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1.
Int J Environ Res Public Health ; 19(22)2022 Nov 11.
Article in English | MEDLINE | ID: covidwho-2110089

ABSTRACT

Several cases of COVID-19-related mental disorders have emerged during the pandemic. In a case of femicide that occurred in Italy during the first phase of the pandemic, coinciding with a national lockdown, a discrepancy arose among forensic psychiatry experts, particularly toward the diagnosis of Brief Psychotic Disorder (BPD) related to COVID-19. We aimed to discuss the evaluation of the case through an integration of information and a literature review on comparable reported cases. An analysis of the diagnosis of brief acute psychosis was then performed, as well as a mini-review on cases of COVID-19-related psychosis. Results showed that psychotic symptomatology was characterized by polythematic delusions that always involved a SARS-CoV-2 infection. To a lesser extent, the delusions were accompanied by hallucinations, bizarre cognitive and associative alterations, insomnia, hyporexia, dysphoria, and suicidal behavior. No particularly violent acts with related injury or death of the victim were described. Finally, we could hypothesize that our case was better represented by a diagnosis of personality with predominantly narcissistic and partly psychopathic traits. The present case highlighted the importance, in the context of forensic psychiatry, of integrating assessments with the crime perpetrators, namely through accurate clinical interviews, neuropsychological tests, diachronic observations, and comparison with similar cases present in the literature. Such an integrated approach allows precise evaluation and reduces the odds of errors in a field, such as forensic psychiatry, where a diagnostic decision can be decisive in the judgment of criminal responsibility. Moreover, discerning forensics from health cases represents an important issue in risk management.


Subject(s)
COVID-19 , Psychotic Disorders , Humans , Communicable Disease Control , SARS-CoV-2 , Psychotic Disorders/diagnosis , Personality
2.
Croat Med J ; 63(5): 412-422, 2022 Oct 31.
Article in English | MEDLINE | ID: covidwho-2092246

ABSTRACT

AIM: To assess whether fear of coronavirus disease 2019 (COVID-19) is associated with depression, anxiety, and psychosis and to evaluate if these variables are correlated with the interaction between spirituality and fear of COVID-19. METHODS: Between September and November 2020, this cross-sectional study enrolled 118 chronic schizophrenia patients. The interview with patients included Fear of COVID-19 Scale, Lebanese Anxiety Scale-10, Montgomery-Asberg Depression Rating Scale, Positive and Negative Syndrome Scale (PANSS), and Functional Assessment of Chronic Illness Therapy-Spiritual Well-Being-12. The results were analyzed by using linear regressions (Enter method), with anxiety, depression, total PANSS score, positive PANSS, negative PANSS, and general psychopathology PANSS subscales as dependent variables. Spirituality, fear of COVID-19, and the interaction of spirituality with fear of COVID-19 were independents variables. RESULTS: Fear of COVID-19 was positively correlated with increased total PANSS scores (Beta=0.90, P=0.030). Higher spirituality was significantly associated with lower anxiety (Beta=-0.14, P=0.009), lower depression (Beta=-0.21, P=0.001), lower total PANSS score (Beta=-0.90, P=0.004), lower negative PANSS score (Beta=-0.23, P=0.009), and lower general psychopathology PANSS score (Beta=-0.61, P=0.001). In patients with high fear of COVID-19, having low spirituality was significantly associated with higher anxiety, depression, and psychotic symptoms. CONCLUSION: This study suggests a positive correlation between fear of COVID-19 and higher psychosis among inpatients with schizophrenia. The interaction of spirituality with fear of COVID-19 was correlated with reduced anxiety, depression, and psychosis.


