RESUMO
Presents a case report of a 45-year-old woman with a brief psychotic disorder, in which pathogeny was an effect of the pandemic, modulating a classic syndrome described more than one century ago by Ernst Kretschmer. During the mandatory screening before hospital admission, the patient tested positive for SARS-CoV-2. Basic tests were performed, including blood alcohol concentration, urinary drug screening, and brain computerized tomography - all normal. Regarding her premorbid personality, she had cluster C personality traits. The discharge diagnosis was a Brief psychotic disorder. Other differential diagnoses were considered such as schizophreniform disorder, psychotic depression, bipolar disorder, late-onset schizophrenia, but the rapid onset of the picture, the brief resolution, the absence of dominant affective symptomatology, and the absence of negative symptomatology led to assume that it was more likely a brief reactive psychosis. antipsychotic medication was suspended gradually and she didn't present any recurrence of symptoms. In this case report, the author reviews a classic nosological entity, commonly forgotten, revived by a very current and particular social situation (the COVID-19 pandemic), whose social conditionings can affect mental health. The author emphasizes the importance of a thorough anamnesis with a complete evaluation of the premorbid character, which allowed an early intervention and subsequent better prognosis. (PsycInfo Database Record (c) 2023 APA, all rights reserved)
RESUMO
Background: Since the outbreak of COVID-19, vaccination has been considered as an important measure against it. Side effects have always been an inseparable component of vaccination, which in this study, Sinopharm vaccine, its side effects and the differences of their manifestation amongst men and women have been investigated. Objective(s): This study aimed to compare the side effects of the Sinopharm vaccine among men and women working in some medical centers in Tehran, Iran. Method(s): This cross-sectional descriptive-analytical study on 890 healthcare workers of 7 medical centers in Tehran within 2 months, from late June to late August 2021. The samples were selected by the complete enumeration method, and the required data were collected using a questionnaire. Only those who received the Sinopharm vaccine at least 10 days before the study were included. Result(s): Of 890 participants, 22.96% and 77.30% were women and men, respectively, and 65.8% of women and 78.1% of men were in the age range of 20-29 years. It was revealed that 74.75% of women and 26.16% of men had at least one side effect. The incidence of at least one side effect was significantly higher in women than in men (P<0.001). It was also found that 12 side effects were significantly higher in women than in men. Most men and women had side effects within the first 24 h after vaccination. There was no significant difference in taking therapeutic measures to reduce or minimize the post-vaccination complications between men and women;however, 9.4% of men and 27.2% of women reported a decline in their ability to perform daily activities as they were unable to do their everyday tasks the day after vaccination which was significantly different between the two groups (P<0.001). Conclusion(s): The results showed that the occurrence rate of side effects after receiving the Sinopharm vaccine was significantly higher in women than in men. Moreover, women were significantly less able to perform daily routines than men.Copyright © 2022, Author(s).
RESUMO
Introduction: Post-COVID-19 autoimmune encephalitis is a rare manifestation following COVID-19. Most cases have not demonstrated solid evidence regarding their pathogenesis. Some believe it to be an immune process. Case presentation: In this case report, we present a case of a young female who presented to our emergency department with visual, auditory, and olfactory hallucinations after successfully treating COVID-19 two weeks prior to this visit. On examination, her vital signs were stable, but she was agitated, distressed, and hallucinating. Neurological examinations were normal. Laboratory investigations, including autoimmune profiles, were all negative. Magnetic resonance imaging of the brain showed non-specific changes in the bilateral frontal area. Electroencephalography (EEG) showed lateralized rhythmic delta activity (LRDA) arising more from the right occipital lobes. Autoimmune psychosis was suspected due to psychosis, abnormal imaging, and abnormal EEG findings. She was given corticosteroids and antipsychotic medication. Her symptoms improved within ten days. On follow-up, she remained well without any return of psychosis. Conclusion(s): Possible autoimmune pediatric encephalitis following COVID-19 is a rare entity that has scarcely been reported. The majority of the cases were reported to have been related to stress following the infection. To establish the correct diagnosis, an extensive workup, including an autoimmune profile, lumbar puncture, magnetic resonance imaging, and electroencephalography, is recommended.Copyright © 2022 The Author(s)
RESUMO
The world is currently going through an extremely stressful time due to the COVID-19 pandemic. This exceptional and alarming situation could increase the incidence of mental health problems, including acute psychotic disorders. Our observation reports two cases of patients with an acute psychotic episode, with a delusional theme related to the coronavirus pandemic. The two patients, who did not have a previous history of psychiatric disorders, were hospitalized in our psychiatry department, after the start of mandatory sanitary confinement in our country. The clinical symptoms found were mainly a hallucinatory syndrome and a delusional syndrome with a religious theme, and delusional ideas centered on COVID-19. This case report suggests that intense psychosocial stress, caused by the current global crisis and confinement measures, may be a trigger for new-onset psychotic episodes, and impact the clinical and delusional expression of acute psychosis.
