First‐onset psychosis in older adults: social isolation influence during <scp>COVID</scp> pandemic – a <scp>UK</scp> case series

Deshpande, Shaunak; Livingstone, Anthea

doi:10.1002/pnp.692

Cited by 9 publications

(10 citation statements)

References 13 publications

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“…Outcome with full remission occurred in two-thirds of patients, and almost as many reports describe a fast response to antipsychotic treatment. Only the paper of Deshpande & Livingstone (2021) presents three patients with slow response to treatment and long inpatient stays. These patients were selected for reporting among others because of their advanced age and to illustrate the deleterious effects of social isolation on elder persons normally living an active life.…”

Section: Patients Without Infectionmentioning

confidence: 99%

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

Rittmannsberger¹,

Barth²,

Malík³

et al. 2022

Acta Neuropsychiatr.

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Objective: Since the onset of COVID-19 pandemic many case reports and case series dealt with new onset psychotic disorders in patients either infected with SARS-CoV-2 or thematically linked to the pandemic, but without an infection. Our aim was to provide a comprehensive collection of these reports to illustrate the nature of these psychoses. Methods: We conducted a literature search in Medline, EMBASE, PSYCHINFO, using search terms regarding first episode psychotic disorders in the context of corona. Results: 96 case reports or case series covering 146 patients (62 without and 84 with SARS-CoV-2 infection) were found. Compared to patients without infection, patients with infection showed significantly more often visual hallucinations (28.6% vs 8.1%), confusion (36.9% vs 11.3%), an acute onset of illness (88.5% vs 59.6%) and less often depression (13.1% vs 35.5%) and a delusional content related to the pandemic (29.5% vs 78.3%). Both groups had an equally favourable outcome with a duration of psychosis ≤2 weeks in half and full remission in two thirds of patients. In patients with infection signs of inflammation were reported in 78.3% and increased CRP in 58.6%. While reports on patients with infection are continuously published, no report about patients without infection was found after July 2020. Conclusion: Cases without infection were considered reactive and originated all from the first wave of the Corona pandemic. In cases with infection, inflammation was considered as the main pathogenetic factor but was not found in all patients. Diagnosis was impeded by the overlap of psychosis with delirium.

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Section: Patients Without Infectionmentioning

confidence: 99%

“…Besides, it might be that 'first' cases have been reported more often during the course of the pandemic and later ones no more for lack of novelty. Some authors mentioned that they treated far more cases but selected only some for publication, for example (Deshpande & Livingstone, 2021;Valdés-Florido et al, 2021).…”

Section: Limitationsmentioning

confidence: 99%

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

Rittmannsberger¹,

Barth²,

Malík³

et al. 2022

Acta Neuropsychiatr.

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“…Due to the large amount of research available on mental health since the start of the pandemic and the broad focus on the UK population as a whole, evidence relating to less common psychiatric disorders was deemed out of scope for this review. Future research should seek to address whether the COVID-19 pandemic has also increased the prevalence of conditions such as psychosis and bipolar disorder, as has been previously discussed [106]. This review was restricted to UK adults, although a systematic review of children and adolescents’ mental health alongside recommendations would be beneficial in light of restrictions such as school closures and evidence they have been impacted as well [107, 108].…”

Section: Discussionmentioning

confidence: 99%

The impact of the COVID-19 pandemic on adult mental health in the UK: A rapid systematic review

Batteux

Taylor

Carter

2021

Preprint

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Background. There is evidence that the COVID-19 pandemic has affected the mental health of the UK population, but this needs synthesising to guide effective policy recommendations and ensure support is targeted to populations most at risk. We conducted a rapid systematic review of the evidence of the impact of COVID-19 and associated restrictions on the mental health of UK adults, including risk and protective factors. Method. A range of databases were searched to identify eligible studies. Studies were eligible if they reported primary quantitative or qualitative research on the mental health of UK adults between March 2020 and March 2021. Journal publications and pre-prints were included. Reviews, position papers, protocol papers and studies published in languages other than English were excluded. The study authors screened papers for eligibility and included 102 papers in the analysis. Results. The evidence from this review indicates that the mental health of UK adults has declined since the start of the pandemic, with different populations being unequally affected. Populations particularly affected are women, young adults, ethnic minorities, people from lower socio-economic backgrounds, people with pre-existing conditions and people who have had COVID-19. Other risk factors include having to isolate and time spent watching pandemic related news. Protective factors include social contact and maintaining healthy behaviours, such as physical activity. Conclusions. Policy should aim to discourage risky behaviours while ensuring support is available for people to engage in protective behaviours. Interventions should be directed towards populations that have been most adversely affected. Addressing the decline in mental health across the UK population since the COVID-19 pandemic will require increasing mental health provision and ensuring equitable access to support.

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“…9 In addition, lockdown has been associated with social isolation and loneliness 10,11 and several case reports have described new onset psychosis in older adults attributed to social isolation. [12][13][14] Given the complexities of diagnosing and treating late-life psychosis, 15 understanding the impact of the pandemic on the older adult population is essential to inform care. Although for many countries social distancing measures have been stopped, for others, they remain a part of life.…”

Section: Introductionmentioning

confidence: 99%

“…High perceived stress, as a result of fears generated during the pandemic, can be an important risk factor for both triggering and exacerbating psychotic symptoms 9 . In addition, lockdown has been associated with social isolation and loneliness 10,11 and several case reports have described new onset psychosis in older adults attributed to social isolation 12–14 …”

Section: Introductionmentioning

confidence: 99%

The impact of the first UK COVID‐19 lockdown on presentations with psychosis to mental health services for older adults: An electronic health records study in South London

Simkin

Yung

Greig

et al. 2022

Int J Geriat Psychiatry

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Objectives: Social distancing restrictions in the COVID-19 pandemic may have had adverse effects on older adults' mental health. Whereby the impact on mood is welldescribed, less is known about psychotic symptoms. The aim of this study was to compare characteristics associated with psychotic symptoms during the first UK lockdown and a pre-pandemic comparison period. Methods:In this retrospective observational study we analysed anonymised records from patients referred to mental health services for older adults in South London in the 16-week period of the UK lockdown starting in March 2020, and in the comparable pre-pandemic period in 2019. We used logistic regression models to compare the associations of different patient characteristics with increased odds of presenting with any psychotic symptom (defined as hallucinations and/or delusion), hallucinations, or delusions, during lockdown and the corresponding pre-pandemic period.Results: 1991 referrals were identified. There were fewer referrals during lockdown but a higher proportion of presentations with any psychotic symptom (48.7% vs. 42.8%, p = 0.018), particularly hallucinations (41.0% vs. 27.8%, p < 0.001). Patients of non-White ethnicity (adjusted odds ratio (OR): 1.83; 95% confidence interval (CI):1.13-2.99) and patients with dementia (adjusted OR: 3.09; 95% CI: 1.91-4.99) were more likely to be referred with psychotic symptoms during lockdown. While a weaker association between dementia and psychotic symptoms was found in the pre-COVID period (adjusted OR: 1.55; 95% CI: 1.19-2.03), interaction terms indicated higher odds of patients of non-White ethnicity or dementia to present with psychosis during the lockdown period.Latha Velayudhan and Christoph Mueller are joint senior authors.This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.

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First‐onset psychosis in older adults: social isolation influence during COVID pandemic – a UK case series

Cited by 9 publications

References 13 publications

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

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

The impact of the COVID-19 pandemic on adult mental health in the UK: A rapid systematic review

The impact of the first UK COVID‐19 lockdown on presentations with psychosis to mental health services for older adults: An electronic health records study in South London

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