Consensus of the Liaison-Psychiatry Committee of the Colombian Psychiatric Association on the diagnosis and treatment of delirium in the context of the COVID-19 pandemic.

The pandemic caused by the new coronavirus named SARS-CoV-2 poses unprecedented challenges in the health care. Among them is the increase in cases of delirium. The severe SARS-CoV-2 disease, COVID-19, has common vulnerabilities with delirium and produces alterations in organs such as the lungs or the brain, among others, which have the potential to trigger the mental disorder. In fact, delirium may be the first manifestation of the infection, before fever, general malaise, cough or respiratory disturbances. It is widely supported that delirium increases the morbidity and mortality in those who suffer from it during hospitalization, so it should be actively sought to carry out the relevant interventions. In the absence of evidence on the approach to delirium in the context of COVID-19, this consensus was developed on three fundamental aspects: diagnosis, non-pharmacological treatment and pharmacological treatment, in patients admitted to the general hospital. The document contains recommendations on the systematic use of diagnostic tools, when to hospitalize the patient with delirium, the application of non-pharmacological actions within the restrictions imposed by COVID-19, and the use of antipsychotics, taking into account the most relevant side effects and pharmacological interactions.

[Atypical presentation of an induced hyperthyroidism]. / Presentación atípica de un hipertiroidismo inducido.

We present the case of a person with baseline Bipolar Affective Disorder, who starts receiving medical treatment for subclinical Hypothyroidism, during this time the patient develops Hyperthyroidism. During the course of the latter, the patient started to exhibit depressed mood symptoms and worsening of her baseline disorder. Typically there are depressive symptoms in hypothyroidism and manic symptoms in hyperthyroidism, there have been a few cases of depressive symptoms (depressed mood, asthenia and apathy) reported in patients with hyperthyroidism. Up till now it's a fact that Hyperthyroidism constitutes itself as a risk factor for developing or precipitating depressive states, thus increasing hospital readmissions, and another important fact is that of manifesting or worsening affective symptoms due to the influence of thyroid hormones. We also present the well-known relationship between thyroid malfunction and affective disorders.