了解2019冠状病毒病大流行期间精神病患者的困惑状态:附两例报告

M. Cvjetković-Bošnjak, Željko Bibić, A. Nedić, O. Zivanovic, V. Vasic, Dusan Kujancic
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摘要

介绍。有很多证据表明,2019冠状病毒病有多种表现。本文报告了两例病例,旨在揭示2019冠状病毒病大流行期间精神障碍患者混乱状态的多因素病因。严重急性呼吸综合征冠状病毒-2不仅影响呼吸系统和心血管系统,还会影响大脑、肾脏和其他器官系统。这种感染的最初表现之一可能是精神错乱。案例研究。第一位患者是一名被诊断为分裂情感性精神病的女性,她突然表现出精神错乱,随后出现过度镇静,这最初被认为是过度用药。在另一位诊断为双相情感障碍的患者中,突然的精神错乱(谵妄)最初被认为是精神障碍恶化的一个因素。更详细的观察表明,两例患者的神志不清状态都是由严重急性呼吸综合征冠状病毒2型感染引起的。讨论。严重急性呼吸综合征冠状病毒2型感染的表现通常包括呼吸道和心血管症状。然而,与其他器官和器官系统有关的症状,包括神经和心理状态的变化,不应被忽视。结论。人们注意到,精神错乱和谵妄样状态是2019冠状病毒病非常常见的早期症状。在精神病患者中,总是有必要排除意识障碍的器质性病因并立即进行诊断程序。我们当然应该记住,诊断错误是可能的,这不仅是由于感染的各种表现,而且还由于精神疾病的污名化,必须克服这一点,以便提供最好的治疗效果。
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Understanding the state of confusion in patients with psychosis during COVID-2019 pandemic: A report of two cases
Introduction. There is a lot of evidence that coronavirus disease 2019 has various manifestations. This paper presents a report of two cases with the aim to indicate the multifactorial etiology of confusional states in patients with mental disorders at the time coronavirus disease 2019 pandemic. The severe acute respiratory syndrome coronavirus-2 affects not only the respiratory and cardiovascular systems, but also the brain, kidneys and other organ systems. One of the first manifestations of this infection can be mental confusion. Case Study. The first patient, a woman diagnosed with schizoaffective psychosis, suddenly presented with confusion, followed by hypersedation which was at first attributed to overmedication. In another patient, with the diagnosis of bipolar affective disorder, sudden confusion (delirium) was initially recognized as an element of mental disorder deterioration. A more detailed observation revealed that the confused state in both patients was caused by severe acute respiratory syndrome coronavirus-2 infection. Discussion. It is common for the manifestations of severe acute respiratory syndrome coronavirus-2 infection to include respiratory and cardiovascular syimptoms. However, symptoms related to other organs and organ systems, including changes in neurological and psychological status, should not be ignored. Conclusion. It was noticed that confusion and delirium-like states are quite common early symptoms of coronavirus disease 2019. In psychiatric patients, it is always necessary to rule out the organic etiology of the consciousness disorder and immediately proceed with the diagnostic procedures. One should certainly keep in mind that diagnostic errors are possible, not only due to various manifestations of the infection, but also due to the stigmatization of mental illness, which must be overcome in order to provide the best possible treatment effects.
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