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CNS & Neurological Disorders - Drug Targets

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ISSN (Print): 1871-5273
ISSN (Online): 1996-3181

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Case Report

Treatment of Major Depression with Psychotic Features and Cotard’s Syndrome after COVID-19 Infection in a Previously Healthy Patient: A Case Report

Author(s): Hasan Mervan Aytac*

Volume 22, Issue 4, 2023

Published on: 25 August, 2022

Page: [614 - 617] Pages: 4

DOI: 10.2174/1871527321666220516110620

open access plus

Abstract

Background: COVID-19 pandemic is related to anxiety, depression, and psychotic symptoms either directly due to invasion or inflammation caused by the virus or indirectly due to related psychosocial stress: fear of infection, social isolation, and financial burden.

Case Presentation: We present a 28-year-old female case of post‐COVID major depression with psychotic features and Cotard’s syndrome with no previous psychiatric history. Her complaints initially described the sadness of mood with early morning worsening, diminished interest in almost all activities, anhedonia, increased anxiety, ideas of worthlessness, hopelessness, guilt, decreased sleep, and appetite. Then, she developed severe depression with psychotic features such as delusions of persecution, poverty, and nihilism. Nihilistic delusions included a description of everything coming to an end. She thought that her organs were no more working. Later, she negated her existence and started believing that she was dead. The patient recovered after a combination of sertraline and olanzapine treatment.

Conclusion: This case of a COVID-19 patient with psychotic depression and Cotard’s delusion highlights the importance of evaluating mental health status and may contribute to our understanding of the potential risk of central nervous system impairment by SARS-CoV-2 infection.

Keywords: COVID-19, SARS-CoV-2, depression, Cotard’s syndrome, psychotic symptoms, psychotic features.

