A Case of Delirious Mania Induced by COVID-19 Treated With Electroconvulsive Therapy

Reinfeld, Samuel; Yacoub, Adeeb

doi:10.1097/yct.0000000000000789

Cited by 9 publications

(9 citation statements)

References 5 publications

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“…Yet there were patients who showed transition from delirium to psychosis (Caan et al, 2020;Clouden, 2020;Lim et al, 2020;Majadas et al, 2020;Khatib et al, 2021) and vice versa (Elkhaled et al, 2020;Panariello et al, 2020a;Jozuka et al, 2021) or states alternating between delirium and psychosis (Bernard-Valnet et al, 2020). Sometimes, delirium was reported as concomitant disorder or as a differential diagnosis to psychosis (Bernard-Valnet et al, 2020;Gillett & Jordan, 2020;Losee & Hanson, 2020;Haddad et al, 2021;Parker et al, 2021;Reinfeld & Yacoub, 2021), and in more than a third of all patients, confusion was documented.…”

Section: Patients With Infectionmentioning

confidence: 99%

First-episode psychotic disorders in the wake of the COVID-19 pandemic: a descriptive review of casereports

Rittmannsberger¹,

Barth²,

Malík³

et al. 2022

Acta Neuropsychiatr.

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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, PSYCHINFO, 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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Section: Patients With Infectionmentioning

confidence: 99%

First-episode psychotic disorders in the wake of the COVID-19 pandemic: a descriptive review of casereports

Rittmannsberger¹,

Barth²,

Malík³

et al. 2022

Acta Neuropsychiatr.

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“…The main mania symptoms experienced in the cases analyzed include classical presentations of mania: insomnia ( 22 , 26 ) abnormal behavior ( 23 , 24 , 27 ), delusions ( 30 , 31 ), irritability ( 34 , 36 ), agitation ( 35 ), aggressive behavior ( 33 , 37 ), anxiety ( 37 ), impaired concentration ( 21 ), persecutory beliefs ( 30 ), auditory hallucinations ( 21 , 25 ), grandiose ideas ( 21 , 28 , 29 ). These findings support the hypothesis that the psychiatric condition experienced is no other than a manic episode, therefore not representing a separate diagnostic entity.…”

Section: Discussionmentioning

confidence: 99%

Clinical Aspects of Manic Episodes After SARS-CoV-2 Contagion or COVID-19

et al. 2022

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As COVID-19 pandemic spread all over the world, it brought serious health consequences in every medical field, including mental health. Not only healthcare professionals were more prone to develop anxiety, depression, and stress, but the general population suffered as well. Some of those who had no prior history of a psychiatric disease developed peculiar symptoms following infection with SARS-CoV-2, mostly because of psychological and social issues triggered by the pandemic. People developed traumatic memories, and hypochondria, probably triggered by social isolation and stress. Infection with SARS-CoV-2 has influenced the mental health of psychiatric patients as well, exacerbating prior psychiatric conditions. In this review, we focus on analyzing those cases of mania in the context of bipolar disorder (BD) reported after COVID-19 disease, both in people with no prior psychiatric history and in psychiatric patients who suffered an exacerbation of the disease. Results have shown that COVID-19 may trigger a pre-existing BD or unmask an unknown BD, due to social and psychological influences (decreased social interaction, change in sleep patterns) and through biological pathways both (neuroinflammation and neuroinvasion through ACE-2 receptors expressed in the peripheral and central nervous systems (PNS and CNS respectively). No direct correlation was found between the severity of COVID-19 disease and manic symptoms. All cases presenting severe symptoms of both diseases needed specific medical treatment, meaning that they concur but are separate in the treatment strategy needed. This review highlights the importance of a now widespread viral disease as a potential agent unmasking and exacerbating bipolar mood disorder, and it can hopefully help physicians in establishing a rapid diagnosis and treatment, and pave the road for future research on neuroinflammation triggered by SARS-CoV-2.

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“…Melo and Serra 22 1 case There were 8 sessions of ECT with complete resolution. Reinfeld and Yacoub 12…”

Section: Publicationmentioning

confidence: 99%

An Examination of Electroconvulsive Therapy and Delivery of Care in Delirious Mania

Reinfeld¹,

Yacoub²

2022

J ECT

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Objectives: Delirious mania is a severe life-threatening syndrome, often misdiagnosed, and eminently treatable as a variant of catatonia. Our aim is to provide a comprehensive examination of electroconvulsive therapy (ECT) parameters and clinical features, as well as describe the delivery of care of the patients with delirious mania.Methods: A retrospective study was conducted of the ECT records at Stony Brook University Hospital from years 2014 to 2021. We characterized demographic and clinical variables, including psychiatric diagnoses and ECT parameters of patients identified with delirious mania. Results:We identified 8 cases (3 women) of delirious mania with 8 corresponding acute treatment series. The mean age was 43.2 ± 12.6 years (range, 23-59 years). There were a total of 55 sessions performed with an average of 6.9 ± 2.6 (range, 5-13); 45 (82%) were bilateral (bifrontal or bitemporal) and 10 (18%) were right unilateral electrode placement. In 40 (73%) of the sessions, a high-energy stimulus was used (>60%, or 302 millicoulombs). Seizure duration measured on electroencephalogram was 47.4 ± 25.9 seconds (range, 0-143 seconds). Motor seizure duration measured on electromyogram was 32.7 ± 14.9 seconds (range, 0-66 seconds). In 6 cases, ECT was delayed for 10 days, and patients were given inappropriate treatments. High-dose antipsychotics caused worsened aggression and hemodynamic instability requiring physical restraints in 50% of cases. Conclusions:The clinical presentation of delirious mania remains poorly recognized, and its treatment is often delayed, which may result in negative outcomes. Bilateral ECTwith high-energy dosing yielded a rapid remission of symptoms.

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A Case of Delirious Mania Induced by COVID-19 Treated With Electroconvulsive Therapy

Cited by 9 publications

References 5 publications

First-episode psychotic disorders in the wake of the COVID-19 pandemic: a descriptive review of casereports

First-episode psychotic disorders in the wake of the COVID-19 pandemic: a descriptive review of casereports

Clinical Aspects of Manic Episodes After SARS-CoV-2 Contagion or COVID-19

An Examination of Electroconvulsive Therapy and Delivery of Care in Delirious Mania

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