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1.
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
2.
JAMA Netw Open ; 4(11): e2134803, 2021 11 01.
Article in English | MEDLINE | ID: covidwho-1516698

ABSTRACT

Importance: Infection with SARS-CoV-2 is associated with fatigue and sleep problems long after the acute phase of COVID-19. In addition, there are concerns of SARS-CoV-2 infection causing psychiatric illness; however, evidence of a direct effect is inconclusive. Objective: To assess risk of risk of incident or repeat psychiatric illness, fatigue, or sleep problems following SARS-CoV-2 infection and to analyze changes according to demographic subgroups. Design, Setting, and Participants: This cohort study assembled matched cohorts using the Clinical Practice Research Datalink Aurum, a UK primary care registry of 11 923 499 individuals aged 16 years or older. Patients were followed-up for up to 10 months, from February 1 to December 9, 2020. Individuals with less than 2 years of historical data or less than 1 week follow-up were excluded. Individuals with positive results on a SARS-CoV-2 test without prior mental illness or with anxiety or depression, psychosis, fatigue, or sleep problems were matched with up to 4 controls based on sex, general practice, and year of birth. Controls were individuals who had negative SARS-CoV-2 test results. Data were analyzed from January to July 2021. Exposure: SARS-CoV-2 infection, determined via polymerase chain reaction testing. Main Outcomes and Measures: Cox proportional hazard models estimated the association between a positive SARS-CoV-2 test result and subsequent psychiatric morbidity (depression, anxiety, psychosis, or self-harm), sleep problems, fatigue, or psychotropic prescribing. Models adjusted for comorbidities, ethnicity, smoking, and body mass index. Results: Of 11 923 105 eligible individuals (6 011 020 [50.4%] women and 5 912 085 [49.6%] men; median [IQR] age, 44 [30-61] years), 232 780 individuals (2.0%) had positive result on a SARS-CoV-2 test. After applying selection criteria, 86 922 individuals were in the matched cohort without prior mental illness, 19 020 individuals had prior anxiety or depression, 1036 individuals had psychosis, 4152 individuals had fatigue, and 4539 individuals had sleep problems. After adjusting for observed confounders, there was an association between positive SARS-CoV-2 test results and psychiatric morbidity (adjusted hazard ratio [aHR], 1.83; 95% CI, 1.66-2.02), fatigue (aHR, 5.98; 95% CI, 5.33-6.71), and sleep problems (aHR, 3.16; 95% CI, 2.64-3.78). However, there was a similar risk of incident psychiatric morbidity for those with a negative SARS-CoV-2 test results (aHR, 1.71; 95% CI, 1.65-1.77) and a larger increase associated with influenza (aHR, 2.98; 95% CI, 1.55-5.75). Conclusions and Relevance: In this cohort study of individuals registered at an English primary care practice during the pandemic, there was consistent evidence that SARS-CoV-2 infection was associated with increased risk of fatigue and sleep problems. However, the results from the negative control analysis suggest that unobserved confounding may be responsible for at least some of the positive association between COVID-19 and psychiatric morbidity.


Subject(s)
COVID-19/complications , Fatigue/etiology , Pandemics , Psychological Distress , Psychotropic Drugs/therapeutic use , Sleep Wake Disorders/etiology , Sleep , Adult , Anxiety/drug therapy , Anxiety/epidemiology , Anxiety/etiology , COVID-19/psychology , COVID-19/virology , Cohort Studies , Depression/drug therapy , Depression/epidemiology , Depression/etiology , England/epidemiology , Fatigue/epidemiology , Female , Humans , Male , Middle Aged , Prevalence , Primary Health Care , Psychotic Disorders/drug therapy , Psychotic Disorders/epidemiology , Psychotic Disorders/etiology , Risk Factors , SARS-CoV-2 , Sleep Wake Disorders/epidemiology , Stress, Psychological/etiology
4.
BMJ Case Rep ; 14(4)2021 Apr 26.
Article in English | MEDLINE | ID: covidwho-1203957

ABSTRACT

This is a case report of a middle-aged man with no psychiatric history who presented with severe anxiety and psychotic symptoms from COVID-19. Following his discharge from intensive care unit, he was unable to sleep, was increasingly agitated and was observed hitting his head off the walls, causing haematomas. He remained highly anxious and developed paranoid delusions and auditory and tactile hallucinations, needing admission to a psychiatric ward. Treatment with antipsychotic medication gradually improved his symptoms in a few weeks. This case report highlights the new onset of psychosis due to COVID-19 infection. It demonstrates the importance of early identification and treatment of neuropsychiatric complications within an acute hospital setting. Furthermore, there is a need for research in this area to help in the prevention and treatment of such psychiatric complications due to COVID-19.


