Insight into psychotic illness: The Coronavirus

The first detected COVID-19 was in Wuhan, China, in December 2019. Infection with SARS-CoV-2, an enveloped single-strand RNA virus, causes it. There have been a growing number of cases of individuals experiencing short-term first episodes of psychosis other than delirium at the time of, or shortly after, a positive SARS-CoV-2 examination. 

 The correlation between COVID-19 diagnosis and hysteria may be spurious, but the details support a causal link in many cases. Various aetiological mechanisms may be at work, including psychosocial stressors associated with inflammation, precipitating insanity in vulnerable people. Anxiety over one's health, fear of death, and social alienation are all examples of stressors. Quarantine has been shown to have negative psychological consequences such as anxiety and frustration. An Italian paper identified three patients who experienced their first mental disorder while being quarantined for COVID-19. Brief depressive symptoms have also occurred in individuals who have experienced psychiatric trauma due to the pandemic but have not been contaminated with SARS-CoV-2. Suicidal behaviour has been observed in some forms of psychosis. The psychotic illness caused by COVID-19 is discussed in this article.

The accumulation of scientific data has improved our understanding of the psychiatric characteristics of cerebral illness through the years. In recent decades, research in viruses' putative aetiologic presence has grown to include not only the organic psychotic illnesses caused by acute viral encephalitis and sluggish viral infections of the central nervous system (CNS) but also so-called functional, psychological diseases such as insanity, depression, and bipolar disorder (BD). It is now widely accepted that the combination of chronic infection, viral neurotropism, and environmental trauma stimulates or even causes the emergence of psychological pathologies, which intensify the trajectory of the pandemic and pose a major therapeutic challenge. Viral infection of the brain may have various physiological and psychological effects, leading to both the acute and long-term effects of the disorder (Fig 1).

Figure 1. Illustration of virus causing a various effect to the brain

Psychosocial causes for psychiatric illnesses

• Furthermore, psychiatric illnesses that arise during the pandemic can be caused by psychosocial causes such as:
• The frequency and degree of exposure to people infected with the virus
• The fear of infecting family members
• Lack of access to COVID-19 testing and medical treatment.
• Physical segregation, home confinement, quarantining, and loneliness
• Inconsistent messages and directives regarding public health measures such as wearing face masks
• Economic hardships and poverty
• Scarcity of available commodities (e.g., foods, paper goods, and personal protective equipment)
• Restrictions on personal liberty
• Constant media coverage of the pandemic and the confusion about the information.

 

Psychiatric Manifestations of COVID-19

 COVID-19's neurologic interactions can also be a source of long-term neurological consequences. SARS-CoV-1 also has a neurological aspect, as expected. Alzheimer's disease and Parkinson's disease can both be caused by the virus. In this respect, and at this point in our knowledge of COVID-19, it is unclear if SARS-CoV-2 activates or accelerates the onset of neurodegenerative diseases. Because of its existence in the brain and resulting neural dysfunction, SARS-CoV-2 impacts long-term cognitive performance. The virus can cause hysteria, mania, delirium, depression, anxiety, and uncertainty, among other things. These studies are open to the possibility that the occurrence of these mental health conditions is linked to COVID-19, implying a connection between SARS-CoV-2 and certain disorders. Mental health issues may lead to factors that increase a person's vulnerability to the virus, such as a loss of "self-regulation" and "self-care," as well as a "lack of understanding" into the virus's dangers; "they may be incapable of exercising infection control, making them vulnerable to the COVID-19 and its complications." Significantly, proinflammatory phenomena may be linked to neurological diseases as a root cause.

 Conclusion

There are currently several preliminary findings on COVID-19's neuropsychiatric complications, but, based on the effects of past epidemics of multiple respiratory viruses, an elevated prevalence of behavioural pathologies as an unwelcome sequela may be assumed. Not only can SARS-COV-2 infiltrate the brain and inflict direct disruption to neural networks, but the experience of possibly fatal and untreatable COVID-19 can cause extreme anxiety, leading to long-term behavioural modifications or exacerbating an underlying psychiatric disorder. COVID-19 patients may experience various neuropsychiatric symptoms due to systemic inflammation, cytokine effects in the CNS, SARS-COV-2 infection of neural cells, neuroinflammation, glial dysfunction, or aberrant epigenetic modifications stress-related genes.