COVID-19-induced psychosis: new challenges for early career psychiatrists

Abstract

The COVID-19 pandemic and its impact on mental health has remained immense and global in all senses. Various types of induced psychiatric disorders, both new episodes and exacerbation of the preexisiting ones has been reported - starting from adjustment disorder to full psychotic illnesses.

Various clinical symptoms, including systematized delusions, affective symptoms and self harm ideas has been mentioned needing upto prolonged admission and in patient care. Various etiopathogenetic models, incluing direct neural infection to cytokine storms or unmasking of the hidden vulnerabilities has been proposed however this needs further research. Traditional antipsychotic pharmacological agents has been proven to work well though special attention to pharmacological interactions is needed with caution for co morbid conditions and chance of side effects.

We collaborated in worldwide Task Force of early career psychiatrists and prepared the definition of our point of view.

Keywords

COVID-19 pandemic / mental health / psychotic disorders / neurobiology / antipsychotics

References

[1] Dickerson F, Jones-Brando L, Ford G, et al. Schizophrenia is Associated With an Aberrant Immune Response to Epstein–Barr Virus. Schizophrenia Bulletin. 2019;45(5):1112-9. doi: 10.1093/schbul/sby164

[2] Dickerson F., Jones-Brando L., Ford G., et al. Schizophrenia is Associated With an Aberrant Immune Response to Epstein–Barr Virus // Schizophrenia Bulletin. 2019. Vol. 45, № 5. P. 1112-1119. doi: 10.1093/schbul/sby164

[3] Watson CJ, Thomas RH, Solomon T, et al. COVID-19 and psychosis risk: Real or delusional concern? Neuroscience Letters. 2021;741:135491. doi: 10.1016/j.neulet.2020.135491

[4] Watson C.J., Thomas R.H., Solomon T., et al. COVID-19 and psychosis risk: Real or delusional concern? // Neuroscience Letters. 2021. Vol. 741. P. 135491. doi: 10.1016/j.neulet.2020.135491

[5] Netland J, Meyerholz DK, Moore S, et al. Severe Acute Respiratory Syndrome Coronavirus Infection Causes Neuronal Death in the Absence of Encephalitis in Mice Transgenic for Human ACE2. Journal of Virology. 2008;82(15):7264-75. doi: 10.1128/jvi.00737-08

[6] Netland J., Meyerholz D.K., Moore S., et al. Severe Acute Respiratory Syndrome Coronavirus Infection Causes Neuronal Death in the Absence of Encephalitis in Mice Transgenic for Human ACE2 // Journal of Virology. 2008. Vol. 82, № 15. P. 7264-7275. doi: 10.1128/jvi.00737-08

[7] Moriguchi T, Harii N, Goto J, et al. A first case of meningitis/encephalitis associated with SARS-Coronavirus-2. International Journal of Infectious Diseases. 2020;94:55-8. doi: 10.1016/j.ijid.2020.03.062

[8] Moriguchi T., Harii N., Goto J., et al. A first case of meningitis/encephalitis associated with SARS-Coronavirus-2 // International Journal of Infectious Diseases. 2020. Vol. 94. P. 55-58. doi: 10.1016/j.ijid.2020.03.062

[9] Zeng F, Huang Y, Guo Y, et al. Association of inflammatory markers with the severity of COVID-19: A meta-analysis. International Journal of Infectious Diseases. 2020;96:467-74. doi: 10.1016/j.ijid.2020.05.055

[10] Zeng F., Huang Y., Guo Y., et al. Association of inflammatory markers with the severity of COVID-19: A meta-analysis // International Journal of Infectious Diseases. 2020. Vol. 96. P. 467-474. doi: 10.1016/j.ijid.2020.05.055

[11] Miller BJ, Gassama B, Sebastian D, et al. Meta-Analysis of Lymphocytes in Schizophrenia: Clinical Status and Antipsychotic Effects. Biological Psychiatry. 2013;73(10):993-9. doi: 10.1016/j.biopsych.2012.09.007

[12] Miller B.J., Gassama B., Sebastian D., et al. Meta-Analysis of Lymphocytes in Schizophrenia: Clinical Status and Antipsychotic Effects // Biological Psychiatry. 2013. Vol. 73, № 10. P. 993-999. doi: 10.1016/j.biopsych.2012.09.007

[13] Mehta P, McAuley DF, Brown M, et al. COVID-19: consider cytokine storm syndromes and immunosuppression. The Lancet. 2020;395(10229):1033-4. doi: 10.1016/s0140-6736(20)30628-0

[14] Mehta P., McAuley D.F., Brown M., et al. COVID-19: consider cytokine storm syndromes and immunosuppression. The Lancet. 2020. Vol. 395, № 10229. P. 1033-1034. doi: 10.1016/s0140-6736(20)30628-0

[15] Desforges M, Le Coupanec A, Dubeau Ph, et al. Human Coronaviruses and Other Respiratory Viruses: Underestimated Opportunistic Pathogens of the Central Nervous System? Viruses. 2019;12(1):14. doi:10.3390/v12010014