Subject(s)
COVID-19 , Psychotic Disorders , Schizophrenia , Humans , Spirituality , Depression/epidemiology , Cross-Sectional Studies , Psychiatric Status Rating Scales , Psychotic Disorders/complications , Psychotic Disorders/diagnosis , Anxiety , Fear
3.
Psychiatr Danub ; 34(Suppl 8): 56-59, 2022 Sep.
Article in English | MEDLINE | ID: covidwho-2046526

ABSTRACT

Vaccines are crucial to ending the COVID-19 pandemic. An mRNA-based COVID-19 vaccine can cause mild to moderate side effects. A number of cases of cardiac, gastrointestinal, and psychiatric side effects have been reported as rare side effects associated with the COVID-19 vaccine. This article presents a patient, who after the second injection of the mRNA-based COVID-19 vaccine, immediately developed anxiety, nonspecific fear, and insomnia as the prodromal phase of psychosis. Starting from the second week, the patient manifested delusions of persecution, delusions of influence, thoughts insertion, and delusional behaviour, culminating in the suicide attempt. The duration of psychosis was eight weeks, and symptom reduction was observed only after the gradual administration of antipsychotics over four weeks. The investigations of the patient did not support any structural changes of the brain, any severe medical conditions, a neurological abnormality, a confusion or a state of unconsciousness or alterations in laboratory tests. Psychosis due to the use of alcohol or psychoactive substances was excluded. The psychological assessment of the patient demonstrated the endogenous type of thinking, and the patient had schizoid and paranoid personality traits strongly associated with schizophrenia. This case indicates a strong causal relationship between the mRNA-based COVID-19 vaccine injection and the onset of psychosis. We intend to follow up this case for possible development of schizophrenia and understand that the COVID-19 vaccine could possible play a trigger role in the development of primary psychosis. Longer-term supporting evidence is needed to estimate the prevalence of psychosis following vaccination with the mRNA-based COVID-19 vaccine.


Subject(s)
COVID-19 Vaccines , COVID-19 , Psychotic Disorders , Humans , COVID-19/prevention & control , COVID-19 Vaccines/adverse effects , Psychotic Disorders/diagnosis , Vaccination
4.
Psychiatry Res ; 317: 114845, 2022 Nov.
Article in English | MEDLINE | ID: covidwho-2031636

ABSTRACT

In our study we aimed to investigate the effect of the pandemic period on disease severity, medication adherence, suicidal behavior, physical health and health behavior in patients with psychotic disorders. 255 patients with any of the diagnoses of Schizophrenia, Schizoaffective Disorder, Delusional Disorder, Bipolar Disorder with psychotic features and Major Depressive Disorder with psychotic features were included, 200 were assessed by telephone and 55 face-to-face. The patient's sociodemographic status, cigarette-alcohol use, physical diseases, body weight, suicidal behaviors, and the effects of the pandemic period on general health were assessed. Clinical global impression scale(CGI) and modified medication adherence scale(MMS) were also administered. We showed that the MMS scores of the patients significantly decreased compared to the pre-pandemic period. In our study, suicidal behavior and decrease in medication adherence during the pandemic period were found to be correlated with higher scores of CGI- Severity and Improvement Scale. Our study is one of the few studies that addresses the effects of the pandemic period on patients with psychotic disorders. The results show that the pandemic period is associated with an increase in negative health behavior and clinical worsening in patients with psychotic disorders. In order to confirm these findings, more research is needed in this area.


Subject(s)
COVID-19 , Health Behavior , Psychotic Disorders , Humans , COVID-19/epidemiology , COVID-19/psychology , Pandemics , Psychotic Disorders/diagnosis , Psychotic Disorders/drug therapy , Psychotic Disorders/psychology
5.
J Nerv Ment Dis ; 210(9): 724-726, 2022 09 01.
Article in English | MEDLINE | ID: covidwho-2018342

ABSTRACT

ABSTRACT: This case series reports three middle-aged male patients with no prior history of psychiatric disorders who developed psychotic symptoms with manic characteristics after COVID-19 infection. They presented mystic and paranoid delusions associated with euphoria, logorrheic, insomnia, and bizarre behaviors. Two of them required psychiatric hospitalization and one received corticosteroids. Treatment with antipsychotic medication improved their symptoms in a few weeks. This case series reports the new-onset psychosis probably due to COVID-19 infection. Pathogenetic speculation about the probable causes of COVID-19 psychosis, such as inflammatory reaction and corticosteroid use, was done. Moreover, other probable causes of manic psychosis, such as late-onset bipolar disorder, were also considered and ruled out. There is a need for more research to determine the causality between psychotic symptoms and COVID-19 infection.


