Case series associated with COVID-19 pandemic in causing psychiatric morbidity

Abstract

The COVID-19 has emerged as a public health emergency across the globe. Countries all over the world have been forced to enforce nationwide lockdowns to curb the transmission of this illness, affecting millions of people. The disorder and the lockdowns enforced have resulted in a complex set of psychosocial stressors in the lives of people, affecting their resilience and causing psychological stress and mental health issues. In this case series, we aim to highlight the role of such psychosocial stressors in causing mental health problems, especially in a vulnerable individual. The first case reports the onset of first-episode mania in a healthy individual with a family history of mental illness, after the sudden demise of the patient’s mother due to COVID-19. The second case highlights the onset of psychosis in an adolescent girl following academic stress due to the inability to carry on her education through online classes. The third case demonstrates the exacerbation of dissociative episodes in a child following the financial crisis in the family during the lockdown period. In low-income to middle-income countries such as India, there is a complex interplay of the psychosocial stressors due to the COVID-19 pandemic with pre-existing issues such as poverty, socioeconomic disparity and inequity of resources leading to a ‘double hit’ for people from disadvantaged sections of the society and individuals with pre-existing mental illness or vulnerability for mental illness.

New-Onset Mania and Psychosis in Adolescents in the Context of COVID-19 Infection

“…This raises concern that stress-related reactions to the infection are an additional confounding variable. The COVID-19 pandemic places children and adolescents under significant social and family stress [ 5 ]. In the second case, there was a complex family dynamic, and the patient’s parents held opposing views regarding the etiology of his symptoms.…”

“…The few adolescent cases of psychosis that have been reported were associated with high levels of psychosocial stress [ 5 ]. It is well known that the COVID-19 pandemic caused significant stress to adults and children worldwide.…”

“…It is well known that the COVID-19 pandemic caused significant stress to adults and children worldwide. In children and adolescents, the stress manifests itself as increased anxiety, irritability, insomnia, clingy behavior due to fear of contracting infection, social isolation, and emotional distress from losing loved ones to the virus [ 3 , 5 ]. One case published in 2021 reported an episode of new-onset mania in a healthy individual after the death of her mother due to COVID-19.…”

“…One case published in 2021 reported an episode of new-onset mania in a healthy individual after the death of her mother due to COVID-19. This same case series also discussed another adolescent patient with psychosis following academic stress in a virtual setting [ 5 ].…”

COVID-19 related Psychotic Disorder: Symptomatology in Infected and Uninfected Patients

“…8. Mahapatra et al, [23] reported on 3 cases. Case 1 was a 48-year-old male hospitalized for COVID-19 and whose mother died simultaneously due to COVID-19.…”