Among the variety of strange and unexpected symptoms of COVID-19, a small but significant number of people are developing severe psychotic symptoms – from wild delusions to vivid hallucinations – after falling ill with the disease. Psychosis and pandemics have been linked before, however, researchers are struggling to understand why these peculiar symptoms are a characteristic of the ongoing disease outbreak.
Although the precise scale of the problem is not yet clear, several studies worldwide have investigated the problem in the past year.
A study, published in November, found that almost 1 in 5 people diagnosed with COVID-19 receive a psychiatric diagnosis in the next 3 months. Surprisingly, 1 in 4 of these people also had no prior history of mental health problems prior to infection. Most of these diagnoses were more often related to anxiety, depression or insomnia – but more than 1,200 of the patients were diagnosed with psychotic disorders. Another study examined 153 people hospitalized with COVID-19 in the UK and found that 10 of them had “recent onset psychosis” after infection.
For some, psychotic symptoms can persist. A case study by a 55-year-old woman in the UK explains how she experienced “persistent and flowery psychotic symptoms” after a COVID-19 infection, despite having no history of mental illness. After being discharged from the hospital where she was being treated for COVID-19, she was readmitted a few days later, suffering from a series of unusual thoughts and behaviors. In addition to looking confused, she began to believe that her cat was a lion and saw “monkeys jumping out of the paramedic’s bag”. She also believed that the hospital nurses were “demons” conspiring to hurt her and that one of her family members had been replaced by a double, known as a Capgras delusion. The patient continued to have disturbing delusions for 34 days, but eventually stopped reporting paranoid thoughts 52 days after the first symptoms appeared.
The question is, what is causing these psychotic experiences? There is an argument that it could be, in some small part, a reflection of how many people suffered from mental health problems during the pandemic due to social isolation, anxiety about the disease and financial problems. Generally speaking, it is also known that many physical illnesses can also trigger mental health problems.
There is also a lot of strong evidence that COVID-19 is involved in a number of brain complications and neurological symptoms, from strokes and apprehensions memory loss, lack of concentration, something referred to as “brain fog”. Along with that, the survey also identified physical changes in the brain associated with the disease. However, it remains uncertain whether this is evidence that the virus is “attacking” brain tissue directly or whether there is indirect damage caused by inflammation of the infection.
Strangely, there is a long history of mental illness and disease outbreaks. Karl Menninger, a psychiatrist at Boston Psychopathic Hospital, was one of many doctors who noticed that a surprising number of “mental disorders” have been documented in survivors of the Spanish flu pandemic of 1918. Researchers have also found some links – albeit less significant compared to COVID-19 – between the increase in mental health problems and other coronavirus outbreaks, such as SARS or MERS.
For more information on COVID-19, check out the IFLScience COVID-19 hub, where you can track the current status of the pandemic, the progress of vaccine development and more information about the disease.