[16] Desforges M., Le Coupanec A., Dubeau Ph., et al. Human Coronaviruses and Other Respiratory Viruses: Underestimated Opportunistic Pathogens of the Central Nervous System? // Viruses. 2019. Vol. 12, № 1. P. 14. doi: 10.3390/v12010014

[17] Gable M, Depry D. Sustained Corticosteroid-Induced Mania and Psychosis Despite Cessation: A Case Study and Brief Literature Review. Journal of Clinical Case Reports. 2015;5(6):1000546. doi: 10.4172/2165-7920.1000546

[18] Gable M., Depry D. Sustained Corticosteroid-Induced Mania and Psychosis Despite Cessation: A Case Study and Brief Literature Review // Journal of Clinical Case Reports. 2015. Vol. 5, № 6. P. 1000546. doi: 10.4172/2165-7920.1000546

[19] Shanbour A, Khalid Z, Fana M. Psychosis and Infodemic Isolation Resulting in First Inpatient Hospitalization During the COVID-19 Pandemic A Case Series. The Primary Care Companion for CNS Disorders. 2020;22(3):20102649. doi: 10.4088/pcc.20102649

[20] Shanbour A., Khalid Z., Fana M. Psychosis and Infodemic Isolation Resulting in First Inpatient Hospitalization During the COVID-19 Pandemic A Case Series // The Primary Care Companion for CNS Disorders. 2020. Vol. 22, № 3. P. 20102649. doi:10.4088/pcc.20102649

[21] Chandra PS, Shiva L, Nagendrappa S, et al. COVID 19 related Psychosis as an interface of fears, socio-cultural issues and vulnerability- case report of two women from India. Psychiatry Research. 2020;290:113136. doi: 10.1016/j.psychres.2020.113136

[22] Chandra P.S., Shiva L., Nagendrappa S., et al. COVID 19 related Psychosis as an interface of fears, socio-cultural issues and vulnerability- case report of two women from India // Psychiatry Research. 2020. Vol. 290. P. 113136. doi:10.1016/j.psychres.2020.113136

[23] Huarcaya-Victoria J, Herrera D, Castillo C. Psychosis in a patient with anxiety related to COVID-19: A case report. Psychiatry Research. 2020;289:113052. doi: 10.1016/j.psychres.2020.113052

[24] Huarcaya-Victoria J., Herrera D., Castillo C. Psychosis in a patient with anxiety related to COVID-19: A case report // Psychiatry Research. 2020. Vol. 289. P. 113052. doi: 10.1016/j.psychres.2020.113052

[25] Rentero D, Juanes A, Losada C, et al. New-onset psychosis in COVID-19 pandemic: a case series in Madrid. Psychiatry Research. 2020;290:113097. doi: 10.1016/j.psychres.2020.113097

[26] Rentero D., Juanes A., Losada C., et al. New-onset psychosis in COVID-19 pandemic: a case series in Madrid // Psychiatry Research. 2020. Vol. 290. P. 113097. doi: 10.1016/j.psychres.2020.113097

[27] Valdés-Florido MJ, López-Díaz Á, Palermo-Zeballos FJ, et al. Reactive psychoses in the context of the COVID-19 pandemic: Clinical perspectives from a case series. Revista de Psiquiatría y Salud Mental (English Edition). 2020;13(2):90-4. doi: 10.1016/j.rpsmen.2020.07.004

[28] Valdés-Florido M. J., López-Díaz Á., Palermo-Zeballos F.J., et al. Reactive psychoses in the context of the COVID-19 pandemic: Clinical perspectives from a case series // Revista de Psiquiatría y Salud Mental (English Edition). 2020. Vol. 13, № 2. P. 90-94. doi: 10.1016/j.rpsmen.2020.07.004

[29] Brown E, Gray R, Lo Monaco S, et al. The potential impact of COVID-19 on psychosis: A rapid review of contemporary epidemic and pandemic research. Schizophrenia Research. 2020;222:79-87. doi: 10.1016/j.schres.2020.05.005

[30] Brown E., Gray R., Lo Monaco S., et al. The potential impact of COVID-19 on psychosis: A rapid review of contemporary epidemic and pandemic research // Schizophrenia Research. 2020. Vol. 222. P. 79-87. doi: 10.1016/j.schres.2020.05.005

[31] Alba L, Coll C, Sáez S, et al. New-onset psychosis: A case report of brief psychosis related to COVID-19 infection. Psychiatry Research. 2021;301:113975. doi: 10.1016/j.psychres.2021.113975

[32] Alba L., Coll C., Sáez S., et al. New-onset psychosis: A case report of brief psychosis related to COVID-19 infection // Psychiatry Research. 2021. Vol. 301. P. 113975. doi: 10.1016/j.psychres.2021.113975

[33] Ferrando S, Klepacz L, Lynch S, et al. COVID-19 Psychosis: A Potential New Neuropsychiatric Condition Triggered by Novel Coronavirus Infection and the Inflammatory Response? Psychosomatics. 2020;61(5):551-5. doi: 10.1016/j.psym.2020.05.012

