COVID-19-Induced Psychosis and Suicidal Behavior: Case Report
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COVID-19
COVID-19-Induced Psychosis and Suicidal Behavior: Case Report Mason Chacko 1,2 & Asha Job 1 & Fred Caston III 1 & Prem George 3 & Adeeb Yacoub 1 & Ricardo Cáceda 1,4 Accepted: 17 September 2020 # This is a U.S. Government work and not under copyright protection in the US; foreign copyright protection may apply 2020
Abstract The COVID-19 pandemic is associated with different types of stressors: fear of infection, financial burden, and social isolation. Additionally, COVID-19 infection seems to increase the risk for neuropsychiatric symptoms including psychosis. We present a case of a 52-year-old male with no previous psychiatric history who developed severe paranoia leading to a suicide attempt. He was successfully treated with a combination of milieu treatment, pharmacotherapy, and electroconvulsive therapy. We add to the nascent literature that COVID-19, as other coronaviruses, can increase the risk for severe psychosis and suicidal behavior. Keywords COVID-19 . Suicide . Psychosis . Depression
Introduction The emergence and global spread of the 2019 novel coronavirus (COVID-19) has imposed a significant mental health burden on communities around the world. Many of the psychiatric manifestations of COVID-19 are a consequence of psychological stressors, such as fear of illness and death, prolonged social isolation, and uncertainty and fear about the future. However, a growing body of evidence suggests that the virus itself can precipitate psychosis among infected individuals [1]. Emerging neuropsychiatric sequelae of COVID-19 include encephalopathy, anxiety, depression, mania, and trauma-related disorders [2]. The potential for the virus to induce psychosis is of particular interest given the association with acute suicidal/homicidal ideation and other severe perceptual and behavioral disturbances. Much is yet to be discovered about the biological mechanisms, presentation, treatment, This article is part of the Topical Collection on Covid-19 * Mason Chacko [email protected] 1
Department of Psychiatry and Behavioral Health, Stony Brook University, Stony Brook, NY, USA
2
Department of Hospital Medicine, Southside Hospital, Bay Shore, NY, USA
3
OP Private Practice/SUNY Downstate, Brooklyn, NY, USA
4
Psychiatry Service, Northport VA Medical Center, Northport, NY, USA
and long-term outcomes of COVID-related psychotic illness. A connection with psychosis has been described in other strains of coronavirus, including the species responsible for severe acute respiratory syndrome (SARS-CoV). Common symptoms observed in SARS-related psychosis include persecutory delusions, auditory hallucinations of gossip, suicidal thoughts and behavior, and sleep disturbances [3]. One survey of recently discharged SARS patients found that disease severity—as measured by chest radiograph on admission, maximum oxygen requirement, need for ICU care, and length of hospital stay—was an independent predictor of new onset psychosis and behavioral problems in both the acute and convalescent stages of illness [4
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