RESUMO
Psychiatrists face complex ethics dilemmas in the COVID-19 pandemic era when assessing dangerousness in patients or forensic evaluees who threaten to purposely infect others or spread the virus. Understanding local public health and medical quarantine laws for their jurisdictions can help guide treating psychiatrists in how to handle some of these situations; however, challenges occur when what is ethically best conflicts with the action that will confer the greatest protection against legal liability. Additionally, the calculus of weighing competing ethics considerations changes based on how relevant it is to the duties of a particular role (e.g., treatment, forensic, research, managed care, etc.) as well as the contextual factors of the situation. We present dialectical principlism as a framework to help psychiatrists resolve such ethics dilemmas related to the COVID-19 and future pandemics, illustrating how it can be applied in different roles (i.e., treatment versus forensic) and situations (i.e., when it is clear the danger of viral transmission is secondary to a delusion versus a delusion-like belief) to come to the best outcome that balances patient welfare, legal considerations, and societal safety. Occasionally, the most ethical action may entail small liability risks.
RESUMO
Introduction: Conspiratorial beliefs are often maladaptive for individuals and dangerous for societies. Other prevalent belief systems such as (normative) religious belief and (pathological) delusional belief show parallels to conspiratorial beliefs, which may also be linked to excessive social media exposure. We conducted an online survey to characterize heterogeneous profiles of conspiracy-mindedness, with respect to these other phenomena. Methods: Eight hundred and thirty six American adults from online panels completed validated questionnaires including the Conspiracy Mindedness Questionnaire (CMQ), Centrality of Religion Scale (CRS), Peters Delusion Inventory (PDI; 21-item version), and Facebook Addiction Scale (FAS). Additionally, they completed 4 questions addressing categorical belief in the origin of SARS-CoV-2, and pandemic-related health behaviors. Total scores on each questionnaire were Z-transformed and entered into K-means cluster analysis. Cluster membership was used in post-hoc analyses to compare pandemic-related items. Results: An optimal solution included 3 clusters with above-mean (high) CMQ and 3 below-mean (low) CMQ scores. The 3 high-CMQ clusters included: (1) high-religion, low-social media addiction; (2) high religion, social media addiction and delusion; (3) low religion and delusion. High-CMQ clusters 1 and 2 each had rates of zoonotic and malevolent viral origin beliefs that were relatively lower and higher than the grand sample rates, respectively. Significant differences in intended pandemic health-related behaviors among the high-CMQ clusters (compared to the rest of the sample) included Cluster 1-high on Precautions and low on Vaccination; Cluster 2-high on Testing. Respondents who endorsed SARS-CoV-2 origin beliefs (across clusters) that were least plausible and most malevolent were least inclined to engage in pandemic health behaviors. Conclusions: Distinct subpopulations of persons with high conspiracy-mindedness exist, which are highly heterogeneous in their other coexisting beliefs and behaviors. Some of these may be pathological, such as delusional belief and social media addiction-like behavior, and they have varied associations with pandemic-related belief and behavior. These results, while cross-sectional, suggest that the psychological origins and consequences of conspiratorial beliefs may not be unitary. Instead, conspiratorial belief may be a common expression of diverse psychological and social/experiential factors, and in turn exert varied influence on decisions and overt behavior.