Subject(s)
Antipsychotic Agents , Bipolar Disorder , COVID-19 , Psychotic Disorders , Antipsychotic Agents/therapeutic use , Bipolar Disorder/drug therapy , COVID-19/complications , Humans , Male , Middle Aged , Psychotic Disorders/diagnosis , SARS-CoV-2
6.
Trials ; 23(1): 751, 2022 Sep 05.
Article in English | MEDLINE | ID: covidwho-2009449

ABSTRACT

BACKGROUND: Substantial data from high-income countries support early interventions in the form of evidence-based Coordinated Specialty Care (CSC) for people experiencing First Episode Psychosis (FEP) to ameliorate symptoms and minimize disability. Chile is unique among Latin American countries in providing universal access to FEP services through a national FEP policy that mandates the identification of FEP individuals in primary care and guarantees delivery of community-based FEP treatments within a public health care system. Nonetheless, previous research has documented that FEP services currently provided at mental health clinics do not provide evidence-based approaches. This proposal aims to address this shortfall by first adapting OnTrackNY (OTNY), a CSC program currently being implemented across the USA, into OnTrackChile (OTCH), and then examine its effectiveness and implementation in Chile. METHODS: The Dynamic Adaptation Process will be used first to inform the adaptation and implementation of OTCH to the Chilean context. Then, a Hybrid Type 1 trial design will test its effectiveness and cost and evaluate its implementation using a cluster-randomized controlled trial (RCT) (N = 300 from 21 outpatient clinics). The OTCH program will be offered in half of these outpatient clinics to individuals ages 15-35. Usual care services will continue to be offered at the other clinics. Given the current COVID-19 pandemic, most research and intervention procedures will be conducted remotely. The study will engage participants over the course of 2 years, with assessments administered at enrollment, 12 months, and 24 months. Primary outcomes include implementation (fidelity, acceptability, and uptake) and service outcomes (person-centeredness, adherence, and retention). Secondary outcomes comprise participant-level outcomes such as symptoms, functioning, and recovery orientation. Over the course of the study, interviews and focus groups with stakeholders will be conducted to better understand the implementation of OTCH. DISCUSSION: Findings from this study will help determine the feasibility, effectiveness, and cost for delivering CSC services in Chile. Lessons learned about facilitators and barriers related to the implementation of the model could help inform the approach needed for these services to be further expanded throughout Latin America. TRIAL REGISTRATION: www. CLINICALTRIALS: gov NCT04247711 . Registered 30 January 2020. TRIAL STATUS: The OTCH trial is currently recruiting participants. Recruitment started on March 1, 2021, and is expected to be completed by December 1, 2022. This is the first version of this protocol (5/12/2021).


Subject(s)
COVID-19 , Psychotic Disorders , Adolescent , Adult , Chile , Humans , Psychotic Disorders/diagnosis , Psychotic Disorders/psychology , Psychotic Disorders/therapy , Randomized Controlled Trials as Topic , Young Adult
7.
PLoS One ; 17(8): e0273579, 2022.
Article in English | MEDLINE | ID: covidwho-2002339

ABSTRACT

BACKGROUND: The COVID-19 pandemic has had unprecedented effects on mental health and community functioning. Negative effects related to disruption of individuals' social connections may have been more severe for those who had tenuous social connections prior to the pandemic. Veterans who have recently experienced homelessness (RHV) or have a psychotic disorder (PSY) are considered particularly vulnerable because many had poor social connections prior to the pandemic. METHODS: We conducted a 15-month longitudinal study between May 2020 -July 2021 assessing clinical (e.g., depression, anxiety) and community (e.g., social functioning, work functioning) outcomes. Eighty-one PSY, 76 RHV, and 74 Veteran controls (CTL) were interviewed over 5 assessment periods. We assessed changes in mental health and community functioning trajectories relative to pre-pandemic retrospective ratings and examined group differences in these trajectories. RESULTS: All groups had significantly increased symptoms of depression, anxiety, and concerns with contamination at the onset of the pandemic. However, RHV and PSY showed faster returns to their baseline levels compared to CTL, who took nearly 15 months to return to baseline. With regards to functioning, both RHV and PSY, but not CTL, had significant improvements in family and social networks over time. Work functioning worsened over time only in PSY, and independent living increased over time in both RHV and PSY but not CTL. CONCLUSIONS: These results reveal that vulnerable Veterans with access to VA mental health and case management services exhibited lower negative impacts of the COVID-19 pandemic on mental health and community functioning than expected.


