Reactive psychoses in the context of the COVID-19 pandemic: Clinical perspectives from a case series

• Published in: Revista de psiquiatria y salud mental (English ed.) 2020-04, Vol.13 (2), p.90-94
• Main Authors: Valdés-Florido, María José, López-Díaz, Álvaro, Palermo-Zeballos, Fernanda Jazmín, Martínez-Molina, Iván, Martín-Gil, Victoria Eugenia, Crespo-Facorro, Benedicto, Ruiz-Veguilla, Miguel
• Format: Article
• Language: English
• Subjects: Adult; Betacoronavirus; Coronavirus; Coronavirus Infections - complications; Coronavirus Infections - psychology; COVID-19; Female; Humans; Male; Middle Aged; Pandemics; Pneumonia, Viral - complications; Pneumonia, Viral - psychology; Psychiatric Status Rating Scales; Psychological Distress; Psychotic disorders; Psychotic Disorders - diagnosis; Psychotic Disorders - etiology; Psychotic Disorders - psychology; Quarantine - psychology; Risk Factors; SARS-CoV-2; Spain; Stress, Psychological - complications; Suicide; Suicide - psychology; Suicidio; Trastornos psicóticos
• ISSN: 1888-9891; 2173-5050; 1989-4600
• DOI: 10.1016/j.rpsm.2020.04.009

The world is currently undergoing an extremely stressful scenario due to the COVID-19 pandemic. This unexpected and dramatic situation could increase the incidence of mental health problems, among them, psychotic disorders. The aim of this paper was to describe a case series of brief reactive psychosis due to the psychological distress from the current coronavirus pandemic. We report on a case series including all the patients with reactive psychoses in the context of the COVID-19 crisis who were admitted to the Virgen del Rocío and Virgen Macarena University Hospitals (Seville, Spain) during the first two weeks of compulsory nationwide quarantine. In that short period, four patients met the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) criteria for a brief reactive psychotic disorder. All of the episodes were directly triggered by stress derived from the COVID-19 pandemic and half of the patients presented severe suicidal behavior at admission. We may now be witnessing an increasing number of brief reactive psychotic disorders as a result of the COVID-19 pandemic. This type of psychosis has a high risk of suicidal behavior and, although short-lived, has a high rate of psychotic recurrence and low diagnostic stability over time. Therefore, we advocate close monitoring in both the acute phase and long-term follow-up of these patients. El mundo está experimentando un escenario extremadamente estresante a causa de la pandemia del COVID-19. Esta situación inesperada y dramática podría incrementar la incidencia de los problemas de salud mental y, entre estos, los trastornos psicóticos. El objetivo de este documento es describir una serie de casos de psicosis reactiva breve, debidos al distrés psicológico debido a la pandemia actual de coronavirus. Reportamos una serie de casos que incluye a todos los pacientes con psicosis reactiva en el contexto de la crisis del COVID-19, ingresados en los Hospitales Universitarios Virgen del Rocío y Virgen Macarena (Sevilla, España) durante las 2 primeras semanas de la cuarentena obligatoria a nivel nacional. En este breve espacio de tiempo, 4 pacientes cumplieron los criterios de trastorno psicótico breve del manual diagnóstico y estadístico de trastornos mentales (DSM-5). Todos los episodios fueron desencadenados por el estrés derivado de la pandemia del COVID-19, y la mitad de los pacientes presentaron un comportamiento suicida grave a su ingreso. Actualmente podemos estar asistiendo a un incremento del núm