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Bravve L, Kaydan M, Kostyuk G. Acute Schizophrenia-like Psychotic Disorder Against the Background of COVID-19. MEDICINA (KAUNAS, LITHUANIA) 2025; 61:298. [PMID: 40005415 PMCID: PMC11857278 DOI: 10.3390/medicina61020298] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/22/2025] [Revised: 02/03/2025] [Accepted: 02/06/2025] [Indexed: 02/27/2025]
Abstract
Background and Objectives: Research in this area focuses on acute schizophrenia-like psychotic disorder, as more than half of cases progress to a chronic course, manifesting as schizophrenia or schizoaffective disorder. Research has shown a link between viral infection and the onset of psychosis, and the influence of viruses on the clinical course of the disease is also being studied. Consequently, in cases where this type of psychosis co-occurs with a viral illness, there is a compelling rationale for identifying commonalities in both treatment and outcome. The ongoing global pandemic of COVID-19 provides a unique opportunity to assess these changes. The aim of this study is twofold: first, to examine the clinical characteristics of acute schizophrenia-like psychotic disorder in the context of the pandemic, and second, to analyze therapeutic interventions and outcomes. Materials and Methods: A non-invasive observational study was conducted in which 310 patients with acute schizophrenia-like psychotic disorder admitted as inpatients to a psychiatric hospital were divided into two groups according to the presence of COVID-19 (group I-F23.2 with COVID-19): 222 patients; Group II-F23.2 without COVID-19: 88 patients). After discharge, the patients in both groups were clinically followed in outpatient treatment for 36 months. Results: The results showed that acute schizophrenia-like psychotic disorder associated with COVID-19 was characterized by a greater severity of productive symptoms and the inclusion of the pandemic theme in psychotic symptoms. These patients were given higher doses of antipsychotic medication. Conclusions: The outcome of this type of psychosis is consistent, irrespective of the infection suffered at the onset of the disease, and is characterized by a chronic course with a predominant transition to the schizophrenic process.
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Affiliation(s)
- Lidia Bravve
- Psychiatric Hospital No. 1 Named After N.A. Alexeev of the Department of Health of Moscow, 115191 Moscow, Russia; (M.K.)
| | - Maria Kaydan
- Psychiatric Hospital No. 1 Named After N.A. Alexeev of the Department of Health of Moscow, 115191 Moscow, Russia; (M.K.)
| | - Georgy Kostyuk
- Psychiatric Hospital No. 1 Named After N.A. Alexeev of the Department of Health of Moscow, 115191 Moscow, Russia; (M.K.)
- Department of Mental Health, Faculty of Psychology, M. V. Lomonosov Moscow State University, 119991 Moscow, Russia
- Department of Psychiatry, Federal State Budgetary Educational Institution of Higher Education Russian Biotechnological University, 125080 Moscow, Russia
- Department of Psychiatry and Psychosomatics, I. M. Sechenov First Moscow State Medical University (Sechenov University), 119435 Moscow, Russia
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Danan LN, Poullé J, Bannay A, Baillot S, Laprévote V, Dobre D. COVID-19 crisis and the incidence of hospital admissions for psychosis in France. L'ENCEPHALE 2024; 50:386-390. [PMID: 37748986 DOI: 10.1016/j.encep.2023.08.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/04/2023] [Revised: 07/21/2023] [Accepted: 08/05/2023] [Indexed: 09/27/2023]
Abstract
OBJECTIVES We aimed to assess the impact of the COVID-19 crisis on the occurrence of new hospital admissions for cases of psychosis in France. METHOD We conducted a retrospective observational study from the French national PMSI database. We included patients hospitalized between 2018 and 2020 with a principal diagnosis of schizophrenia or delusional disorder with no history of psychosis in the previous 10 years. In total, we included 77,172 inpatients at crisis centers and/or in full-time hospitalization at 465 French hospitals. We assessed the number of inpatients during the year of the Covid crisis (2020) and the two years prior (2018, 2019). RESULTS The number of inpatients in full-time hospitalization decreased gradually from 2018 to 2020 by 10.6%. This downward trend was observed in all age groups. In contrast, in crisis centers the number of inpatients increased by 13.4% between 2019 and 2020, while a 7.6% decrease was seen between 2018 and 2019. The greatest increase was observed in the 31-60-year age category, and particularly amongst 46-60-year-olds, i.e. 38.0%. CONCLUSION The COVID-19 crisis was associated with an increase in the number of inpatients with a new episode of psychosis in crisis centers but not in full-time hospitalization. The profile of patients in crisis centers was different from that seen in preceding years and included more middle-to-late age adults. Particular attention should be given to this category of patients in the crisis environment to prevent the occurrence of new cases of psychosis in France.
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Affiliation(s)
- Lara-Noëmie Danan
- Centre Psychothérapique de Nancy, 5420 Laxou, France; University of Lorraine, Lorraine, France
| | - Jessica Poullé
- Centre Psychothérapique de Nancy, 5420 Laxou, France; University of Lorraine, Lorraine, France
| | - Aurélie Bannay
- Department of Evaluation and Medical Informatics, CHRU-Nancy, 29, avenue du Maréchal-de-Lattre-de-Tassigny, 54035 Nancy, France
| | - Sylvain Baillot
- Department of Evaluation and Medical Informatics, CHRU-Nancy, 29, avenue du Maréchal-de-Lattre-de-Tassigny, 54035 Nancy, France
| | - Vincent Laprévote
- Grand Nancy Hospital-University Center for Adult Psychiatry and Addictology, Psychotherapeutic Center of Nancy, 1, rue Dr-Archambault, BP 11010, 5421 Laxou cedex, France; Inserm U1114, Strasbourg, France; Department of Medical Informatics and Clinical Research and Investigation Unit, Psychotherapeutic Center of Nancy, 1, rue Dr-Archambault, 5420 Laxou, France
| | - Daniela Dobre
- Department of Medical Informatics and Clinical Research and Investigation Unit, Psychotherapeutic Center of Nancy, 1, rue Dr-Archambault, 5420 Laxou, France.
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Xie Y, Xu Z, Zhang Y, Li Y, Du P, Wang C. First-episode psychiatric disorder risk from SARS-CoV-2 infection: A clinical analysis with Chinese psychiatric inpatients. J Biomed Res 2024; 39:50-60. [PMID: 38807424 PMCID: PMC11873594 DOI: 10.7555/jbr.38.20240005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2024] [Revised: 03/27/2024] [Accepted: 04/07/2024] [Indexed: 05/30/2024] Open
Abstract
The extensive spread of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) throughout China in late 2022 has underscored the correlation between this virus and severe psychiatric disorders. However, there remains a lack of reported clinical and pathological features. Accordingly, we retrospectively reviewed the electronic medical records of psychiatric inpatients for seven days from early January 2023. Twenty-one inpatients who developed first-episode psychiatric disorders within two weeks after SARS-CoV-2 infection were recruited, while 24 uninfected first-episode psychiatric inpatients were selected as controls. Comparative analyses of clinical manifestations, routine laboratory tests, and imaging examinations were performed. Our investigation demonstrated a 330% increase in the incidence of first-episode psychiatric inpatients after SARS-CoV-2 infection in 2023, compared with the preceding year without SARS-CoV-2 infections. Most cases exhibited psychiatric symptoms within one week of SARS-CoV-2 infection, which resolved after approximately two weeks, with no residual symptoms after three months. One-way ANOVA demonstrated a significant difference in the highest fever temperature between inpatients with and without psychotic symptoms. Infected inpatients displayed elevated levels of interleukin-4, interleukin-8, and interferon-α, but decreased levels of eosinophils and basophils. These findings suggest that SARS-CoV-2 may contribute to the development of psychiatric disorders, likely mediated by the virus-induced inflammatory response and neuronal dysfunction in the context of psychological distress.
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Affiliation(s)
- Ya Xie
- Clinical Mental Health Center, the Affiliated Brain Hospital of Nanjing Medical University, Nanjing, Jiangsu 210029, China
| | - Zifeng Xu
- Clinical Mental Health Center, the Affiliated Brain Hospital of Nanjing Medical University, Nanjing, Jiangsu 210029, China
| | - Yumin Zhang
- Clinical Mental Health Center, the Affiliated Brain Hospital of Nanjing Medical University, Nanjing, Jiangsu 210029, China
| | - Yisheng Li
- Clinical Mental Health Center, the Affiliated Brain Hospital of Nanjing Medical University, Nanjing, Jiangsu 210029, China
| | - Pengyu Du
- Medical School of Nanjing University, Nanjing, Jiangsu 210008, China
| | - Chun Wang
- Clinical Mental Health Center, the Affiliated Brain Hospital of Nanjing Medical University, Nanjing, Jiangsu 210029, China
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4
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Rittmannsberger H, Barth M, Lamprecht B, Malik P, Yazdi-Zorn K. [Interaction of somatic findings and psychiatric symptoms in COVID-19. A scoping review]. NEUROPSYCHIATRIE : KLINIK, DIAGNOSTIK, THERAPIE UND REHABILITATION : ORGAN DER GESELLSCHAFT OSTERREICHISCHER NERVENARZTE UND PSYCHIATER 2024; 38:1-23. [PMID: 38055146 DOI: 10.1007/s40211-023-00487-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/13/2022] [Accepted: 10/24/2023] [Indexed: 12/07/2023]
Abstract
An infection with SARS-CoV‑2 can affect the central nervous system, leading to neurological as well as psychiatric symptoms. In this respect, mechanisms of inflammation seem to be of much greater importance than the virus itself. This paper deals with the possible contributions of organic changes to psychiatric symptomatology and deals especially with delirium, cognitive symptoms, depression, anxiety, posttraumatic stress disorder and psychosis. Processes of neuroinflammation with infection of capillary endothelial cells and activation of microglia and astrocytes releasing high amounts of cytokines seem to be of key importance in all kinds of disturbances. They can lead to damage in grey and white matter, impairment of cerebral metabolism and loss of connectivity. Such neuroimmunological processes have been described as a organic basis for many psychiatric disorders, as affective disorders, psychoses and dementia. As the activation of the glia cells can persist for a long time after the offending agent has been cleared, this can contribute to long term sequalae of the infection.
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Affiliation(s)
- Hans Rittmannsberger
- Abteilung Psychiatrie und psychotherapeutische Medizin, Pyhrn-Eisenwurzen Klinikum Steyr, Steyr, Österreich.
| | - Martin Barth
- Abteilung Psychiatrie und psychotherapeutische Medizin, Pyhrn-Eisenwurzen Klinikum Steyr, Steyr, Österreich
| | - Bernd Lamprecht
- Med Campus III, Universitätsklinik für Innere Medizin mit Schwerpunkt Pneumologie, Kepler Universitätsklinikum GmbH, Linz, Österreich
- Medizinische Fakultät, Johannes Kepler Universität Linz, Linz, Österreich
| | - Peter Malik
- Abteilung Psychiatrie und psychotherapeutische Medizin, Pyhrn-Eisenwurzen Klinikum Steyr, Steyr, Österreich
| | - Kurosch Yazdi-Zorn
- Neuromed Campus, Klinik für Psychiatrie mit Schwerpunkt Suchtmedizin, Kepler Universitätsklinikum GmbH, Linz, Österreich
- Medizinische Fakultät, Johannes Kepler Universität Linz, Linz, Österreich
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Zurlo MC, Vallone F. COVID-19 Pandemic: What We Have Learned on Stress, Technology Use, and Psychological Health Among University Students. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2024; 1458:289-302. [PMID: 39102204 DOI: 10.1007/978-3-031-61943-4_19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/06/2024]
Abstract
Nowadays, the medical COVID-19 emergency is ending worldwide, whereas there is an increasing need to understand the marks and the lessons learned from over two years of unprecedented changes in all life domains. Recent research has highlighted growing rates of psychological suffering among the general population as well as among university students, who were yet well-recognized as a vulnerable population even before the pandemic. The present work drives from university students' experience, and it aims to provide an overview of the key dimensions to take into account, in terms of main risks, changes, challenges, and resources, to develop updated tailored research and interventions promoting psychological health conditions in the current time within and beyond the educational context/university students' population. Implications for research and interventions are highlighted and discussed.
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Affiliation(s)
- Maria Clelia Zurlo
- Dynamic Psychology Laboratory, Department of Political Sciences, University of Naples Federico II, Naples, Italy.
