Emerging cycloid psychosis episodes during COVID-19 pandemic: a case series

Abstract

Aims

Cycloid psychosis (CP) is a clinical entity characterized by sudden onset of psychotic polymorphic symptomatology and fluctuant course. It has a reported rate of psychosocial precipitating factors ranging 30–65%. The aim of the study was to describe all cases of CP, admitted in our Psychiatry ward, during the first two months of the COVID-19 pandemic.

Method

In this retrospective and observational study, we reported a sample of eight patients who were treated as inpatients in the psychiatric ward of our hospital during the first two months of COVID-19 pandemic (mid-March to mid-May 2020) and compared it with previous years. All our patients fulfilled all four Perris & Brockington criteria for CP. We reported the sociodemographic, clinical and biological parameters.

Results

In our sample, all of the patients had maladaptive personality traits; the major external stressing factor was COVID-19; all our patients had short prodromal symptomatology, short Duration of Untreated Psychosis (DUP) and high score at the Positive Scale at Positive and Negative Syndrome Scale (PANSS-P) at hospital admission with the majority showing psychotic symptoms related to the actual COVID-19 pandemic. The predominant treatment during admission was olanzapine and a short time to full remission of psychotic symptoms was observed in all patients.

Conclusion

We found an increase in the admission of patients with CP during the first two months of the actual pandemic. Stress caused by the COVID-19 situation has possibly incremented the frequency of stress-related disorders and it has also influenced its clinical presentation.

Keywords:

• Atypical psychosis
• epidemic
• first psychotic episode
• reactive psychosis
• SARS-CoV-2

Disclosure statement

No potential conflict of interest was reported by the author(s).

Additional information

Notes on contributors

Eloi Giné Servén

Eloi Giné Servén, MD, is a psychiatrist in Mataró Hospital, Barcelona. He works mainly with first episode psychosis. His research focuses on autoimmunity in Psychiatry.

Maria Martinez Ramirez

Maria Martinez Ramirez, MD, is a psychiatrist in Mataró Hospital, Barcelona. Her main fields of interest are bipolar disorder and autism.

Ester Boix Quintana

Ester Boix Quintana, MD, is a psychiatrist in Mataró Hospital, Barcelona. She works mainly with treatment-resistant psychiatric disorders.

Araitz Petrizan Aleman

Araitz Petrizan Aleman, LP, works as a psychologist in Mataró Hospital, Barcelona, and is specialized in Children and Adolescent Psychiatry. She is a clinical psychologist.

Francisco-Javier Barón Fernández

Francisco-Javier Barón Fernández, MD, is a psychiatrist in Mataró Hospital, Barcelona. He is an Associate Professor at the University of Ramon Llull, Barcelona.

Paloma Fernández Corcuera

Paloma Fernández Corcuera, MD, PhD, is a psychiatrist in Mataró Hospital, Barcelona. She works mainly with treatment-resistant psychiatric disorders. Her main field of research is neuroimaging in Bipolar disorder.

Maria Serra Buil

Maria Serra Buil, MD, is a psychiatrist in Mataró Hospital, Barcelona. She is the Associate Chief of the acute psychiatry ward in Mataró Hospital.

Josep Cañete Crespillo

Josep Cañete Crespillo, MD, PhD, is the Chief of the Mental Health department in Mataró Hospital, Barcelona. He is Professor of Psychiatry at the University of Ramon Llull, Barcelona.