Mental Health

Mental Health Outcomes After the Acute Phase of COVID-19: Factors Identified in a Korean Public Mental Health Service.

TL;DR

Baseline psychological responses and pre-existing psychiatric disorders during the acute phase of COVID-19 significantly predicted persistent mental health symptoms, with cognitive-physical exhaustion and emotional distress being key sub-factors, particularly in women.

Key Findings

The most common post-COVID psychological responses were anxiety, depression, and sleep problems.

  • Data were drawn from 515 COVID-19 patients who received free counseling services from the Korean National Center for Disaster and Trauma.
  • Mental health was repeatedly assessed at each counseling session using the Clinical Global Impression Severity Scale (CGI-S).
  • CGI-S scores dropped from 2.83 initially to 1 by the last observed session, averaging 2.38 at the third follow-up, indicating overall improvement over time.

Exploratory factor analysis identified four sub-factors of psychological response during acute COVID-19: cognitive and physical exhaustion, emotional distress, self-destructive coping, and somatized anxiety.

  • Factor analysis was applied to baseline psychological response data from the 515 counseling records.
  • The four sub-factors represent distinct dimensions of psychological response during the acute phase of COVID-19.
  • These sub-factors were used as predictors in subsequent multivariate mixed effect models.

Baseline psychological responses and pre-existing psychiatric disorders were significantly associated with higher CGI-S scores over time following the acute phase of COVID-19.

  • Baseline psychological responses were a significant predictor of mental health outcomes (β = 0.06, P < 0.001).
  • Pre-existing psychiatric disorders were also a significant predictor (β = 0.37, P < 0.001).
  • Analyses used multivariate mixed effect models and were stratified by gender.
  • Baseline predictors included demographic characteristics, psychiatric and medical comorbidities, and psychological response.

Among the four psychological sub-factors, cognitive-physical exhaustion, emotional distress, and self-destructive coping were significant predictors of worse mental health outcomes.

  • Cognitive-physical exhaustion was a significant predictor (β = 0.28, P < 0.001).
  • Emotional distress was a significant predictor (β = 0.32, P < 0.001).
  • Self-destructive coping was a significant predictor (β = 0.12, P < 0.001).
  • Somatized anxiety was not reported as a significant predictor in the overall model.

Gender-stratified analyses revealed different predictive sub-factors for men and women.

  • In men, emotional distress was a significant predictor of worse mental health outcomes (β = 0.26, P = 0.001).
  • In women, both cognitive-physical exhaustion (β = 0.36, P < 0.001) and emotional distress (β = 0.36, P < 0.001) were significant predictors.
  • The magnitude of the associations for cognitive-physical exhaustion and emotional distress were equal in women (both β = 0.36).
  • These findings suggest gender differences in which psychological response patterns predict persistent mental health symptoms.

Identifying baseline psychological response profiles may help with early identification of high-risk groups during acute COVID-19.

  • The study used electronic counseling records, noting that collecting prospective data during the acute phase of COVID-19 is challenging.
  • Services were provided free of charge through the Korean National Center for Disaster and Trauma.
  • The authors conclude that 'baseline psychological responses predict persistent mental health symptoms, and identified profiles may help early identification of high-risk groups during acute COVID-19.'

What This Means

This research suggests that how people psychologically respond during the acute (early) phase of a COVID-19 infection can predict whether they will continue to experience mental health problems afterward. Using counseling records from 515 COVID-19 patients in South Korea, researchers found that the most common mental health issues following COVID-19 were anxiety, depression, and sleep problems. Overall, mental health tended to improve over time, but people who had stronger psychological distress early on—or who had pre-existing psychiatric conditions—were more likely to have worse mental health outcomes at follow-up sessions. The study identified four distinct patterns of psychological response during acute COVID-19: cognitive and physical exhaustion, emotional distress, self-destructive coping, and somatized anxiety. Of these, cognitive-physical exhaustion, emotional distress, and self-destructive coping were the strongest predictors of ongoing mental health difficulties. Notably, the research found gender differences: in men, emotional distress alone was the key predictor, while in women, both cognitive-physical exhaustion and emotional distress were equally important predictors of worse outcomes. This research suggests that early psychological screening during a COVID-19 infection could help identify people at higher risk for lasting mental health problems, potentially allowing for earlier and more targeted mental health support. The identification of specific psychological profiles—particularly emotional distress and cognitive-physical exhaustion—may be useful tools for public mental health services in triaging and prioritizing care for vulnerable individuals during and after infectious disease outbreaks.

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Citation

Kim H, Kwak E, Lee D, Lee S, Lee D, Ko S, et al.. (2026). Mental Health Outcomes After the Acute Phase of COVID-19: Factors Identified in a Korean Public Mental Health Service.. Journal of Korean medical science. https://doi.org/10.3346/jkms.2026.41.e165