Psychosis during the COVID-19 pandemic: A systematic review of case reports and case series.
Level 4 - case-series / case-control
Systematic review of case reports and case series
PubMed 35797814 · doi:10.1016/j.jpsychires.2022.06.041
What was done
Authors searched six databases plus manual reference lists for case reports and case series describing new-onset psychosis or exacerbation of clinically stable psychosis concurrent with COVID-19. They extracted demographic details, psychiatric history, COVID-19 severity, clinical management, and patient outcomes.
What was found
The review identified 57 unique cases. The mean age of psychotic symptom onset was 43.4 years for men and 40.3 years for women. Approximately 69% of patients had no prior history of psychiatric disorders, and only 15 (26.3%) presented with moderate to severe COVID-19 disease. Delusions and hallucinations were the most common psychotic symptoms. Treatments included antipsychotics, benzodiazepines, valproic acid, and electroconvulsive therapy. Psychotic symptoms resolved completely or improved significantly in 36 cases, 10 had partial improvement with residual symptoms, and 1 patient died of cardiac arrest.
Why it matters
This review compiles the clinical presentations and treatments reported for COVID-19-related psychosis, highlighting that new-onset psychotic symptoms can appear even in mild viral illness and in patients without prior psychiatric history.
Limits
The analysis is restricted to published case reports and case series, introducing severe selection and reporting biases. It cannot establish incidence, prevalence, or definitive causality between COVID-19 infection and psychosis, and long-term follow-up data were not systematically available.
Cited by
- supports Published studies have documented new-onset psychosis as a rare post-infection complication in previously healthy individuals who contracted COVID-19.