Posttraumatic Stress Disorder Exacerbation as a Result of Public Masking in Times of COVID-19

Self Cite

The universal donning of masks during the coronavirus disease 2019 pandemic led to a decreased ability to read people's facial expressions. In this context, it is prudent to think about how diagnoses can be missed or worsened by the practice of mandatory masking. Here, we report the case of an adolescent white male who presented with new-onset agitation, akathisia, and orofacial dyskinesia in the context of chronic stimulant use for the treatment of attention-deficit hyperactivity disorder and antipsychotic use for oppositional defiant disorder.

Section: Discussionmentioning

confidence: 99%

Masked Tardive Dyskinesia in the Coronavirus Disease 2019 Era

Laboe

Jain

Sam

2021

Self Cite

“…The authors were able to identify only one published case series within the past decade describing the relationship between MPH and RP [3]. Another distinct possibility is a latent COVID-19 infection or exacerbation of symptoms of RP secondary to increased anxiety and depression caused by the sense of isolation due to the pandemic [5,12,13]. A previously documented case describes a 19-year-old female who initially developed mild RP that worsened in severity over three years while on MPH and was subsequently diagnosed with systemic sclerosis [3].…”

Section: Discussionmentioning

confidence: 99%

“…It is noteworthy that medical and psychiatric illnesses reported during the COVID-19 pandemic have had varied and unprecedented types of presentations. Numerous studies have documented exacerbation and different manifestations of diseases either due to pandemic-related stress or due to infection and post-infection sequelae [ 2 , 5 , 6 ]. In this report, we discuss the case of a 14-year-old Caucasian female who presented with chief complaints of suicidal ideations and attempted suicide by overdosing on ibuprofen tablets and had a history of attention-deficit hyperactivity disorder (ADHD) and persistent RP after a stimulant trial.…”

Section: Introductionmentioning

confidence: 99%

Persistent Raynaud's Phenomenon Following Methylphenidate Hydrochloride Use During the COVID-19 Pandemic

Laboe

Batchelder²,

Vasireddy³

2021

Self Cite

Raynaud's phenomenon (RP) is a medical condition characterized by vasospasm of the digital vessels in the fingers and toes. The prevalence of RP in the general population is estimated at 3-5% and can vary based on climate. It is classified into primary and secondary RP based on causality. RP has been reported in some cases diagnosed with coronavirus disease 2019 (COVID-19) infection. We report the case of a 14-year-old Caucasian female who presented during the pandemic with chief complaints of suicidal ideations and attempted suicide and had a history of attention-deficit hyperactivity disorder (ADHD) and persistent RP after a stimulant trial. After an initial failure of treatment with lisdexamfetamine, she was switched to methylphenidate hydrochloride (MPH). Within two months of starting MPH, the patient noticed skin discoloration of the lower legs and feet along with numbness. The discoloration of skin was mainly limited to her feet and gradually moved up her legs. She was advised to discontinue the MPH, but her symptoms persisted for four more months until her admission. Other etiologies were ruled out by multi-specialties and during her hospitalization. She was started on atomoxetine and buspirone with appropriate dose titration. Post-discharge from the hospital, no improvement was observed in the patient's RP at an outpatient follow-up performed within a month. The development of RP following MPH treatment and its persistence after stopping MPH is a fascinating event. Clinicians should be aware of the potential rare side effects of stimulants and stimulant-like medications, including vascular, hematological, and dermatological effects. Adolescents with ADHD may be particularly distressed by the COVID-19 pandemic and display increased behavioral issues. Stress can be a trigger for RP; therefore, minimizing stress in at-risk patients is essential.

“…Coronavirus disease (COVID-19) is a strain of the coronavirus family that was initially identified in Wuhan, China in late 2019, and subsequently quickly spread across the globe. The pandemic has led to worsening of existing mental health conditions and new onset of psychiatric illnesses in the context of increased stressors in adults and children alike [1,2]. The COVID-19 pandemic has been a cause of significant psychological stress for most individuals, and social factors such as isolation, anxiety, and financial difficulties have been implicated in playing a role in the development of various neuropsychiatric complications [3].…”

Section: Introductionmentioning

confidence: 99%

New-Onset Catatonia and Delirium in a COVID-Positive Patient

Kaur

Khavarian

Basith

et al. 2021

Coronavirus disease (COVID-19) is a strain of coronavirus family, which was initially found in China in late 2019 and subsequently spread to rest of the world. COVID-19 has led to physical and mental health complications since its onset. In addition to the pandemic-associated social stresses, biological complications include direct viral encephalitis, autoimmune-mediated responses, medication side effects, hypoxic brain injury, and delirium, which can collectively cause varied presentations of neuropsychiatric symptoms. Neuropsychiatric complications have been reported in the acute stages of COVID-19 and postinfection period. Here we report our experience treating a patient who initially presented with a severe depressive episode and subsequently developed catatonia and delirium following hospital-acquired COVID-19 infection.