ABSTRACT
INTRODUCTION: The SARS-CoV-2 infection has been associated with the acute onset of mental and behavioural symptoms and psychiatric disorders. The aim of this study was to assess the prevalence of the different neuropsychiatric diagnoses in hospitalized patients with SARS-CoV-2 infection assessed by Liaison Psychiatry. MATERIAL AND METHODS: We performed a cross-sectional study in a hospital near Lisbon, Portugal. We reviewed the electronic health records from all inpatients with a positive SARS-CoV-2 RT-PCR test that were assessed by the Liaison Psychiatry Unit (LPU) between February and December 2020. We reviewed relevant sociodemographic and clinical data, including 15 neuropsychiatric symptoms. The prevalence of psychiatric disorders was our main outcome. We also explored differences between two groups: patients with delirium (delirium group) and patients without delirium (no delirium group). RESULTS: We included 46 cases [Age: median = 67 years; interquartile range (IQR) = 24)], with 60.9% male individuals. Delirium was the most frequent diagnosis in our sample (43.5%), followed by major depressive disorder (21.7%). Patients with delirium were more likely to suffer from COVID-19 symptoms (delirium: 19/20, 95%; no delirium: 14/26, 53.8%; p = 0.02), and to have a longer time interval between a positive SARS-CoV-2 RT-PCR test and an evaluation by the LPU (delirium: median = 16.5 days, IQR = 16; no delirium: median = 8 days, IQR = 16.3; p = 0.045). Agitation (52.2%) and cognitive symptoms (47.8%) were the most reported neuropsychiatric symptoms. CONCLUSION: We found a high prevalence of delirium in our sample. This finding is in line with recent literature concerning hospitalized COVID-19 patients The higher frequency of COVID-19 symptoms found in the delirium group suggests a possible association between symptomatic SARS-CoV-2 infection and delirium onset.
Introdução: A infecção por SARS-CoV-2 tem sido associada ao desenvolvimento agudo de sintomas mentais e comportamentais e perturbações psiquiátricas. O objetivo deste estudo foi determinar a prevalência de diferentes diagnósticos neuropsiquiátricos em doentes hospitalizados com infeção SARS-CoV-2 avaliados pela Psiquiatria de Ligação. Material e Métodos: Realizámos um estudo transversal num hospital da região de Lisboa, em Portugal. Revimos os processos clínicos dos pacientes internados com um resultado RT-PCR positivo para SARS-CoV-2 avaliados pela Unidade de Psiquiatria de Ligação (UPL) entre fevereiro e dezembro de 2020. Incluímos dados sociodemográficos e clínicos, incluindo quinze sintomas neuropsiquiátricos. A incidência de diferentes diagnósticos psiquiátricos foi o nosso outcome primário. Explorámos também diferenças entre dois grupos: doentes com delirium e doentes sem delirium. Resultados: Incluímos 46 casos [Idade: mediana = 67 anos; amplitude interquartil (AIQ) = 24)], a maioria do sexo masculino (60,9%). Delirium foi o diagnóstico mais frequente na nossa amostra (43,5%), seguido de perturbação depressiva major (21,7%). Doentes com delirium tiveram uma prevalência maior de sintomas de COVID-19 (delirium: 19/20, 95%; sem delirium: 14/26, 53,8%; p = 0,02), bem como um intervalo de tempo mais longo entre um teste RT-PCR SARS-CoV-2 positivo e observação pela UPL (delirium: mediana = 16,5, AIQ = 16; sem delirium: mediana = 8, AIQ = 16,3; p = 0,045). Agitação (52,2%) e sintomas cognitivos (47,8%) foram os sintomas neuropsiquiátricos mais relatados. Conclusão: Foi encontrada na nossa amostra uma elevada prevalência de delirium. Este resultado está de acordo com literatura recente relativamente a doentes internados com COVID-19. A maior frequência de sintomas COVID-19 no grupo com delirium sugere uma possível associação entre infecção sintomática por SARS-CoV-2 e o desenvolvimento desta síndrome.
Subject(s)
COVID-19 , Depressive Disorder, Major , Psychiatry , Humans , Male , Aged , Female , SARS-CoV-2 , COVID-19/diagnosis , COVID-19/epidemiology , Cross-Sectional Studies , PrevalenceABSTRACT
Wernicke-Korsakoff syndrome (WKS) is a life-threatening and underdiagnosed neuropsychiatric condition caused by thiamine deficiency that comprises Wernicke encephalopathy and Korsakoff syndrome. Although mainly associated with chronic alcoholism, WKS can arise from other circumstances. This report describes a series of cases of WKS that were clinically evaluated by liaison psychiatrists on a nonpsychiatric inpatient unit. The cases illustrate a deficit in the recognition and adequate treatment of WKS, demonstrating its clinical complexity and the need to improve physicians' knowledge.