RESUMO
Objective To demonstrate a case of suspected post-vaccine autoimmune encephalitis associated with leucine-rich glioma-inactivated protein (LGI1) antibodies with significant clinical improvement after initiation of immunotherapy nearly a year after symptom onset. Background Although the autoimmune encephalitides have overlap in presentation, some have unique manifestations (such as orofacial dyskinesias seen with NMDA encephalitis). These unique associations can serve as a clinical marker of response to treatment and even allow for earlier initiation of immunotherapy while awaiting results from antibody testing. LGI1 encephalitis characteristically presents with faciobrachial dystonic seizures (FBDS) that are refractory to anti-seizure medications (ASMs) but responsive to immunotherapy. Design/Methods Case report Results A previously healthy and highly independent 89-year-old woman developed what she described as abnormal posturing and spasms of the right shoulder two to three weeks after receiving the J&J COVID-19 vaccine. The abnormal movements progressed to involve the right side of her face and were refractory to multiple ASMs. EEG captured multiple events without epileptiform correlate. Several months later she developed paranoia, delusions, and hallucinations. Autoimmune encephalopathy panel returned positive for the LGI1-antibody around nine months after the onset of FBDS. Upon our initial exam, she had a fluctuating level of arousal, impaired recall of recent events, and was tangential in conversation. There were frequent, brief, repetitive, dystonic movements of the right side of the face consistent with FBDS. Admission was arranged for immunotherapy (intravenous methylprednisolone and intravenous immunoglobulin). Upon follow-up four weeks later, there was significant improvement in arousal and concentration with resolution of FBDS and delusions. Conclusions This case highlights a classic case of LGI1 encephalitis after vaccination presenting with FBDS and progressive cognitive changes. Despite immunotherapy being delayed, there was marked clinical improvement. It is important to recognize this entity and that it typically has a favorable outcome.
RESUMO
Introduction: Conspiracy theories are popular during the COVID- 19 pandemic. Conspiratorial thinking is characterised by the strong conviction that a certain situation that one sees as unjust is the result of a deliberate conspiracy of a group of people with bad intentions. Conspiratorial thinking appears to have many similarities with paranoid delusions. Objective(s): To explore the nature, consequences, and socialpsychological dimensions of conspiratorial thinking, and describe similarities and differences with paranoid delusions. Method(s): Critically assessing relevant literature about conspiratorial thinking and paranoid delusions. Result(s): Conspiratorial thinking meets epistemic, existential, and social needs. It provides clarity in uncertain times and connection with an in-group of like-minded people. Both conspiratorial thinking and paranoid delusions involve an unjust, persistent, and sometimes bizarre conviction. Unlike conspiracy theorists, people with a paranoid delusion are almost always the only target of the presumed conspiracy, and they usually stand alone in their conviction. Furthermore, conspiracy theories are not based as much on unusual experiences of their inner self, reality, or interpersonal contacts. Conclusion(s): Conspirational thinking is common in uncertain circumstances. It gives grip, certainty, moral superiority and social support. Extreme conspirational thinking seems to fit current psychiatric definitions of paranoid delusions, but there are also important differences. To make a distinction with regard to conspiratorial thinking, deepening of conventional definitions of delusions is required. Instead of the strong focus on the erroneous content of delusions, more attention should be given to the underlying idiosyncratic, changed way of experiencing reality.
