Menstrual psychosis was first described in the 18th century. Brockington defined its characteristics: acute onset; brief duration with full recovery; confusion, stupor and mutism, delusions, hallucinations, or a manic syndrome and periodicity in temporal association with the menstrual cycle.

Description of a clinical case of menstrual psychosis and review of the literature.

Description of a clinical case. Non systematic review of the literature, searching the terms “psychosis”; “menstrual”; “catamenial” in the databases Pubmed, Medline and Cochrane.

Female, 39-year-old patient. No psychiatric history until the postpartum period of a traumatic vaginal birth, when she developed stupor and mutism which lasted for two days. During the following 2 years, she progressively presented with sadness, asthenia, anhedonia, insomnia and incapacity for self-care. She was prescribed paroxetine and olanzapine, with partial recovery. Subsequently, she had at least 6 episodes with about 3-day duration of asthenia, food refusal, insomnia, incapacity for self-care, disorganization of thought and behavior and mystical and persecutory delusions, coincident with the beginning of menstruation. She was hospitalized in two of them and received treatment with venlafaxine 75mg and paliperidone 6mg, with psychotic symptoms remission after a week.

This case presents the characteristics of menstrual psychosis. This is a rare condition, with only 30 reported cases worldwide. According to current classification systems, this condition fulfills diagnostic criteria for brief psychotic disorder. Nonetheless, studying in more detail this disorder could be interesting, with the goal of deepening the knowledge of the neurobiology of psychosis, particularly the effects of estrogen on this disorder.

No significant relationships.

ATPD is defined in the ICD‐10 as a polymorphic, predominantly delusional, or schizophreniform psychotic condition characterized by an acute onset (≤2 weeks) and rapid remission (expected within 1–3 months), which is often associated with acute stressful life events. A woman in her 30s was brought to the emergency department in an acute psychotic state. Her mental health had deteriorated rapidly following her attendance to Reiki training two weeks ago (Reiki is a form of alternative medicine called energy healing). She presented as agitated, confused and had disorganised thoughts. She had paranoid, referential, misidentification and bizarre delusions.

This paper reports the case of a 37-year-old woman with stress-induced new-onset psychosis instigated by Reiki practise.

A female patient is described who developed an acute and transient psychosis with polymorphic symptomatology after meditating. Physical examinations, paraclinical testing, and neuroimaging excluded an organic cause of symptoms.

In this case, we wanted to present an example of acute and transient psychosis episodes in which individuals with low psychosis threshold experienced recipient factors such as insomnia, dopaminergic agent (modafinil), practising reiki and meditation.While the family history of the patient, fragile personality structure suggest that the threshold of psychosis may be low; physical fatigue, insomnia, which is common in all 3 episodes, may have triggered acute psychosis.

Our patient recovered completely within 1week after a brief admission and treatment with haloperidol. The real question here is whether the patient needs psychotropic medication for life.

No significant relationships.

COVID19 has brought several psychosocial stressors that are having an impact on global mental health. The impact of the pandemic on the incidence of First Episode of Psychosis (FEP) is not clear.

To describe the clinical and sociodemographic characteristics of FEP patients diagnosed since the onset of the COVID19 pandemic and compare them with the equivalent period of the previous year.

We included all FEP patients attended at Parc de Salut Mar (Barcelona, Spain) from March 14, 2020 (when the state of emergency in Spain began) to December 31, 2020 with the same period of 2019. We assessed sociodemographic variables, duration of untreated psychosis (DUP), cannabis and alcohol use, psychiatric diagnosis, and psychiatric symptom scales. We performed a univariate analysis between the groups using U-Mann Whitney for continuous variables and Chi-Square for qualitative variables.

A total of 20 FEP patients were diagnosed in each period. No differences were found in sociodemographic variables, scales scores or DUP. During COVID19 period there was a smaller proportion of cannabis users (60% vs 90%; p=0.028) and a tendency of lower weekly consumption (14.44 vs 16.42; p=0.096). There were more cases of BPD (25% vs 5%; p=0.077) and less of affective psychosis (0% vs 25%; 0.017).