- Department of Humanities, University of Naples Federico II, Naples, Italy.
| | - Federica Vallone
- Dynamic Psychology Laboratory, Department of Political Sciences, University of Naples Federico II, Naples, Italy
- Department of Humanities, University of Naples Federico II, Naples, Italy
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6
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O'Leary KB, Keenmon C. New-Onset Psychosis in the Context of COVID-19 Infection: An Illustrative Case and Literature Review. J Acad Consult Liaison Psychiatry 2023; 64:383-391. [PMID: 36634910 PMCID: PMC9827676 DOI: 10.1016/j.jaclp.2023.01.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/28/2022] [Revised: 12/22/2022] [Accepted: 01/04/2023] [Indexed: 01/10/2023]
Abstract
BACKGROUND Infection with COVID-19 virus can result in a wide array of neuropsychiatric symptoms, such as anxiety, depression, psychosis, and delirium. Complications can occur even in the absence of a severe respiratory illness. OBJECTIVE To recognize patterns in the presentation and treatment of patients with psychosis in the context of COVID-19 infection to help inform clinicians who directly care for these patients. METHODS In this case report and literature review, the authors first present a case of a 70-year-old female who developed new-onset psychosis in the context of mild infection with COVID-19. The authors then review the literature to present case reports that describe patients similar to the female patient presented. RESULTS The patient presented in the case report showed improved psychotic symptoms after 3 days of receiving a very low dose of risperidone. Of the case reports reviewed, more than half of the patients presented showed improvement of psychotic symptoms on low or very low doses of antipsychotics. CONCLUSIONS This review shows the necessity of additional research on psychosis due to COVID-19 in order to better understand the course of illnesses and the most effective treatment.
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Affiliation(s)
- Kerry B O'Leary
- Menninger Department of Psychiatry & Behavioral Sciences, Baylor College of Medicine, Houston, TX. Kerry.O'
| | - Corinna Keenmon
- Menninger Department of Psychiatry & Behavioral Sciences, Baylor College of Medicine, Houston, TX
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Messina A, Signorelli MS. COVID-19 associated psychosis. Ind Psychiatry J 2023; 32:215-221. [PMID: 38161482 PMCID: PMC10756597 DOI: 10.4103/ipj.ipj_27_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2023] [Revised: 02/11/2023] [Accepted: 02/13/2023] [Indexed: 01/03/2024] Open
Abstract
Since the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic was declared, cases of psychosis, delusions, hallucinations, and disorganized behavior have been reported worldwide, both during the acute phase of COVID-19 and after recovery. Given the recent emergence of COVID-19, data are still accumulating, and it is premature to correlate COVID-19 with psychotic disorders causally. However, SARS-CoV-2 has been shown to have the ability to cross the blood-brain barrier and penetrate neurons. This finding and the amount of published work on COVID-19 and psychotic disorders compel special attention to elucidate the link between SARS-CoV-2 and the occurrence of psychotic symptoms. In this article, several reviews and case reports that have analyzed the link between COVID-19 and psychotic disorders are reviewed. In light of the data that have emerged at the present time, study criteria were proposed to identify COVID-19-related psychosis.
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Affiliation(s)
- Antonino Messina
- Department of Clinical and Experimental Medicine, Institute of Psychiatry, University of Catania, Catania, Italy
| | - Maria Salvina Signorelli
- Department of Clinical and Experimental Medicine, Institute of Psychiatry, University of Catania, Catania, Italy
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8
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McAlpine LS, Lifland B, Check JR, Angarita GA, Ngo TT, Chen P, Dandekar R, Alvarenga BD, Browne WD, Pleasure SJ, Wilson MR, Spudich SS, Farhadian SF, Bartley CM. Anti-SARS-CoV-2 and Autoantibody Profiling of a COVID-19 Patient With Subacute Psychosis Who Remitted After Treatment With Intravenous Immunoglobulin. Biol Psychiatry 2023; 93:e25-e29. [PMID: 36481066 PMCID: PMC9722219 DOI: 10.1016/j.biopsych.2022.09.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/06/2022] [Accepted: 09/07/2022] [Indexed: 12/12/2022]
Affiliation(s)
- Lindsay S McAlpine
- Department of Neurology, Yale University School of Medicine, New Haven, Connecticut
| | - Brooke Lifland
- Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut
| | - Joseph R Check
- Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut
| | - Gustavo A Angarita
- Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut
| | - Thomas T Ngo
- Weill Institute for Neurosciences, University of California, San Francisco, California; Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, California
| | - Peixi Chen
- Weill Institute for Neurosciences, University of California, San Francisco, California; Department of Neurology, University of California, San Francisco, California
| | - Ravi Dandekar
- Weill Institute for Neurosciences, University of California, San Francisco, California; Department of Neurology, University of California, San Francisco, California
| | - Bonny D Alvarenga
- Weill Institute for Neurosciences, University of California, San Francisco, California; Department of Neurology, University of California, San Francisco, California
| | - Weston D Browne
- Weill Institute for Neurosciences, University of California, San Francisco, California; Department of Neurology, University of California, San Francisco, California
| | - Samuel J Pleasure
- Weill Institute for Neurosciences, University of California, San Francisco, California; Department of Neurology, University of California, San Francisco, California
| | - Michael R Wilson
- Weill Institute for Neurosciences, University of California, San Francisco, California; Department of Neurology, University of California, San Francisco, California
| | - Serena S Spudich
- Department of Neurology, Yale University School of Medicine, New Haven, Connecticut
| | - Shelli F Farhadian
- Department of Internal Medicine, Section of Infectious Diseases, Yale School of Medicine, New Haven, Connecticut
| | - Christopher M Bartley
- Weill Institute for Neurosciences, University of California, San Francisco, California; Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, California.
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Maglia M, Signorelli MS, Petralia A, Verduzzo I, Carmen C, Rodolico A, Di Piazza J, Caponnetto P. A Clinical Psychological View about Delusional Characterizations in Subjects with Schizophrenia Spectrum Disorder during the COVID-19 Period. J Clin Med 2023; 12:jcm12072698. [PMID: 37048782 PMCID: PMC10094991 DOI: 10.3390/jcm12072698] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2023] [Revised: 03/20/2023] [Accepted: 03/30/2023] [Indexed: 04/14/2023] Open
Abstract
(Background) The period experienced during the COVID-19 virus and the respective social regulations associated with it caused enormous psychosocial stress. (Objective) The objective of the present work was to observe whether the lived period induced a change in delusional characterizations in subjects with schizophrenia spectrum disorder. (Methods) A systematic literature review was conducted following the PRISMA 2020 guidelines for systematic reviews of the PRISMA GROUP. The literature search was conducted from November 2021 to May 2022, using various scientific platforms including PubMed. (Results) A total of 865 articles were found, from which 176 duplicates were removed. The remaining articles were reviewed by reading the titles and abstracts; fourteen were included. (Conclusions) During this research, it was possible to confirm the initial thesis, namely that delirium absorbs external reality by being modified by it. It was observed that the speed of absorption is estimated to be directly proportional to the speed of the modification of social reality and to the impact that the latter has on the subject's private sphere. Moreover, the situation of radical change represented a condition of abnormal psychosocial stress, which led to an increase in diagnoses of schizophrenia spectrum disorders and, specifically, a weighty increase in diagnoses of brief psychotic disorder (BDP). In the coming years, it is estimated that there will be an increase in diagnoses of schizophrenia spectrum disorder caused by both environmental and biological factors.
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Affiliation(s)
- Marilena Maglia
- Department of Educational Sciences, Section of Psychology, University of Catania, 95121 Catania, Italy
- Center of Excellence for the Acceleration of Harm Reduction (COEHAR), University of Catania, 95121 Catania, Italy
| | | | - Antonino Petralia
- Department of Clinical and Experimental Medicine, University of Catania, 95121 Catania, Italy
| | - Idria Verduzzo
- Department of Educational Sciences, Section of Psychology, University of Catania, 95121 Catania, Italy
| | - Concerto Carmen
- Department of Clinical and Experimental Medicine, University of Catania, 95121 Catania, Italy
| | - Alessandro Rodolico
- Department of Clinical and Experimental Medicine, University of Catania, 95121 Catania, Italy
| | - Jennifer Di Piazza
- Hunter Bellevue School of Nursing, Hunter College, City University of New York, New York, NY 10065, USA
| | - Pasquale Caponnetto
- Department of Educational Sciences, Section of Psychology, University of Catania, 95121 Catania, Italy
- Center of Excellence for the Acceleration of Harm Reduction (COEHAR), University of Catania, 95121 Catania, Italy
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First episode psychosis during the Covid-19 pandemic in Milan, Italy: Diagnostic outcomes at 1-year follow-up. Psychiatry Res 2023; 321:115068. [PMID: 36724649 DOI: 10.1016/j.psychres.2023.115068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/17/2022] [Revised: 01/17/2023] [Accepted: 01/22/2023] [Indexed: 01/25/2023]
Abstract
An influence of the Covid-19 pandemic on First Episode Psychosis (FEP) has been hypothesized. We previously reported an increase of FEP during the early stages of the pandemic in Milan, Italy. Here we report a 1-year follow-up of the same cohort and comparison with a FEP cohort from 2019. The higher proportion of non-chronic psychoses observed during the pandemic (58.62% in 2020 vs 43,75% in 2019) should be confirmed in larger cohorts over a longer follow-up period.
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COVID-19-Associated Acute Psychotic Disorder-Longitudinal Case Report and Brief Review of Literature. MEDICINA (KAUNAS, LITHUANIA) 2023; 59:medicina59020408. [PMID: 36837609 PMCID: PMC9963865 DOI: 10.3390/medicina59020408] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/29/2023] [Revised: 02/15/2023] [Accepted: 02/18/2023] [Indexed: 02/22/2023]
Abstract
Even though since the beginning of the COVID-19 pandemic, the literature became more and more abundant on data and hypotheses about the various consequences on people's lives, more clarity needs to be added to the existing information. Besides the stressful experiences related to the COVID-19 pandemic, SARS-CoV-2 infection has been proven to impact brain functioning through direct and indirect pathogenic mechanisms. In this context, we report a case of a patient presenting with a first episode of psychosis following COVID-19. In our case, a 28-year-old male patient with no personal or family psychiatric history developed psychotic symptoms (delusions, hallucinations, and disorganized behaviour) that required antipsychotic treatment and inpatient hospitalization one week after he was discharged from the hospital after COVID-19. At the six-month and one-year follow-up, the patient was in remission without any psychotic signs or symptoms. A brief review of the literature is also provided. The case presented in this article outlines the possibility that the post-COVD-19 recovery period might be a crucial time for the onset of acute psychotic disorder, and therefore, routine psychiatric assessments should be carried out during all phases of the disease. A clearer picture of the impact of the COVID-19 pandemic on mental health will most likely be revealed in the future as many consequences need long-term evaluation.
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12
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New-Onset Hyperreligiosity, Demonic Hallucinations, and Apocalyptic Delusions following COVID-19 Infection. Case Rep Psychiatry 2023; 2023:9792099. [PMID: 36819980 PMCID: PMC9938787 DOI: 10.1155/2023/9792099] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2022] [Revised: 12/08/2022] [Accepted: 01/18/2023] [Indexed: 02/13/2023] Open
Abstract
Background Neuropsychiatric sequelae of COVID-19 have been documented, including delusions, hallucinations, agitation, and disorganized behavior. Although the mechanisms for these symptoms remain unclear, there has been an increasing body of literature suggesting a correlation between COVID-19 infection and psychosis. Here, we illustrate the case of a 34-year-old female with no previous psychiatric history who contracted COVID-19 and subsequently developed severe symptoms of psychosis. After presenting to the emergency department with one month of worsening mood, auditory hallucinations, intrusive thoughts, and hyperreligiosity, she was admitted to the inpatient psychiatric unit. The patient was treated with multiple antipsychotic medications and was discharged in stable condition with resolution of her auditory hallucinations; however, her delusions, hyperreligiosity, and negative psychotic symptoms persisted, resulting in a second inpatient psychiatric admission eight days after discharge, during which she again did not reach full remission. Objectives With this information, we hope to increase awareness of COVID-induced psychosis and further discuss the relationship between COVID-19 infection and neuropsychiatric symptoms. Conclusions Although there has been increasing research about the COVID-19 pandemic, there is much to be elucidated regarding the neuropsychiatric symptoms related to these infections. Similar to previous studies, our case describes a patient with no previous psychiatric history who developed severe psychotic symptoms after COVID-19 infection and was admitted to the inpatient psychiatric unit. These symptoms resulting from infection can be severe or debilitating for the patient. Therefore, physicians should be aware of these potential neuropsychiatric sequelae when treating patients with active COVID-19 infections, and treatment with antipsychotics or acute inpatient psychiatric admission should be considered.
