First Reported Case Of Covid-19-Related Psychotic Delusions

Isolation, anxiety, and poverty linked to the Covid-19 pandemic could be fuelling a mental health crisis, says the UN. Zenza Flarini/Shutterstock

A new psychiatric case report tells the story of a man whose psychotic delusions revolved around the Covid-19 pandemic. 

Back in March, when the Covid-19 pandemic was just starting to sink in its teeth into Europe, a 43-year-old man who had previously been diagnosed with paranoid psychosis was brought to a hospital in Germany by his father after suffering from a week-long string of hallucinations and paranoid thoughts. Many of his most vivid delusions were centered on the Covid-19 pandemic.

The man, who had previously worked as an ambulance paramedic, told his doctors that he was hearing the voices of his neighbors who were accusing him of not taking care of his parents during the outbreak. He even acted on this delusion by visiting his parents’ house in the middle of the night to check if they were still alive, but he decided not to enter the house.

Another delusion was focused on the idea that he had immunity to Covid-19 because he had been infected with the virus by a Chinese message on WhatsApp.

Reported in the journal Psychiatry Research, the researchers from the University of Rostock in Germany say this appears to be “the first report of a Covid-19-related paranoid processing in a psychosis patient.” 

“It’s an example of how prevailing topics can become the main content of psychotic thinking,” Matthias Fischer, study author from the Clinic and Polyclinic for Psychiatry and Psychotherapy at the University of Rostock, told IFLScience.

The report doesn’t suggest that the psychotic episode was necessarily caused by the stress of the Covid-19 pandemic, but it does indicate this global event was coloring his delusions. This is concluded because the man had previously experienced two previous hospitalizations in 2011 and 2019 after experiencing similar symptoms, such as hearing voices and paranoid delusions, and he was diagnosed with acute polymorphic psychotic disorder and paranoid psychosis. 

Nevertheless, there is also some evidence that people with psychiatric conditions might suffer from higher levels of fear during a disease outbreak. As cited in the case report, another study from 2019 found that patients with schizophrenia suffered from increased anxiety during the 2009 swine flu pandemic, along with heightened fear they might become infected.

“The patient already had the schizophrenic disease and had similar episodes before, so ‘Corona-Crisis’ didn't cause the paranoid episode by itself; it may have developed also without it, we don't know,” Fischer added. 

“It is also of note that the ‘Corona-crisis’ may be leading to more admissions to psychiatric hospitals by causing or inducing... psychotic or depressive episodes that have to be treated. We are actually investigating this in more detail."

There have been similar instances where a psychotic episode has been themed by other world events and current affairs. For example, last year a man suffered an acute psychotic disorder associated with anxiety related to Brexit, the UK's decision to leave the European Union.

While this new case report focuses on someone with fairly severe pre-existing psychiatric health concerns, it also highlights how mental health can be affected by the ongoing Covid-19 pandemic, along with the stress and strains associated with social distancing and lockdown measures. The United Nations has recently warned that a mental health crisis could be around the corner as millions of people worldwide are faced with isolation, poverty, and anxiety linked to the Covid-19 pandemic. 

If you or someone you know is struggling with mental health concerns during this unusual time, you can find accessible advice from a number of different national health authorities here, here, and here.

Edited 20/05/2020: This article has been edited to include comments from one of the study authors. 

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