Baral Nischit, Adhikari Govinda, Karki Sandip, Champine Andrew, Sud Parul
Internal Medicine, McLaren Flint/Michigan State University, Flint, USA.
Psychiatry, McLaren Flint/Michigan State University, Flint, USA.
Cureus. 2021 Jan 28;13(1):e12973. doi: 10.7759/cureus.12973.
Social stigma and neglect post-coronavirus disease 2019 (COVID-19) and self-quarantine can be associated with a brief psychotic disorder (BPD). A 53-year-old African-American man with no significant past medical and psychiatric history was brought to the emergency department (ED) with symptoms of persecutory delusions post COVID-19 and self-quarantine. His symptoms included false beliefs that people were plotting to kill him which made him combative at work and home. As his symptoms worsened, his wife brought him to the hospital. He was given intramuscular haloperidol 5 mg one dose in the ED. The Clinical Health Psychology and Psychiatry team diagnosed the patient with BPD as per the Diagnostic and Statistical Method of Mental Disorder Fifth Edition (DSM-5). Over the next few days, his symptoms slowly improved. At follow-up visit in the outpatient clinic in a week, we found him back to his baseline without any delusional thoughts. Increased stressors post COVID-19, neglect at home, and social stigmata at work associated with COVID-19 along with his individual vulnerability appeared to be the cause of his delusions but various other mechanisms may exist. Our case raises the question: does social stigma and neglect post-COVID-19 and self-quarantine matter?
2019冠状病毒病(COVID-19)后的社会耻辱感、被忽视情况以及自我隔离可能与短暂性精神病性障碍(BPD)有关。一名53岁的非裔美国男子,既往无重大内科及精神病史,因COVID-19感染及自我隔离后出现被害妄想症状被送至急诊科(ED)。他的症状包括坚信有人密谋杀害他,这使他在工作和家中都具有攻击性。随着症状加重,他的妻子将他送往医院。在急诊科,他接受了一剂5毫克的肌肉注射氟哌啶醇。临床健康心理学与精神病学团队根据《精神疾病诊断与统计手册》第五版(DSM-5)将该患者诊断为BPD。在接下来的几天里,他的症状逐渐改善。在一周后的门诊随访中,我们发现他已恢复至基线状态,没有任何妄想思维。COVID-19后的压力源增加、在家中被忽视以及工作中与COVID-19相关的社会耻辱感,再加上他个人的易感性,似乎是导致他出现妄想的原因,但可能还存在其他多种机制。我们的病例提出了一个问题:COVID-19后的社会耻辱感和被忽视情况以及自我隔离重要吗?