{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,27]],"date-time":"2026-06-27T23:31:54Z","timestamp":1782603114666,"version":"3.54.5"},"reference-count":21,"publisher":"Royal College of Psychiatrists","issue":"5","license":[{"start":{"date-parts":[[2020,7,22]],"date-time":"2020-07-22T00:00:00Z","timestamp":1595376000000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["cambridge.org"],"crossmark-restriction":true},"short-container-title":["BJPsych open"],"published-print":{"date-parts":[[2020,9]]},"abstract":"<jats:title>Summary<\/jats:title>\n\t  <jats:p>To date, there have been no detailed reports of patients developing persistent psychotic symptoms following Coronavirus disease 2019 (COVID-19) infection. There have been reports of patients developing transient delirium (with and without hypoxia) after COVID-19 infection as well as other neurological manifestations. We report on a female patient who, post-COVID-19 infection, developed an initial delirium followed by persistent and florid psychotic symptoms consisting of persecutory delusion, complex visual and auditory hallucinations and Capgras phenomenon in the absence of hypoxia but elevated tumour necrosis factor (TNF)-\u03b1. The psychotic symptoms persisted for about 40 days. Her magnetic resonance imaging brain scan, electroencephalogram, cerebrospinal fluid examination and extensive autoimmune panel did not show any abnormalities. The cause of the psychotic symptoms in this patient were not ascertained but we propose either an inflammatory state, characterised by the patient's elevated TNF-alpha levels as a possible contributing mechanism for her psychosis in line with the proinflammatory changes observed in some cases of psychosis. Or, an alternative, but unproven, hypothesis is one of an antibody-mediated encephalitic event induced by viral infection.<\/jats:p>","DOI":"10.1192\/bjo.2020.76","type":"journal-article","created":{"date-parts":[[2020,7,22]],"date-time":"2020-07-22T09:49:28Z","timestamp":1595411368000},"update-policy":"https:\/\/doi.org\/10.1017\/policypage","source":"Crossref","is-referenced-by-count":50,"title":["Persistent psychotic symptoms following COVID-19 infection"],"prefix":"10.1192","volume":"6","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1345-3079","authenticated-orcid":false,"given":"Soon Tjin","family":"Lim","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Benjamin","family":"Janaway","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Harry","family":"Costello","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anand","family":"Trip","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gary","family":"Price","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"170","published-online":{"date-parts":[[2020,7,22]]},"reference":[{"key":"S2056472420000769_ref20","doi-asserted-by":"publisher","DOI":"10.1128\/JVI.00737-08"},{"key":"S2056472420000769_ref18","doi-asserted-by":"publisher","DOI":"10.1016\/j.schres.2014.03.005"},{"key":"S2056472420000769_ref17","doi-asserted-by":"publisher","DOI":"10.1016\/j.biopsych.2011.04.013"},{"key":"S2056472420000769_ref16","doi-asserted-by":"publisher","DOI":"10.1038\/nn.3922"},{"key":"S2056472420000769_ref14","doi-asserted-by":"publisher","DOI":"10.1176\/appi.ajp.2008.08010089"},{"key":"S2056472420000769_ref13","doi-asserted-by":"publisher","DOI":"10.3389\/fpsyt.2020.00072"},{"key":"S2056472420000769_ref3","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMc2008597"},{"key":"S2056472420000769_ref15","doi-asserted-by":"publisher","DOI":"10.1001\/jamapsychiatry.2013.1111"},{"key":"S2056472420000769_ref1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMp2008017"},{"key":"S2056472420000769_ref2","doi-asserted-by":"publisher","DOI":"10.1001\/jamaneurol.2020.1127"},{"key":"S2056472420000769_ref5","doi-asserted-by":"publisher","DOI":"10.1016\/S1474-4422(20)30109-5"},{"key":"S2056472420000769_ref19","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2018-027925"},{"key":"S2056472420000769_ref12","doi-asserted-by":"crossref","first-page":"182","DOI":"10.1176\/ajp.151.6.182","article-title":"Influenza and schizophrenia. An analysis of post-influenzal \u201cdementia precox,\u201d as of 1918, and five years later further studies of the psychiatric aspects of influenza. 1926","volume":"151","author":"Menninger","year":"1994","journal-title":"Am J Psychiatry"},{"key":"S2056472420000769_ref7","doi-asserted-by":"publisher","DOI":"10.1016\/j.pharmthera.2010.08.007"},{"key":"S2056472420000769_ref6","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(20)30211-7"},{"key":"S2056472420000769_ref11","doi-asserted-by":"publisher","DOI":"10.1111\/j.1440-1819.2009.01945.x"},{"key":"S2056472420000769_ref8","doi-asserted-by":"publisher","DOI":"10.1016\/S2215-0366(20)30287-X"},{"key":"S2056472420000769_ref4","doi-asserted-by":"publisher","DOI":"10.1136\/jnnp-2020-323586"},{"key":"S2056472420000769_ref9","doi-asserted-by":"publisher","DOI":"10.1016\/j.neuroscience.2015.05.018"},{"key":"S2056472420000769_ref21","doi-asserted-by":"publisher","DOI":"10.1093\/brain\/awaa240"},{"key":"S2056472420000769_ref10","doi-asserted-by":"publisher","DOI":"10.1016\/S2215-0366(14)00122-9"}],"container-title":["BJPsych Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.cambridge.org\/core\/services\/aop-cambridge-core\/content\/view\/S2056472420000769","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2020,9,7]],"date-time":"2020-09-07T07:44:24Z","timestamp":1599464664000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.cambridge.org\/core\/product\/identifier\/S2056472420000769\/type\/journal_article"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,7,22]]},"references-count":21,"journal-issue":{"issue":"5","published-online":{"date-parts":[[2020,9]]}},"alternative-id":["S2056472420000769"],"URL":"https:\/\/doi.org\/10.1192\/bjo.2020.76","relation":{},"ISSN":["2056-4724"],"issn-type":[{"value":"2056-4724","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,7,22]]},"assertion":[{"value":"Copyright \u00a9 The Author(s), 2020. Published by Cambridge University Press on behalf of the Royal College of Psychiatrists","name":"copyright","label":"Copyright","group":{"name":"copyright_and_licensing","label":"Copyright and Licensing"}},{"value":"This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (http:\/\/creativecommons.org\/licenses\/by\/4.0\/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.","name":"license","label":"License","group":{"name":"copyright_and_licensing","label":"Copyright and Licensing"}},{"value":"This content has been made available to all.","name":"free","label":"Free to read"}],"article-number":"e105"}}