During the COVID-19 pandemic we did not find an increase of FEP or more severe clinical presentations. However, we identified differences in the type of FEP that could be related to the psychosocial stressors of this time.

No significant relationships.

The concept of cycloid psychosis has a long tradition in European psychiatry since it was introduced by Kleist in 1926. Nevertheless, this concept is not included explicitly in modern classifications, leading to a controversial discussion about its utility in current psychiatry.

Starting from a case study, we intend to review the evolution of cycloid psychosis concept and analyze its role in modern psychiatry.

Non-systematic review of the literature and report of a case study.

Following Kleist’s work, Leonhard described the three overlapping subtypes, and later Perris developed the first operational diagnostic criteria. Since then, this entity has shown a high diagnostic stability, validity and a good predictive diagnostic and prognostic value. We report a case of a 30-year-old woman, previous heathy, without regular medication, living with her parents and 5-year-old son, until she emigrated alone to Switzerland. After 10 days abroad, she was sent back to Portugal, and after organic disease and drug misuse exclusion, she was admitted in our inward with a clinical picture of perplexity, anxiety, thinking and behavioral disturbance with persecutory and poisoning delusions, auditory hallucinations, and total insomnia. Following rapid and full recovery, she was discharged 14 days later while being medicated with Paliperidone 3 mg/day and Lorazepam 4 mg/day, which was abandoned by her 2 months later, without relapse of the symptoms.

The current lack of a satisfactory system for categorizing acute, and remittent psychoses seems to be reason enough to remain awareness of this unique diagnostic entity, which is worthy of further investigation.

No significant relationships.

Epilepsy is a common and severe neurologic condition, with a high prevalence of psychiatric comorbidity. Epilepsy surgery has been used for its treatment, resulting in remission or significant reduction of crisis. An improvement of previously existing psychopathology has been more frequently described, however its exacerbation or de novo psychopathology post-surgery has also been reported. The prevalence rate for post-surgery psychosis is 1.1%. There are no clear risk factors associated to this condition, or a proposed pathological mechanism. However, most cases described in the literature are of patients submitted to temporal lobectomy.

Description of a clinical case of a first-episode psychosis post-epilepsy surgery and review of the literature.

Description of a clinical case. Non systematic review of the literature, searching the terms “psychiatric”; “psychosis”; “epilepsy surgery” in the databases Pubmed, Medline and Cochrane.

Male, 29-year-old patient, diagnosed with refractory temporal lobe epilepsy. Neuropsychiatric history of mixed adaptation disorder, treated with escitalopram 10 mg daily. Submitted to anterior temporal lobectomy with no complications. On the 6th day post-surgery, he developed persecutory and self-referent delusions. There’s no evidence of other causal factors. Treated with paliperidone 3 mg daily with symptom remission after one week. The diagnosis of brief psychotic disorder was made.

We present a case of a de novo psychotic disorder, a rare complication of epilepsy surgery. In the future, it might be interesting to study this association in detail, with the goal of deepening the knowledge of the neurobiology of psychosis, particularly the involvement of temporal circuits.

No significant relationships.

Coronavirus disease (COVID-19) could result in various medical consequences. Clinical manifestations are diverse and range from asymptomatic or mild, fever-like symptoms, to more severe and life-threatening complications. Although the clinical presentation was initially dominated by respiratory symptoms, psychiatric symptoms and sequelae have been reported in COVID- 19 patients and convalescents.

To describe four clinical case reports of patients admitted to the inpatient unit of Psychiatric Hospital Sarajevo (PHS) with acute onset of psychosis in the recovery stage of COVID-19.

