key: cord-0840454-5n1aqrpa
authors: Ovejero, Santiago; Baca-García, Enrique; Barrigón, María Luisa
title: Coronovirus infection as a novel delusional topic
date: 2020-05-08
journal: Schizophr Res
DOI: 10.1016/j.schres.2020.05.009
sha: 4d593f87359c3840ce22b1bd736cb0a953599329
doc_id: 840454
cord_uid: 5n1aqrpa

Abstract Delusional topics tend to rapidly incorporate popular hot topical issues. Thus, the current coronavirus COVID-19 pandemic has rapidly reached delusional themes in patients with psychiatric disorders. Here we present the clinical case of a Spanish woman with bipolar disorder that included coronavirus infection in her delusional themes even faster than the real infection reached mainland Spain.

To the editor:

Although delusional core themes tend to be the same throughout different epochs (i.e., persecution, grandiosity, guilt, religion, hypochondria, love, or jealous), clinicians commonly notice how delusions tend to rapidly incorporate popular hot topical issues (Stompe et al., 2003) . Hence, delusions are dynamic and often represent a combination of psychopathology and external events.

The current coronavirus COVID-19 pandemic, expanded to 213 countries over the world with 2,810,325 confirmed cases and 193,825 deaths by April 27 (World Health Organization, 2020), represents the most critical global crisis in recent years and will probably have a social and psychological impact in all our lives. Nevertheless, even before to rise such this critical situation, in the early phase of the coronavirus outbreak, the disease became a topic of global concern across nations with an unprecedented speed of dissemination (Stoye, 2020; Xiang et al., 2020) .

Despite, obviously, the focus has been on people infected, and their medical management, which has even required a complete reorganization of many national health services (Legido-Quigley et al., 2020) , psychological and psychiatric aspects of coronavirus infection are also being taken into account. Thus, the necessity of appropriate mental health care for health professionals has been pointed out Lai et al., 2020) , and recommendations for psychological crisis intervention for people affected by COVID-19 have widely emerged (Duan and Zhu, 2020) . However, less attention has been paid to the potential worsening of people with previous mental disorders In this connection, psychiatrists have observed how coronavirus has rapidly reached delusional themes, even faster than the infection itself. Here, we present one early case of delusional contents related to COVID-19 infection.

Díaz Hospital in Madrid, Spain, diagnosed with bipolar disorder since 2010. She gave her consent to report her case. In a previous admission, in 2011, she exhibited megalomaniac delusions with sexual references. After that, she was stable for eight years. Two weeks before the admission, on 21.02.2020, she dropped the treatment and suffered a relapse consisting of a manic episode with psychotic symptoms. She presented to us with restlessness and dysphoric mood, accelerated and verbiage speech, and a tendency to derailment and tangentially. Sexual disinhibition and inappropriate contact were also shown. Delusional This case report illustrates how the current COVID-19 pandemic affects the pathoplasty of the delusion, as the main topic in this patient was rapidly adapted to current events. As the COVID-19 situation was turning into a matter of concern in the general population, it becomes increasingly included in the delusional contents of patients with psychiatric disorders. In this case, it is of particular interest the speed at which a current topic is included as a delusional thought. There was a 21 days gap between the first declared infection by COVID-19 in Spain and the delusional symptoms presented by this patient. Furthermore, this delusional case

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