First Manic Attack During COVID-19 Treatment: A Case Report

Varsak, Nalan; Topaloğlu, Mert; Özdemir, Elif Yetkin

doi:10.9758/cpn.2021.19.4.786

Cited by 9 publications

(9 citation statements)

References 19 publications

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“…The severity of COVID-19 was different among them, most often it was mild or moderate infection, and the manic symptoms developed at varying time intervals from the onset of COVID-19 symptoms. In three patients, SARS-CoV-2 infection was not confirmed by a formal test, but only on the basis of the clinical picture and characteristic imaging changes in the lungs [ 27 , 31 , 32 ]. The most common symptoms of mania among them were: insomnia, elevated mood, agitation, irritability, delusions, grandiosity and talkativeness.…”

Section: Resultsmentioning

confidence: 99%

“…The most common symptoms of mania among them were: insomnia, elevated mood, agitation, irritability, delusions, grandiosity and talkativeness. Acute manic episode was diagnosed in 26 patients [ 24 , 25 , 26 , 27 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 ], hypomanic episode in 3 [ 32 ], steroid-induced mania in 4 [ 41 , 42 , 43 , 44 ], delirious mania in 2 [ 45 , 46 ], and a full diagnosis of BD was given in 1 patient [ 47 ]. The details of the patients are described in Table 1 .…”

Section: Resultsmentioning

confidence: 99%

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Is SARS-CoV-2 a Risk Factor of Bipolar Disorder?—A Narrative Review

Lorkiewicz

Waszkiewicz

2022

JCM

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For 2.5 years we have been facing the coronavirus disease (COVID-19) and its health, social and economic effects. One of its known consequences is the development of neuropsychiatric diseases such as anxiety and depression. However, reports of manic episodes related to COVID-19 have emerged. Mania is an integral part of the debilitating illness—bipolar disorder (BD). Due to its devastating effects, it is therefore important to establish whether SARS-CoV-2 infection is a causative agent of this severe mental disorder. In this narrative review, we discuss the similarities between the disorders caused by SARS-CoV-2 and those found in patients with BD, and we also try to answer the question of whether SARS-CoV-2 infection may be a risk factor for the development of this affective disorder. Our observation shows that disorders in COVID-19 showing the greatest similarity to those in BD are cytokine disorders, tryptophan metabolism, sleep disorders and structural changes in the central nervous system (CNS). These changes, especially intensified in severe infections, may be a trigger for the development of BD in particularly vulnerable people, e.g., with family history, or cause an acute episode in patients with a pre-existing BD.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Is SARS-CoV-2 a Risk Factor of Bipolar Disorder?—A Narrative Review

Lorkiewicz

Waszkiewicz

2022

JCM

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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%

“…Regarding the hypothesis that the pandemic social consequences themselves can be triggering factors for a previously unknown BD [as happened in some case reports analyzed: Uzun et al ( 36 ), Varsak et al ( 37 ), Meltem et al ( 32 )] or an exacerbating factor for those who had already been diagnosed with BD ( 52 , 53 ), this appears to be relevant, as previous studies have already shown that social disasters can exacerbate BD mania symptoms but no other psychiatric disorders ( 54 ). Lockdown measures adopted to embank the pandemic influenced some of those factors which are crucial in mood maintenance in BD, such as sleep and social interactions, therefore possibly causing exacerbation of the mood disorder ( 55 ).…”

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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“…Although few, cases of mania and psychosis associated with COVID‐19 infection have been reported in the literature. 3 , 4 In this case, we present a female patient who experienced their first manic episode during the course of a COVID‐19 infection, with which she was infected after an incidental IVF treatment.…”

Section: Introductionmentioning

confidence: 99%