RESUMO
Introduction: Hypochondria is characterized by the presence, for 6 months or more, of a generalized and non-delusional concern with fear of having (or the idea that one has) a serious illness, based on the wrong interpretation of the symptoms. In somatic-type delusional disorder, the delusional idea is fixed, indisputable, and occurs intensely because the patient is fully convinced of the physical nature of the disorder. Objective(s): To describe a clinical case and make a differential diagnosis of hypochondriac disorder vs somatic-type delusional disorder. Method(s): Case report: 61-year-old woman, after suffering from COVID-19, develops a hypochondriacal disorder vs. somatic delusional disorder, presenting anxiety-depressive symptoms and digestive somatic complaints, with a loss of 15 kg of weight. She made frequent visits to doctors and multiple complementary tests discarding organicity. She required involuntary hospital admission for 48 days, and pharmacological treatment with Venlafaxine 150 mg, Olanzapine 5mg, Mirtazapine 30mg and Alprazolam 1mg. The patient presented slow evolution during admission, with ups and downs and stagnation, meriting enteral nutrition due to refusal to ingest, given abdominal kinesthetic hallucinations and digestive evaluation (EDS) with a result of antral gastritis and negative H. pylori. In subsequent follow-ups after partial remission of symptoms, obsessive personality traits are glimpsed, although with better personal functioning. Result(s): The diagnosis at discharge was inconclusive, however the data points to a somatic-type delusional disorder. Conclusion(s): The influence of COVID-19 as a triggering factor, social isolation and premorbid personality traits, influence the development of a Somatic Delusional Disorder vs Hypochondriac Disorder, regarding this case.
RESUMO
Introduction: A major increase in mental health issues was noted since the outbreak of the covid-19 pandemic even in patients with no history of mental health illness, specifically brief psychotic disorders. Objective(s): Establish the covid-19 pandemic circumstances as precipitating factors of psychosis independently from other stressors Methods: This is a cross-sectional and descriptive study carried out in the psychiatric department of the University Hospital of Mahdia including two groups of patients over a period of 15 months: From October 2018 to December 2019 are pre-covid cases, and the second group consists of the ones admitted between June 2020 and August 2021. We have collected the data of patients diagnosed with brief psychotic disorder according to DSM-5. We have focused on two clinical characteristics of the psychotic episodes (theme of delusions, stressors). Result(s): We have collected 19 patients, 12 among them during the pre-covid period. In our pre-covid period, brief psychotic disorder presented mostly with marked stressors (33.3%) whilst in the middle of the pandemic, marked stressors are present in only 14.3% of the cases. Which could suggest that this state of alarm can singlehandedly trigger psychosis. For the theme of delusions, in the pre-covid period, the religious theme appeared to be the most frequent (58.3%), whilst during the pandemic, persecution became the most prevalent (71.4%), showing how living in fear of contracting the virus could manifest itself in delusional content. Conclusion(s): Living in a prolonged state of alarm is, in itself, a marked stressor, theoretically capable of increasing the psychosis rate and altering its characteristics.
RESUMO
Introduction: COVID-19 infection may lead to encephalopathy and various neurotrophic effects which can result in neuropsychiatric complications. Here, an asymptomatic adolescent female developed acute onset catatonia and psychosis manifesting during the resolution of Covid-19 infection. Objective(s): Discuss differential diagnosis, medical workup, and initial treatment optimization for acute stabilization. Method(s): This 15-year-old female with no previous psychiatric history nor prodromal symptomatology was hospitalized secondary to Covid -19. During the immediate three-month recovery phase following resolution of Covid-19, the patient exhibited gradually increasing anxiety, paranoia, delusions, disorganized behavior, and weight loss leading to re-hospitalization secondary to catatonia. Negative workup included rapid strep test, urinalysis, chest and abdominal x-ray, EEG, and brain MRI. Lumbar puncture revealed elevated WBC of 18 but was unremarkable for NDMA receptor antibodies, CSF HSV, and encephalitis panel. IV steroids, IVIG, and Anakinra were all given without benefit. Inadequate response to olanzapine, clonidine, and lorazepam led to an Index Series of bilateral electroconvulsive therapy (ECT). Result(s): The provisional diagnosis of psychotic disorder secondary to COVID-19 infection responded robustly regarding sleep, behavior, and affect by session #6, yet positive symptoms of psychosis persist. Ongoing ECT, psychopharmacology, and narrowing of the differential diagnosis continue. Conclusion(s): As more COVID-19 cases evolve during the pandemic, potential post-infectious neuropsychiatric complications should be considered as potentially contributory and kept in a thoughtful differential diagnosis. Regardless of ultimate causation, the acute symptom profile responded robustly to an initial Index Series of ECT.
