New-Onset Mania and Psychosis in Adolescents in the Context of COVID-19 Infection

Abstract

There is a growing body of evidence that coronavirus disease 2019 (COVID-19) is linked with neuropsychiatric complications such as psychosis and delirium in adults. Much less is known about the neuropsychiatric manifestations of this virus in the child and adolescent population. This case series discusses two unique adolescent patients who presented with new-onset mania and psychosis in the context of an otherwise asymptomatic COVID-19 infection, which raises several questions about whether and how the virus precipitates mania and psychosis, whether these symptoms are transient or predisposes patients to a chronic psychiatric disorder, and confounding variables that may have contributed to the symptoms. These questions can then be points for future research and longitudinal follow-up that can better improve our knowledge about the relationship between this complicated virus and how it affects children psychiatrically.

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

“…Within recent years, there have been case reports illustrating new-onset mania and psychosis in adolescents with asymptomatic COVID-19 infections [ 23 ]. The hypothesis in these cases is that the COVID-19 infection potentially triggered or exacerbated psychosis and mania in these patients [ 23 ]. There were a few confounding variables in these case reports which include prior psychiatric history and substance abuse disorder.…”

Impact of COVID-19 on Neuropsychiatric Disorders

“…Overall, psychotic symptoms resolved markedly in 63.2% of cases after treatment with antipsychotics, benzodiazepines, valproic acid, and electroconvulsive treatment [ 21 ]. COVID-19-related new-onset psychosis and mania have been also reported in children and adolescents, even in those with asymptomatic COVID-19 infections as described in some case reports in the U.S. [ 22 ].…”