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Stress during lockdowns may lead to more psychosis cases and increase risk of Covid-19 infection: Study

Stress due to isolation could trigger psychosis and patients may not grasp infection control measures such as hygiene, masks, or social distancing, said an expert
UPDATED MAY 14, 2020
(Getty Images)
(Getty Images)

Coronavirus has triggered widespread stress and a small number of people may become vulnerable to psychosis, a mental health condition. And this condition may increase the risk of contracting Covid-19.

At the same time, the virus may be hard on patients already suffering from psychosis, according to a new study that looked at how past viral infections have affected psychotic patients. People with this condition may experience delusions and struggle to separate them from reality. They are also at risk of hurting themselves. Schizophrenia patients, for instance, go through these episodes.

“Covid-19 is a very stressful experience for everyone, particularly for those with complex mental health needs,” Dr Ellie Brown from the University of Melbourne, who was involved in the study, said in a statement. “People with psychosis are a population that is particularly vulnerable in the current Covid-19 pandemic, and their needs are often overlooked," Brown added.

Covid-19 and psychosis may impact each other

Stress due to isolation could trigger psychosis and patients may not grasp infection control measures such as hygiene, masks, or social distancing, she explained. Dr Brown's study shows that their thoughts around contamination and their understanding of concepts such as physical distancing may be different from the rest.

As a result, psychosis patients are at higher risk of contracting and spreading Covid-19. The authors suggest that authorities may have to change how they reach out to this population.

(Getty Images)

“Maintaining infection control procedures when people are psychotic is challenging,” Co-lead author of the research, Professor Richard Gray of La Trobe University, said. “For them not to become potential transmitters of the virus, clinicians and service providers may benefit from specific infection control advice to mitigate any transmission risk," he added.

Spike in psychosis cases

One Chinese study examined whether regions with high Covid-19 prevalence showed a spike in cases of psychosis. They found schizophrenia cases went up by 25% in January 2020, when the virus took hold in the country, compared to the previous years. 

The authors analyzed data from 13,783 outpatients from a hospital. Of them, 1,210 sought care for the first time, in January, when Covid-19 took hold in China.

In Malaysia, a 31-year-old patient with no history of mental illness in his family began showing odd behavior. The doctors explained the man was worried about his safety and kept a constant tab on the news about the pandemic.

"He was causing a public nuisance within his neighborhood by holding a knife, talking irrelevantly and constantly expressing his belief that the world will end soon," the case report read. The man bounced back to normalcy after a three-day treatment.

Dr Brown and her colleagues argue that the existing evidence should warrant more research. They also call for more attention toward the condition. Professor Gray said, “This is a group that's probably going to need more support, with isolation, physical distancing, hand washing, etc, and clinicians may be the ones who need to be thinking and working on this to assist this vulnerable population."

The study appears in Schizophrenia Research.

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