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社交隔离引发的痴呆或精神病?新冠疫情期间的一则简短病例报告。

Dementia or psychosis precipitated by social isolation? A brief case report in COVID-19 pandemic times.

作者信息

de Oliveira Gustavo Carvalho

机构信息

Faculdade de Ciências da Educação e Saúde Centro Universitário de Brasília (UNICEUB) Brasília Brazil.

Centre for Forensic Behavioral Science Swinburne University of Technology Melbourne Australia.

出版信息

Alzheimers Dement (Amst). 2021 Apr 7;13(1):e12166. doi: 10.1002/dad2.12166. eCollection 2021.

Abstract

BACKGROUND

The year 2020 was marked by the pandemic of COVID-19, which abruptly changed the ways of dealing with viral infections and social relationships. Cognitive, emotional, and neurological effects due to infection with this condition, as well as several health damages, are due to social isolation.

AIM

To recognize the consequences of and reasons behind forced social isolation and related psychosis symptoms.

METHOD

This is a case report of a healthy 70-year-old female patient who began to experience paranoid delusions and auditory hallucinations after adopting strict measures that abruptly impacted her routine of activities outside the home, by confining herself at home overnight. The patient has agreed to the publication anonymously and signed an informed consent.

RESULTS

The patient required rapid and home treatment with risperidone antipsychotics, and eventually had a total remission of symptoms. The suspicion of dementia or another organic cause was investigated and has so far been ruled out.

DISCUSSION AND CONCLUSIONS

It is suggested that the situation was triggered by abrupt and unorganized social isolation during the pandemic. A literature review on the subject was carried out, finding pertinent information about psychosis, social isolation due to COVID-19, and the case described. The patient will follow a careful follow-up with a plan for withdrawal of antipsychotic medication after 6 asymptomatic months with monitoring of demented prodrome. It is necessary to study more about this topic and promote planning in case of a need to adopt extreme measures, such as isolation and lockdown.

摘要

背景

2020年以新冠疫情为标志,它突然改变了应对病毒感染和社会关系的方式。感染这种疾病所导致的认知、情感和神经方面的影响,以及一些健康损害,都归因于社会隔离。

目的

认识强制社会隔离及其相关精神病症状的后果和背后原因。

方法

这是一例关于一名70岁健康女性患者的病例报告,该患者在采取突然影响其外出日常活动的严格措施,即在家中过夜禁闭后,开始出现偏执妄想和幻听。患者已同意匿名发表并签署了知情同意书。

结果

患者需要使用利培酮抗精神病药物进行快速居家治疗,最终症状完全缓解。对痴呆或其他器质性病因的怀疑进行了调查,目前已排除。

讨论与结论

表明这种情况是由疫情期间突然且无组织的社会隔离引发的。对该主题进行了文献综述,找到了关于精神病、因新冠疫情导致的社会隔离以及所描述病例的相关信息。患者将进行密切随访,计划在无症状6个月后停用抗精神病药物,并监测痴呆前驱症状。有必要对该主题进行更多研究,并在需要采取诸如隔离和封锁等极端措施时促进规划。

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