TITLE
COVID-19 and psychosis: Neuropsychiatric impact and therapeutic approaches
ABSTRACT
COVID-19 infection has been linked to the development of psychotic symptoms through various neurobiological and inflammatory mechanisms. It has been proposed that the virus may activate epidermal growth factor signaling, a process linked to schizophrenia. Furthermore, it has been observed that infection-induced systemic inflammation, characterized by elevated levels of interleukin-6 and interleukin-10, can alter neurochemical balance and contribute to the onset of psychotic symptoms, even in patients without a history of psychiatric illness.
Changes in neurotransmitter systems, particularly disruption of glutamate and dopamine homeostasis, have also been implicated in the pathogenesis of post-COVID-19 psychosis. Furthermore, cerebral hypoxia resulting from central nervous system damage by the virus can lead to neuronal dysfunction and promote acute psychotic episodes. These effects have been documented in case studies reporting the onset of psychotic symptoms in patients recovering from the disease.
From a psychosocial perspective, the pandemic has impacted mental health by increasing stress and anxiety, factors that can trigger psychosis in predisposed individuals. Paradoxically, the duration of untreated psychosis decreased during the pandemic, possibly due to greater accessibility to mental health services. In terms of clinical management, antipsychotics remain the first-line treatment, while psychotherapeutic and psychosocial rehabilitation strategies are essential to mitigate the long-term effects of COVID-19 on mental health.