RESUMO
Introduction: A 21-year-old woman diagnosed with bipolar disorder was hospitalized in the Mental Health Day Hospital of Salamanca during the Covid pandemic. The patient engaged with 4 different jobs and a master's degree, beginning with verbose speech, dysphoria, global insomnia, grandiose delusions, extremely high energy and thinking she has the vaccine. She works the following objectives: illness insight, risk factors, psychopathological stabilization, social skills, slowing down of activities and taking responsibilities. Objective(s): The objective is do a follow-up of the patient during her hospitalization in the Mental Health Day Hospital and to carry out a structured search in PubMed and Up-to-Date about psychotherapy and bipolar disorder. Method(s): 3-month follow-up of a 21-year-old woman diagnosed with bipolar disorder during her hospitalization in the Mental Health Day Hospital in Salamanca and a structured search in PubMed and Up-to-Date in April 2021 in English, French and Spanish, including the last 10 years with the keywords "psychotherapy", "psychotherapies" and "bipolar disorder ".77 studies were analyzed: 12 included, 65 excluded. Result(s): Several randomized trials highlight the efficacy of group psychoeducation and cognitive-behavioural therapy in relapse prevention, improving illness insight, medical adherence and less hospitalizations. Therapeutic alliance plays a significant role in the process. Our patient improved her knowledge of her illness and treatment, her social skills and reconnected with her relatives and slowed down her activity. She then was referred to her community mental heath center psychiatrist. Conclusion(s): The insight in bipolar disorder plays an important role in medical adherence and prevention of relapses. Therapeutic alliance improves their insight, their functionality in their daily life and enables close monitoring. Medical treatment should be accompanied by psychotherapy for a complete approach of the treatment.
RESUMO
Introduction: As disorders of thought, delusions are modified by patients' background, and so their content varies widely according to location and throughout the ages. The COVID-19 pandemic has shown its global impact on society and mental health of the population, thus becoming a new delusional topic. Objective(s): We report a case where the COVID-19 pandemic has been integrated into a patient's delusion in an attempt to raise professional awareness for this new psychotic presentation. Method(s): Review of clinical notes and literature review. Result(s): A 38-year-old female patient with no prior psychiatric history presented with psychotic symptoms characterized by selfreferential ideas, feelings of guilt and delusions of ruin, with a sudden onset of less than 24 hours prior to observation. The patient claimed that she was the coronavirus and, as such, she was a common topic of conversation in both television and social media, and the reported deaths caused by COVID-19 were her own doing. As a result of this, the patient was asking doctors to kill her in order to save everyone else affected by the virus. After evaluation, a diagnosis of Acute and Transient Psychotic Disorder was considered. The patient was initially treated with paliperidone, but due to hyperprolactinemia and menstrual changes this was switched to aripiprazole. Symptoms remitted fully after 21 days of treatment, and six months later no recurrences have been described. Conclusion(s): This case illustrates the potential of the coronavirus pandemic outbreak as a new delusional topic. Possible side effects of treatment are also discussed.
RESUMO
Voici un siècle, alors que se répandait l'épidémie de grippe dite espagnole, René Cruchet, en France, et Constantin von Economo, en Autriche, attiraient l'attention des médecins militaires et civils sur l'apparition d'une autre pandémie, l'encéphalite léthargique. Après une phase de somnolence irrépressible plus ou moins prolongée, ceux qui survivaient développaient, progressivement, des séquelles permanentes de type syndrome parkinsonien ou paroxystiques à type de dystonies variées. Les patients étaient souvent des enfants et de jeunes adultes. De 1920 à 1946, la Société Médico-Psychologique consacre vingt séances à l'étude des séquelles neuropsychiatriques de ces encéphalites. À côté des mouvements anormaux, les psychiatres prennent en charge des délires hallucinatoires, des comportements violents et agressifs avec désinhibition sexuelle, des épilepsies myocloniques, etc. Il ressort des présentations cliniques résumées ici que cette pandémie permet aux psychiatres de rapporter à des lésions diencéphaliques et mésencéphaliques des détériorations psychiatriques comme jamais ils ne l'avaient fait auparavant. L'hypothèse étiologique actuelle conclut cette présentation. A century ago, when the so-called Spanish flu epidemic was spreading, René Cruchet in France and Constantin von Economo in Austria drew the attention of military and civilian physicians to the existence of another pandemic, encephalitis lethargica. After a more or less prolonged phase of irrepressible drowsiness, those who survived progressively developed permanent sequelae, i.e. parkinson' syndrome, or various types of paroxysmal dystonia. The patients were often children and young adults. From 1920 to 1946, the Société Médico-Psychologique devoted twenty sessions to the study of the neuropsychiatric sequelae of these encephalitides. In addition to abnormal movements, psychiatrists treated hallucinatory delusions, violent and aggressive behaviors with sexual disinhibition, myoclonic epilepsy, etc. The clinical presentations summarized here seem to demonstrate that this pandemic allowed psychiatrists to relate psychiatric deterioration to diencephalic and mesencephalic lesions in a way that they had never done before. The current etiological hypothesis concludes this presentation. [ FROM AUTHOR]