Subject(s)
COVID-19 , Homeless Persons , Psychotic Disorders , Veterans , COVID-19/epidemiology , Humans , Longitudinal Studies , Mental Health , Pandemics , Psychotic Disorders/diagnosis , Psychotic Disorders/epidemiology , Retrospective Studies , Veterans/psychology
8.
Psychiatr Danub ; 34(2): 342-347, 2022.
Article in English | MEDLINE | ID: covidwho-1912580

ABSTRACT

BACKGROUND: Several cases of psychosis caused directly or indirectly by the COVID-19 pandemic have been identified. Especially psychosocial stress factors are thought to trigger first-episode psychosis. The aim of this study was to compare the sociodemographic and clinical features of the cases diagnosed with psychotic disorder for the first time in the two periods 1 year before and 1 year after the date of 11.03.2020, when COVID-19 was first detected in Turkey and COVID-19 was declared as a pandemic by World Health Organization (WHO). SUBJECTS AND METHODS: In this retrospective cohort study, we compared age, gender, marital status, and clinical characteristics of 27 pre-pandemic (PR) and 32 post-pandemic (PS) patients during their first psychotic episode. RESULTS: We compared age, gender and clinical features of PR and PS cases and no statistically significant difference was found (age p=0.836, gender p=0.091, clinical features p=0.579). CONCLUSIONS: There are a limited number of studies comparing first-episode psychosis (FEP) patients in the PR and PS periods. This is the first study conducted in Turkey on this subject. The present study may contribute to the literature by examining the impact of the pandemic process on the epidemiology of psychiatric diseases.


Subject(s)
COVID-19 , Psychiatry , Psychotic Disorders , COVID-19/epidemiology , Humans , Pandemics , Psychotic Disorders/diagnosis , Psychotic Disorders/epidemiology , Psychotic Disorders/psychology , Retrospective Studies
9.
JMIR Mhealth Uhealth ; 8(11): e22997, 2020 11 06.
Article in English | MEDLINE | ID: covidwho-1862476

ABSTRACT

BACKGROUND: eHealth interventions are widely used in clinical trials and increasingly in care settings as well; however, their efficacy in real-world contexts remains unknown. ReMindCare is a smartphone app that has been systematically implemented in a first episode of psychosis program (FEPP) for patients with early psychosis since 2018. OBJECTIVE: The objective of this study was to assess the efficacy of ReMindCare after 19 months of use in the clinic and varying use by individual patients. METHODS: The integration of the ReMindCare app into the FEPP started in October 2018. Patients with early psychosis self-selected to the app (ReMindCare group) or treatment as usual (TAU group). The outcome variables considered were adherence to the intervention and number of relapses, hospital admissions, and visits to urgent care units. Data from 90 patients with early psychosis were analyzed: 59 in the ReMindCare group and 31 in the TAU group. The mean age of the sample was 32.8 (SD 9.4) years, 73% (66/90) were males, 91% (83/90) were White, and 81% (74/90) were single. RESULTS: Significant differences between the ReMindCare and TAU groups were found in the number of relapses, hospitalizations, and visits to urgent care units, with each showing benefits for the app. Only 20% (12/59) of patients from the ReMindCare group had a relapse, while 58% (18/31) of the TAU patients had one or more relapses (χ2=13.7, P=.001). Moreover, ReMindCare patients had fewer visits to urgent care units (χ2=7.4, P=.006) and fewer hospitalizations than TAU patients (χ2=4.6, P=.03). The mean of days using the app was 352.2 (SD 191.2; min/max: 18-594), and the mean of engagement was 84.5 (SD 16.04). CONCLUSIONS: To our knowledge, this is the first eHealth intervention that has preliminarily proven its benefits in the real-world treatment of patients with early psychosis. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): RR2-10.1111/eip.12960.


