School of Medicine, New York, New York
  • 2Department of Child and Adolescent Psychiatry, NYU Grossman School of Medicine, New York, New York
  • 3Center for Alcohol Use Disorders and PTSD, Department of Psychiatry, NYU Grossman School of Medicine, New York, New York
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Since February 2020, the coronavirus disease 2019 (COVID-19) pandemic has led to at least 200 000 deaths in the US and 1 million deaths worldwide. These numbers probably underestimate COVID-19 deaths by 50%, with excess cardiovascular, metabolic, and dementia-related deaths likely misclassified COVID-19 deaths.1 In this issue of JAMA, Woolf and colleagues1 update their previous estimate, suggesting that the number of excess deaths between February and August 2020 attributable to COVID-19 is estimated to be about 225 000.

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CME Disclosure Statement: Unless noted, all individuals in control of content reported no relevant financial relationships. If applicable, all relevant financial relationships have been mitigated.

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Psychiatry and Behavioral Health Substance Use and Addiction Medicine Public Health Coronavirus (COVID-19)
Article Information

Corresponding Author: Charles R. Marmar, MD, Psychiatry Department, NYU Langone Medical Center, 1 Park Ave, 8th Floor, New York, NY 10016 (charles.marmar@nyumc.org).

Published Online: October 12, 2020. doi:10.1001/jama.2020.19632

Conflict of Interest Disclosures: Dr Simon reported receiving research grants from the American Foundation for Suicide Prevention, Department of Defense, Patient-Centered Outcomes Research Institute, the Highland Street Foundation, the National Institute of Mental Health (NIMH), the National Center for Complementary and Integrative Health, and the Cohen Veterans Network; personal fees from Vanda Pharmaceuticals Inc, MGH Psychiatry Academy, Axovant Sciences, Springworks, Praxis Therapeutics, Aptinyx, Genomind, and Wiley (deputy editor, Depression and Anxiety); spousal equity from G1 Therapeutics; and royalties from Wolters Kluwer (UpToDate) and APA Press (Simon, Hollander, Rothbaum, & Stein, The APA Publishing Textbook of Anxiety, Trauma and OCD Related Disorders, 2020). Dr Saxe reported receiving NIMH grant R01MH119114 (Dr Saxe, principal investigator [PI]), Substance Abuse and Mental Health Services Administration grants U79SM080049 (Dr Saxe, PI) and U79SM080013 (Julian Ford, PI), and royalties from Guilford Press for the book Trauma Systems Therapy for Children and Teens (2016). Dr Marmar reported receiving support from the National Institute on Alcohol Abuse and Alcoholism, the NIMH, Department of Defense, US Army Congressionally Directed Medical Research Program, the Steven and Alexandra Cohen Foundation, Cohen Veterans Bioscience, Cohen Veterans Network, the Home Depot Foundation, the McCormick Foundation, the Robin Hood Foundation, and New York City. He serves on the scientific advisory board and owns equity in Receptor Life Sciences and on the PTSD advisory board for Otsuka Pharmaceutical.

References
1.
Woolf  SH , Chapman  DA , Sabo  RT , Weinberger  DM , Hill  LJ , Taylor  DDH .  Excess deaths from COVID-19 and other causes, March-April 2020.   JAMA. Published October 20, 2020. doi:10.1001/jama.2020.19545Google Scholar
2.
Czeisler  MÉ , Lane  RI , Petrosky  E ,  et al.  Mental health, substance use, and suicidal ideation during the COVID-19 pandemic: United States, June 24-30, 2020.   MMWR Morb Mortal Wkly Rep. 2020;69(32):1049-1057. doi:10.15585/mmwr.mm6932a1 PubMedGoogle ScholarCrossref
3.
World Health Organization. ICD-11 for mortality and morbidity statistics. Accessed September 8, 2020. https://icd.who.int/browse11/l-m/en#/http://id.who.int/icd/entity/1183832314
4.
Lundorff  M , Holmgren  H , Zachariae  R , Farver-Vestergaard  I , O’Connor  M .  Prevalence of prolonged grief disorder in adult bereavement.   J Affect Disord. 2017;212:138-149. doi:10.1016/j.jad.2017.01.030PubMedGoogle ScholarCrossref
5.
American Psychiatric Association. Considerations for family and other personal losses due to COVID-19–related death. Accessed September 8, 2020. https://www.psychiatry.org/File%20Library/Psychiatrists/APA-Guidance-Death-Dying-Personal-Bereavement.pdf
6.
Verdery  AM , Smith-Greenaway  E , Margolis  R , Daw  J .  Tracking the reach of COVID-19 kin loss with a bereavement multiplier applied to the United States.   Proc Natl Acad Sci U S A. 2020;117(30):17695-17701. doi:10.1073/pnas.2007476117PubMedGoogle ScholarCrossref
7.
American Psychiatric Association. Considerations for healthcare workers and staff exposed to COVID-19 death and dying. Accessed September 8, 2020. https://www.psychiatry.org/File%20Library/Psychiatrists/APA-Guidance-Death-Dying-in-Workplace.pdf
AMA CME Accreditation Information

Credit Designation Statement: The American Medical Association designates this Journal-based CME activity activity for a maximum of 1.00  AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Successful completion of this CME activity, which includes participation in the evaluation component, enables the participant to earn up to:

  • 1.00 Medical Knowledge MOC points in the American Board of Internal Medicine's (ABIM) Maintenance of Certification (MOC) program;;
  • 1.00 Self-Assessment points in the American Board of Otolaryngology – Head and Neck Surgery’s (ABOHNS) Continuing Certification program;
  • 1.00 MOC points in the American Board of Pediatrics’ (ABP) Maintenance of Certification (MOC) program;
  • 1.00 Lifelong Learning points in the American Board of Pathology’s (ABPath) Continuing Certification program; and
  • 1.00 CME points in the American Board of Surgery’s (ABS) Continuing Certification program

It is the CME activity provider's responsibility to submit participant completion information to ACCME for the purpose of granting MOC credit.

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