RESUMO
COVID-19 has become one of the main causes of febrile illness among emergency department patients and is always a differential diagnosis to keep in mind. Nonetheless, some patients with a history of exposure, persistent fever, and suspicion of COVID-19 end up having entirely different etiologies. Here, we present the case of a 29-year-old male biologist with an uncommon presentation of a zoonotic disease, characterized by unspecific signs and symptoms, which led to a delayed diagnosis, causing significant emotional distress in the patient. We also coin the term "COVID-19 Mirage," to serve as a constant reminder for clinicians of the effect that COVID-19 has caused on the differential diagnosis of fever of unknown etiology.
RESUMO
SARS-CoV-2, the pathogen responsible for COVID-19, has infected hundreds of millions since its emergence in late December 2019. Recently, concern has been raised due to the increased prevalence of co-infections with opportunistic pathogens among these pa-tients. Though not common, co-infections may be associated with adverse outcomes and increased risk of morbidity and mortality among patients suffering from COVID-19. Cytomegalovirus (CMV) infection is a serious problem among immunocompromised and critically ill patients. So far, few cases of co-infection with COVID-19 and CMV have been reported. Here, we report the co-infection with COVID-19 and CMV in a young woman presenting with sudden, progressive fever, delusion, agitation, bizarre behavior, seizure, and loss of consciousness leading to death despite receiving appropriate anti-viral treatment. To the best of our knowledge, this is the first case of coexisting SARS-CoV-2 and CMV infection presenting with severe, progressive meningoencephalitis in the era of COVID-19.
RESUMO
BACKGROUND: Cotard syndrome is a rare neuropsychiatric condition in which individuals have delusions of being deceased or losing their organs. It is often seen in patients with severe depression and is associated with catatonia.1 Neurosyphilis is a severe sequelae of untreated treponema pallidum infection in which the paretic form of this disorder commonly has a psychiatric presentation. 2 We present a rare case of Cotard syndrome in a patient with neurosyphilis with successful treatment. OBJECTIVE: To understand Cotard syndrome and underlying neuropsychiatric conditions, and characterize the diagnosis and management of psychiatric symptoms in a patient with neurosyphilis. METHODS: Review of a case using electronic medical records and relevant literature. Key terms searched: 'Cotard syndrome,' 'neurosyphilis,' 'COVID-19 infection' using Medscape and Google Scholar. RESULTS: We present a 49-year-old male with a history of alcohol use disorder in remission, depression, and history of COVID-19 (asymptomatic) 6 months prior. The patient presented to the emergency department for recent changes in behavior. He was agitated, threatening, and required chemical and physical restraint. Evaluation was notable for illogical thought processes with somatic delusions. He repeatedly stated, 'I am already dead, my organs have died,' and had an episode of catatonia. All tests including drug screen and COVID-19 were negative. Rapid plasma regain (RPR) titer was 1:64. Neurology and Infectious Disease were consulted. Lumbar puncture revealed positive venereal disease research laboratory (VDRL) titer of 1:4. The patient was diagnosed with neurosyphilis and major depressive disorder with psychosis with Cotard syndrome. He was treated with intravenous (IV) penicillin G and was discharged on oral mirtazapine 30 mg and olanzapine 20 mg nightly at bedtime, oral donepezil 5 mg daily, thiamine, and folate. CONCLUSIONS: Cotard syndrome is often seen in depression with psychotic features.1 Neurosyphilis can present with depression, anxiety, psychosis, and dementia. Early identification is the key for successful treatment. This is a unique case of neurosyphilis with features of Cotard syndrome in a patient with a history of depression with treatment noncompliance. Studies show that quetiapine and risperidone improve psychosis in neurosyphilis.5 In this case, neurosyphilis was successfully treated with IV penicillin G for 2 weeks. The patient was also tried on antipsychotics and mood stabilizers ' specifically aripiprazole, valproic acid, and haloperidol ' and was eventually stabilized on oral olanzapine 20 mg taken nightly at bedtime. Our differential diagnosis also included COVID-19 delirium with Cotard syndrome, which was ruled out due to a negative COVID test. To our knowledge, there are 2 cases of COVID-19 delirium with Cotard syndrome.6 We present this case to inform clinicians of rare manifestations of neurosyphilis in patients with comorbid psychiatric illness and to advance research into treatment options for psychosis in neurosyphilis.