Subject(s)
Mobile Applications , Psychotic Disorders , Telemedicine , Adult , Ambulatory Care , Female , Humans , Male , Psychotic Disorders/diagnosis , Psychotic Disorders/therapy , Smartphone
10.
Ann Clin Psychiatry ; 34(2): 123-135, 2022 05.
Article in English | MEDLINE | ID: covidwho-1811357

ABSTRACT

BACKGROUND: The coronavirus disease 2019 (COVID-19) pandemic has been associated with the emergence of various psychiatric illnesses, although very little literature has focused on the effect of COVID-19 on psychosis. Preliminary data have shown possible increases in new-onset psychosis. METHODS: Using MEDLINE, we performed a review of the current literature to identify the mechanisms by which pandemics may increase psychosis risk and generate evidence-based recommendations to control surges of psychosis. We identified 85 relevant studies, of which 34 were case reports on psychosis during the COVID-19 pandemic. RESULTS: Underlying mechanisms of psychosis include "direct viral mechanisms," such as neuroinflammation linked with the coronavirus, and "nonviral mechanisms," such as stress, isolation, and uncertainty. CONCLUSIONS: Improvement of our understanding of the pathophysiology of psychosis related to COVID-19 along with implementation of strategies to fight against stress and social isolation in addition to awareness campaigns regarding new-onset psychotic symptoms are much needed to optimize early detection and management of psychosis.


Subject(s)
COVID-19 , Psychotic Disorders , Humans , Pandemics/prevention & control , Psychotic Disorders/diagnosis , Social Isolation
11.
J Med Case Rep ; 16(1): 171, 2022 Apr 22.
Article in English | MEDLINE | ID: covidwho-1799092

ABSTRACT

BACKGROUND: The coronavirus disease 2019 syndrome typically consists of respiratory symptoms and other general nonspecific symptoms. Psychotic manifestations of coronavirus disease 2019 attributable to severe acute respiratory syndrome coronavirus 2 infection are seldom reported. We report a case of coronavirus disease 2019 in a young West African male who had no known risk factors of psychiatric illness or past history of psychiatric disease presenting with acute psychosis. CASE PRESENTATION: Our patient, who was a young West African male, presented without the typical respiratory symptoms of coronavirus disease 2019 and also without a background history of psychiatric illness or any other significant stressors in his past or present social history. He had acute onset of psychotic symptoms consisting of visual and auditory hallucinations, delusions of persecution, and lack of insight. He was admitted and managed with antipsychotic medication and mood stabilizer. His laboratory workup was normal except for positive coronavirus disease 2019 polymerase chain reaction and his liver enzymes, which showed elevated gamma glutamyl transferase, a finding consistent with coronavirus disease 2019. His head computed tomography scan was also normal. The patient made a gradual recovery from his psychotic symptoms, with gain of insight 7 weeks after onset of symptoms, at which time his coronavirus disease 2019 test came back negative along with other laboratory parameters. He returned to work 12 weeks after his presentation and has been performing well. CONCLUSION: Psychosis can be a primary presenting symptom in patients with coronavirus disease 2019, including those without respiratory symptoms.


Subject(s)
Antipsychotic Agents , COVID-19 , Psychotic Disorders , Antipsychotic Agents/therapeutic use , COVID-19/complications , Hallucinations/diagnosis , Hospitalization , Humans , Male , Psychotic Disorders/diagnosis , Psychotic Disorders/drug therapy , Psychotic Disorders/etiology
12.
Acta Neuropsychiatr ; 34(6): 289-310, 2022 Dec.
Article in English | MEDLINE | ID: covidwho-1768731

