Psychotic disorders in COVID-19: mechanisms of development, clinical and treatment features

Abstract

The purpose of this review was to study the mechanisms of development, clinical features and treatment of psychotic disorders during the disease caused by the SARS-CoV-2 virus. In the first part of the review, especial attention was paid to the available literature data on the mechanisms of development of mental disorders in COVID-19. Among the main pathogenetic mechanisms of the onset of psychotic disorders in coronavirus infections, there are direct effects of a viral infection (including a brain infection), cerebrovascular diseases, hypoxia, an immunological response, the consequences of medical interventions, social isolation, the psychological impact of a severe and potentially fatal illness, fears of infecting another’s and stigmatization. The second part of the publication is devoted to a review of clinical studies and syndromokinesis in infectious and coronavirus psychoses. Particular attention is paid to delirious syndrome, including pharmacogenic delirium and antibiotic-associated encephalopathy. The article describes the features of therapy for psychotic disorders in COVID-19, taking into account drug‑drug interactions and the effect on the cardiovascular and respiratory systems. The analyzed literature allows us to make a reasonable conclusion that the management of coronavirus psychoses should be aimed at treating the underlying disease while eliminating psychotic symptoms with antipsychotics while ensuring maximum safety of psychopharmacotherapy.