Clinical characterization of brief psychotic disorders triggered by the COVID-19 pandemic: a multicenter observational study.

This study aimed to characterize the clinical profile of patients with brief psychotic disorders (BPD) triggered by the psychosocial distress derived from the COVID-19 crisis. A multicenter study was conducted from March 14 to May 14, 2020 (the peak weeks of the pandemic in Europe). All consecutive patients presenting non-affective psychotic episodes with a duration of untreated psychosis of less than 1 month and whose onset was related to the COVID-19 crisis were recruited, but only those patients meeting Diagnostic Statistical Manual 5th edition (DSM-5) criteria for "BPD with marked stressors" (DSM-5 code: 298.8) during follow-up were finally included. Patients' sociodemographic and clinical characteristics were collected at baseline and summarized with descriptive statistics. During the study period, 57 individuals with short-lived psychotic episodes related to the emotional stress of the COVID-19 pandemic were identified, of whom 33 met DSM-5 criteria for "BPD with marked stressors". The mean age was 42.33 ± 14.04 years, the gender distribution was almost the same, and the majority were rated as having good premorbid adjustment. About a quarter of the patients exhibited suicidal symptoms and almost half presented first-rank schizophrenia symptoms. None of them were COVID-19 positive, but in more than half of the cases, the topic of their psychotic features was COVID-19-related. The coronavirus pandemic is triggering a significant number of BPD cases. Their risk of suicidal behavior, their high relapse rate, and their low temporal stability make it necessary to closely monitor these patients over time.

Reactive psychoses in the context of the COVID-19 pandemic: clinical perspectives from a case series / Psicosis reactivas en el contexto de la pandemia del COVID-19: perspectivas clínicas de una serie de casos

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

INTRODUCCIÓN: El mundo está experimentando un escenario extremadamente estresante a causa de la pandemia del COVID-19. Esta situación inesperada y dramática podría incrementar la incidencia de los problemas de salud mental y, entre estos, los trastornos psicóticos. El objetivo de este documento es describir una serie de casos de psicosis reactiva breve, debidos al distrés psicológico debido a la pandemia actual de coronavirus. MATERIALES Y MÉTODOS: Reportamos una serie de casos que incluye a todos los pacientes con psicosis reactiva en el contexto de la crisis del COVID-19, ingresados en los Hospitales Universitarios Virgen del Rocío y Virgen Macarena (Sevilla, España) durante las 2 primeras semanas de la cuarentena obligatoria a nivel nacional. RESULTADOS: En este breve espacio de tiempo, 4 pacientes cumplieron los criterios de trastorno psicótico breve del manual diagnóstico y estadístico de trastornos mentales (DSM-5). Todos los episodios fueron desencadenados por el estrés derivado de la pandemia del COVID-19, y la mitad de los pacientes presentaron un comportamiento suicida grave a su ingreso. CONCLUSIONES: Actualmente podemos estar asistiendo a un incremento del número de trastornos psicóticos reactivos breves, como resultado de la pandemia del COVID-19. Este tipo de psicosis tiene un elevado riesgo de comportamiento suicida y, aunque es transitorio, tiene una elevada tasa de recurrencia psicótica y baja estabilidad diagnóstica a lo largo del tiempo. Por tanto, somos partidarios de una supervisión estrecha tanto en la fase aguda como en el seguimiento a largo plazo de estos pacientes

Reactive psychoses in the context of the COVID-19 pandemic: Clinical perspectives from a case series.

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.

Reactive psychoses in the context of the COVID-19 pandemic: Clinical perspectives from a case series.

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.

Introducción: El mundo está experimentando un escenario extremadamente estresante a causa de la pandemia del COVID-19. Esta situación inesperada y dramática podría incrementar la incidencia de los problemas de salud mental y, entre estos, los trastornos psicóticos. El objetivo de este documento es describir una serie de casos de psicosis reactiva breve, debidos al distrés psicológico debido a la pandemia actual de coronavirus. Materiales y métodos: Reportamos una serie de casos que incluye a todos los pacientes con psicosis reactiva en el contexto de la crisis del COVID-19, ingresados en los Hospitales Universitarios Virgen del Rocío y Virgen Macarena (Sevilla, España) durante las 2 primeras semanas de la cuarentena obligatoria a nivel nacional. Resultados: En este breve espacio de tiempo, 4 pacientes cumplieron los criterios de trastorno psicótico breve del manual diagnóstico y estadístico de trastornos mentales (DSM-5). Todos los episodios fueron desencadenados por el estrés derivado de la pandemia del COVID-19, y la mitad de los pacientes presentaron un comportamiento suicida grave a su ingreso. Conclusiones: Actualmente podemos estar asistiendo a un incremento del número de trastornos psicóticos reactivos breves, como resultado de la pandemia del COVID-19. Este tipo de psicosis tiene un elevado riesgo de comportamiento suicida y, aunque es transitorio, tiene una elevada tasa de recurrencia psicótica y baja estabilidad diagnóstica a lo largo del tiempo. Por tanto, somos partidarios de una supervisión estrecha tanto en la fase aguda como en el seguimiento a largo plazo de estos pacientes.