Haddad Peter M, Al Abdulla Majid, Latoo Javed, Iqbal Yousaf
Psychiatry, Hamad Medical Corporation, Doha, Qatar
Clinical Department, College of Medicine, QU Health, Qatar University, Doha, Qatar.
BMJ Case Rep. 2020 Dec 16;13(12):e240088. doi: 10.1136/bcr-2020-240088.
A 30-year-old man with no significant previous or family psychiatric history became severely anxious about his health after a positive COVID-19 test. Physical symptoms of COVID-19 were mild, with no evidence of hypoxia or pneumonia, throughout his illness. He was admitted to a quarantine facility. He remained highly anxious, and 1 week later, he developed paranoid delusions and auditory hallucinations (his first psychotic episode). He was treated with lorazepam 1 mg four times a day, mirtazapine 30 mg nocte and risperidone 1 mg two times a day. His psychotic symptoms lasted 1 week. He stopped psychiatric medication after 4 weeks and had remained well when reviewed 3 months later. A Diagnostic and Statistical Manual of Mental Disorders fifth edition diagnosis of brief psychotic disorder with marked stressor (brief reactive psychosis) was made. Anxiety about his health and social isolation appeared the main aetiological factors but an inflammatory component cannot be excluded. The case highlights that first episode psychosis can be associated with mild COVID-19.
一名30岁男性，既往及家族均无显著精神病史，在新冠病毒检测呈阳性后，对自己的健康状况产生了严重焦虑。在整个患病期间，他的新冠病毒身体症状较轻，没有缺氧或肺炎的迹象。他被收治到一家隔离设施。他一直高度焦虑，1周后，出现了偏执妄想和幻听（他的首次精神病发作）。他接受了每天4次、每次1毫克劳拉西泮，每晚30毫克米氮平以及每天2次、每次1毫克利培酮的治疗。他的精神病症状持续了1周。4周后他停用了精神科药物，3个月后复诊时情况良好。根据《精神疾病诊断与统计手册》第五版，诊断为伴有明显应激源的短暂精神病性障碍（短暂反应性精神病）。对自身健康的焦虑和社交隔离似乎是主要病因，但不能排除炎症因素。该病例凸显了首次发作的精神病可能与轻度新冠病毒感染有关。