RESUMO
Cotard syndrome (CS) is a rare one characterized by the presence of nihilistic delusions. It is typically associated with depression and is mostly seen in middle-aged women (1). A few cases have been reported in youth, of which 90% are women. Here we present a young female case diagnosed with CS. This patient is the first report of the syndrome triggered by the COVID-19 (Coronavirus disease 2019) pandemic.
RESUMO
Coronavirus disease 2019 (COVID-19) has caused a huge burden across the world. COVID-19 affects not only physical health but also neuropsychiatric health. Reported neuropsychiatric presentations due to COVID-19 include encephalopathy, mood changes, and neuromuscular dysfunction, which may occur during the infection. There have been also reports showing that the COVID-19 could provoke psychosis during the infection. However, there is still no available evidence regarding this event. In this report, three uncommon cases of new-onset psychosis with mild symptoms of COVID-19 admitted to Bali Provincial Mental Hospital in Bangli, Indonesia are described. The patients had presented persecutory delusions and auditory hallucinations. None of the patients had suicidal ideation or behavior. Three of the cases met the criteria for brief psychosis according to Indonesia’s guidelines for mental health disorders and classification. This report showed brief psychosis without suicidal ideation. However, clinicians have to be more alert in treating this condition due to its potential emergency risk shown in previous reports.
RESUMO
Objectives: There is often an assumption that remote monitoring is challenging to implement among individuals with schizophrenia, due to symptoms such as paranoia and suspicion of technology, however the promise of digital approaches for passive and real-time data collection has recently been emphasized as a result of the COVID-19 pandemic and increased need for digitally-enabled approaches to care and research. This research describes the use of a mHealth app by a self-selected population of users with Schizophrenia to assess the feasibility of using mobile apps for remote monitoring and research. Methods: Data from Health Storylines users between 2016-2021 who self-identified as being diagnosed with Schizophrenia is described. Data includes quantitative tracking and free text journal entries from tools designed to support the self-management of a variety of health conditions, including Schizophrenia. Results: 5,012 app users reported Schizophrenia as a diagnosed condition, all of whom reported having additional comorbidities with 70% reporting two comorbid conditions. The most frequently reported comorbidities are Anxiety disorder, Depression, Bipolar Disorder and ADD/ADHD. The three most commonly used tools were the Medication Tracker, Symptom Tracker, and Daily Moods. The most commonly reported symptoms were Hallucinations, Paranoid behavior, Hearing voices, Anxiety, Depressed mood and Delusions. Among the qualitative data, several broad themes were consistently the most frequently reported across the duration of the time period examined: Psychosocial impact of the condition, Quality of life, and Experience of the condition. Conclusions: This descriptive analysis of patient engagement with the Health Storylines app reveals that many people with Schizophrenia are willing and able to engage in mobile health technology for the purpose of self-monitoring, engagement, and research. Further research is required to understand the degree of representation of the full spectrum of patients’ experience with Schizophrenia, and the role of patient engagement in completeness and quality of data collected using mobile health apps.