Subject(s)
COVID-19/complications , Delusions/etiology , Psychotic Disorders/etiology , Antipsychotic Agents/therapeutic use , COVID-19/psychology , Delusions/drug therapy , Humans , Male , Middle Aged , Psychotic Disorders/drug therapy , SARS-CoV-2 , Treatment Outcome
5.
Sci Rep ; 11(1): 7169, 2021 03 30.
Article in English | MEDLINE | ID: covidwho-1160544

ABSTRACT

In current international classification systems (ICD-10, DSM5), the diagnostic criteria for psychotic disorders (e.g. schizophrenia and schizoaffective disorder) are based on symptomatic descriptions since no unambiguous biomarkers are known to date. However, when underlying causes of psychotic symptoms, like inflammation, ischemia, or tumor affecting the neural tissue can be identified, a different classification is used ("psychotic disorder with delusions due to known physiological condition" (ICD-10: F06.2) or psychosis caused by medical factors (DSM5)). While CSF analysis still is considered optional in current diagnostic guidelines for psychotic disorders, CSF biomarkers could help to identify known physiological conditions. In this retrospective, partly descriptive analysis of 144 patients with psychotic symptoms and available CSF data, we analyzed CSF examinations' significance to differentiate patients with specific etiological factors (F06.2) from patients with schizophrenia, schizotypal, delusional, and other non-mood psychotic disorders (F2). In 40.3% of all patients, at least one CSF parameter was out of the reference range. Abnormal CSF-findings were found significantly more often in patients diagnosed with F06.2 (88.2%) as compared to patients diagnosed with F2 (23.8%, p < 0.00001). A total of 17 cases were identified as probably caused by specific etiological factors (F06.2), of which ten cases fulfilled the criteria for a probable autoimmune psychosis linked to the following autoantibodies: amphiphysin, CASPR2, CV2, LGl1, NMDA, zic4, and titin. Two cases presented with anti-thyroid tissue autoantibodies. In four cases, further probable causal factors were identified: COVID-19, a frontal intracranial tumor, multiple sclerosis (n = 2), and neurosyphilis. Twenty-one cases remained with "no reliable diagnostic classification". Age at onset of psychotic symptoms differed between patients diagnosed with F2 and F06.2 (p = 0.014), with the latter group being older (median: 44 vs. 28 years). Various CSF parameters were analyzed in an exploratory analysis, identifying pleocytosis and oligoclonal bands (OCBs) as discriminators (F06.2 vs. F2) with a high specificity of > 96% each. No group differences were found for gender, characteristics of psychotic symptoms, substance dependency, or family history. This study emphasizes the great importance of a detailed diagnostic workup in diagnosing psychotic disorders, including CSF analysis, to detect possible underlying pathologies and improve treatment decisions.


Subject(s)
Psychotic Disorders/cerebrospinal fluid , Adolescent , Adult , Age of Onset , Aged , Autoimmune Diseases of the Nervous System/cerebrospinal fluid , Autoimmune Diseases of the Nervous System/psychology , Biomarkers/cerebrospinal fluid , COVID-19/psychology , Cerebrospinal Fluid Proteins/analysis , Child , Child, Preschool , Humans , Middle Aged , Psychotic Disorders/etiology , Psychotic Disorders/psychology , Retrospective Studies , Schizophrenia/cerebrospinal fluid , Young Adult
6.
J Clin Neurosci ; 87: 29-31, 2021 May.
Article in English | MEDLINE | ID: covidwho-1116965

