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COVID-19 and psychosis risk: Real or delusional concern?

Lookup NU author(s): Dr Rhys ThomasORCiD


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© 2020 Elsevier B.V. Historical epidemiological perspectives from past pandemics and recent neurobiological evidence link infections and psychoses, leading to concerns that COVID-19 will present a significant risk for the development of psychosis. But are these concerns justified, or mere sensationalism? In this article we review the historical associations between viral infection and the immune system more broadly in the development of psychosis, before critically evaluating the current evidence pertaining to SARS-CoV-2 and risk of psychosis as an acute or post-infectious manifestation of COVID-19. We review the 42 cases of psychosis reported in infected patients to date, and discuss the potential implications of in utero infection on subsequent neurodevelopment and psychiatric risk. Finally, in the context of the wider neurological and psychiatric manifestations of COVID-19 and our current understanding of the aetiology of psychotic disorders, we evaluate possible neurobiological and psychosocial mechanisms as well as the numerous challenges in ascribing a causal pathogenic role to the infection.

Publication metadata

Author(s): Watson CJ, Thomas RH, Solomon T, Michael BD, Nicholson TR, Pollak TA

Publication type: Review

Publication status: Published

Journal: Neuroscience Letters

Year: 2021

Volume: 741

Print publication date: 10/01/2021

Online publication date: 18/11/2020

Acceptance date: 03/11/2020

ISSN (print): 0304-3940

ISSN (electronic): 1872-7972

Publisher: Elsevier Ireland Ltd


DOI: 10.1016/j.neulet.2020.135491

PubMed id: 33220366