The impact of the COVID-19 pandemic on health outcomes in delusional disorder: A systematic review

Abstract

Introduction The health impact of the COVID-19 pandemic has been widely recognized in both physical and mental health. Relatively little attention has been paid to patients with delusional disorder (DD). Objectives Our goal was to synthesize the known mental and physical health consequences of the COVID-19 pandemic in patients diagnosed with DD. Methods A systematic review was carried out using the PubMed and Scopus database (2019-October 2022) following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. Search terms: “delusional disorder” or “delusional disorder” AND “COVID-19 OR SARS-CoV2.” Inclusion criteria: 1)DD according to DSM/ICD, 2)languages: English, French, German and Spanish, 3)studies reporting health consequences of COVID-19 pandemic. From a total of 615 records, 6 were included: meta-analysis (n=1), cross-sectional studies (n=2), retrospective study (n=1), case reports (n=2). Results A full third of patients with psychosis (including DD) presented with increased psychiatric symptom severity, reportedly activated by increased daily life stress. Suicidal behavior was reported in a previously undiagnosed DD patient in association with a worsening clinical picture. Perhaps surprisingly, admissions for DD in 2020 were lower than in 2019. The duration of hospitalization was, however, longer. There was a report of new onset DD with delusional material centred on COVID. There was also a report of COVID-19 symptoms being more severe in DD patients than in the larger community. Conclusions Health emergencies affect the seriously mentally ill more than other community members. Awareness and outreach can help to maintain treatment adherence and minimize risk of psychotic exacerbation. Disclosure of Interest None Declared