ABSTRACT

Despite neuropsychiatric outcomes of SARS-CoV-2 infection are now under close scrutiny, psychoneuroimmunological characteristics of COVID-19 and precise pathophysiology of neuropsychiatric manifestations of the infection are still obscure. Moreover, there still exists a shortfall in demonstrating specific clinical manifestations of the brain involvement of the virus. Here, we presented a 33-year-old female patient with COVID-19, reporting acute-onset paranoid delusions symptoms, insomnia and irritability. Cranial MRI showed an hyperintense signal in the splenium of the corpus callosum with decreased apparent diffusion coefficient, which might possibly indicate the presence of cytotoxic edema related to the brain involvement of the infection. Following the completion of SARS-CoV-2 treatment, both cytotoxic edema and psychiatric symptoms resolved. In light of this report, we suggest that either heightened immune response and direct viral infection that SARS-CoV-2 may lead to such psychiatric manifestations and neuropsychiatric monitoring should be performed in patients with COVID-19. Prompt recognition of psychiatric consequences of COVID-19 may help clinicians provide guidance for differential diagnosis and manage them accordingly.


Subject(s)
COVID-19/diagnostic imaging , Mania/diagnostic imaging , Psychotic Disorders/diagnostic imaging , Acute Disease , Adult , Brain/diagnostic imaging , COVID-19/complications , COVID-19/psychology , Female , Humans , Magnetic Resonance Imaging , Mania/etiology , Mania/psychology , Psychotic Disorders/etiology , Psychotic Disorders/psychology
7.
J Psychiatr Pract ; 27(2): 145-146, 2021 03 05.
Article in English | MEDLINE | ID: covidwho-1114927

ABSTRACT

Two cases are presented involving neuropsychiatric symptoms occurring in the context of coronavirus disease 2019 (COVID-19) infections. The first case involved a middle-age man with no known psychiatric history who presented with acute psychotic symptoms (delusions, hallucinations, disorganization) after recovery from a recent respiratory illness. This patient tested positive for COVID-19 on admission. The patient's symptoms were not consistent with delirium and testing did not suggest a neurological etiology. The patient's psychosis eventually resolved 6 weeks after its abrupt onset with treatment with antipsychotic medication. The second case involved a 44-year-old man with a history of depression and psychotic symptoms who presented after a serious suicide attempt and tested positive for COVID-19 on admission. The patient had subsequent negative tests while on the inpatient psychiatric unit before again testing positive later in his admission. The patient's positive COVID-19 tests appeared to coincide with exacerbations in his mood symptoms, which led to the suicide attempt and psychotic episode that initially caused his admission. This patient was successfully treated with clozapine. In both of these cases, the question arose as to whether there was a link between the COVID-19 infections and the neuropsychiatric symptoms. Growing evidence suggests that severe neuropsychiatric sequelae can develop after COVID-19 infection.


Subject(s)
COVID-19 , Coronavirus Infections , Coronavirus , Psychotic Disorders , Adult , Humans , Male , Middle Aged , Psychotic Disorders/drug therapy , Psychotic Disorders/etiology , SARS-CoV-2
8.
Rev Psiquiatr Salud Ment (Engl Ed) ; 13(2): 90-94, 2020.
Article in English, Spanish | MEDLINE | ID: covidwho-125044

ABSTRACT

INTRODUCTION: The world is currently undergoing an extremely stressful scenario due to the COVID-19 pandemic. This unexpected and dramatic situation could increase the incidence of mental health problems, among them, psychotic disorders. The aim of this paper was to describe a case series of brief reactive psychosis due to the psychological distress from the current coronavirus pandemic. MATERIALS AND METHODS: We report on a case series including all the patients with reactive psychoses in the context of the COVID-19 crisis who were admitted to the Virgen del Rocío and Virgen Macarena University Hospitals (Seville, Spain) during the first two weeks of compulsory nationwide quarantine. RESULTS: In that short period, four patients met the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) criteria for a brief reactive psychotic disorder. All of the episodes were directly triggered by stress derived from the COVID-19 pandemic and half of the patients presented severe suicidal behavior at admission. CONCLUSIONS: We may now be witnessing an increasing number of brief reactive psychotic disorders as a result of the COVID-19 pandemic. This type of psychosis has a high risk of suicidal behavior and, although short-lived, has a high rate of psychotic recurrence and low diagnostic stability over time. Therefore, we advocate close monitoring in both the acute phase and long-term follow-up of these patients.