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Soyka M. COVID-19-assoziierte Psychosen. DIE NEUROLOGIE & PSYCHIATRIE 2023; 24. [PMCID: PMC9889122 DOI: 10.1007/s15202-022-5587-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Affiliation(s)
- Michael Soyka
- Psychiatrische Universitätsklinik LMU München, Nußbaumstr. 7, 80336 München, Germany
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14
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Effect of psychotropics on the risk of COVID-19 in middle-aged and older adults. Eur Neuropsychopharmacol 2023; 66:67-77. [PMID: 36463771 PMCID: PMC9682054 DOI: 10.1016/j.euroneuro.2022.11.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Revised: 11/15/2022] [Accepted: 11/17/2022] [Indexed: 11/25/2022]
Abstract
Older adults have been markedly impacted by the coronavirus disease 19 (COVID-19) pandemic, and many reports have cited concerns regarding potential psychiatric sequelae of coronavirus disease (COVID-19), but the actual effects of psychotropics on the COVID-19 are unclear. In this study, multivariate logistic regression was used to evaluate associations between the prescription of psychotropics and the risk of SARS-CoV-2 infection, and COVID-19-related death among the participants who were tested for severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) before October 18, 2021, in UK Biobank. The psychotropics included 18 types of medications. Among 168,173 participants who underwent testing for SARS-CoV-2 RNA, 30,577 (18.2%) were positive, and 14,284 (8.5%) participants used psychotropics. Among 30,577 participants who were infected with SARS-CoV-2, 1,181 (3.9%) were COVID-19-related deaths, and 2,542 (8.3%) participants used psychotropics. In multivariate logistic regression, psychotropics use was significantly associated with the risk of SARS-CoV-2 infection (odds ratio [OR], 0.95; 95% confidence interval [CI], 0.88-0.98), and COVID-19-related death (OR, 0.78; 95% CI, 0.64-0.98). Interestingly, the use of diazepam was significantly associated with a 31% lower risk of SARS-CoV-2 infection (OR, 0.69; 95% CI, 0.53-0.88). The use of sertraline was significantly associated with a 89% lower risk of COVID-19-related death (OR, 0.11; 95% CI, 0.02-0.39). In conclusion, our findings suggested that the use of psychotropics was associated with a lower risk of SARS-CoV-2 infection and COVID-19-related deaths.
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15
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Casanovas F, Trabsa A, Bergé D, Sánchez-Gistau V, Moreno I, Sanchez J, Montalvo I, Tost M, Labad J, Pérez-Solà V, Mané A. Incidence rate and distinctive characteristics of first episode psychosis during the COVID-19 pandemic: a multicenter observational study. Sci Rep 2022; 12:22036. [PMID: 36543820 PMCID: PMC9772195 DOI: 10.1038/s41598-022-26297-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2022] [Accepted: 12/13/2022] [Indexed: 12/24/2022] Open
Abstract
The COVID-19 pandemic has affected the mental health of people around the world. However, its impact on first-episode psychosis (FEP) remains unclear. The aim of this study was to determine the incidence rate (IR) and the clinical and sociodemographic characteristics of patients who developed FEP during the nine-month period following the COVID-19 outbreak in Spain and to compare these data to the corresponding period in the previous year. We included all patients (n = 220) treated for the first time during these two time periods at three FEP programs in Spain. The IR was 0.42/100,000 person-years during the pandemic vs. 0.54/100,000 in the prior year (p = 0.057). Compared to prior year, women accounted for a significantly higher proportion of FEP patients (46.3% vs. 28%; p = 0.005) during the COVID-19 period. This association was significant on the logistic regression analysis (odds ratio, female: 2.12 [confidence interval 1.17-3.82]; p = 0.014). These data reveal a non-significant trend towards a lower incidence of FEP during the pandemic period. Female sex was associated with a greater risk of developing FEP during the pandemic period, perhaps due to differences between males and females in the susceptibility and expression of psychosis. The findings of this study contribute to a better understanding of stress-related disorders.
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Affiliation(s)
- Francesc Casanovas
- Institut de Neuropsiquiatria i Adiccions (INAD), Parc de Salut Mar, Barcelona, Spain
| | - Amira Trabsa
- Institut de Neuropsiquiatria i Adiccions (INAD), Parc de Salut Mar, Barcelona, Spain
- Hospital del Mar Medical Research Institute (IMIM), Barcelona, Spain
| | - Daniel Bergé
- Institut de Neuropsiquiatria i Adiccions (INAD), Parc de Salut Mar, Barcelona, Spain
- Hospital del Mar Medical Research Institute (IMIM), Barcelona, Spain
- Department of Medicine and Life Sciences (MELIS), Universitat Pompeu Fabra, Barcelona, Spain
- Centro de Investigación Biomédica en Red, Área de Salud Mental (CIBERSAM), Madrid, Spain
| | - Vanessa Sánchez-Gistau
- Centro de Investigación Biomédica en Red, Área de Salud Mental (CIBERSAM), Madrid, Spain
- Hospital Universitari Institut Pere Mata, IISPV, Universitat Rovira i Virgili, Reus, Spain
| | - Irene Moreno
- Centro de Investigación Biomédica en Red, Área de Salud Mental (CIBERSAM), Madrid, Spain
- Hospital Universitari Institut Pere Mata, IISPV, Universitat Rovira i Virgili, Reus, Spain
| | - Julia Sanchez
- Centro de Investigación Biomédica en Red, Área de Salud Mental (CIBERSAM), Madrid, Spain
- Hospital Universitari Institut Pere Mata, IISPV, Universitat Rovira i Virgili, Reus, Spain
| | - Itziar Montalvo
- Centro de Investigación Biomédica en Red, Área de Salud Mental (CIBERSAM), Madrid, Spain
- Department of Mental Health, Hospital Universitari Parc Taulí, I3PT, Sabadell, Spain
| | - Meritxell Tost
- Centro de Investigación Biomédica en Red, Área de Salud Mental (CIBERSAM), Madrid, Spain
- Department of Mental Health, Hospital Universitari Parc Taulí, I3PT, Sabadell, Spain
| | - Javier Labad
- Centro de Investigación Biomédica en Red, Área de Salud Mental (CIBERSAM), Madrid, Spain
- Department of Mental Health, Hospital Universitari Parc Taulí, I3PT, Sabadell, Spain
- Department of Mental Health, Consorci Sanitari del Maresme, Mataró, Spain
| | - Victor Pérez-Solà
- Institut de Neuropsiquiatria i Adiccions (INAD), Parc de Salut Mar, Barcelona, Spain
- Hospital del Mar Medical Research Institute (IMIM), Barcelona, Spain
- Department of Medicine and Life Sciences (MELIS), Universitat Pompeu Fabra, Barcelona, Spain
- Centro de Investigación Biomédica en Red, Área de Salud Mental (CIBERSAM), Madrid, Spain
| | - Anna Mané
- Institut de Neuropsiquiatria i Adiccions (INAD), Parc de Salut Mar, Barcelona, Spain.
- Hospital del Mar Medical Research Institute (IMIM), Barcelona, Spain.
- Department of Medicine and Life Sciences (MELIS), Universitat Pompeu Fabra, Barcelona, Spain.
- Centro de Investigación Biomédica en Red, Área de Salud Mental (CIBERSAM), Madrid, Spain.
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16
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First-episode psychotic disorders in the wake of the COVID-19 pandemic: a descriptive review of casereports. Acta Neuropsychiatr 2022; 34:289-310. [PMID: 35357298 DOI: 10.1017/neu.2022.11] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
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.
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17
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Fekih-Romdhane F, Pandi-Perumal SR, Conus P, Krebs MO, Cheour M, Seeman MV, Jahrami HA. Prevalence and risk factors of self-reported psychotic experiences among high school and college students: A systematic review, meta-analysis, and meta-regression. Acta Psychiatr Scand 2022; 146:492-514. [PMID: 36000793 DOI: 10.1111/acps.13494] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/19/2022] [Revised: 08/17/2022] [Accepted: 08/18/2022] [Indexed: 01/29/2023]
Abstract
BACKGROUND Adolescents are at high risk of incident psychopathology. Fleeting psychotic experiences (PEs) that emerge in young people in response to stress may be warning signs that are missed by research that fails to study stressed populations, such as late high school and college/university students. Our aim in this systematic review was to conduct a meta-analysis that estimates prevalence rates of PEs in students, and to assess whether these rates differ by gender, age, culture, and COVID-19 exposure. METHOD We searched nine electronic databases, from their inception until January 31, 2022 for relevant studies. We pooled the estimates using the DerSimonian-Laird technique and random-effects meta-analysis. Our main outcome was the prevalence of self-reported PEs in high school and college/university students. We subsequently analyzed our data by age, gender, population, country, culture, evaluation tool, and COVID-19 exposure. RESULTS Out of 486 studies retrieved, a total of 59 independent studies met inclusion criteria reporting 210' 024 students from 21 different countries. Nearly one in four students (23.31%; 95% CI 18.41%-29.05%), reported having experienced PEs (heterogeneity [Q = 22,698.23 (62), p = 0.001] τ2 = 1.4418 [1.0415-2.1391], τ = 1.2007 [1.0205-1.4626], I2 = 99.7%, H = 19.13 [18.59-19.69]). The 95% prediction intervals were 04.01%-68.85%. Subgroup analyses showed that the pooled prevalence differed significantly by population, culture, and COVID-19 exposure. CONCLUSION This meta-analysis revealed high prevalence rates of self-reported PEs among teen and young adult students, which may have significance for mental health screening in school settings. An important realization is that PEs may have very different mental health meaning in different cultures.
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Affiliation(s)
- Feten Fekih-Romdhane
- Tunis El Manar University, Faculty of Medicine of Tunis, Tunis, Tunisia
- The Tunisian Center of Early Intervention is Psychiatry, Department of psychiatry "Ibn Omrane", Razi Hospital, Manouba, Tunisia
| | - Seithikurippu R Pandi-Perumal
- Somnogen Canada Inc., Toronto, Canada
- Saveetha Medical College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, Tamil Nadu, India
| | - Philippe Conus
- Service of General Psychiatry, Treatment and Early Intervention in Psychosis Program (TIPP-Lausanne), Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Marie-Odile Krebs
- Inserm, Laboratoire de Physiopathologie des maladies Psychiatriques, UMR_S1266 Institut de Psychiatrie et Neurosciences de Paris, Université Paris Descartes, Paris, France
- Institut de Psychiatrie (CNRS GDR 3557), Paris, France
- Faculté de Médecine Paris Descartes, Service Hospitalo-Universitaire, Centre Hospitalier Sainte-Anne, Université Paris Descartes, Paris, France
| | - Majda Cheour
- Tunis El Manar University, Faculty of Medicine of Tunis, Tunis, Tunisia
- The Tunisian Center of Early Intervention is Psychiatry, Department of psychiatry "Ibn Omrane", Razi Hospital, Manouba, Tunisia
| | - Mary V Seeman
- Department of Psychiatry, University of Toronto, Canada
| | - Haitham A Jahrami
- Psychiatric Hospital, Ministry of Health, Manama, Bahrain
- Department of Psychiatry, College of Medicine and Medical Sciences, Arabian Gulf University, Manama, Bahrain
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18
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Wong RPY, George P. Covid-19, not your normal flu: A case report on Covid-19 psychosis and mania in a Malaysian hospital. MALAYSIAN FAMILY PHYSICIAN : THE OFFICIAL JOURNAL OF THE ACADEMY OF FAMILY PHYSICIANS OF MALAYSIA 2022; 17:144-148. [PMID: 36606171 PMCID: PMC9809429 DOI: 10.51866/cr1369] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/17/2023]
Abstract
Evidence suggests that acute severe coronavirus disease 2019 (COVID-19) may be associated with neuropsychiatric symptoms. This is a case report of a patient who had recently been infected with COVID-19 and had no history of psychiatric disorders presenting a few days after inpatient discharge from COVID-19 treatment with acute onset of psychosis and manic symptoms. This case illustrates the psychiatric presentation, possible causes, and management of post-COVID-19 psychosis.
