King's College London

TY - JOUR

T1 - COVID-19 and psychosis risk

T2 - Real or delusional concern?

AU - Watson, Cameron J.

AU - Thomas, Rhys H.

AU - Solomon, Tom

AU - Michael, Benedict Daniel

AU - Nicholson, Timothy R.

AU - Pollak, Thomas A.

N1 - Funding Information: TS is supported by the National Institute for Health Research (NIHR) Health Protection Research Unit in Emerging and Zoonotic Infections (Grant Nos. IS-HPU-1112−10117 Funding Information: and NIHR200907), NIHR Global Health Research Group on Brain Infections (No. 17/63/110), and the European Union's Horizon 2020 research and innovation program ZikaPLAN (Preparedness Latin America Network), grant agreement No. 734584. Funding Information: BDM has received funding from the UKRI, MRC, Wellcome, BMA, AMS, and NIHR. Publisher Copyright: © 2020 Elsevier B.V. Copyright: Copyright 2021 Elsevier B.V., All rights reserved.

PY - 2021/1/10

Y1 - 2021/1/10

N2 - 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.

AB - 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.

KW - COVID-19

KW - Encephalitis

KW - Neurology

KW - Neuropsychiatry

KW - Psychiatry

KW - Psychosis

KW - SARS-CoV-2

KW - Schizophrenia

UR - http://www.scopus.com/inward/record.url?scp=85097048188&partnerID=8YFLogxK

U2 - 10.1016/j.neulet.2020.135491

DO - 10.1016/j.neulet.2020.135491

M3 - Review article

C2 - 33220366

AN - SCOPUS:85097048188

VL - 741

JO - Neuroscience Letters

JF - Neuroscience Letters

SN - 0304-3940

M1 - 135491

ER -