ABSTRACT

OBJECTIVE: Since the onset of COVID-19 pandemic, many case reports and case series dealt with new-onset psychotic disorders in patients either infected with SARS-CoV-2 or thematically linked to the pandemic, but without an infection. Our aim was to provide a comprehensive collection of these reports to illustrate the nature of these psychoses. METHODS: We conducted a literature search in MEDLINE, Embase, PsycINFO, using search terms regarding first-episode psychotic disorders in the context of corona. RESULTS: 96 case reports or case series covering 146 patients (62 without and 84 with SARS-CoV-2 infection) were found. Compared to patients without infection, patients with infection showed significantly more often visual hallucinations (28.6% vs 8.1%), confusion (36.9% vs 11.3%), an acute onset of illness (88.5% vs 59.6%) and less often depression (13.1% vs 35.5%) and a delusional content related to the pandemic (29.5% vs 78.3%). Both groups had an equally favourable outcome with a duration of psychosis ≤2 weeks in half and full remission in two-thirds of patients. In patients with infection, signs of inflammation were reported in 78.3% and increased CRP in 58.6%. While reports on patients with infection are continuously published, no report about patients without infection was found after July 2020. CONCLUSION: Cases without infection were considered reactive and originated all from the first wave of the corona pandemic. In cases with infection, inflammation was considered as the main pathogenetic factor but was not found in all patients. Diagnosis was impeded by the overlap of psychosis with delirium.


Subject(s)
COVID-19 , Psychotic Disorders , Humans , COVID-19/epidemiology , Pandemics , SARS-CoV-2 , Psychotic Disorders/epidemiology , Psychotic Disorders/diagnosis , Inflammation
13.
J Am Acad Child Adolesc Psychiatry ; 61(7): 844-847, 2022 07.
Article in English | MEDLINE | ID: covidwho-1729847

ABSTRACT

As many as one-third of patients who have coronavirus disease 2019 (COVID-19) develop long-term neuropsychiatric symptoms, such as anxiety, depression, brain fog, psychosis, seizures, and suicidal behavior.1 Several case reports have demonstrated the association between psychotic symptoms following infection with COVID-19 in adults.1,2 In a first episode of psychosis, clinical findings on history, examination, and diagnostic studies may suggest that the psychotic symptoms are due to medical illness, which may be reversible. The presentation can include acute onset, predominance of visual or tactile hallucinations, and association with other neurological symptoms.3.


Subject(s)
COVID-19 , Psychotic Disorders , Adolescent , Adult , COVID-19/complications , Hallucinations/etiology , Humans , Psychotic Disorders/diagnosis , SARS-CoV-2 , Suicidal Ideation
14.
Early Interv Psychiatry ; 16(10): 1152-1158, 2022 Oct.
Article in English | MEDLINE | ID: covidwho-1662258

ABSTRACT

AIM: Coordinated specialty care (CSC) is a collaborative-team based approach that has been shown to be helpful for patients with first-episode psychosis. Peer support is an important component of CSC. Here, we describe the development and implementation of peer-led group programming (McLean WellSpace) that was loosely affiliated with a CSC (McLean OnTrack). We discuss how we adapted this program to the challenges imposed by COVID-19. METHODS: WellSpace was developed to have minimal barriers to entry other than a self-reported history of recent onset of psychosis. It is free for participants with minimal restrictions about who may attend. WellSpace and WellSpace groups are largely administered by peer specialists who align with the recovery movement. WellSpace has been a virtual program since March 2020. RESULTS: McLean WellSpace participants include many people who are not patients of McLean OnTrack, suggesting that such programs may have greater reach than standard medical programs. We transitioned to virtual programming and saw average group attendance and unique participants increase during the pandemic. CONCLUSIONS: Our experience suggests that peer-led group programming for first-episode psychosis is well-accepted by patients, including many who are not engaged with a CSC. This may be related to our efforts to minimize barriers to entry and our peer-led, non-medical orientation.


Subject(s)
COVID-19 , Psychotic Disorders , Humans , Peer Group , Psychotic Disorders/diagnosis , Psychotic Disorders/therapy
16.
Schizophr Res ; 241: 36-43, 2022 03.
Article in English | MEDLINE | ID: covidwho-1594576