Subject(s)
Betacoronavirus , Coronavirus Infections/psychology , Pneumonia, Viral/psychology , Psychological Distress , Psychotic Disorders/etiology , Quarantine/psychology , Stress, Psychological/complications , Adult , COVID-19 , Coronavirus Infections/complications , Female , Humans , Male , Middle Aged , Pandemics , Pneumonia, Viral/complications , Psychiatric Status Rating Scales , Psychotic Disorders/diagnosis , Psychotic Disorders/psychology , Risk Factors , SARS-CoV-2 , Spain , Suicide/psychology
9.
Psychiatry Res ; 298: 113802, 2021 04.
Article in English | MEDLINE | ID: covidwho-1078137

ABSTRACT

The ongoing Corona Virus Disease 2019 (COVID-19) pandemic appears to increase risk for mental illness, either directly due to inflammation caused by the virus or indirectly due to related psychosocial stress, resulting in the development of both anxious-depressive and psychotic symptoms. The purpose of the present study was to assess the frequency and characteristics of all patients with First Episodes Psychosis (FEP) without COVID-19 infection hospitalized in the first four months since lockdown in Milan. We recruited sixty-two patients hospitalized between March 8 to July 8, 2020 versus those first  hospitalized in the same period in 2019. The two subgroups were compared for sociodemographic variables and clinical characteristics of the episodes. Patients with FEP in 2020 were significantly older than patients with FEP in 2021, and presented with significantly less substances abuse. Interestingly, patients presenting with FEP in 2020 were significantly older than patients with FEP in 2019. These data are compatible with the greater vulnerability to stressful factors during the pandemic, as well as with the greater concern regarding a possible COVID-19 infection producing brain damage causing the FEP.


Subject(s)
COVID-19 , Communicable Disease Control , Hospitalization , Psychotic Disorders , Adult , COVID-19/prevention & control , Female , Hospitalization/statistics & numerical data , Humans , Italy/epidemiology , Male , Psychotic Disorders/epidemiology , Psychotic Disorders/etiology , Psychotic Disorders/therapy
10.
Neurosci Lett ; 741: 135491, 2021 01 10.
Article in English | MEDLINE | ID: covidwho-1071804

ABSTRACT

Historical epidemiological perspectives from past pandemics and recent neurobiological evidence link infections and psychoses, leading to concerns that COVID-19 will present a significant risk for the development of psychosis. But are these concerns justified, or mere sensationalism? In this article we review the historical associations between viral infection and the immune system more broadly in the development of psychosis, before critically evaluating the current evidence pertaining to SARS-CoV-2 and risk of psychosis as an acute or post-infectious manifestation of COVID-19. We review the 42 cases of psychosis reported in infected patients to date, and discuss the potential implications of in utero infection on subsequent neurodevelopment and psychiatric risk. Finally, in the context of the wider neurological and psychiatric manifestations of COVID-19 and our current understanding of the aetiology of psychotic disorders, we evaluate possible neurobiological and psychosocial mechanisms as well as the numerous challenges in ascribing a causal pathogenic role to the infection.


Subject(s)
COVID-19/complications , COVID-19/diagnosis , Delusions/diagnosis , Delusions/etiology , Psychotic Disorders/diagnosis , Psychotic Disorders/etiology , Adolescent , Adult , COVID-19/psychology , Delusions/psychology , Female , Humans , Male , Middle Aged , Psychotic Disorders/psychology , Risk Factors , Young Adult
11.
Encephale ; 46(3S): S66-S72, 2020 Jun.
Article in French | MEDLINE | ID: covidwho-1065052

