Clinical Features and Prognosis of Coronavirus Disease 2019-Related Psychosis: A Retrospective Case Series.

IF 1.3 Q3 PSYCHIATRY Alpha psychiatry Pub Date : 2023-11-01 DOI:10.5152/alphapsychiatry.2023.231266
Jinyuan Du, Xiaobo Zhou, Yi Guo, Fugui Jiang, Mengfan Yan, Qiong Zhu
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Abstract

Background: It has been reported that coronavirus disease 2019 (COVID-19) may cause psychiatric disorders, but there are too many confounding factors in the various studies, making it difficult to draw accurate conclusions.

Methods: We analyzed the clinical features and treatment of patients with non-severe COVID-19 who were hospitalized in neurology and psychiatry departments due to acute psychiatric disorders and performed a descriptive analysis.

Results: Of the 57 patients included, 65% were hospitalized in the neurology department. Eighty-two percent of the patients exhibited abnormal mental behavior 1 week or less after COVID-19 diagnosis, and more than 60% of the patients had normal electroencephalogram (EEG), head imaging, autoimmune encephalitis antibody, and cerebrospinal fluid (CSF) results. Abnormal EEG results included an increase in nonspecific slow waves, abnormal imaging results included small ischemic areas and lacunar infarctions, and abnormal CSF results included a slight increase in cell numbers and protein levels and an increase in pressure. After administering antipsychotic drugs and/or immunotherapy, 67% of the patients experienced improvement in their psychiatric disorders by the time of discharge. Thirty-nine percent of the patients were discharged without antipsychotic medication and experienced no relapse of psychiatric symptoms.

Conclusion: Patients with non-severe COVID-19 and psychiatric disorders usually have a good prognosis and do not require long-term antipsychotic medication. Patients with uncontrollable mental symptoms experienced rapid remission after immunotherapy, suggesting that inflammation or the immune response may play an important role in the occurrence of simple acute psychiatric disorders caused by COVID-19.

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2019年冠状病毒病相关精神病的临床特征和预后:回顾性病例系列。
背景:有报道称冠状病毒病2019(COVID-19)可能导致精神障碍,但各种研究中混杂因素太多,难以得出准确结论:我们分析了神经内科和精神科因急性精神障碍住院的非重症COVID-19患者的临床特征和治疗情况,并进行了描述性分析:在纳入的57名患者中,65%在神经内科住院治疗。82%的患者在确诊COVID-19后1周或更短时间内表现出精神行为异常,60%以上的患者脑电图(EEG)、头部成像、自身免疫性脑炎抗体和脑脊液(CSF)结果正常。异常的脑电图结果包括非特异性慢波增加,异常的影像学结果包括小缺血区和腔隙性梗死,异常的脑脊液结果包括细胞数量和蛋白质水平轻微增加以及压力增加。在使用抗精神病药物和/或免疫疗法后,67%的患者在出院时精神障碍有所改善。39%的患者在出院时无需服用抗精神病药物,且精神症状没有复发:结论:不严重的 COVID-19 和精神障碍患者通常预后良好,无需长期服用抗精神病药物。有无法控制的精神症状的患者在接受免疫治疗后病情迅速缓解,这表明炎症或免疫反应可能在 COVID-19 引起的单纯急性精神障碍的发生中扮演重要角色。
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