Medically unexplained symptoms in the times of COVID-19 pandemic: A case-report

Marco Colizzi; Riccardo Bortoletto; Marta Silvestri; Federica Mondini; Elena Puttini; Chiara Cainelli; Rossella Gaudino; Mirella Ruggeri; Leonardo Zoccante

Brain, Behavior, & Immunity - Health (May 2020)

Medically unexplained symptoms in the times of COVID-19 pandemic: A case-report

Marco Colizzi,
Riccardo Bortoletto,
Marta Silvestri,
Federica Mondini,
Elena Puttini,
Chiara Cainelli,
Rossella Gaudino,
Mirella Ruggeri,
Leonardo Zoccante

Affiliations

Marco Colizzi: Section of Psychiatry, Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Italy; Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, United Kingdom; Child and Adolescent Neuropsychiatry Unit, Maternal-Child Integrated Care Department, Integrated University Hospital of Verona, Italy; Corresponding author. Section of Psychiatry, Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Italy.
Riccardo Bortoletto: Child and Adolescent Neuropsychiatry Unit, Maternal-Child Integrated Care Department, Integrated University Hospital of Verona, Italy
Marta Silvestri: Child and Adolescent Neuropsychiatry Unit, Maternal-Child Integrated Care Department, Integrated University Hospital of Verona, Italy
Federica Mondini: Child and Adolescent Neuropsychiatry Unit, Maternal-Child Integrated Care Department, Integrated University Hospital of Verona, Italy
Elena Puttini: Child and Adolescent Neuropsychiatry Unit, Maternal-Child Integrated Care Department, Integrated University Hospital of Verona, Italy
Chiara Cainelli: Child and Adolescent Neuropsychiatry Unit, Maternal-Child Integrated Care Department, Integrated University Hospital of Verona, Italy
Rossella Gaudino: Section of Paediatrics, Department of Surgery, Dentistry, Paediatrics and Gynaecology, University of Verona, Verona, Italy
Mirella Ruggeri: Section of Psychiatry, Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Italy
Leonardo Zoccante: Child and Adolescent Neuropsychiatry Unit, Maternal-Child Integrated Care Department, Integrated University Hospital of Verona, Italy

Journal volume & issue: Vol. 5
p. 100073

Abstract

Read online

In early 2020, a novel coronavirus (SARS-CoV-2) leading to a potentially fatal condition was discovered. Since then, the 2019 coronavirus disease (COVID-19) has spread worldwide becoming a pandemic. Beyond the risks strictly related to the infection, concerns have been expressed for the psychological impact that COVID-19 may have, especially on vulnerable individuals with pre-existing mental health conditions. Somatic symptom disorder (SSD) is characterized by a dysfunctional preoccupation with physical symptoms leading to excessive and unnecessary healthcare utilization. Despite being quite common, such condition remains underrecognized. We report a detailed clinical case of a 16 years old adolescent, who presented with a history suggestive of COVID-19 infection and associated psychological distress. Despite testing negative for the presence of SARS-CoV-2, his extreme and persisting health preoccupations required an inpatient admission to the Child and Adolescent Neuropsychiatric Unit. He responded rapidly to a low dose of antipsychotic and an antidepressant. Based on his medical history and current presentation, he received a diagnosis of SSD. When COVID-19-like symptoms occur, we highlight the importance of differentially diagnosing a possible exacerbation of a pre-existing SSD, triggered by fear of being infected. This may help preventing further burden to the healthcare system.

Published in Brain, Behavior, & Immunity - Health

ISSN: 2666-3546 (Online)
Publisher: Elsevier
Country of publisher: United States
LCC subjects: Medicine: Internal medicine: Neurosciences. Biological psychiatry. Neuropsychiatry
Website: https://www.journals.elsevier.com/brain-behavior-and-immunity-health

About the journal

Abstract

Keywords