A case of Sars-Cov-2-related mania with prominent psychosis&gt;

Russo, Mirella; Consoli, Stefano; Rosa, Matteo A. De; Carrarini, Claudia; Onofrj, Marco; Angelis, Maria Vittoria De; Sensi, Stefano L.

doi:10.1016/j.psychres.2021.114266

Cited by 6 publications

(7 citation statements)

References 16 publications

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“…On the contrary, in four patients a 'lack of preoccupation' was documented and stress as a causal factor therefore excluded (Ferrando et al, 2020) (three patients), (Alvarez-Cisneros et al, 2021). One patient presented with a long-lasting manic psychosis (Russo et al, 2021), two with intense organic-like psychoses (in one patients with seizures) which led to a full diagnostic workup (Losee & Hanson, 2020;Elfil et al, 2021). One patient's psychosis was complicated by adrenal insufficiency which afforded additional CS replacement (Spiegel et al, 2021), and one patient developed a change of behaviour over 2 months, leading to a diagnosis of schizophreniform disorder (DeLisi, 2021).…”

Section: Discussionmentioning

confidence: 91%

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: Discussionmentioning

confidence: 91%

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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“…All studies regarded mania manifestations in different scenarios, and patients from cases analyzed shared a diagnosis of mania plus SARS-CoV-2 infection. Seven patients had a preexisting diagnosis of BD ( 21 , 29 ); two patients had a preexisting diagnosis of major depressive disorder/unipolar depression ( 21 , 31 ) 1 patient had a preexisting diagnosis of OCD ( 33 ), 2 of psychosis ( 21 ). Some cases, despite having a negative psychiatric history, had a positive psychiatric family history: 3 for BD ( 27 , 28 , 35 ) 1 for cognitive deficits, major depressive disorder and delirium ( 31 ).…”

Section: Resultsmentioning

confidence: 99%

“…Seven patients had a preexisting diagnosis of BD ( 21 , 29 ); two patients had a preexisting diagnosis of major depressive disorder/unipolar depression ( 21 , 31 ) 1 patient had a preexisting diagnosis of OCD ( 33 ), 2 of psychosis ( 21 ). Some cases, despite having a negative psychiatric history, had a positive psychiatric family history: 3 for BD ( 27 , 28 , 35 ) 1 for cognitive deficits, major depressive disorder and delirium ( 31 ). Since the aim of the review was to identify episodes of mania in the context of Covid-19, single patient outcome (resolution of the disease, remission, etc.)…”

Section: Resultsmentioning

confidence: 99%

“…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%

“…Studies have shown that individuals affected by BD may show an increased inflammatory status ( 49 ), therefore neuroinvasion may act as a trigger for the disease in those with a certain predisposition, culminating with the well-known manifestations of mania. Knowing the role played by the inflammatory cascade in the development of BD ( 50 , 51 ), the hypothesis that COVID-19 may be a co-protagonist in unmasking a latent BD, as has happened in some cases analyzed ( 27 , 28 , 31 , 35 , 36 ) is gaining importance, yet needing further investigation.…”

Section: Discussionmentioning

confidence: 99%

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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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Clotiapine/haloperidol/prednisone

2021

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A case of Sars-Cov-2-related mania with prominent psychosis>

Cited by 6 publications

References 16 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

Clotiapine/haloperidol/prednisone

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