Clinical characterization of brief psychotic disorders triggered by the COVID-19 pandemic: a multicenter observational study

Eur Arch Psychiatry Clin Neurosci. 2022 Feb;272(1):5-15. doi: 10.1007/s00406-021-01256-w. Epub 2021 Apr 3.

Abstract

This study aimed to characterize the clinical profile of patients with brief psychotic disorders (BPD) triggered by the psychosocial distress derived from the COVID-19 crisis. A multicenter study was conducted from March 14 to May 14, 2020 (the peak weeks of the pandemic in Europe). All consecutive patients presenting non-affective psychotic episodes with a duration of untreated psychosis of less than 1 month and whose onset was related to the COVID-19 crisis were recruited, but only those patients meeting Diagnostic Statistical Manual 5th edition (DSM-5) criteria for "BPD with marked stressors" (DSM-5 code: 298.8) during follow-up were finally included. Patients' sociodemographic and clinical characteristics were collected at baseline and summarized with descriptive statistics. During the study period, 57 individuals with short-lived psychotic episodes related to the emotional stress of the COVID-19 pandemic were identified, of whom 33 met DSM-5 criteria for "BPD with marked stressors". The mean age was 42.33 ± 14.04 years, the gender distribution was almost the same, and the majority were rated as having good premorbid adjustment. About a quarter of the patients exhibited suicidal symptoms and almost half presented first-rank schizophrenia symptoms. None of them were COVID-19 positive, but in more than half of the cases, the topic of their psychotic features was COVID-19-related. The coronavirus pandemic is triggering a significant number of BPD cases. Their risk of suicidal behavior, their high relapse rate, and their low temporal stability make it necessary to closely monitor these patients over time.

Keywords: COVID-19; Psychoses; Schizophrenia; Stress; Suicide.

Publication types

  • Multicenter Study
  • Observational Study

MeSH terms

  • Adult
  • COVID-19* / epidemiology
  • COVID-19* / psychology
  • Europe / epidemiology
  • Humans
  • Middle Aged
  • Pandemics*
  • Psychotic Disorders* / epidemiology
  • Schizophrenia / epidemiology