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Affiliation(s)
- Rebecca Pei Ying Wong
- International Medical University (IMU) Jalan Rasah, Bukit Rasah, Seremban, Negeri Sembilan, Malaysia.
| | - Philip George
- MBBS(Mang), MMed(Psych), Department Of Psychiatry, International Medical University, Jalan Rasah, Bukit Rasah, Seremban, Negeri Sembilan, Malaysia
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19
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Jevoux C, Krymchantowski A, Silva-Neto RP, Cotrik EM, Nardi AE, Gomes JP, Krymchantowski AG. Psychosis and Bilateral Peripheral Facial Palsy Associated With COVID-19. J Med Cases 2022; 13:525-529. [PMID: 36506757 PMCID: PMC9728148 DOI: 10.14740/jmc3984] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2022] [Accepted: 10/27/2022] [Indexed: 11/28/2022] Open
Abstract
Neuropsychiatric disorders associated with coronavirus infections emerged with the coronavirus disease 2019 (COVID-19) pandemic. We describe the clinical, laboratory and radiological features of a patient who presented, after recent COVID-19, two rare neuropsychiatric manifestations: a brief psychotic break followed by severe bilateral peripheral facial palsy.
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Affiliation(s)
- Carla Jevoux
- Department of Neurology, Headache Center of Rio, Rio de Janeiro, Brazil
| | | | - Raimundo Pereira Silva-Neto
- Department of Neurology, Federal University of the Parnaiba Delta, Parnaiba, Brazil,Corresponding Author: Raimundo Silva-Neto, Federal University of Delta of Parnaiba, Avenida Sao Sebastiao, 2819/Fatima, Parnaiba, PI 64001-020, Brazil.
| | - Ervin Michelstaedter Cotrik
- Department of Psychiatry, Centro de Psicologia Aplicacao e Formacao, Rio de Janeiro, Brazil,Universidade de Santiago de Compostela, Spain
| | - Antonio Egidio Nardi
- Institute of Psychiatry, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Joao Pedro Gomes
- Department of Neurology, Hospital Geral de Bom Sucesso, Rio de Janeiro, Brazil
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20
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Fiks G, Duarte JM, Lisi GR, Garro M, Appiani F. Psychotic Symptoms After SARS-CoV-2 Infection. J Nerv Ment Dis 2022; 210:724-726. [PMID: 36037326 PMCID: PMC9426316 DOI: 10.1097/nmd.0000000000001488] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
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.
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Affiliation(s)
- Gerardo Fiks
- Mental Health Service, Hospital Miguel Capredoni Bolívar
| | - Juan Manuel Duarte
- Neuropsychopharmacology Division, Psychiatry and Mental Health Department, Hospital de Clínicas José de San Martín, Facultad de Medicina, Universidad de Buenos Aires, Buenos Aires, Argentina
| | - Gisela Roxana Lisi
- Neuropsychopharmacology Division, Psychiatry and Mental Health Department, Hospital de Clínicas José de San Martín, Facultad de Medicina, Universidad de Buenos Aires, Buenos Aires, Argentina
| | - Marcelo Garro
- Neuropsychopharmacology Division, Psychiatry and Mental Health Department, Hospital de Clínicas José de San Martín, Facultad de Medicina, Universidad de Buenos Aires, Buenos Aires, Argentina
| | - Francisco Appiani
- Neuropsychopharmacology Division, Psychiatry and Mental Health Department, Hospital de Clínicas José de San Martín, Facultad de Medicina, Universidad de Buenos Aires, Buenos Aires, Argentina
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21
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Chaudhary AMD, Musavi NB, Saboor S, Javed S, Khan S, Naveed S. Psychosis during the COVID-19 pandemic: A systematic review of case reports and case series. J Psychiatr Res 2022; 153:37-55. [PMID: 35797814 PMCID: PMC9248300 DOI: 10.1016/j.jpsychires.2022.06.041] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/05/2021] [Revised: 06/15/2022] [Accepted: 06/24/2022] [Indexed: 02/07/2023]
Abstract
BACKGROUND Preliminary data suggest that patients with COVID-19 may experience psychiatric symptoms, including psychosis. We systematically reviewed the literature to evaluate the concurrence of new-onset psychosis or exacerbation of clinically stable psychosis through case reports and case series. METHODS Six databases were searched, followed by an electronic and manual search of the relevant articles. Studies were identified using predetermined eligibility criteria. We evaluated the demographic characteristics, clinical history, course of illness, management, and prognosis of the patients in these studies. RESULTS Case reports and case series, altogether consisting of 57 unique cases were included. The mean patient age for onset of psychotic symptoms was 43.4 years for men and 40.3 years for women. About 69% of patients had no prior history of psychiatric disorders. Most patients had mild COVID-19-related symptoms, with only 15 (26.3%) presenting with moderate to severe COVID-19-related disease and complications. The most commonly reported psychotic symptoms were delusions and hallucinations. Patients with psychotic symptoms were treated with antipsychotics, benzodiazepines, valproic acid, and electroconvulsive treatment. In 36 cases, psychotic symptoms resolved completely or improved significantly. Ten cases had partial improvement with residual psychotic symptoms, and one patient died due to cardiac arrest. CONCLUSION Most patients responded to a low-to-moderate dose of antipsychotics with a quick recovery. However, the residual psychiatric symptoms highlight the need for careful monitoring and longer follow-up. Clinicians should be mindful of the occurrence of psychosis due to COVID-19 infection in a subset of COVID-19 patients that can be misdiagnosed as a psychotic disorder alone.
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Affiliation(s)
- Amna Mohyud Din Chaudhary
- Department of Psychiatry, Case Western Reserve University/ University Hospitals, Cleveland, OH, USA.
| | | | - Sundas Saboor
- Harvard T.H. Chan School of Public Health, Boston, MA, USA.
| | - Sana Javed
- Nishtar Medical University, Multan, Pakistan.
| | - Sonia Khan
- Frontier Medical and Dental College, Abbottabad, Pakistan.
| | - Sadiq Naveed
- Clinical Lead - Child and Adolescent Inpatient Units, Institute of Living, Hartford, CT, USA; Frank H. Netter M.D. School of Medicine at Quinnipiac University, North Haven, CT, USA; University of Connecticut School of Medicine, CT, USA.
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22
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Vasile CI, Vasile MC, Zlati ML, Herbei EE, Lepădatu L, Munteanu C, Nechifor A, Tatu AL. Post COVID-19 Infection Psychosis: Could SARS-CoV-2 Virus Infection Be a Neuropsychiatric Condition That Triggers Psychotic Disorders? - A Case-Based Short Review. Infect Drug Resist 2022; 15:4697-4705. [PMID: 36034176 PMCID: PMC9416515 DOI: 10.2147/idr.s373578] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2022] [Accepted: 08/01/2022] [Indexed: 12/15/2022] Open
Abstract
Corona virus (COVID-19) is an epidemy of respiratory disease caused by a novel corona virus and it was declared by the World Health Organization (WHO) to be a global health pandemic emergency. Due to the neuropsychiatric manifestation of Covid-19 that have been associated with psychotic disorders, in this paper we choose to present a case from “Elena Doamna” Psychiatric Hospital from Galati, Romania and to correlate it with other cases from literature in a mini review presentation. In our paper, we present the case of a patient of 44-year-old men, with no past psychiatric history whose behavior included psycho-motor agitation, perception and thinking disorders, disorganized behaviour, attempted suicide by stabbing. The last perspectives from the two years of pandemic together with psychiatric disease linked the virus infections with psychosis to the main concern that Covid-19 could determine psychiatric disorders. There were also presented same literature studies of patients with no personal pathological history in the psychiatric field which developed psychiatric disorders after COVID-19 infection. SARS-CoV-2 has a psychological impact on the mental health status of the worldwide and, especially when it is associated with psychotic symptoms and can affect the quality-of-life. In some cases, the virus affected the brain and as a result, the psychosis symptoms could be an emerging phenomenon associated with the corona virus. Based on the DSM V and ICD-10 criteria, the diagnosis was of acute psychiatric disorders with symptoms of schizophrenia (F23.1). The case report and review reliefs that there is a causal link between the SARS CoV-2 infection and mental disorders, which is currently being investigated.
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Affiliation(s)
- Claudiu Ionut Vasile
- Clinical Medical Department, Faculty of Medicine and Pharmacy, "Dunărea de Jos" University, Galați, România.,"Elena Doamna" Clinical Hospital of Psychiatry, Galaţi, România
| | - Mihaela Camelia Vasile
- Clinical Medical Department, Faculty of Medicine and Pharmacy, "Dunărea de Jos" University, Galați, România.,Infectious Diseases Department, Clinical Hospital of Infectious Diseases "Sf. Cuvioasa Parascheva", Galați, România
| | - Monica Laura Zlati
- Business Administration Department, Dunărea de Jos University, Galați, România.,Accounting, Audit and Finance Department, Stefan Cel Mare University, Suceava, România
| | - Elena Emanuela Herbei
- Department of Materials and Environmental Engineering, Centre of Nanostructures and Functional Materials, Faculty of Engineering, University "Dunărea de Jos", Galaţi, România
| | - Lorena Lepădatu
- "Sf Ap Andrei" Emergency County Clinical Hospital, Galați, România
| | | | - Alexandru Nechifor
- Research Center in the Field of Medical and Pharmaceutical Sciences, ReFORM-UDJ, Galați, România
| | - Alin Laurențiu Tatu
- Research Center in the Field of Medical and Pharmaceutical Sciences, ReFORM-UDJ, Galați, România.,Dermatology Department, "Sf Cuv Parascheva" Clinical Hospital of Infectious Diseases, Galați, România.,Multidisciplinary Integrated Center of Dermatological Interface Research MIC DIR, Dunărea de Jos" University, Galați, România
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23
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Zurlo MC, Vallone F, Cattaneo Della Volta MF. Perceived Past and Current COVID-19-Stressors, Coping Strategies and Psychological Health among University Students: A Mediated-Moderated Model. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:10443. [PMID: 36012077 PMCID: PMC9408686 DOI: 10.3390/ijerph191610443] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/21/2022] [Revised: 08/15/2022] [Accepted: 08/18/2022] [Indexed: 06/12/2023]
Abstract
The COVID-19-pandemic entailed abrupt/long-lasting changes in university students' lives, resulting in growing stress and stress-related outcomes. Although nowadays the pre-pandemic-life is gradually re-establishing, past-COVID-19-stressful experiences and strategies adopted to adjust to this condition may significantly impact students' current experiences. Therefore, the development of research exploring the complex interplay between perceived past/present COVID-19-related experiences, coping strategies, and psychological health currently reported by students is needed. This study simultaneously tests the associations between Past-COVID-19-stressors and Current-COVID-19-stressors as moderated by Coping Strategies and the associations between Past-COVID-19-stressors and Psychological Symptoms as mediated by Current-COVID-19-stressors. A mediated-moderated model was tested on 355 university students. COVID-19-Student-Stress-Questionnaire (CSSQ) was used to assess COVID-19-stressors. Two CSSQ-versions were used, one of which was adjusted to assess Past-COVID-19-stressors recalled from previous restrictive pandemic phases. Coping-Orientation-to-Problem-Experienced-New-Italian-Version and Symptom-Checklist-90-Revised were used to assess, respectively, Coping Strategies and Psychological Symptoms. Findings confirmed the hypothesized Mediated-Moderated Model. The effects of Past-COVID-19-stressors on Current-COVID-19-stressors were moderated by Coping Strategies, and the effects of Past-COVID-19-stressors on Psychological Symptoms were mediated by Current-COVID-19-stressors. Unique psychopathological risk profiles deriving from the interplay between specific past/present stressors and coping strategies were found. Researchers and clinicians can use these findings to develop updated research and timely evidence-based interventions fostering students' adjustment in the current period. Future research should further explore the impact of the complex interplay between perceived past/present COVID-19-related experiences and individual characteristics on psychological health conditions reported by people in the aftermath of the COVID-19 pandemic.
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Affiliation(s)
- Maria Clelia Zurlo
- Dynamic Psychology Laboratory, Department of Political Sciences, University of Naples Federico II, 80138 Napoli, Italy
| | - Federica Vallone
- Dynamic Psychology Laboratory, Department of Political Sciences, University of Naples Federico II, 80138 Napoli, Italy
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24
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Parsa S, Pliszka A, Portley R. COVID-19-Induced Aggression and Hypersexuality in an Adolescent Patient. J Acad Consult Liaison Psychiatry 2022; 63:406-407. [PMID: 35868835 PMCID: PMC9296144 DOI: 10.1016/j.jaclp.2022.03.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/29/2021] [Revised: 03/04/2022] [Accepted: 03/12/2022] [Indexed: 11/25/2022]
Affiliation(s)
- Shyon Parsa
- Department of Psychiatry, UT Southwestern Medical Center, Dallas, TX
| | - Andrew Pliszka
- Department of Psychiatry, UT Southwestern Medical Center, Dallas, TX
| | - Robert Portley
- Department of Psychiatry, UT Southwestern Medical Center, Dallas, TX.