ABSTRACT

OBJECTIVE: The COVID-19 pandemic affected today more than 3,000,000 worldwide, and more than half of humanity has been placed in quarantine. The scientific community and the political authorities fear an epidemic of suicide secondary to this crisis. The aim of this review is to analyze the impact of the COVID-19 pandemic on the dimensions of the suicidal process and its interaction with the various risk factors. We also propose innovative strategies to manage suicidal behavior in the context of pandemic. METHODS: We carried out a narrative review of international publications dealing with major pandemics (COVID-19, SARS) and their influence on suicidal vulnerability. RESULTS: Many factors are likely to increase the emergence of suicidal ideation and suicide attempts during this crisis. Social distancing and quarantine could increase the feeling of disconnection and the perception of social pain in vulnerable individuals. Some populations at high suicidal risk could be further impacted by the current pandemic: the elderly, medical staff and individuals exposed to economic insecurity. Several innovative tools adapted to the constraints of social distancing and quarantine may prevent suicide risk: e-health, VigilanS, buddhist-derived practices and art engagement. CONCLUSIONS: This unprecedented crisis may interact with certain dimensions of the suicidal process. However, it is time to innovate. Several suicide prevention tools all have their place in new modes of care and should be tested on a large scale.


Subject(s)
Betacoronavirus , Coronavirus Infections , Pandemics , Pneumonia, Viral , Suicide/psychology , Alcoholic Intoxication/psychology , Artificial Intelligence , Betacoronavirus/physiology , COVID-19 , Coronavirus Infections/complications , Coronavirus Infections/physiopathology , Coronavirus Infections/psychology , Cost of Illness , Crisis Intervention/instrumentation , Economic Recession , France/epidemiology , Humans , Inflammation , Loneliness/psychology , Models, Neurological , Pneumonia, Viral/complications , Pneumonia, Viral/physiopathology , Pneumonia, Viral/psychology , Psychotherapy/methods , Psychotic Disorders/etiology , Psychotic Disorders/physiopathology , Psychotic Disorders/virology , Quarantine/psychology , Renin-Angiotensin System/physiology , SARS-CoV-2 , Severe Acute Respiratory Syndrome/epidemiology , Severe Acute Respiratory Syndrome/psychology , Social Isolation/psychology , Stress, Psychological/etiology , Stress, Psychological/therapy , Suicidal Ideation , Suicide/prevention & control , Suicide/statistics & numerical data , Suicide, Attempted/prevention & control , Suicide, Attempted/psychology , Telemedicine , Vulnerable Populations
12.
Brain Behav Immun ; 91: 756-770, 2021 01.
Article in English | MEDLINE | ID: covidwho-1064862

ABSTRACT

The SARS-CoV-2 virus has emerged as a striking 21st century pandemic. Communities across the globe have experienced significant infection rates and widespread psychosocial stress and trauma, leading to calls for increased allocation of resources for mental health screening and treatment. In addition to the burden of psychosocial stress, there is increasing evidence of direct viral neuroinvasion of the central nervous system through physical contact with the nasal mucosa. In a parallel fashion, there is a significant body of ongoing research related to the risk of in utero viral transmission and the resulting neurodevelopmental impact in the fetus. Aberrant neurodevelopment secondary to viral transmission has previously been related to the later development of psychosis, schizophrenia, and schizophrenia spectrum disorders, generating the hypothesis that this population of individuals exposed to SARS-CoV-2 may see an increased incidence in future decades. We discuss the current understanding of the possible neurotropism and vertical transmission of SARS-CoV-2, and relate this to the history of viral pandemics to better understand the relationship of viral infection, aberrant immune response and neurodevelopment, and the risk for schizophrenia disorder.


Subject(s)
Mental Disorders/etiology , Mental Disorders/virology , Virus Diseases/physiopathology , Animals , COVID-19/epidemiology , COVID-19/psychology , COVID-19/virology , Female , Humans , Infectious Disease Transmission, Vertical/prevention & control , Male , Pandemics/prevention & control , Pregnancy , Prenatal Exposure Delayed Effects , Psychotic Disorders/epidemiology , Psychotic Disorders/etiology , Psychotic Disorders/virology , Risk Factors , SARS-CoV-2/immunology , SARS-CoV-2/metabolism , SARS-CoV-2/pathogenicity
13.
Isr J Health Policy Res ; 10(1): 2, 2021 01 15.
Article in English | MEDLINE | ID: covidwho-1067273