« Previous Next »
[1]
Aytaç HM, Pehlivan S. Viral pandemics as possible psychoimmunological causes of psychiatric symptoms: From past to present. Sağlık Bilimlerinde İleri Araştırmalar Dergisi 2020; 3(S1): 92-8.
[2]
Medina RA. 1918 influenza virus: 100 years on, are we prepared against the next influenza pandemic? Nat Rev Microbiol 2018; 16(2): 61-2.
[http://dx.doi.org/10.1038/nrmicro.2017.174] [PMID: 29332942]
[3]
Troyer EA, Kohn JN, Hong S. Are we facing a crashing wave of neuropsychiatric sequelae of COVID-19? Neuropsychiatric symptoms and potential immunologic mechanisms. Brain Behav Immun 2020; 87: 34-9.
[http://dx.doi.org/10.1016/j.bbi.2020.04.027] [PMID: 32298803]
[4]
Vindegaard N, Benros ME. COVID-19 pandemic and mental health consequences: Systematic review of the current evidence. Brain Behav Immun 2020; 89: 531-42.
[http://dx.doi.org/10.1016/j.bbi.2020.05.048] [PMID: 32485289]
[5]
Grover S, Aneja J, Mahajan S, Varma S. Cotard’s syndrome: Two case reports and a brief review of literature. J Neurosci Rural Pract 2014; 5 (Suppl. 1): S59-62.
[http://dx.doi.org/10.4103/0976-3147.145206] [PMID: 25540544]
[6]
Debruyne H, Portzky M, Van den Eynde F, Audenaert K. Cotard’s syndrome: A review. Curr Psychiatry Rep 2009; 11(3): 197-202.
[http://dx.doi.org/10.1007/s11920-009-0031-z] [PMID: 19470281]
[7]
Morgado P, Ribeiro R, Cerqueira JJ. Cotard syndrome without depressive symptoms in a schizophrenic patient. Case Reports Psychiatry 2015; 2015: 1-3.
[http://dx.doi.org/10.1155/2015/643191]
[8]
Yesilkaya UH, Sen M, Karamustafalioglu N. New variants and new symptoms in COVID-19: First episode psychosis and Cotard’s Syndrome two months after infection with the B.1.1.7 variant of coronavirus. Schizophr Res 2022; 243: 315-6.
[http://dx.doi.org/10.1016/j.schres.2021.06.001] [PMID: 34176695]
[9]
Ignatova D, Krasteva K, Akabalieva K, Alexiev S. Post-COVID-19 psychosis: Cotard’s syndrome and potentially high risk of harm and self-harm in a first-onset acute and transient psychotic disorder after resolution of COVID-19 pneumonia. Early Interv Psychiatry 2021. Epub ahead of print
[http://dx.doi.org/10.1111/eip.13254] [PMID: 34796667]
[10]
Stewart AL, Robinson DM. Cotard’s syndrome as a neuropsychiatric sequela of COVID-19. J Acad Consult Liaison Psychiatry 2022; 63(2): 182-3.
[http://dx.doi.org/10.1016/j.jaclp.2021.09.002] [PMID: 35241254]
[11]
Chavez M, Rojas M, Fortea A. Post dengue psychosis: Report of 4 cases. Eur Neuropsychopharmacol 2016; 2(26): S574.
[http://dx.doi.org/10.1016/S0924-977X(16)31633-9]
[12]
Corrêa-Oliveira GE, do Amaral JL, da Fonseca BAL, Del-Ben CM. Zika virus infection followed by a first episode of psychosis: Another flavivirus leading to pure psychiatric symptomatology. Br J Psychiatry 2017; 39(4): 381-2.
[http://dx.doi.org/10.1590/1516-4446-2017-2308] [PMID: 29160530]
[13]
Carter A, Bulbena A, Dunn N, Gersh R, Swift R. New-onset psychosis in patient with untreated HIV. Eur Psychiatry 2016; (33): S655.
[14]
Rothschild AJ. Treatment for major depression with psychotic features (psychotic depression). Focus Am Psychiatr Publ 2016; 14(2): 207-9.
[http://dx.doi.org/10.1176/appi.focus.20150045] [PMID: 31975804]
[15]
Meyers BS, Flint AJ, Rothschild AJ, et al. A double-blind randomized controlled trial of olanzapine plus sertraline vs olanzapine plus placebo for psychotic depression: The study of pharmacotherapy of psychotic depression (STOP-PD). Arch Gen Psychiatry 2009; 66(8): 838-47.
[http://dx.doi.org/10.1001/archgenpsychiatry.2009.79] [PMID: 19652123]
[16]
Fu R, Zhang Y. Case report of a patient with suspected COVID-19 with depression and fever in an epidemic stress environment. Gen Psychiatr 2020; 33(3): e100218.
[http://dx.doi.org/10.1136/gpsych-2020-100218] [PMID: 34192229]
[17]
Huang Y, Zhao N. Generalized anxiety disorder, depressive symptoms and sleep quality during COVID-19 outbreak in China: A web-based cross-sectional survey. Psychiatry Res 2020; 288: 112954.
[http://dx.doi.org/10.1016/j.psychres.2020.112954] [PMID: 32325383]
[18]
Ahmed MZ, Ahmed O, Aibao Z, Hanbin S, Siyu L, Ahmad A. Epidemic of COVID-19 in China and associated psychological problems. Asian J Psychiatr 2020; 51: 102092.
[http://dx.doi.org/10.1016/j.ajp.2020.102092] [PMID: 32315963]
[19]
Desforges M, Le Coupanec A, Dubeau P, et al. Human Coronaviruses and other respiratory viruses: Underestimated opportunistic pathogens of the central nervous system? Viruses 2019; 12(1): 14.
[http://dx.doi.org/10.3390/v12010014] [PMID: 31861926]
[20]
Aytac HM, Yazar MS, Erol A, Pehlivan S. Investigation of inflammation related gene polymorphism of the mannose-binding lectin 2 in schizophrenia and bipolar disorder. Neurosciences (Riyadh) 2021; 26(4): 346-56.
[http://dx.doi.org/10.17712/nsj.2021.4.20200050] [PMID: 34663707]
[21]
Aytac HM, Oyaci Y, Yazar MS, Pehlivan S. Macrophage migration inhibitory factor - 173 G/C Polymorphism is associated with the age of onset and insight in schizophrenia in the Turkish population. Neurol Res 2021; 43(12): 977-84.
[http://dx.doi.org/10.1080/01616412.2021.1948748] [PMID: 34264160]
[22]
Bechter K. Virus infection as a cause of inflammation in psychiatric disorders. Mod Trends Pharmacopsychiatry 2013; 28: 49-60.
[http://dx.doi.org/10.1159/000343967] [PMID: 25224890]
[23]
Veleri S. Neurotropism of SARS-CoV-2 and neurological diseases of the central nervous system in COVID-19 patients. Exp Brain Res 2022; (240)1: 9-25.
[PMID: 34694467]
[24]
Li YC, Bai WZ, Hashikawa T. The neuroinvasive potential of SARS-CoV2 may play a role in the respiratory failure of COVID-19 patients. J Med Virol 2020; 92(6): 552-5.
[http://dx.doi.org/10.1002/jmv.25728] [PMID: 32104915]
[25]
Chacko M, Job A, Caston F III, George P, Yacoub A, Cáceda R. COVID-19-induced psychosis and suicidal behavior: Case Report. SN Compr Clin Med 2020; 2(11): 2391-5.
[http://dx.doi.org/10.1007/s42399-020-00530-7] [PMID: 33015547]
[26]
Arrigo BA, Bullock JL. The psychological effects of solitary confinement on prisoners in supermax units: Reviewing what we know and recommending what should change. Int J Offender Ther Comp Criminol 2008; 52(6): 622-40.
[http://dx.doi.org/10.1177/0306624X07309720] [PMID: 18025074]
[27]
Cole SW, Capitanio JP, Chun K, Arevalo JM, Ma J, Cacioppo JT. Myeloid differentiation architecture of leukocyte transcriptome dynamics in perceived social isolation. Proc Natl Acad Sci USA 2015; 112(49): 15142-7.
[http://dx.doi.org/10.1073/pnas.1514249112] [PMID: 26598672]
[28]
Raony Í, de Figueiredo CS, Pandolfo P, Giestal-de-Araujo E, Oliveira-Silva Bomfim P, Savino W. Psycho-neuroendocrineimmune interactions in COVID-19: Potential impacts on mental health. Front Immunol 2020; 11: 1170.
[http://dx.doi.org/10.3389/fimmu.2020.01170] [PMID: 32574266]

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