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25
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Kaur M, Farooq B, Nagarajah A, Kotak A. A curious case of COVID-19: A novel cause of psychosis. Australas Psychiatry 2022; 30:410-411. [PMID: 35332796 PMCID: PMC8960745 DOI: 10.1177/10398562221079278] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Idehen JB, Kazi U, Quainoo-Acquah JA, Sperry B, Zaman I, Goodarzi A, Chida S, Nalbandyan L, Hernandez EW, Sharma V, Mulume R, Okoh OM, Okonkwo I, Harrison H, Soetan OT, Iqbal R, Lesniowska MK, Baloch AH, Jolayemi A. On Patterns of Neuropsychiatric Symptoms in Patients With COVID-19: A Systematic Review of Case Reports. Cureus 2022; 14:e25004. [PMID: 35712343 PMCID: PMC9194523 DOI: 10.7759/cureus.25004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/14/2022] [Indexed: 01/24/2023] Open
Abstract
Coronavirus disease 2019 (COVID-19) has various neuropsychiatric manifestations, including psychotic, mood, anxiety disorders, trauma-related disorders, and cognitive disorders, such as delirium. Although the psychosocial effects of the COVID-19 pandemic contribute to an increase in psychiatric comorbidities, the COVID-19 virus is also an independent risk factor. Previous studies have revealed that the virus can invade the neural tissue, which causes an imbalance of neurotransmitters that cause neuropsychiatric symptoms. The aim of this article is to conduct a systematic review to determine the patterns of neuropsychiatric manifestations of COVID-19, discussing the frequency and its impact on pre-existing psychiatric disorders. Thirty-nine case reports were collected and analyzed for a systematic review. They were full-text, peer-reviewed journal publications from November 2020 to February 2021. Fifty-three patients were included in our study. The most frequent symptom was abnormal/bizarre behavior (50.9%), followed by agitation/aggression (49.1%), and the third most common was altered mental status and delirium (47.2%). Only 48% of our patients had a pre-existing psychiatric disorder, including three not formally diagnosed but displayed psychiatric symptoms prior to the COVID-19 infection. Findings suggest a positive correlation of new-onset psychiatric symptoms with the SARS-CoV-2 virus. However, the exact pathophysiology of the virus itself causing neuropsychiatric manifestations needs to be investigated further.
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27
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Neurological and Psychiatric Symptoms of COVID-19: A Narrative Review. PSYCHIATRY INTERNATIONAL 2022. [DOI: 10.3390/psychiatryint3020013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Recently dubbed Long COVID or Long-Haul COVID, those recovering from the initial COVID-19 infection may maintain clinical signs for longer than two or more weeks following the initial onset of the infection. The virus can gain entry into the CNS through axonal transport mediated through the olfactory nerve or hematogenous spread and can also cross the blood–brain barrier to access the temporal lobe and the brainstem. The neurologic and neuropsychiatric symptoms associated with COVID-19 patients are becoming a highly studied area due to the increased frequency of reported cases. Multiple hospital case series and observational studies have found a headache to be a common symptom among patients who are symptomatic with the SARS-CoV-2 virus. The headache described by many of these patients is similar to new daily persistent headache (NDPH). NDPH potentially develops in response to pro-inflammatory cytokines during a persistent systemic or CNS inflammation, mostly due to the initial infection. The treatments investigated were high-dose steroids, tetracycline derivatives, onabotulinum toxin type A, and long-term multidrug regimens. Among the identified symptoms of post-COVID-19 viral illness, fatigue appears to be the most ubiquitous. High-dose vitamin C is currently a suggested therapy proposed for its antioxidant, anti-inflammatory, and immunomodulatory properties. The mental health consequences of this diagnosis are being identified among large portions of COVID-19 survivors. Among these consequences, cases of major depressive disorder (MDD) and anxiety are being reported and closely examined. The aim of this narrative review is to highlight the neurological and psychiatric symptoms that have been associated with Long-Haul COVID and their possible treatments.
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Llorca-Bofí V, Buil-Reiné E, Adrados-Pérez M, del Agua E, Palacios-Garrán R. PSYCHOTIC DEPRESSION IN HEALTHCARE WORKERS DURING THE COVID-19 HEALTHCARE CRISIS: A CASE SERIES. ACTAS ESPANOLAS DE PSIQUIATRIA 2022; 50:163-166. [PMID: 35643975 PMCID: PMC10803851] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 05/01/2022] [Accepted: 05/01/2022] [Indexed: 06/15/2023]
Abstract
After the initial phases of the COVID-19 pandemic, new waves have occurred that have chronicled the epidemiological situation. This could especially affect the Mental Health of healthcare professionals with the appearance of serious conditions such as psychotic depression. The objective of this article is to describe a series of cases of psychotic depression in health professionals during the chronic phase of the sanitary crisis.
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Affiliation(s)
| | | | | | - Enrique del Agua
- Psychiatry Service, Santa María University Hospital, Lleida, Spain
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Psychotic disorders amid the COVID-19 pandemic: a consideration of risks and impacts. Curr Opin Psychiatry 2022; 35:140-145. [PMID: 35125397 DOI: 10.1097/yco.0000000000000784] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE OF REVIEW The COVID-19 pandemic has had a severe and widespread global impact but particularly for those with psychosis. This review summarizes recent evidence on the relationship between the COVID-19 pandemic and psychotic disorders, highlighting the risks faced by these individuals including the negative impacts on treatment services, complications from contracting COVID-19, and the acceptability of digital interventions. RECENT FINDINGS Mortality, morbidity, and infection outcomes are among the worst for individuals with psychotic disorders. Presentation rates for psychotic disorders are elevated at emergency departments compared with before the COVID-19 pandemic; demand for inpatient services has increased, and there have been complications in access because of pandemic restrictions. COVID-19 related stressors have led to the exacerbation and incidence of psychotic symptoms among individuals with and without preexisting psychotic diagnoses. Digital interventions may be an acceptable method for maintaining patient contact and treatment during extended isolation. SUMMARY More data is needed on the longitudinal trajectory for psychotic symptoms post-COVID-19 infection and pandemic restrictions to better support individuals with psychotic disorders. Development of a long-term pandemic management plan is needed to monitor and support psychiatric health across the population.
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Önder M, Dufeutrelle A, Benali F, Gourevitch R, Pham-Scottez A. À propos d’un premier épisode délirant aigu à 57 ans, concomitant de la COVID-19. Encephale 2022; 49:321-322. [PMID: 35973842 PMCID: PMC9375144 DOI: 10.1016/j.encep.2022.04.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2021] [Revised: 04/06/2022] [Accepted: 04/07/2022] [Indexed: 11/28/2022]
Affiliation(s)
- M Önder
- CPOA, GHU Paris psychiatrie et neurosciences, site Sainte-Anne, Paris, France.
| | - A Dufeutrelle
- CMME, GHU Paris psychiatrie et neurosciences, site Sainte-Anne, Paris, France
| | - F Benali
- Secteur 93G12, EPS Ville-Evrard, 93330 Neuilly-Sur-Marne, France
| | - R Gourevitch
- CPOA, GHU Paris psychiatrie et neurosciences, site Sainte-Anne, Paris, France
| | - A Pham-Scottez
- CPOA, GHU Paris psychiatrie et neurosciences, site Sainte-Anne, Paris, France
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31
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Meeder R, Adhikari S, Sierra-Cintron K, Aedma K. New-Onset Mania and Psychosis in Adolescents in the Context of COVID-19 Infection. Cureus 2022; 14:e24322. [PMID: 35607548 PMCID: PMC9123385 DOI: 10.7759/cureus.24322] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/19/2022] [Indexed: 12/12/2022] Open
Abstract
There is a growing body of evidence that coronavirus disease 2019 (COVID-19) is linked with neuropsychiatric complications such as psychosis and delirium in adults. Much less is known about the neuropsychiatric manifestations of this virus in the child and adolescent population. This case series discusses two unique adolescent patients who presented with new-onset mania and psychosis in the context of an otherwise asymptomatic COVID-19 infection, which raises several questions about whether and how the virus precipitates mania and psychosis, whether these symptoms are transient or predisposes patients to a chronic psychiatric disorder, and confounding variables that may have contributed to the symptoms. These questions can then be points for future research and longitudinal follow-up that can better improve our knowledge about the relationship between this complicated virus and how it affects children psychiatrically.
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Affiliation(s)
- Ryan Meeder
- Psychiatry, UnityPoint Health - Methodist Hospital/University of Illinois College of Medicine, Peoria, USA
| | - Samicchya Adhikari
- Psychiatry, UnityPoint Health - Methodist Hospital/University of Illinois College of Medicine, Peoria, USA
| | - Kiela Sierra-Cintron
- Psychiatry, UnityPoint Health - Methodist Hospital/University of Illinois College of Medicine, Peoria, USA
| | - Kapil Aedma
- Psychiatry, UnityPoint Health - Methodist Hospital/University of Illinois College of Medicine, Peoria, USA
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32
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Siembida J, Mohammed S, Chishty M, Leontieva L. Diagnostic Difficulties and Treatment Challenges of a Young Patient With Severe Acute Psychosis and Complete Recovery. Cureus 2022; 14:e23744. [PMID: 35509728 PMCID: PMC9057638 DOI: 10.7759/cureus.23744] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/30/2022] [Indexed: 11/18/2022] Open
Abstract
First break psychosis in young adults is sometimes presented as a dichotomous model of organic or substance-induced etiology or a primary psychiatric disorder on the schizophrenia spectrum and related disorders. In this case of a young adult with a typical age of onset for psychotic symptoms also presenting with cannabis use, excessive vaping, history of COVID-19 illness, pineal cyst, and extreme elevation of blood pressure, the diagnostic certainty decreases. Increased risk of progression to schizophrenia in individuals with cannabis use disorder and genetic loading has been extensively reported in the literature. Clinicians may face significant diagnostic and treatment challenges when managing a patient with severe psychotic symptoms. For the clinicians acutely managing such patients facing these exact questions of unknown certainty in progression to full-blown schizophrenia, we highlight a case of severe acute psychosis and complete recovery on a first-generation antipsychotic and mood stabilizer.
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Łoś K, Kulikowska J, Waszkiewicz N. The Impact of the COVID-19 Virus Pandemic on the Incidence of First Psychotic Spectrum Disorders. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:3781. [PMID: 35409462 PMCID: PMC8997854 DOI: 10.3390/ijerph19073781] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/25/2022] [Revised: 02/20/2022] [Accepted: 03/09/2022] [Indexed: 02/05/2023]
Abstract
The effects of COVID-19 on the human body are not yet understood enough. Medical history provides information on cases of psychiatric symptoms during viral infections in the 20th century, such as the influenza pandemic. Currently, it is observed that there is an increasing number of new psychiatric disorders in previously healthy individuals. In addition, because of the decreased amount of reporting to health care providers, including psychiatrists, many physicians suggest that the number of neuropsychiatric disorders may be underestimated. In this paper, we review available studies on the occurrence of first-time psychotic spectrum disorder (PSD) in individuals related to SARS-CoV-2 infection. The reviewed studies suggest that first-time psychotic disorder in COVID-19 patients is statistically significantly more frequent compared to influenza, as well as to other respiratory infections. The emergence of new PSDs is explained by direct neurotropism of the virus on the one hand and by immunological mechanisms on the other. The main conclusions of this review should be treated with caution, and future research on this topic is needed. The authors recognize the particular need to develop standardized laboratory panels that include inflammatory markers (IL-6, TNF-α), cerebrospinal fluid (CSF) testing, and SARS-CoV-2 antibody assays to entirely understand the etiology of neuropsychiatric complications of SARS-CoV-2 infections and the pandemic itself. In addition, public health efforts are required to promote mental health, especially during COVID-19.
