Emerging cycloid psychosis episodes during COVID-19 pandemic: a case series

Abstract

Aims: Cycloid psychosis (CP) is a clinical entity characterized by sudden onset of psychotic polymorphic symptomatology and fluctuant course. It has a reported rate of psychosocial precipitating factors ranging 30-65%. The aim of the study was to describe all cases of CP, admitted in our Psychiatry ward, during the first two months of the COVID-19 pandemic. Method: In this retrospective and observational study, we reported a sample of eight patients who were treated as inpatients in the psychiatric ward of our hospital during the first two months of COVID-19 pandemic (mid-March to mid-May 2020) and compared it with previous years. All our patients fulfilled all four Perris & Brockington criteria for CP. We reported the sociodemographic, clinical and biological parameters. Results: In our sample, all of the patients had maladaptive personality traits; the major external stressing factor was COVID-19; all our patients had short prodromal symptomatology, short Duration of Untreated Psychosis (DUP) and high score at the Positive Scale at Positive and Negative Syndrome Scale (PANSS-P) at hospital admission with the majority showing psychotic symptoms related to the actual COVID-19 pandemic. The predominant treatment during admission was olanzapine and a short time to full remission of psychotic symptoms was observed in all patients. Conclusion: We found an increase in the admission of patients with CP during the first two months of the actual pandemic. Stress caused by the COVID-19 situation has possibly incremented the frequency of stress-related disorders and it has also influenced its clinical presentation.

First-episode psychotic disorders in the wake of the COVID-19 pandemic: a descriptive review of casereports

“…(Continued )Servén et al, 2021). Some patients presented features complicating diagnosis: On two occasions(Dhir et al, 2020;Ambar Akkaoui et al, 2021), self-treatment with different drugs might have contributed to psychosis.…”

Reactive Psychosis

“…Moreover, increased rates of polymorphic ATPDs have been described during the early stages of COVID-19 pandemic (Servén et al, 2021). A report of the Welsh religious revival in 1904–1905 revealed significantly high admission rates and a favorable outcome for what would now be diagnosed as ATPD (Linden et al, 2010).…”

Mood Disorder or Psychotic Disorder? Yes: A Case Report on Cycloid Psychosis

“…Cases of cycloid psychosis have also increased. One hospital in Barcelona, Spain saw 8 patients with cycloid psychosis in a 2-month span during the pandemic, a notable increase from 6 patients per year in previous years 29 . Their psychotic symptomatology was also related to the pandemic, with delusions of infection, persecution, and grandiosity with COVID-19 content (eg, belief that one was infected, that one caused the illness, or that one had found the cure).…”

“…There is no fixed combination of symptoms, and the symptoms may change frequently during an episode and show bipolar characteristics increase from 6 patients per year in previous years. 29 Their psychotic symptomatology was also related to the pandemic, with delusions of infection, persecution, and grandiosity with COVID-19 content (eg, belief that one was infected, that one caused the illness, or that one had found the cure). This increase in cases was thought to be the result of the psychological effect of the pandemic, as opposed to a direct biological effect of the virus itself.…”