ABSTRACT

Measles is a highly contagious disease. A 24 years old patient, recently exposed to measles (unvaccinated), presented in the emergency department with severe agitation, compatible with an acute psychotic episode, during the measles epidemic which spread in Israel in 2018-2019. Upon hospital admission, strict isolation was instructed, yet, without compliance, probably due to the patient's status. Measles diagnosis was promptly confirmed. As measles transmission was eminent, public health measures were employed through immediate implementation of the section 15 of the Public Health Ordinance, allowing for compulsory short-term isolation. The patient's condition improved within a few days and the measures were no longer necessary. This measles case occurred in the pre-Coronavirus disease 2019 (COVID-19) epidemic when use of a Public Health Ordinance was considered an extreme measure. This is in contrast to the current global use of Public Health laws to enforce strict quarantine and isolation on persons infected or potentially exposed to COVID-19. Nevertheless, minimizing infectious diseases transmission is a core function of public health law. Utilizing legal enforcement in circumstances of immediate public health hazard, such as nosocomial measles transmission, necessitates careful consideration. The integrative clinical and public health approach and prompt measures employed in this exceptional case, led to prevention of further infection spread.


Subject(s)
Cross Infection/prevention & control , Measles/prevention & control , Patient Isolation/legislation & jurisprudence , Public Health/legislation & jurisprudence , Acute Disease , Emergency Service, Hospital , Hospitalization , Humans , Israel/epidemiology , Male , Measles/complications , Measles/epidemiology , Psychotic Disorders/etiology , Psychotic Disorders/therapy , Young Adult
14.
Schizophr Bull ; 47(1): 15-22, 2021 01 23.
Article in English | MEDLINE | ID: covidwho-1045828

ABSTRACT

The impact of the COVID-19 pandemic on psychosis remains to be established. Here we report 6 cases (3 male and 3 female) of first-episode psychosis (FEP) admitted to our hospital in the second month of national lockdown. All patients underwent routine laboratory tests and a standardized assessment of psychopathology. Hospitalization was required due to the severity of behavioral abnormalities in the context of a full-blown psychosis (the Brief Psychiatric Rating Scale [BPRS] = 75.8 ± 14.6). Blood tests, toxicological urine screening, and brain imaging were unremarkable, with the exception of a mild cortical atrophy in the eldest patient (male, 73 years). All patients were negative for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) throughout their stay, but 3 presented the somatic delusion of being infected. Of note, all 6 cases had religious/spiritual delusions and hallucinatory contents. Despite a generally advanced age (53.3 ± 15.6), all patients had a negative psychiatric history. Rapid discharge (length of stay = 13.8 ± 6.9) with remission of symptoms (BPRS = 27.5 ± 3.1) and satisfactory insight were possible after relatively low-dose antipsychotic treatment (Olanzapine-equivalents = 10.1 ± 5.1 mg). Brief psychotic disorder/acute and transient psychotic disorder diagnoses were confirmed during follow-up visits in all 6 cases. The youngest patient (female, 23 years) also satisfied the available criteria for brief limited intermittent psychotic symptoms. Although research on larger populations is necessary, our preliminary observation suggests that intense psychosocial stress associated with a novel, potentially fatal disease and national lockdown restrictions might be a trigger for FEP.


Subject(s)
COVID-19/prevention & control , Communicable Disease Control , Delusions , Hallucinations , Psychotic Disorders , Stress, Psychological/complications , Adult , Aged , Antipsychotic Agents/administration & dosage , Delusions/diagnosis , Delusions/drug therapy , Delusions/etiology , Female , Follow-Up Studies , Hallucinations/diagnosis , Hallucinations/drug therapy , Hallucinations/etiology , Humans , Italy , Male , Middle Aged , Psychotic Disorders/diagnosis , Psychotic Disorders/drug therapy , Psychotic Disorders/etiology , Remission Induction , Time Factors , Young Adult
15.
Rev Colomb Psiquiatr (Engl Ed) ; 50(1): 39-42, 2021.
Article in English, Spanish | MEDLINE | ID: covidwho-1003012

ABSTRACT

INTRODUCTION: Three cases are presented that are characterised by an acute psychopathological decompensation during the state of alarm in Spain due to the COVID-19 epidemic, as an example of the mental morbidity that can be generated as a result of the confinement and social isolation measures. CASE REPORT: Three cases are presented, all of them with a diagnosis of "brief psychotic episode" (F23). In these selected cases, the social restrictions implemented as a result of COVID-19 have played a very relevant role as an external stressor of psychotic symptoms in the patients. The response to antipsychotic treatment was rapid and very favourable. There could be specific psychological vulnerability factors related to the epidemic, which are still being studied today. CONCLUSIONS: Our cases are just a sample of the new paradigm that psychiatry is facing, requiring an early and effective approach to the upturn in mental illness that is foreseeable in the coming months.