ABSTRACT

BACKGROUND: This study investigated whether SARS-CoV-2 infection, depression, anxiety, sleep problems, cigarette, alcohol, drug usage contribute to psychotic-like experiences (PLEs) among adolescents during the pandemic. We also aimed to explore whether baseline inflammatory markers or the number of SARS-CoV-2-related symptoms are associated with PLEs, and the latter is mediated by internalizing symptoms. METHODS: Altogether, 684 adolescents aged 12-18 (SARS-CoV-2 group n = 361, control group (CG) n = 323) were recruited. The Community Assessment of Psychic Experiences-42-Positive Dimension (CAPE-Pos), Patient Health Questionnaire-9 (PHQ-9), Generalized Anxiety Disorder-7 (GAD-7), and Pittsburg Sleep Quality Index (PSQI) questionnaires were completed by all volunteers using an online survey. C-reactive Protein and hemogram values, and SARS-CoV-2-related symptoms during the acute infection period were recorded in the SARS-CoV-2 group. Group comparisons, correlations, logistic regression, and bootstrapped mediation analyses were performed. RESULTS: CAPE-Pos-Frequency/Stress scores were significantly higher, whereas GAD-7-Total and PSQI-Total scores were significantly lower in SARS-CoV-2 than CG. Among the SARS-CoV-2 group, monocyte count and the number of SARS-CoV-2-symptoms were positively correlated with CAPE-Pos-Frequency/Stress scores. Besides SARS-CoV-2, cigarette use, GAD-7, and PHQ-9 scores significantly contributed to the presence of at least one CAPE-Pos "often" or "almost always". PHQ-9 and GAD-7 fully mediated the relationship between the number of SARS-CoV-2 symptoms and CAPE-Pos-Frequency. CONCLUSIONS: This study is the first to show a possible relationship between SARS-CoV-2 infection and PLEs among adolescents. Depression, anxiety, and cigarette use also contributed to PLEs. The number of SARS-Cov-2-symptoms and PLEs association was fully mediated by internalizing symptoms, but prospective studies will need to confirm this result.


Subject(s)
COVID-19 , Psychotic Disorders , Adolescent , COVID-19/epidemiology , Child , Humans , Pandemics , Prospective Studies , Psychotic Disorders/diagnosis , Psychotic Disorders/epidemiology , SARS-CoV-2 , Surveys and Questionnaires
17.
Prim Care Companion CNS Disord ; 23(6)2021 Dec 16.
Article in English | MEDLINE | ID: covidwho-1574646

ABSTRACT

Despite several reports of the neuropsychiatric effects of coronavirus disease 2019 (COVID-19) in older adults, only a few cases of COVID-related psychosis have been reported in young patients. This case-based review compares the clinical presentations of 2 previously published cases of adolescent patients who developed psychosis in the context of COVID-related complications with a new case of a male adolescent who developed post-COVID psychosis. A discussion to raise clinicians' awareness of COVID-related psychosis in young patients as well as the need for cautious use of antipsychotic medications in this highly vulnerable age group is also provided.


Subject(s)
COVID-19 , Psychotic Disorders , Adolescent , Aged , Humans , Male , Psychotic Disorders/diagnosis , Psychotic Disorders/drug therapy , Psychotic Disorders/etiology , SARS-CoV-2
18.
J Med Case Rep ; 15(1): 548, 2021 Nov 04.
Article in English | MEDLINE | ID: covidwho-1502017

ABSTRACT

BACKGROUND: Over-the-counter medication overdose is a difficult diagnostic challenge for many physicians as common drug screening assays cannot detect these substances. We present a case of acute psychosis, serotonin syndrome, and anticholinergic overdose-like properties in the setting of Coricidin HBP Cough & Cold tablets, known by their street name Triple-C. This is the first case report we are aware of involving a patient presenting with these symptoms and requiring critical-care-level support. CASE PRESENTATION: A 31-year-old African American female with a past medical history of anxiety, childhood asthma, previous methamphetamine abuse, and coronavirus disease 2019 infection in August 2020 was brought to the emergency department by the local police department with altered mental status. Initial blood work, including extended drug screens, were unremarkable for a definitive diagnosis. This patient required critical-care-level support and high sedation because of her symptoms. Collateral history revealed the patient regularly consumed Triple-C daily for the 6 weeks prior to admission. A trial off sedation was attempted after 24 hours with no complications. The patient admitted to regular Triple-C consumption and auditory hallucinations since adolescence. She was discharged safely after 48 hours back into the community. She was lost to follow-up with psychiatry and internal medicine; however, she was evaluated in the emergency room 1 month later with a similar psychiatric presentation. CONCLUSION: Overdose of Triple-C should be kept in the differential diagnosis of patients presenting with a triad of psychosis, serotonin syndrome, and anticholinergic overdose, in the setting of unknown substance ingestion.


