Initial Presentation of OCD and Psychosis in an Adolescent during the COVID-19 Pandemic

Abstract

The COVID-19 pandemic is unparalleled in recent history when accounting for the true disease burden and dramatic impact on physical and mental health. Due to its infectious pathology, COVID-19 presents with a variety of symptoms including neuropsychiatric complications. Moreover, factors such as quarantine, social isolation, and fear of illness have negatively impacted the health of non-COVID-19 patients. There has been significant literature reporting new-onset psychiatric illness in all global populations including those without history of psychiatric illness. This report discusses an adolescent male without prior psychiatric history presenting with new onset symptoms of obsessive-compulsive disorder and psychosis in the context of COVID-19. There are considerable reports describing new-onset obsessive-compulsive disorder, albeit conflicting in terms of prevalence and exacerbations in the setting of COVID-19 in both adult and adolescent populations but limited reports of new-onset psychosis in those same populations and setting.

A Case of New-Onset Obsessive-Compulsive Disorder and Schizophrenia in a 14-Year-Old Male following the COVID-19 Pandemic

“…There have been similar reports of OCD and psychosis presentations in adolescence during the COVID-19 pandemic [ 13 ]. In that case report, the patient also had no prior psychiatric history but did have a positive urine drug sample for cannabis.…”

“…In that case report, the patient also had no prior psychiatric history but did have a positive urine drug sample for cannabis. The patient presented with similar obsessive-compulsive behavior such as repetitive cleaning of home and not wearing clothes outside of his bedroom, suicidal ideation, and auditory hallucinations [ 13 ]. The continued isolation, fear, and anxiety that the COVID-19 pandemic brought was a significant factor in that patient's worsening symptoms.…”

“…In addition to the depressive and anxiety-related symptoms brought on by the pandemic, the virus itself has also been linked to rare neuropsychiatric complications [12]. Furthermore, multiple case reports have alluded to the emergence of new-onset obsessive-compulsive disorder in both adolescents and adults, along with exacerbations of preexisting OCD during the COVID-19 pandemic [13][14][15][16]. However, only a small subset of case reports has linked COVID-19 infection with psychosis in adults as well as adolescents [17,18].…”