Subject(s)
Antipsychotic Agents/administration & dosage , COVID-19/psychology , Psychotic Disorders/diagnosis , Quarantine/psychology , Acute Disease , Adult , Female , Humans , Middle Aged , Physical Distancing , Psychotic Disorders/drug therapy , Psychotic Disorders/etiology , Spain
16.
Psychiatry Res ; 295: 113573, 2021 01.
Article in English | MEDLINE | ID: covidwho-951418

ABSTRACT

The viral hypothesis for schizophrenia has persisted for decades, initially supported by observed increases in psychoses subsequent to the influenza pandemic of the early twentieth century, and then later by evidence of elevated viral antibody titres particularly in schizophrenia patient populations. Several research studies have also focused on maternal infections during the second trimester of pregnancy and their long-term effects on fetal brain development, ultimately leading to schizophrenia. No specific virus has been implicated although a handful have received increasing attention. The current pandemic spreading the SARS CoV-2 corona virus world-wide is now showing anecdotal evidence of psychoses newly developing post viral exposure, implicating neuronal inflammation in crucial areas of the brain that could initiate psychotic symptoms. Time will tell if epidemiological data will, similar to the 1918 influenza pandemic, show that schizophrenia spectrum disorders increase after serious viral infections.


Subject(s)
COVID-19/complications , Psychotic Disorders/etiology , Schizophrenia/etiology , COVID-19/immunology , Humans , Psychotic Disorders/immunology , Psychotic Disorders/virology , Schizophrenia/immunology , Schizophrenia/virology
17.
Riv Psichiatr ; 55(5): 319-321, 2020.
Article in English | MEDLINE | ID: covidwho-881250

ABSTRACT

CoViD-19 pandemic has created a global concern in the whole population. The psychiatric and social impact of the viral infection is recorded differently by the community. However, more vulnerable individuals with negative psychiatric history are presenting to mental health hospitals for admission, assessment and treatment due to abnormal reactions to CoViD-19 pandemic. The current study reports six clinical cases of first psychiatric presentation that were characterised by sudden onset of symptoms, manic and psychotic symptoms, adverse response to stress, psychomotor agitation and behaviours out of character. The presentation was short-lived and responded to typical antipsychotics and antidepressants. The posed diagnoses were acute and transient psychotic disorder and acute stress reaction.


Subject(s)
Betacoronavirus , Bipolar Disorder/etiology , Coronavirus Infections/psychology , Depression/etiology , Pneumonia, Viral/psychology , Psychotic Disorders/etiology , Adult , COVID-19 , Coronavirus Infections/epidemiology , Female , Humans , Male , Middle Aged , Pandemics , Pneumonia, Viral/epidemiology , SARS-CoV-2
20.
BMJ Case Rep ; 13(8)2020 Aug 11.
Article in English | MEDLINE | ID: covidwho-714270

ABSTRACT

A 36-year-old previously healthy woman with no personal or family history of mental illness presented with new-onset psychosis after a diagnosis of symptomatic COVID-19. Her psychotic symptoms initially improved with antipsychotics and benzodiazepines and further improved with resolution of COVID-19 symptoms. This is the first case of COVID-19-associated psychosis in a patient with no personal or family history of a severe mood or psychotic disorder presenting with symptomatic COVID-19, highlighting the need for vigilant monitoring of neuropsychiatric symptoms in these individuals.


Subject(s)
Betacoronavirus , Coronavirus Infections/complications , Coronavirus Infections/psychology , Pneumonia, Viral/complications , Pneumonia, Viral/psychology , Psychotic Disorders/etiology , Psychotic Disorders/psychology , Adult , Antipsychotic Agents/therapeutic use , COVID-19 , Diagnosis, Differential , Female , Humans , Pandemics , Psychotic Disorders/drug therapy , SARS-CoV-2
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