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Affiliation(s)
- Kacper Łoś
- Department of Psychiatry, Medical University of Bialystok, 15-089 Bialystok, Poland;
| | - Joanna Kulikowska
- Department of Neurology, Medical University of Bialystok, 15-089 Bialystok, Poland;
| | - Napoleon Waszkiewicz
- Department of Psychiatry, Medical University of Bialystok, 15-089 Bialystok, Poland;
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34
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COVID-19 Induced Brief Psychotic Disorder: A Case Report and Review of Literature. Case Rep Psychiatry 2022; 2022:9405630. [PMID: 35036019 PMCID: PMC8754596 DOI: 10.1155/2022/9405630] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2021] [Accepted: 12/13/2021] [Indexed: 12/25/2022] Open
Abstract
The COVID-19 pandemic has significantly impacted people around the world, with asymptomatic infection to severe diseases and death. There is an increasing incidence of mental health problems in patients diagnosed with COVID-19. There are some studies that discuss possible mechanisms responsible for psychotic disorders due to coronavirus as well as risk factors for developing psychosis in patients infected with the virus. We report the case and a review of the literature in a 29-year-old female with no past psychiatric history who was diagnosed with a brief psychotic disorder following infection with COVID-19.
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35
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Theoharides TC. Could SARS-CoV-2 Spike Protein Be Responsible for Long-COVID Syndrome? Mol Neurobiol 2022; 59:1850-1861. [PMID: 35028901 PMCID: PMC8757925 DOI: 10.1007/s12035-021-02696-0] [Citation(s) in RCA: 92] [Impact Index Per Article: 30.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2021] [Accepted: 12/10/2021] [Indexed: 02/06/2023]
Abstract
SARS-CoV-2 infects cells via its spike protein binding to its surface receptor on target cells and results in acute symptoms involving especially the lungs known as COVID-19. However, increasing evidence indicates that many patients develop a chronic condition characterized by fatigue and neuropsychiatric symptoms, termed long-COVID. Most of the vaccines produced so far for COVID-19 direct mammalian cells via either mRNA or an adenovirus vector to express the spike protein, or administer recombinant spike protein, which is recognized by the immune system leading to the production of neutralizing antibodies. Recent publications provide new findings that may help decipher the pathogenesis of long-COVID. One paper reported perivascular inflammation in brains of deceased patients with COVID-19, while others showed that the spike protein could damage the endothelium in an animal model, that it could disrupt an in vitro model of the blood-brain barrier (BBB), and that it can cross the BBB resulting in perivascular inflammation. Moreover, the spike protein appears to share antigenic epitopes with human molecular chaperons resulting in autoimmunity and can activate toll-like receptors (TLRs), leading to release of inflammatory cytokines. Moreover, some antibodies produced against the spike protein may not be neutralizing, but may change its conformation rendering it more likely to bind to its receptor. As a result, one wonders whether the spike protein entering the brain or being expressed by brain cells could activate microglia, alone or together with inflammatory cytokines, since protective antibodies could not cross the BBB, leading to neuro-inflammation and contributing to long-COVID. Hence, there is urgent need to better understand the neurotoxic effects of the spike protein and to consider possible interventions to mitigate spike protein-related detrimental effects to the brain, possibly via use of small natural molecules, especially the flavonoids luteolin and quercetin.
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Affiliation(s)
- Theoharis C Theoharides
- Laboratory of Molecular Immunopharmacology and Drug Discovery, Department of Immunology, Tufts University School of Medicine, 136 Harrison Avenue, Suite 304, Boston, MA, 02111, USA.
- School of Graduate Biomedical Sciences, Tufts University School of Medicine, Boston, MA, 02111, USA.
- Departments of Internal Medicine and Psychiatry, Tufts University School of Medicine and Tufts Medical Center, Boston, MA, 02111, USA.
- Institute of Neuro-Immune Medicine, Nova Southeastern University, Clearwater, FL, 33759, USA.
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36
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Durnaoglu S, Lee SK, Ahnn J. Syncytin, envelope protein of human endogenous retrovirus (HERV): no longer 'fossil' in human genome. Anim Cells Syst (Seoul) 2022; 25:358-368. [PMID: 35059135 PMCID: PMC8765258 DOI: 10.1080/19768354.2021.2019109] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2021] [Accepted: 12/07/2021] [Indexed: 12/17/2022] Open
Abstract
Human endogenous retroviruses (HERVs) are 'fossil viruses' that resulted from stable integrations of exogenous retroviruses throughout evolution. HERVs are defective and do not produce infectious viral particles. However, some HERVs retain a limited coding capacity and produce retroviral transcripts and proteins, which function in human developmental process and various pathologies, including many cancers and neurological diseases. Recently, it has been reported that HERVs are differently expressed in COVID-19 disease caused by infection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). In this review, we discuss the molecular structure and function of HERV ENV proteins, particularly syncytins, and their conventional roles in human development and diseases, and potential involvement in COVID-19 regarding the newly reported mental symptoms. We also address COVID-19 vaccine-related infertility concerns arising from the similarity of syncytin with the spike protein of SARS-CoV-2, which have been proved invalid.
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Affiliation(s)
- Serpen Durnaoglu
- College of Natural Sciences, Hanyang University, Seoul, Republic of Korea
- Research Institute for Natural Sciences, College of Natural Sciences, Hanyang University, Seoul, Republic of Korea
| | - Sun-Kyung Lee
- College of Natural Sciences, Hanyang University, Seoul, Republic of Korea
- Research Institute for Natural Sciences, College of Natural Sciences, Hanyang University, Seoul, Republic of Korea
| | - Joohong Ahnn
- College of Natural Sciences, Hanyang University, Seoul, Republic of Korea
- Research Institute for Natural Sciences, College of Natural Sciences, Hanyang University, Seoul, Republic of Korea
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37
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Zurlo MC, Cattaneo Della Volta MF, Vallone F. Psychological Health Conditions and COVID-19-Related Stressors Among University Students: A Repeated Cross-Sectional Survey. Front Psychol 2022; 12:741332. [PMID: 35069321 PMCID: PMC8766709 DOI: 10.3389/fpsyg.2021.741332] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2021] [Accepted: 12/03/2021] [Indexed: 01/07/2023] Open
Abstract
The Coronavirus Disease 2019 (COVID-19) pandemic has broadly impacted university students' customary life, resulting in remarkable levels of stress and psychological suffering. Although the acute phase of the crisis has been overcome, it does not imply that perceived stress related to the risk of contagion and to the changes in the relational life experienced over more than 1 year of the pandemic will promptly and abruptly decrease. This study aims at comparing university students' psychological health conditions before and during the COVID-19 pandemic, but also at providing information on how psychological health conditions evolved over the 1 year of the pandemic. We analyzed data from a repeated cross-sectional survey on different samples of university students before the pandemic in 2017 (n = 545) and during the pandemic (n = 671). During the pandemic, data were collected at three stages (Stage 1, April 2020 n = 197; Stage 2, November 2020 n = 274; and Stage 3, April 2021 n = 200). The COVID-19 Student Stress Questionnaire (CSSQ) and the Symptom-Checklist-90-Revised (SCL-90-R) were used to assess, respectively, COVID-19-related stressors (Relationships and Academic Life, Isolation, and Fear of Contagion) and the presence of psychological symptoms. Psychological health conditions were compared at baseline and during the pandemic, whereas both psychological health conditions and perceived levels of COVID-19-related stressors were compared over the three pandemic stages. In addition, Logistic Regression was used to explore the associations between COVID-19-related stressors and psychological symptoms. Findings revealed a significant increase in symptoms of Depression (DEP), Phobic-Anxiety (PHOB), Obsessive-Compulsive (O-C), and Psychoticism (PSY) from pre to during the pandemic. Perceived levels of COVID-19-related stress and specific psychological symptoms significantly increased as the pandemic was progressing. COVID-19-related stressors emerged as significantly associated with several psychopathological symptoms. Findings are discussed with the aim of providing tailored interventions to prevent mental disease and promote psychological adjustment in this specific stage of transition within this exceptional global emergency.
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Affiliation(s)
- Maria Clelia Zurlo
- Dynamic Psychology Laboratory, Department of Political Science, University of Naples Federico II, Naples, Italy
| | - Maria Francesca Cattaneo Della Volta
- Dynamic Psychology Laboratory, Department of Political Science, University of Naples Federico II, Naples, Italy
- Department of Humanities, University of Naples Federico II, Naples, Italy
| | - Federica Vallone
- Dynamic Psychology Laboratory, Department of Political Science, University of Naples Federico II, Naples, Italy
- Department of Humanities, University of Naples Federico II, Naples, Italy
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38
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Thomas SP. Finding Hope in 2022. Issues Ment Health Nurs 2022; 43:1-2. [PMID: 35080995 DOI: 10.1080/01612840.2022.2026186] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Sandra P Thomas
- College of Nursing, University of Tennessee Knoxville, Knoxville, Tennessee, USA
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39
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Cafaro R, Piccoli E, Ferrara L, Russo S, Dragogna F, Viganò C, Mencacci C, Dell'Osso B. The impact of COVID-19 on the psychiatric emergency departments of two Italian hospitals in Milan. Psychiatry Res 2022; 307:114303. [PMID: 34896844 PMCID: PMC8627594 DOI: 10.1016/j.psychres.2021.114303] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/28/2021] [Revised: 11/09/2021] [Accepted: 11/22/2021] [Indexed: 01/04/2023]
Abstract
During the first wave of the SARS-CoV-2 contagion in Italy, mental health care services continuity has been granted to the general population. Emergent and urgent conditions, however, are managed in collaboration with Emergency Departments (EDs). This collaboration may have suffered from the overload of the EDs due to the high number of SARS-CoV-2 positive patients. In this perspective, we analysed the possible impact of COVID-19 on the EDs accesses of psychiatric patients in two of the main hospitals of Milan, the "Luigi Sacco" Hospital and the "Fatebenefratelli" Hospital, comparing their admissions between the periods of March, April and May 2019 and 2020. We found a significant reduction in the number of evaluated patients in 2020 in both EDs. Emergency Medical Services (EMSs) brought a significant lower number of patients to the ED of Sacco Hospital during 2020, while this number increased for the ED of Fatebenefratelli Hospital, confirming the hypothesis that the overload of the Sacco Hospital ED significantly influenced the possibility to receive a psychiatric evaluation there. Moreover, we found a significant difference between diagnosis at discharge of the different samples.
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Affiliation(s)
- Rita Cafaro
- Department of Biomedical and Clinical Sciences Luigi Sacco, University of Milan, Milan, Italy.
| | - Eleonora Piccoli
- Department of Biomedical and Clinical Sciences Luigi Sacco, University of Milan, Milan, Italy
| | - Luca Ferrara
- Department of Biomedical and Clinical Sciences Luigi Sacco, University of Milan, Milan, Italy
| | - Stefania Russo
- Department of Neuroscience, ASST Fatebenefratelli Sacco, Milan, Italy
| | - Filippo Dragogna
- Department of Neuroscience, ASST Fatebenefratelli Sacco, Milan, Italy
| | - Caterina Viganò
- Department of Biomedical and Clinical Sciences Luigi Sacco, University of Milan, Milan, Italy
| | - Claudio Mencacci
- Department of Neuroscience, ASST Fatebenefratelli Sacco, Milan, Italy
| | - Bernardo Dell'Osso
- Department of Biomedical and Clinical Sciences Luigi Sacco, University of Milan, Milan, Italy; CRC Aldo Ravelli, University of Milan, Milan, Italy; Department of Psychiatry and Behavioural Sciences, Stanford University, CA, USA
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40
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López-Atanes M, González-Briceño JP, Abeal-Adham A, Fuertes-Soriano S, Cabezas-Garduño J, Peña-Rotella Á, Sáenz-Herrero M. Liaison Psychiatry During the Peak of the Coronavirus Pandemic: A Description of Referrals and Interventions. Front Psychiatry 2021; 12:555080. [PMID: 34955903 PMCID: PMC8698874 DOI: 10.3389/fpsyt.2021.555080] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/24/2020] [Accepted: 10/29/2021] [Indexed: 12/22/2022] Open
Abstract
Introduction: The novel coronavirus SARS-CoV-2 belongs to the coronavirus family, a group of viruses that can cause upper respiratory infections in humans. Among other symptoms, it can present as an asymptomatic infection or as a more severe disease requiring hospitalization. Neuropsychiatric symptoms have been described in the acute phase of the illness and as long-term repercussions. We describe the characteristics and interventions in those COVID-19 patients referred to our liaison psychiatry service. Materials and Methods: This is a cross-sectional descriptive study. This study was carried out within the Department of Psychiatry of Cruces University Hospital (Basque Country, Spain). Data from each psychiatric consultation within our consultation-liaison service were consecutively obtained for 1 month from March 17 to April 17, 2020. We recruited data regarding clinical and referral characteristics and psychiatric interventions. Results: Of a total of 721 SARS-CoV-2 hospitalizations, 43 (5.6%) patients were referred to our psychiatry liaison service. The median age was 61 years old, and 62.8% were women. The infectious disease department was the most frequent petitioner (37.2%), and the most common reason for referral was patient anxiety (25.6%). A total of 67.4% of patients received psychological counseling and 55.8% received some pharmacological approach, with a median of 3.7 visits/calls per patient. In addition, 20.3% needed a medication switch due to potential interactions between psychotropics and drugs used to treat SARS-CoV-2. Discussion: In our study, up to 5.6% of SARS-CoV-2 hospitalized patients needed a psychiatric evaluation, especially for anxiety and mood symptoms. Psychosocial factors associated with the pandemic, drugs used to treat the infection, or a direct causative effect of the virus may explain our findings.
