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Among the spectrum of weird and unexpected symptoms of COVID-19, a small but significant number of people develop severe psychotic symptoms – from wild delusions to vivid hallucinations – after becoming ill with the disease. Psychosis and pandemics have already been linked, however, researchers are struggling to understand why these particular symptoms are a hallmark of the ongoing disease outbreak.
While the precise extent of the problem is not yet clear, a number of studies around the world have looked into the issue over the past year.
A study, published in November, found that nearly one in five people diagnosed with COVID-19 will receive a psychiatric diagnosis within the next 3 months. Shockingly, 1 in 4 people had no history of mental health problems prior to their infection. Most of these diagnoses were most often related to anxiety, depression or insomnia – but over 1,200 patients have been diagnosed with psychotic disorders. Another study examined 153 people hospitalized for COVID-19 in the UK and found that 10 of them had ‘new onset psychosis’ after their infection.
For some, psychotic symptoms may persist. A case study of a 55-year-old woman in the UK explains how she experienced ‘persistent and flourishing psychotic symptoms’ following COVID-19 infection, despite having no history of mental illness. After being discharged from the hospital where she was being treated for COVID-19, she was readmitted a few days later, suffering from an array of unusual thoughts and behaviors. In addition to acting confused, she began to believe her cat was a lion and saw “monkeys jumping out of the nurse’s bag.” She also believed that the nurses at the hospital were “demons” plotting to harm her, and that one of her family members had been replaced by a lookalike, known as the Capgras illusion. The patient continued to experience disturbing delusions for 34 days, but eventually stopped reporting paranoid thoughts 52 days after the first onset of her symptoms.
The question is: what causes these psychotic experiences? There is an argument that this might be, in a small part, a reflection of how many people have suffered from mental health problems pandemic due to social isolation, anxiety about illness and financial problems. Generally speaking, it is also known that many physical illnesses can also trigger mental health problems.
There is also a bunch of strong evidence that COVID-19 is involved in a range of brain complications and neurological symptoms, from strokes and seizures memory loss poor concentration, something called “brain fog”. Along with this, the research also identified physical brain changes associated with the disease. It is not known, however, whether this is evidence that the virus directly “attacks” brain tissue, or of indirect damage caused by the inflammation of the infection.
Strangely enough, there is a long history of mental illnesses and epidemics. Karl Menninger, psychiatrist at Boston Psychopathic Hospital, was one of the many clinicians who noted that a surprising number of “mental disorders” have been documented in survivors of 1918 Spanish flu pandemic. The researchers have also found some links – although less significant compared to COVID-19 – between rising mental health issues and other coronavirus outbreaks, like SARS or MERS.
For more information on COVID-19, check out the IFLScience COVID-19 hub where you can follow the current status of the pandemic, vaccine development progress, and other disease information.
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