A systematic review of neuropsychological and psychiatric sequalae of COVID-19: implications for treatment.

PURPOSE OF REVIEW: COVID-19 impacts multiple organ systems and is associated with high rates of morbidity and mortality. Pathogenesis of viral infection, co-morbidities, medical treatments, and psychosocial factors may contribute to COVID-19 related neuropsychological and psychiatric sequelae. This systematic review aims to synthesize available literature on psychiatric and cognitive characteristics of community-dwelling survivors of COVID-19 infection. RECENT FINDINGS: Thirty-three studies met inclusion/exclusion criteria for review. Emerging findings link COVID-19 to cognitive deficits, particularly attention, executive function, and memory. Psychiatric symptoms occur at high rates in COVID-19 survivors, including anxiety, depression, fatigue, sleep disruption, and to a lesser extent posttraumatic stress. Symptoms appear to endure, and severity of acute illness is not directly predictive of severity of cognitive or mental health issues. The course of cognitive and psychiatric sequelae is limited by lack of longitudinal data at this time. Although heterogeneity of study design and sociocultural differences limit definitive conclusions, emerging risk factors for psychiatric symptoms include female sex, perceived stigma related to COVID-19, infection of a family member, social isolation, and prior psychiatry history. SUMMARY: The extant literature elucidates treatment targets for cognitive and psychosocial interventions. Research using longitudinal, prospective study designs is needed to characterize cognitive and psychiatric functioning of COVID-19 survivors over the course of illness and across illness severity. Emphasis on delineating the unique contributions of premorbid functioning, viral infection, co-morbidities, treatments, and psychosocial factors to cognitive and psychiatric sequelae of COVID-19 is warranted.

Temperament, executive control, and attention-deficit/hyperactivity disorder across early development.

Research examining factors linking early temperament and later attention-deficit/ hyperactivity disorder (ADHD) is limited by cross-sectional approaches and having the same informant rate both temperament and psychopathology. The authors used multiinformant/multimethod longitudinal data to test the hypothesis that negative emotionality during preschool is positively associated with ADHD symptom severity in middle childhood, but developing executive control mediates this relation. Children (N = 161) with and without ADHD were evaluated 3 times: parent and teacher temperament ratings and NEPSY visual attention at ages 3-4 years; Wechsler Intelligence Scale for Children-4th edition Working Memory Index and NEPSY Response Set at age 6 years; and ADHD symptoms using the Kiddie-SADS at age 7 years. Parent and teacher ratings of preschoolers' temperament were combined to form an anger/frustration composite. Similarly, an executive functioning composite was derived from age 6 measures. Bootstrapping was used to determine whether age 6 executive functioning mediated the relation between early anger/frustration and later ADHD symptom severity, while controlling for early executive functioning. Preschoolers' anger/frustration was significantly associated with later ADHD symptoms, with this relation partially mediated by age 6 executive functioning. Developing executive control mediates the relation between early anger/frustration and later ADHD symptom severity, suggesting that anger/frustration influences ADHD symptom severity through its impact on developing executive control. Early interventions targeting the harmful influences of negative emotionality or enhancing executive functioning may diminish later ADHD severity.