Background: Complex trauma is a variant of post-traumatic stress disorder (PTSD), adding symptoms of affect dysregulation, difficulty in relationships, and negative self-perception. Its neurobiology is closely linked to the pro-inflammatory alterations by the disruption of the hypothalamic-pituitary-adrenal axis, which are also described in psychosis, and neuropsychiatric symptoms of the SARS-CoV-2 virus infection. Aim: To present a case that illustrates the clinical and neurobiological overlap between COVID-19, psychosis, and complex trauma. Case presentation: A 24-year-old female who initially presented dissociative symptoms evolving into a psychotic episode, after suffering from COVID-19 disease, in whom a history of abuse was later clarified. The clinical case is reviewed, performing a free search of articles for the discussion of clinical and pathophysiological challenges. Conclusion: Trauma is one of the greatest determinants in mental health, and is associated with several clinical spectra, being necessary to open the phenomenological and physiological debate to understand the sum of effects in patients who present with severe mental illness.
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