RESUMEN
An influence of the Covid-19 pandemic on First Episode Psychosis (FEP) has been hypothesized. We previously reported an increase of FEP during the early stages of the pandemic in Milan, Italy. Here we report a 1-year follow-up of the same cohort and comparison with a FEP cohort from 2019. The higher proportion of non-chronic psychoses observed during the pandemic (58.62% in 2020 vs 43,75% in 2019) should be confirmed in larger cohorts over a longer follow-up period.
Asunto(s)
COVID-19 , Trastornos Psicóticos , Humanos , Pandemias , Estudios de Seguimiento , Trastornos Psicóticos/diagnóstico , Italia , Prueba de COVID-19RESUMEN
The ongoing Corona Virus Disease 2019 (COVID-19) pandemic appears to increase risk for mental illness, either directly due to inflammation caused by the virus or indirectly due to related psychosocial stress, resulting in the development of both anxious-depressive and psychotic symptoms. The purpose of the present study was to assess the frequency and characteristics of all patients with First Episodes Psychosis (FEP) without COVID-19 infection hospitalized in the first four months since lockdown in Milan. We recruited sixty-two patients hospitalized between March 8 to July 8, 2020 versus those first hospitalized in the same period in 2019. The two subgroups were compared for sociodemographic variables and clinical characteristics of the episodes. Patients with FEP in 2020 were significantly older than patients with FEP in 2021, and presented with significantly less substances abuse. Interestingly, patients presenting with FEP in 2020 were significantly older than patients with FEP in 2019. These data are compatible with the greater vulnerability to stressful factors during the pandemic, as well as with the greater concern regarding a possible COVID-19 infection producing brain damage causing the FEP.
Asunto(s)
COVID-19 , Control de Enfermedades Transmisibles , Hospitalización , Trastornos Psicóticos , Adulto , COVID-19/prevención & control , Femenino , Hospitalización/estadística & datos numéricos , Humanos , Italia/epidemiología , Masculino , Trastornos Psicóticos/epidemiología , Trastornos Psicóticos/etiología , Trastornos Psicóticos/terapiaAsunto(s)
Proteínas CLOCK/metabolismo , Relojes Circadianos/genética , Depresión/genética , Complicaciones del Embarazo/psicología , Adulto , Animales , Estudios de Casos y Controles , Criptocromos/metabolismo , Depresión/tratamiento farmacológico , Depresión/epidemiología , Depresión/psicología , Femenino , Factores de Transcripción Forkhead/metabolismo , Productos del Gen env/metabolismo , Edad Gestacional , Humanos , Inflamación/genética , Metilación , Ratones , Proteínas Circadianas Period/metabolismo , Polimorfismo de Nucleótido Simple/genética , Embarazo , Proteínas Gestacionales/metabolismoRESUMEN
International guidelines consider quetiapine at medium doses (300-400 mg/day) as valid options for the treatment of bipolar depression for the supposed lower risk of a switch to hypomania/mania than antidepressants. Norquetiapine is an active metabolite with antidepressant action. We describe three cases of induced hypomania in bipolar type 2 subjects who received quetiapine extended-release monotherapy (300 mg/day) for a mild/moderate major depressive episode. Quetiapine and norquetiapine plasma concentrations were measured after 1 week of treatment. Hypomania appeared after 7-10 days of quetiapine extended-release monotherapy and all subjects had a quetiapine/norquetiapine plasma concentration ratio <1. We propose a ratio value <1 as a predictor of risk for a switch to hypomania in bipolar depressed subjects receiving quetiapine extended-release monotherapy. Future research should ascertain the validity of this laboratory parameter to assess the risk of quetiapine-induced hypomania in large samples of bipolar patients.