COVID-19-associated psychosis: A systematic review of case reports.

Journal Article (Journal Article;Review;Systematic Review)

OBJECTIVES: To describe the comorbidities, presentations, and outcomes of adults with incident psychosis and a history of COVID-19. METHODS: We completed a descriptive systematic review of case reports according to PRISMA guidelines, including cases of adult patients with incident psychosis and antecedent or concurrent COVID-19. We extracted patient demographics, comorbidities, clinical course, and outcomes, and assessed cases for quality using a standardized tool. RESULTS: Of 2396 articles, we included 40 reports from 17 countries, comprising 48 patients. The mean age of patients was 43.9 years and 29 (60%) were males. A total of 7 (15%) had a documented psychiatric history, 6 (13%) had a substance use history and 11 (23%) had a comorbid medical condition. Delusions were the most common (44 [92%]) psychiatric sign and psychosis lasted between 2 and 90 days. A total of 33 (69%) patients required hospitalization to a medical service and 16 (33%) required inpatient psychiatric admission. The majority (26 [54%]) of cases did not assess for delirium and 15 (31%) cases were judged to be of high risk of bias. CONCLUSIONS: Despite the growing awareness of COVID-19's association with incident psychosis at a population level, cases of COVID-19-associated psychosis often lacked clinically relevant details and delirium was frequently not excluded. PROSPERO registration number: CRD42021256746.

Full Text

Duke Authors

Cited Authors

  • Smith, CM; Gilbert, EB; Riordan, PA; Helmke, N; von Isenburg, M; Kincaid, BR; Shirey, KG

Published Date

  • 2021

Published In

Volume / Issue

  • 73 /

Start / End Page

  • 84 - 100

PubMed ID

  • 34717240

Pubmed Central ID

  • PMC8546431

Electronic International Standard Serial Number (EISSN)

  • 1873-7714

Digital Object Identifier (DOI)

  • 10.1016/j.genhosppsych.2021.10.003


  • eng

Conference Location

  • United States