The Use of Electroconvulsive Therapy in Neuropsychiatric Complications of Coronavirus Disease 2019: A Systematic Literature Review and Case Report

Austgen, Gabriela; Meyers, Matthew S.; Gordon, Mollie; Livingston, Robin

doi:10.1016/j.jaclp.2021.07.010

Cited by 12 publications

(20 citation statements)

References 21 publications

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“…Finally, 18 articles did not include individual level data and 7 articles were available as abstracts only. A total of 40 articles met inclusion criteria, comprising 48 individual patients from 17 countries ( Table 1 ) [ [25] , [26] , [27] , [28] , [29] , [30] , [31] , [32] , [33] , [34] , [35] , [36] , [37] , [38] , [39] , [40] , [41] , [42] , [43] , [44] , [45] , [46] , [47] , [48] , [49] , [50] , [51] , [52] , [53] , [54] , [55] , [56] , [57] , [58] , [59] , [60] , [61] , [62] , [63] , [64] ]. All but a single study [ 54 ] were in English and 20 (42%) cases were reported in the United States, where the largest proportion of these cases were documented.…”

Section: Resultsmentioning

confidence: 99%

“… Reported Dx: Psychosis associated with probable encephalitis associated with SARS-CoV-2 DSM-5 Dx: Psychotic disorder due to autoimmune encephalitis History of borderline intellectual functioning and “thinking with a high level of pervious mysticism.” Receipt of ampicillin/sulbactam before onset of symptoms. Austgen et al, 2021 [ 29 ] 52, F, US Insomnia and anxiety after receiving steroids for “mild COVID-19,” which progressed to paranoia and depression over 1 month requiring hospitalization. Again hospitalized 48 h later for suicidal thoughts, psychomotor slowing, paranoia and catatonia.…”

Section: Resultsmentioning

confidence: 99%

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COVID-19-associated psychosis: A systematic review of case reports

Smith

Gilbert

Riordan

et al. 2021

General Hospital Psychiatry

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Objectives To describe the comorbidities, presentations, and outcomes of adults with incident psychosis and a history of COVID-19. Methods We completed a descriptive systematic review of case reports according to PRISMA guidelines, including cases of adult patients with incident psychosis and antecedent or concurrent COVID-19. We extracted patient demographics, comorbidities, clinical course, and outcomes, and assessed cases for quality using a standardized tool. Results Of 2396 articles, we included 40 reports from 17 countries, comprising 48 patients. The mean age of patients was 43.9 years and 29 (60%) were males. A total of 7 (15%) had a documented psychiatric history, 6 (13%) had a substance use history and 11 (23%) had a comorbid medical condition. Delusions were the most common (44 [92%]) psychiatric sign and psychosis lasted between 2 and 90 days. A total of 33 (69%) patients required hospitalization to a medical service and 16 (33%) required inpatient psychiatric admission. The majority (26 [54%]) of cases did not assess for delirium and 15 (31%) cases were judged to be of high risk of bias. Conclusions Despite the growing awareness of COVID-19's association with incident psychosis at a population level, cases of COVID-19-associated psychosis often lacked clinically relevant details and delirium was frequently not excluded. PROSPERO registration number: CRD42021256746.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

COVID-19-associated psychosis: A systematic review of case reports

Smith

Gilbert

Riordan

et al. 2021

General Hospital Psychiatry

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“…Patients not treated with APs suffered either from a defined organic brain disorder (Panariello et al, 2020a;Alvarez-Cisneros et al, 2021;Elfil et al, 2021;McAlpine et al, 2021), from catatonia (Caan et al, 2020;Zain et al, 2021) or were thought to have a psychosis due to an offending drug, which was then withdrawn. Three patients were treated with electroconvulsive therapy (ECT) (Chacko et al, 2020;Vepa et al, 2020;Austgen et al, 2021). The mean dosage of antipsychotics at discharge was 3.4 mg risperidone equivalents.…”

Section: Patients With Infectionmentioning

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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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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“… 37 , 38 Of note, there was one case in which ECT was effective for neuropsychiatric symptoms in COVID-19. 39 All these reports reaffirm the importance of ECT. We must continue to provide ECT to as many eligible patients as possible with appropriate infection control measures.…”

Section: Discussionmentioning

confidence: 83%

An Online Survey About Electroconvulsive Therapy in Japan During the COVID-19 Pandemic: Comparison of Early and Recent Stages

Hirata¹,

Kawashima²,

Tsuboi³

et al. 2022

NDT

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To provide an overview of how electroconvulsive therapy (ECT) practice in Japan has changed as the coronavirus disease 2019 (COVID-19) pandemic continues. Patients and Methods: We surveyed healthcare institutions, primarily university and general hospitals, regarding changes in the number of patients undergoing ECT and infection control measures in the early (August 2020) and recent (August 2021) stages of the COVID-19 pandemic. Data for the early and recent stages were also compared between urban and non-urban areas. Results: Among 32 facilities, the number of patients undergoing ECT decreased in 11 facilities (34.4%) from April 2020 to March 2021 compared with the previous year, whereas the number increased in 12 (37.5%) from April to June 2021 compared with the previous year. As of August 2021, some facilities had ongoing restrictions. Compared with non-urban facilities, the number of patients undergoing ECT decreased more in urban facilities, which also had more ECT restrictions. Maintenance ECT was used at the same rate as before the pandemic for 23 (82.1%) of 28 institutions. Regarding infection control measures, many facilities considered polymerase chain reaction testing before ECT and required all staff to wear surgical masks and eye shields during ECT. Conclusion:The COVID-19 pandemic in Japan greatly affected the use of ECT in 2020; however, by the summer of 2021, infection control measures were relatively well established, the number of ECT cases stabilized and increased, and the decision to use ECT was again possible.

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The Use of Electroconvulsive Therapy in Neuropsychiatric Complications of Coronavirus Disease 2019: A Systematic Literature Review and Case Report

Cited by 12 publications

References 21 publications

COVID-19-associated psychosis: A systematic review of case reports

COVID-19-associated psychosis: A systematic review of case reports

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

An Online Survey About Electroconvulsive Therapy in Japan During the COVID-19 Pandemic: Comparison of Early and Recent Stages

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