3 results
Post-COVID syndrome or persistent COVID and depression
- S. Castelao-Almodovar, R. Ojea Quintana, A. Arrieta Artigas, A. Arce de la Riva, B. Tejero Soriano
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- Journal:
- European Psychiatry / Volume 66 / Issue S1 / March 2023
- Published online by Cambridge University Press:
- 19 July 2023, pp. S806-S807
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Introduction
Since the start of the COVID19 pandemic, numerous patients have exhibited symptoms related to the viral infection once the acute phase has resolved. The most frequent are fatigue or weakness, cognitive difficulties, insomnia, and anxiety or depression. It has been observed that the persistence of these symptoms is more common in cases of severe infections.
ObjectivesWe expose a case that exemplifies it; A 60-year-old man suffering from severe COVID19 infection during 2021, with bilateral pneumonia and secondary pneumothorax. Three months after the acute episode, he continues to present related symptoms, such as dyspnea, asthenia, arthromyalgia, nausea, hyporexia, memory lapses, anxiety and depressive mood with apathy, anhedonia and suicidal ideas.
MethodsThe patient starts follow-up in Mental Health and antidepressant treatment with Vortioxetine 10mg. In the following months he presented significant improvement consisting in decrease of the asthenia, dyspnea, arthromyalgia and especially in anxious symptoms and depressive mood, disappearing the apathy, anhedonia and suicidal ideation. However, the persistence of memory failures draws attention, which remain in a similar degree or with slight subjective improvement.
The exploration and complementary test were the following:
- Chest CT: Hydropneumothorax, parenchymal infiltrates, alveolar consolidations, left lamellar pneumothorax.
- Head CT, complete analysis, microbiological and cytological studies without relevant resolution.
- Assessment by the Rehabilitation and Neurology service.
ResultsThis case exposes the existence of a post-COVID syndrome, where the symptoms related to the infection persist, including anxious-depressive symptoms of moderate-severe intensity. The different diagnoses that were considered were the following: Post-COVID syndrome, Adjustment disorder with mixed anxious-depressive symptomatology, Depressive episode.
ConclusionsWe consider that in this case and in others that are similar, which are increasingly common in routine clinical practice, the etiopathogenesis of the syndrome is of interest. We found that it is difficult to discern the origin of the symptoms, not being able to differentiate an adaptive difficulty to the infection situation (added to the COVID pandemic context), versus a more organic affectation that improves when receiving pharmacological treatment, as in this case with antidepressants.
Disclosure of InterestNone Declared
Psychosis and COVID-19: About a case
- T. Ponte, S. Castelao-Almodóvar, B. Sanz-Aranguez, E. Gil-Benito, J. Herranz
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- Journal:
- European Psychiatry / Volume 64 / Issue S1 / April 2021
- Published online by Cambridge University Press:
- 13 August 2021, pp. S671-S672
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Introduction
Cases of psychosis are being reported in people infected by the SARS-CoV-2 virus. The relationship between psychosis and corticosteroids treatment is well known. However, there are relatively limited data so far correlating psychosis and SARS-CoV-2.
ObjectivesTo describe a case of manic psychosis in a 55-year-old woman treated with corticosteroids for COVID-19 infection. Discuss the etiopathogenic factors involved in psychosis in patients infected by COVID-19.
MethodsWe present the case of a 55-year-old woman, without previous psychiatric history, who was admitted to psychiatry due to a psychotic episode with maniac symptoms. Three weeks earlier, the patient had been admitted to Internal Medicine for bilateral SArs-CoV2 pneumonia, under treatment with high doses of corticosteroids. The patient presents a verbose and salty speech, euphoric mood with hyperergia, subjective increase of capacities, insomnia and delusional ideation with mystical-spiritual content with delusional interpretations and auditory hallucinations. The patient comes from Ukraine and she has been living in Spain for 20 years. She works as a household assistant. The patient relates various psychosocial stressors throughout her life.
ResultsComplementary diagnostic tests were without alterations. Low-dose antipsychotic treatment is prescribed, with a rapid recovery within a week. Finally, the patient showed complete insight of the episode and was discharged from the hospital being asymptomatic.
ConclusionsIt would be interesting to publish the reported cases of psychosis and infection by COVID-19 as well as to investigate the etiopathogenic factors that may be contributing to the development of psychosis in patients infected by the virus.
DisclosureNo significant relationships.
Electroconvulsive therapy in a patient with resistant paranoid schizophrenia treated with clozapine
- S. Castelao-Almodóvar, A. Pérez-Balaguer, T. Ponte, B. Estevez Peña, Y.D. Corres Fuentes, E. Gil-Benito, E.M. Suárez Del Río, L. Gayubo-Moreo, B. Sanz-Aranguez
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- Journal:
- European Psychiatry / Volume 64 / Issue S1 / April 2021
- Published online by Cambridge University Press:
- 13 August 2021, p. S810
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Introduction
One of the usual indications for Electroconvulsive Therapy (ECT) is Paranoid Schizophrenia (PS), being performed usually in cases resistant to antipsychotics.
ObjectivesTo present a clinical case of a patient with antipsychotic-resistant PS, including Clozapine, who received ECT.
MethodsWe present the case of a 47-year-old patient with an 8-years diagnosis of PS. He presented visual, auditory, and kinesthetic hallucinations, delusions, and thought insertion and diffusion phenomena that impeded concentration. He had received treatment with different antipsychotics (including Clozapine), without achieving remission of symptoms. He also presented significant adverse effects such as hypersalivation and extrapyramidal symptoms. Due to the poor response and the adverse effects that limited the dose increase, it was decided to start ECT.
ResultsThe patient received a total of 9 sessions, presenting a significant reduction in symptoms since the 5th session (disappearance of the sensory-perceptual alterations and thought disturbances). As side effects, the patient presented amnesia of the moments prior to applying the therapy, which subsequently resolved. The patient continued to present concentration difficulties, although after ECT he denied the presence of thought insertion or diffusion phenomena to which he previously attributed the cause of these difficulties.
ConclusionsAlthough less responsive than in other indications, ECT combined with antipsychotic drugs has been proven to be more effective than monotherapy (regardless of whether it’s Clozapine or another). This lower response could be due to the use of ECT in the most resistant cases, since it has been demostrated that in more acute cases a faster improvement occurs when the two treatments are combined.
DisclosureNo significant relationships.