[34] Ferrando S., Klepacz L., Lynch S., et al. COVID-19 Psychosis: A Potential New Neuropsychiatric Condition Triggered by Novel Coronavirus Infection and the Inflammatory Response? // Psychosomatics. 2020. Vol. 61, № 5. P. 551-555. doi: 10.1016/j.psym.2020.05.012

[35] Parra A, Juanes A, Losada C, et al. Psychotic symptoms in COVID-19 patients. A retrospective descriptive study. Psychiatry Research. 2020;291:113254. doi: 10.1016/j.psychres.2020.113254

[36] Parra A., Juanes A., Losada C., et al. Psychotic symptoms in COVID-19 patients. A retrospective descriptive study // Psychiatry Research. 2020. Vol. 291. P. 113254. doi: 10.1016/j.psychres.2020.113254

[37] Tariku M, Hajure M. Available Evidence and Ongoing Hypothesis on Corona Virus (COVID-19) and Psychosis: Is Corona Virus and Psychosis Related? A Narrative Review. Psychology Research and Behavior Management. 2020;13:701-4. doi: 10.2147/prbm.s264235

[38] Tariku M., Hajure M. Available Evidence and Ongoing Hypothesis on Corona Virus (COVID-19) and Psychosis: Is Corona Virus and Psychosis Related? A Narrative Review // Psychology Research and Behavior Management. 2020. Vol. 13. P. 701-704. doi: 10.2147/prbm.s264235

[39] Nakamura ZV, Nash RP, Laughon SL, et al. Neuropsychiatric Complications of COVID-19. Current Psychiatry Reports. 2021;23(5):5. doi: 10.1007/s11920-021-01237-9

[40] Nakamura Z.V., Nash R.P., Laughon S.L., et al. Neuropsychiatric Complications of COVID-19 // Current Psychiatry Reports. 2021. Vol. 23, № 5. P. 25. doi: 10.1007/s11920-021-01237-9

[41] Parker C, Slan A, Shalev D, et al. Abrupt Late-onset Psychosis as a Presentation of Coronavirus 2019 Disease (COVID-19). Journal of Psychiatric Practice. 2021;27(2):131-6. doi: 10.1097/pra.0000000000000533

[42] Parker C., Slan A., Shalev D., et al. Abrupt Late-onset Psychosis as a Presentation of Coronavirus 2019 Disease (COVID-19) // Journal of Psychiatric Practice. 2021. Vol. 27, № 2. P. 131-136. doi: 10.1097/pra.0000000000000533

[43] Smith CM, Komisar JR, Mourad A, et al. COVID-19-associated brief psychotic disorder. BMJ Case Reports. 2020;13(8):e236940. doi: 10.1136/bcr-2020-236940

[44] Smith C.M., Komisar J.R., Mourad A., et al. COVID-19-associated brief psychotic disorder // BMJ Case Reports. 2020. Vol. 13, № 8. P. e236940. doi: 10.1136/bcr-2020-236940

[45] Correa-Palacio A, Hernandez-Huerta D, Gómez-Arnau J, et al. Affective psychosis after COVID-19 infection in a previously healthy patient: a case report. Psychiatry Research. 2020;290:113115. doi: 10.1016/j.psychres.2020.113115

[46] Correa-Palacio A., Hernandez-Huerta D., Gómez-Arnau J., et al. Affective psychosis after COVID-19 infection in a previously healthy patient: a case report // Psychiatry Research. 2020. Vol. 290. P. 113115. doi: 10.1016/j.psychres.2020.113115

[47] Siskind D, Honer W, Clark S, et al. Consensus statement on the use of clozapine during the COVID-19 pandemic. Journal of Psychiatry and Neuroscience. 2020;45(3):222-3. doi: 10.1503/jpn.200061

[48] Siskind D., Honer W., Clark S., et al. Consensus statement on the use of clozapine during the COVID-19 pandemic // Journal of Psychiatry and Neuroscience. 2020. Vol. 45, № 3. P. 222-223. doi: 10.1503/jpn.200061

[49] Ennis L, Rose D, Denis M, et al. Can't surf, won't surf: The digital divide in mental health. Journal of Mental Health. 2012;21(4):395-403. doi: 10.3109/09638237.2012.689437

[50] Ennis L., Rose D., Denis M., et al. Can't surf, won't surf: The digital divide in mental health // Journal of Mental Health. 2012. Vol. 21, № 4. P. 395-403. doi: 10.3109/09638237.2012.689437

[51] Kozloff N, Mulsant B, Stergiopoulos V, et al. The COVID-19 Global Pandemic: Implications for People With Schizophrenia and Related Disorders. Schizophrenia Bulletin. 2020;46(4):752-7. doi: 10.1093/schbul/sbaa051

[52] Kozloff N., Mulsant B., Stergiopoulos V., et al. The COVID-19 Global Pandemic: Implications for People With Schizophrenia and Related Disorders // Schizophrenia Bulletin. 2020. Vol. 46, № 4. P. 752-757. doi: 10.1093/schbul/sbaa051