Subject(s)
COVID-19 , Drug Overdose , Psychotic Disorders , Serotonin Syndrome , Adolescent , Adult , Child , Drug Overdose/complications , Drug Overdose/diagnosis , Female , Humans , Psychotic Disorders/diagnosis , Psychotic Disorders/drug therapy , SARS-CoV-2 , Serotonin Syndrome/chemically induced , Serotonin Syndrome/diagnosis
19.
Infect Dis (Lond) ; 54(2): 152-156, 2022 02.
Article in English | MEDLINE | ID: covidwho-1434329

ABSTRACT

INTRODUCTION: The SARS-Cov-2 infection has multiple neurologic manifestations including encephalitis in multiple cases reported, however the psychosis as principal manifestation of this condition is infrequently. CASE REPORT: We report the case of a 48-year-old woman with a confirmed diagnosis of SARS-CoV-2 who developed paranoid and self-referential ideas with behavioural alteration and multiple findings on mental examination. Encephalitis associated with Covid-19 was suspected due to the neurological clinical presentation (persistent despite resolve hypoxaemia and systemic symptoms) and brain magnetic resonance image (MRI) that showed asymmetric hippocampal hyperintensities, although cerebrospinal fluid and electroencephalogram (EEG) were normal. The patient received medical treatment with methylprednisolone for 5 days with complete resolution of her symptoms. DISCUSSION: The current SARS-CoV-2 pandemic has neurological complications either by direct involvement or by para-infectious or post-infectious phenomena. Encephalitis occurs in a small proportion of the cases, while psychiatric symptoms have been described in a variable percentage of the events. However, a psychotic picture such as the one reported in our case is unusual. MRI, cerebrospinal fluid and EEG are important for the diagnostic evaluation of these patients but not obligatory to the diagnosis. The treatment of this condition with corticosteroids has been successful even in cases associated with Anti-NMDA. Our case is the second reported in Colombia, the first to be associated with psychosis.


Subject(s)
COVID-19 , Encephalitis , Psychotic Disorders , Female , Humans , Middle Aged , Psychotic Disorders/diagnosis , Psychotic Disorders/drug therapy , Psychotic Disorders/etiology , SARS-CoV-2 , Steroids/therapeutic use
20.
Compr Psychiatry ; 111: 152274, 2021 11.
Article in English | MEDLINE | ID: covidwho-1415330

ABSTRACT

BACKGROUND: The COVID-19 pandemic has increased psychological stress among adolescents, and the relation between perceived stress (PS) and psychotic-like experiences (PLEs) has been well-established. However, little is known about the role of family functioning (FF) in this relation, especially when adolescents experienced the extended lockdown period with family members. METHODS: A total of 4807 adolescents completed this retrospective paper-and-pencil survey after school reopening between May 14th and June 6th, 2020 in Hunan Province, China. We measured PS with the Perceived stress scale (PSS-10), PLEs with the eight positive items from Community Assessment of Psychic Experiences (CAPE-8), and FF with the Family APGAR scale. We conducted subgroup analysis based on three FF levels (good, moderate, and poor) determined by previous studies. Finally, correlation and moderation analysis were performed to detect the effect of FF in the relation between PS and PLEs after adjusting for demographic variables. RESULTS: Adolescents with poor FF had higher levels of PS and higher prevalence of PLEs compared to those with good FF (both p < 0.001). FF was negatively associated with both PS (r = -0.34, p < 0.001) and PLEs (r = -0.29, p < 0.001). Higher FF significantly attenuated the effect of PS on PLEs after adjusting for sex and age (effect = -0.011, bootstrap 95% CI -0.018, -0.005). CONCLUSION: Our findings indicate that well-functioned family could protect against stress-induced PLEs among adolescents during this crisis. Thus family system could be an early interventional target for distressing psychotic-like experiences in youngsters.


Subject(s)
COVID-19 , Psychotic Disorders , Adolescent , Communicable Disease Control , Humans , Pandemics , Psychotic Disorders/diagnosis , Psychotic Disorders/epidemiology , Retrospective Studies , SARS-CoV-2 , Stress, Psychological/epidemiology , Surveys and Questionnaires
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