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Affiliation(s)
- Mayte López-Atanes
- Department of Psychiatry, Cruces University Hospital, Osakidetza-Basque Health Service, Barakaldo, Spain
| | | | - Adrián Abeal-Adham
- Department of Preventive Medicine and Public Health, Cruces University Hospital, Osakidetza-Basque Health Service, Barakaldo, Spain
| | - Sara Fuertes-Soriano
- Department of Psychiatry, Cruces University Hospital, Osakidetza-Basque Health Service, Barakaldo, Spain
| | - Janire Cabezas-Garduño
- Department of Psychiatry, Cruces University Hospital, Osakidetza-Basque Health Service, Barakaldo, Spain
| | - Álvar Peña-Rotella
- Department of Psychiatry, Cruces University Hospital, Osakidetza-Basque Health Service, Barakaldo, Spain
| | - Margarita Sáenz-Herrero
- Department of Psychiatry, Cruces University Hospital, Osakidetza-Basque Health Service, Barakaldo, Spain
- Department of Psychiatry, Biocruces Bizkaia Health Research Institute, Cruces University Hospital, Barakaldo, Spain
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41
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Panariello F, Longobardi S, Cellini L, De Ronchi D, Atti AR. Psychiatric hospitalization during the two SARS-CoV-2 pandemic waves: New warnings for acute psychotic episodes and suicidal behaviors. World J Psychiatry 2021; 11:1095-1105. [PMID: 34888176 PMCID: PMC8613752 DOI: 10.5498/wjp.v11.i11.1095] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/30/2021] [Revised: 07/23/2021] [Accepted: 09/03/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND The subsequent waves of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic have represented a dramatic health emergency characterized by significant consequences on mental health. Diachronic variations in the incidence rates of acute relapse of psychiatric disorders may represent significant "sentinel events" for assessing the mental health response to an unprecedented stressful event.
AIM To investigate the variation in psychiatric hospitalization rates and differences in sociodemographic and clinical-psychopathological peculiarities at Bologna "Maggiore" General Hospital Psychiatric Ward (GHPW) between the first two waves SARS-CoV-2 pandemic and the same periods of the previous 3 years. The secondary purpose of the study was to suggest a diachronic response pathway to stress by reporting additional literature data on coping strategies.
METHODS This observational and retrospective study collected information on admission to the GHPW at the "Maggiore" Hospital in Bologna in the index periods defined as follows: the first period between February 24, 2020 and April 30, 2020 (first epidemic wave) and the second period between October 8, 2020, and January 7, 2021 (second pandemic wave). Absolute numbers and proportion of admitted patients, their sociodemographic and clinical-psychopathological characteristics were compared with the same parameters recorded in the two same periods of the previous 3 years. No strict inclusion or exclusion criteria were provided in the data collection to collect information on all patients requiring acute psychiatric hospitalization.
RESULTS During the first wave, there was a significant reduction in hospitalization rates, although there was a simultaneous increase in compulsory hospitalizations and the acute relapse of schizophrenia spectrum and other psychotic disorders. During the second wave, hospitalization rates reached those recorded during the same period of the previous 3 years, mainly due to the rise of bipolar and related disorders, depressive disorders, anxiety disorders, trauma- and stressor-related disorders and suicidal behaviors.
CONCLUSION The coping strategies adopted during the first wave of the SARS-CoV-2 pandemic protected the vulnerable population from the general risk of clinical-psychopathological acute relapse, even if they increased the susceptibility to run into schizophrenia spectrum and other psychotic disorder relapses. In the medium-long term (as in the second pandemic wave), the same strategies do not play protective roles against the stress associated with the pandemic and social restriction measures. Indeed, during the second wave of the SARS-CoV-2 pandemic, an increase in total hospitalization rate, suicidal behaviors and the incidence rate of bipolar and related disorders, depressive disorders, anxiety disorders, trauma- and stressor-related disorders was observed.
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Affiliation(s)
- Fabio Panariello
- Department of Biomedical and NeuroMotor Sciences, Institute of Psychiatry, University of Bologna, Bologna 40126, Italy
| | - Sara Longobardi
- Department of Biomedical and NeuroMotor Sciences, Institute of Psychiatry, University of Bologna, Bologna 40126, Italy
| | - Lorenzo Cellini
- Department of Biomedical and NeuroMotor Sciences, Institute of Psychiatry, University of Bologna, Bologna 40126, Italy
| | - Diana De Ronchi
- Department of Biomedical and NeuroMotor Sciences, Institute of Psychiatry, University of Bologna, Bologna 40126, Italy
| | - Anna Rita Atti
- Department of Biomedical and NeuroMotor Sciences, Institute of Psychiatry, University of Bologna, Bologna 40126, Italy
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Zyablov VA, Gusev MA, Chizhikov VS. Clinical Features of First-episode Psychoses During the COVID-19 Pandemic. CONSORTIUM PSYCHIATRICUM 2021; 2:27-33. [PMID: 39044749 PMCID: PMC11262247 DOI: 10.17816/cp85] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2021] [Accepted: 08/03/2021] [Indexed: 11/08/2022] Open
Abstract
INTRODUCTION The pandemic of the new coronavirus infection has become one of the most significant global social shocks in the past decade. It influenced the lifestyle of many people, including those with mental disorders. AIM To compare the psychopathological structure of psychotic states in young patients (up to 40 years old) with first-episode psychosis before the COVID-19 pandemic and during the COVID-19 pandemic. METHODS The research was conducted at the First psychotic episode clinic of the Mental-health clinic No. 1 n.a. N.A. Alexeev, Moscow, Russia. In total, 66 patients were enrolled, who met the inclusion criteria: first-in-life admission to a mental healthcare unit that occurred during the spring of 2019 (control group) or spring 2020 (experimental group), diagnosis on admission that belonged to the group "Acute and transient psychotic disorders" (F23.XX) of ICD-10. Patients with a disability or concurrent somatic or neurologic conditions were excluded from the study. Assessment of clinical and psychopathological characteristics with the allocation of the leading syndrome within the psychotic state, psychometric assessment according to the PANSS scale was carried out, the above indicators were compared between the experimental and control group. RESULTS We observed statistically insignificant increase in the rates of affective and catatonic subtypes of psychoses, a decrease in the rate of the delusional subtype of paranoid syndrome. PANSS scores differed significantly for different clinical subtypes of psychoses, although the differences between the experimental and control groups showed no statistical significance. Additionally, in spring 2020, a considerable decrease in the total number of hospitalizations was revealed. CONCLUSIONS The differences in the clinical and psychopathological structure of psychotic states revealed during the COVID-19 pandemic were statistically insignificant. Additional results of the study may indicate a decrease in the availability of mental healthcare for patients with psychoses, which requires further investigation.
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Manolis TA, Apostolopoulos EJ, Manolis AA, Melita H, Manolis AS. COVID-19 Infection: A Neuropsychiatric Perspective. J Neuropsychiatry Clin Neurosci 2021; 33:266-279. [PMID: 34280318 DOI: 10.1176/appi.neuropsych.20110277] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
As a potentially life-threatening disease with no definitive treatment and without fully implemented population-wide vaccination, COVID-19 has created unprecedented turmoil in socioeconomic life worldwide. In addition to physical signs from the respiratory and many other systems, the SARS-CoV-2 virus produces a broad range of neurological and neuropsychiatric problems, including olfactory and gustatory impairments, encephalopathy and delirium, stroke and neuromuscular complications, stress reactions, and psychoses. Moreover, the psychosocial impact of the pandemic and its indirect effects on neuropsychiatric health in noninfected individuals in the general public and among health care workers are similarly far-ranging. In addition to acute neuropsychiatric manifestations, COVID-19 may also produce late neuropsychiatric sequelae as a function of the psychoneuroimmunological cascade that it provokes. The present article presents a state-of-the-science review of these issues through an integrative review and synthesis of case series, large-cohort studies, and relevant meta-analyses. Heuristics for evaluation and further study of the neuropsychiatric manifestations of SARS-CoV-2 infection are offered.
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Affiliation(s)
- Theodora A Manolis
- Red Cross Hospital, Athens, Greece (T. A. Manolis); Canterbury Christ Church University, Canterbury, United Kingdom (Apostolopoulos); Patras University School of Medicine, Patras, Greece (A. A. Manolis); Onassis Cardiac Surgery Center, Athens, Greece (Melita); and Athens University School of Medicine, Greece (A. S. Manolis)
| | - Evdoxia J Apostolopoulos
- Red Cross Hospital, Athens, Greece (T. A. Manolis); Canterbury Christ Church University, Canterbury, United Kingdom (Apostolopoulos); Patras University School of Medicine, Patras, Greece (A. A. Manolis); Onassis Cardiac Surgery Center, Athens, Greece (Melita); and Athens University School of Medicine, Greece (A. S. Manolis)
| | - Antonis A Manolis
- Red Cross Hospital, Athens, Greece (T. A. Manolis); Canterbury Christ Church University, Canterbury, United Kingdom (Apostolopoulos); Patras University School of Medicine, Patras, Greece (A. A. Manolis); Onassis Cardiac Surgery Center, Athens, Greece (Melita); and Athens University School of Medicine, Greece (A. S. Manolis)
| | - Helen Melita
- Red Cross Hospital, Athens, Greece (T. A. Manolis); Canterbury Christ Church University, Canterbury, United Kingdom (Apostolopoulos); Patras University School of Medicine, Patras, Greece (A. A. Manolis); Onassis Cardiac Surgery Center, Athens, Greece (Melita); and Athens University School of Medicine, Greece (A. S. Manolis)
| | - Antonis S Manolis
- Red Cross Hospital, Athens, Greece (T. A. Manolis); Canterbury Christ Church University, Canterbury, United Kingdom (Apostolopoulos); Patras University School of Medicine, Patras, Greece (A. A. Manolis); Onassis Cardiac Surgery Center, Athens, Greece (Melita); and Athens University School of Medicine, Greece (A. S. Manolis)
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Ahmed GK, Khedr EM, Hamad DA, Meshref TS, Hashem MM, Aly MM. Long term impact of Covid-19 infection on sleep and mental health: A cross-sectional study. Psychiatry Res 2021; 305:114243. [PMID: 34673325 PMCID: PMC8507572 DOI: 10.1016/j.psychres.2021.114243] [Citation(s) in RCA: 54] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/07/2021] [Revised: 10/03/2021] [Accepted: 10/10/2021] [Indexed: 01/15/2023]
Abstract
The long-term impact of the COVID-19 infection on mental health in people and its relation to the severity is unclear. We aimed to study the long-term effect of post-COVID-19 disease on sleep and mental health and to detect possible relationship between severity of COVID-19 at onset and sleep and mental illness. We enrolled 182 participants 6 months post COVID-19 infection and grouped into non-severe(101),severe(60) and critical(20) according to according to WHO guidance. All participants were assessed using Pittsburgh Sleep Quality Index ", Post traumatic stress disorder (PTSD) Checklist for DSM-5, and Symptom Checklist90 test. Only 8.8% had no psychiatric symptoms while 91.2% had psychiatric symptoms as follow (poor sleep (64.8%), PTSD (28.6%), somatization (41.8%), obsessive-compulsive (OCD) (19.8%), depression (11.5%), anxiety (28%), phobic-anxiety (24.2%), psychoticism (17.6%)). Diabetes, oxygen support or mechanically ventilated were a risk for sleep impairment, while high Neutrophil/lymphocyte ratio(NLR) was the only risk factor for PTSD. Other psychiatric illnesses had several risk factors: being female, diabetes, oxygen support or mechanically ventilated. Abnormal sleep, somatization and anxiety are the most common mental illnesses in Post-Covid19. The critical group is common associated with PTSD, anxiety, and psychosis. Being female, diabetic, having oxygen support or mechanically ventilated, and high NLR level are more vulnerable for mental illness in post COVID19.
