Herrera Shaynna N, Sarac Cansu, Bilgrami Zarina R, Dobbs Matthew F, Jespersen Rachel, Haas Shalaila S, Garg Sahil, Shaik Riaz B, Landa Yulia, Corcoran Cheryl M
Icahn School of Medicine at Mount Sinai, New York, NY 10029.
Psychosis. 2022;14(2):190-199. doi: 10.1080/17522439.2021.1915369. Epub 2021 Jun 30.
The COVID-19 pandemic is expected to increase stress and mental health symptoms. We present the case of a young man at risk for psychosis who has paradoxically shown symptomatic and functional improvement as a result of circumstances produced by COVID-19. These changes were unexpected given the client's persistent mental health struggles in the year leading up to the COVID-19 outbreak in the United States and the expectation of an exacerbation of psychotic-like symptoms.
This report is based on clinical assessments and the client's first-person account during the height of the pandemic when stay at home orders were in place.
During the pandemic, the client demonstrated increased agency by taking on more responsibility at home and obtaining part-time employment. He showed improvement in his mood and relationships with others, had less symptom-related distress, and significantly reduced his cannabis use. The client interpreted these improvements in terms of changing his mindset toward more adaptive thoughts and engaging in healthy coping skills such as praying, reading, and healthy eating.
This case highlights the importance of fostering agency in clients during a time of crisis and ensuring that clinicians be aware of potential biases about mental health symptom exacerbation.
预计新冠疫情会增加压力和心理健康症状。我们介绍一例有精神病风险的年轻男性病例，该病例因新冠疫情引发的情况，反常地出现了症状和功能改善。鉴于该患者在美国新冠疫情爆发前的一年里持续存在心理健康问题，且预计类似精神病症状会加重，这些变化出乎意料。
本报告基于临床评估以及疫情高峰期实施居家令期间患者的第一人称叙述。
疫情期间，该患者通过在家承担更多责任并获得兼职工作，展现出更强的自主性。他的情绪和与他人的关系有所改善，与症状相关的痛苦减轻，大麻使用量显著减少。该患者将这些改善归因于将思维方式转变为更具适应性的想法，并采用祈祷、阅读和健康饮食等健康应对技巧。
本病例凸显了在危机时期培养患者自主性以及确保临床医生意识到心理健康症状加重的潜在偏见的重要性。
