First-episode mania after COVID-19: A case series in Iran

How to treat major depressive disorder with shorter-duration hypomanic episodes? A case report

Here we report on a case of a 61-year-old female patient with 7-year history of major depressive disorder with shorter-duration hypomanic episodes who was prescribed with antidepressants which turned out to be ineffective. After a COVID-19 infection, the patient's clinical presentation became sufficient for the diagnosis of bipolar disorder and she was consistently effective on a mood stabilizer and an atypical antipsychotic. The course of treatment in this case suggests bipolar disorder is not a binary disorder, but a continuous spectrum disorder. For patients suffering from major depressive disorder with shorter-duration hypomanic episodes, mood stabilizers and atypical antipsychotics are possibly more suitable than antidepressants.

[A clinical case of the new-onset bipolar affective disorder in the postcovid period]

A large number of people who have had COVID-19 have developed mental symptoms and mood disorders. Anxiety and depression prevail among affective pathology. Evidence is accumulating that the Sars-CoV-2 virus can induce mania or hypomania in people with no personal psychopathological history. Some clinical, anamnestic and paraclinical patterns of new-onset mania and hypomania have been found. In cases of severe manic symptoms, it is possible to quickly assume the occurrence of bipolar affective disorder. The predominance of depressive and anxiety syndromes in the long-term disease and the presence of vivid vegetative symptoms can mask brief and syndromally incomplete episodes of hypomania, which distorts the understanding of the disease as a bipolar disorder. This article presents such a clinical case of the occurrence of bipolar affective disorder in a patient who had COVID-19 with an asymptomatic course. Approaches to rational diagnosis and treatment are discussed.