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Affiliation(s)
- Gellan K. Ahmed
- Department of Neurology and Psychiatry, Faculty of Medicine, Assiut University, Assiut, Egypt,Department of Child & Adolescent Psychiatry, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London SE5 8AF, United Kingdom,Corresponding author at: Department of Neurology and Psychiatry, Faculty of Medicine, Assiut University, Assiut, Egypt
| | - Eman M. Khedr
- Department of Neurology and Psychiatry, Faculty of Medicine, Assiut University, Assiut, Egypt
| | - Dina A. Hamad
- Critical Care unit, Department of Internal Medicine, Faculty of Medicine, Assiut University, Assiut, Egypt
| | - Taghreed S. Meshref
- Critical Care unit, Department of Internal Medicine, Faculty of Medicine, Assiut University, Assiut, Egypt
| | - Mustafa M. Hashem
- Department of Neurology and Psychiatry, Faculty of Medicine, Assiut University, Assiut, Egypt
| | - Mai M. Aly
- Clinical Hematology Unit, Department of Internal Medicine, Faculty of Medicine, Assiut University, Assiut, Egypt
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Segev A, Hirsch-Klein E, Kotz G, Kamhi-Nesher S, Halimi S, Qashu K, Schreiber E, Krivoy A. Trends of new-onset psychosis or mania in psychiatric emergency departments during the COVID19 pandemic: a longitudinal comparative study. Sci Rep 2021; 11:21002. [PMID: 34697335 PMCID: PMC8546064 DOI: 10.1038/s41598-021-00310-w] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2021] [Accepted: 10/05/2021] [Indexed: 12/13/2022] Open
Abstract
COVID19 infection was associated with possible psychiatric manifestations, including psychosis and mania. In addition, psychiatric disorders might be triggered by severe psychological reactions to the pandemic or the measures taken to contain it. This study aimed to assess the trends of new-onset psychosis/mania during the pandemic timeline. Psychiatric emergency department records during January-July 2019 and 2020 of two regional mental health centers were manually examined. Cases of new-onset psychosis or mania were found in 326 out of 5161 records examined. The ratio of these cases increased by 45.5% in 2020 compared to 2019 (189 out of 2367, 137 out of 2479, respectively, p = 0.001). The peak increase was in April 2020 (9.4% vs. 4.7%, p = 0.015). There was no association between the rise of new-onset psychotic or manic episodes and national incidence of COVID19 cases, as observed during Israel 2nd wave. PCR tests were negative, except a single case. In this study, an increase in new-onset psychosis/mania was identified during the initial phase of the pandemic. Though causality could not be directly inferred, lack of infection symptoms, negative PCR testing and temporal distribution incongruent with COVID19 caseload did not support a direct effect of SARS-CoV-2. Alternative explanations are discussed, such as psychological reaction to stress and preventive measures, as well as case-shifting between different mental health settings.
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Affiliation(s)
- Aviv Segev
- Shalvata Mental Health Center, Alyat Hanoar 13th St., Hod Hasharon, Israel.
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
- Department of Psychosis, Institute of Psychiatry, Psychology and Neuroscience (IoPPN), King's College London, 16 De Crespigny Park, London, SE5 8AF, UK.
| | - Efrat Hirsch-Klein
- Shalvata Mental Health Center, Alyat Hanoar 13th St., Hod Hasharon, Israel
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Gershon Kotz
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
- Be'er Yaakov Mental Health Center, 1st Rabin Av., Be'er Ya'akov, Israel
| | - Shiri Kamhi-Nesher
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
- Geha Mental Health Center, 1st Helsinki St., Petach Tikva, Israel
| | - Shikma Halimi
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
- Geha Mental Health Center, 1st Helsinki St., Petach Tikva, Israel
| | - Khalil Qashu
- Shalvata Mental Health Center, Alyat Hanoar 13th St., Hod Hasharon, Israel
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Ephraim Schreiber
- Shalvata Mental Health Center, Alyat Hanoar 13th St., Hod Hasharon, Israel
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Amir Krivoy
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
- Department of Psychosis, Institute of Psychiatry, Psychology and Neuroscience (IoPPN), King's College London, 16 De Crespigny Park, London, SE5 8AF, UK
- Geha Mental Health Center, 1st Helsinki St., Petach Tikva, Israel
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Al-Busaidi S, Al Huseini S, Al-Shehhi R, Zishan AA, Moghadas M, Al-Adawi S. COVID-19 Induced New-onset Psychosis: A Case Report from Oman. Oman Med J 2021; 36:e303. [PMID: 34676111 PMCID: PMC8511796 DOI: 10.5001/omj.2022.25] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2021] [Accepted: 04/04/2021] [Indexed: 12/15/2022] Open
Abstract
Neurobehavioral impairment associated with COVID-19 infection has been recently documented in the literature. COVID-19 infection has also been associated with an increased risk for developing psychiatric symptoms, including rare reports on psychosis. We report a case of a 46-year-old male with no significant medical, family, and psychiatric history admitted to the hospital with COVID-19-related psychosis. Possible contributory factors for his condition are discussed, including the relationship between infections and the brain circuitry, inadvertent iatrogenic effects of pharmaceuticals used to manage COVID-19, as well as diathesis-stress associated with the tribulation of the prevailing pandemic.
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Affiliation(s)
| | - Salim Al Huseini
- Psychiatry Residency Program, Oman Medical Specialty Board, Muscat, Oman
| | | | | | - Marzieh Moghadas
- Department of Behavioral Medicine, College of Medicine and Health Sciences, Sultan Qaboos University, Muscat, Oman
| | - Samir Al-Adawi
- Department of Behavioral Medicine, College of Medicine and Health Sciences, Sultan Qaboos University, Muscat, Oman
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Łoś K, Kulikowska J, Waszkiewicz N. First-Time Psychotic Symptoms in a Patient After COVID-19 Infection-A Case Report. Front Psychiatry 2021; 12:726059. [PMID: 34721104 PMCID: PMC8554044 DOI: 10.3389/fpsyt.2021.726059] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/16/2021] [Accepted: 09/20/2021] [Indexed: 12/26/2022] Open
Abstract
A 39-year-old, previously healthy, white male with no personal or family history of mental illness presented with new, first-time psychotic symptoms. The new psychotic symptoms appeared on patient admission to the hospital, occurring during a diagnosis of symptomatic SARS-CoV-2 infection. On the first day of hospitalization for worsening psychotic symptoms and the appearance of aggression toward the staff, the patient was transferred to the psychiatric hospital. After the initial treatment with antipsychotics and benzodiazepines, his mental condition improved. The patient was then transferred for further treatment of his somatic condition in the internal medicine ward, with a recommendation to continue treatment in the psychiatric ward once his somatic condition was stabilized. This is one of the few reported cases of COVID-19-related psychosis in a patient without a personal or family history; moreover, this description contains important data regarding elevated IL-6, which may prove to be a key factor in the induction of new psychotic symptoms. It indicates the important need for careful monitoring of neuropsychiatric symptoms among COVID-19 patients.
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Affiliation(s)
- Kacper Łoś
- Department of Psychiatry, Medical University of Bialystok, Bialystok, Poland
| | - Joanna Kulikowska
- Department of Neurology, Medical University of Bialystok, Bialystok, Poland
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Tripathy S, Singh N, Singh A, Kar SK. COVID-19 and Psychotic Symptoms: the View from Psychiatric Immunology. Curr Behav Neurosci Rep 2021; 8:172-178. [PMID: 34631364 PMCID: PMC8487803 DOI: 10.1007/s40473-021-00235-8] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/24/2021] [Indexed: 12/22/2022]
Abstract
PURPOSE OF REVIEW To explore the immunological underpinnings of psychosis in the COVID-19 patients. RECENT FINDINGS COVID-19 pandemic led to a surge in psychiatric morbidities, including psychosis. Various putative biological and psychosocial changes have been implicated in COVID-19-related psychosis. COVID-19 is a proinflammatory state. Alterations in immunological processes both as a direct consequence of infection or secondary to the hyperimmune response heuristically explain the etiopathogenesis of psychosis in the affected individual. The uses of immunosuppressant and immunomodulatory drugs may be the other moderators of a psychotic presentation in COVID-19 patients. Evidence to substantiate this hypothesis is still lacking however, which further studies should address. Because of its management implications, a better understanding of the involved immunological mechanisms becomes extremely important. SUMMARY Evidence suggests a putative role of immunological alterations in the pathogenesis of COVID-19-related psychosis. The immunological abnormalities are primarily attributed to the pathophysiology of COVID-19 infection, medications used, and stress.
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Affiliation(s)
- Sarvodaya Tripathy
- Department of Microbiology, M.K.C.G Medical College, Brahmapur, Ganjam, Odisha India
| | - Nitika Singh
- Department of Psychiatry, King George’s Medical University, Lucknow, U.P India
| | - Amit Singh
- Department of Psychiatry, King George’s Medical University, Lucknow, U.P India
| | - Sujita Kumar Kar
- Department of Psychiatry, King George’s Medical University, Lucknow, U.P India
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Marazziti D, Dell’Osso L. Planet Health and Mental Health: The Lesson We Should Learn from Covid-19 Pandemic. CLINICAL NEUROPSYCHIATRY 2021; 18:235-236. [PMID: 34984066 PMCID: PMC8696286 DOI: 10.36131/cnfioritieditore20210501] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Affiliation(s)
- Donatella Marazziti
- Section of Psychiatry, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Liliana Dell’Osso
- Section of Psychiatry, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
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Dutta BK, Mani RN, Sharma S, Singh VV, Aggarwal T, Chandra H, Ratna S, Sharma S, Gupta AK. COVID-19-associated psychosis in Indian settings: A retrospective descriptive study. Ind Psychiatry J 2021; 30:S25-S28. [PMID: 34908660 PMCID: PMC8611608 DOI: 10.4103/0972-6748.328784] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/21/2021] [Revised: 06/11/2021] [Accepted: 06/29/2021] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND The coronavirus-19 (COVID-19) pandemic has affected millions of people across the world since early 2020. Besides the large number of case fatalities, this virus has produced significant health-related sequelae involving multiple systems of the body. As with previous coronavirus infections, this was also found to be associated with various neuropsychiatric symptoms. Psychosis has been uncommon, and the few reported cases across the world have forwarded association with either raised inflammatory markers or the consequences of social isolation. MATERIALS AND METHODS This is a retrospective descriptive study of 12 patients, who were admitted with COVID-19 infection and psychosis, between March 2020 and December 2020. Cases of head injury, any neurological or metabolic illnesses, and substance use disorders were excluded. RESULTS Cases with psychosis formed only 0.19% of all cases of COVID-19 admissions. All of them were young male and employed. Most of them had abrupt onset of psychosis with confusion, delusions, hallucinations, agitation, and sleep disturbances. Investigations including inflammatory markers (C-reactive protein) and computerized tomography scans were largely normal. Medications used were mainly benzodiazepines and antipsychotics. Most of the cases resolved within the second week, and follow-up after a month did not elicit any residual symptoms in majority. Diagnosis was acute and transient psychotic disorder (about 75%), bipolar affective disorder (2 cases), and schizophrenia (one). CONCLUSIONS The major findings included nonreactive inflammatory markers, quick resolution of symptoms, requirement of low doses of antipsychotic drugs, and no long-term sequelae.
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Affiliation(s)
- B K Dutta
- Department of Psychiatry, Army College of Medical Sciences and Base Hospital, Delhi, India
| | - R N Mani
- Department of Psychiatry, Army College of Medical Sciences and Base Hospital, Delhi, India
| | - S Sharma
- Department of Psychiatry, Army College of Medical Sciences and Base Hospital, Delhi, India
| | - V V Singh
- Department of Psychiatry, Army College of Medical Sciences and Base Hospital, Delhi, India
| | - T Aggarwal
- Department of Psychiatry, Army College of Medical Sciences and Base Hospital, Delhi, India
| | - H Chandra
- Department of Psychiatry, Army College of Medical Sciences and Base Hospital, Delhi, India
| | - Sweta Ratna
- Department of Psychiatry, Army College of Medical Sciences and Base Hospital, Delhi, India
| | - Sumit Sharma
- Department of Psychiatry, Army College of Medical Sciences and Base Hospital, Delhi, India
| | - A K Gupta
- Department of Psychiatry, Army College of Medical Sciences and Base Hospital, Delhi, India
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