In this case series we report cases of 4 patients, all female, mean age 53.25 years, hospitalized in PHS during the third wave of the COVID-19 pandemic. All developed psychotic symptoms in the recovery phase of COVID-19. None had a previous history of psychiatric disturbances of any kind. All patients were diagnosed with brief psychotic disorder (BPD), according to DSM 5 criteria for BPD.

COVID-19 affects various organ systems, including the brain, with variable symptoms based on disease severity. Psychotic features have been observed as well. The pathophysiology and direct biological effects of the disease are not fully understood. COVID-19 patients and convalescents can develop psychotic symptoms as a consequence of multiple concurrent factors. Several proposed mechanisms include direct central nervous system infiltration, cytokine network dysregulation, peripheral immune cell transmigration, and post-infectious autoimmunity [1], treatments used to manage the infection, and psychosocial stress.

Clinicians need to be aware of possible psychotic manifestations in COVID-19 patients and survivors. Long-term follow-up is warranted to provide efficient patient care.

No significant relationships.

A major increase in mental health issues was noted since the outbreak of the covid-19 pandemic even in patients with no history of mental health illness, specifically brief psychotic disorders.

Establish the covid-19 pandemic circumstances as precipitating factors of psychosis independently from other stressors

This is a cross-sectional and descriptive study carried out in the psychiatric department of the University Hospital of Mahdia including two groups of patients over a period of 15 months: From October 2018 to December 2019 are pre-covid cases, and the second group consists of the ones admitted between June 2020 and August 2021. We have collected the data of patients diagnosed with brief psychotic disorder according to DSM-5. We have focused on two clinical characteristics of the psychotic episodes (theme of delusions, stressors).

We have collected 19 patients, 12 among them during the pre-covid period. In our pre-covid period, brief psychotic disorder presented mostly with marked stressors (33.3%) whilst in the middle of the pandemic, marked stressors are present in only 14.3% of the cases. Which could suggest that this state of alarm can singlehandedly trigger psychosis. For the theme of delusions, in the pre-covid period, the religious theme appeared to be the most frequent (58.3%), whilst during the pandemic, persecution became the most prevalent (71.4%), showing how living in fear of contracting the virus could manifest itself in delusional content.

Living in a prolonged state of alarm is, in itself, a marked stressor, theoretically capable of increasing the psychosis rate and altering its characteristics.

No significant relationships.

Acute and transient psychotic disorders are a rare condition entity as the sudden appearance of affective, confusional symptoms and paranoia triggered by some psychological trauma. The current pandemic caused by COVID-19 is an important psychological stressor that could favor the appearance of acute psychotic disorders. Several studies have been recently published proposing that the multifactorial stress associated with lockdown could function as a catalyst for acute psychotic disorders.

To present a case of a brief psychotic disorder during the national lockdown in Spain and to review the literature about the relationship between the current pandemic and psychosis.

We will present a case report and a literature review.

We report a case of a 27-year-old woman, with no previous psychiatric history. Three weeks after the start of Spain lockdown sudden symptoms appeared with psychomotor restlessness, confused speech, emotional lability, thought blocking and persecutory and referential delusions. Physical exam, blood analysis and cerebral CT scan with no alterations. Treatment was performed with aripiprazole 10 mg and lorazepam 1 mg daily with clinical improvement in one weeks. She was diagnosed of Acute transient psychotic disorder.

Stressful life events that can trigger psychosis in vulnerable individuals and the current pandemic and lockdown context could favor the appearance of acute psychotic disorders. The case reported here is in line with other current studies that show a preliminary intuition of this trend.

Short-lived psychotic disorders are currently classified under “acute and transient psychotic disorders” (ATPDs) in ICD-10, and “brief psychotic disorder” (BPD) in DSM-5. This study's aim is to review the literature and address the validity of ATPDs and BPD.

Papers published between January 1993 and December 2016 were identified through searches in Web of Science. Reference lists in the located papers provided further sources.

A total of 295 articles were found and 100 were included in the review. There were only a few studies about the epidemiology, vulnerability factors, neurobiological correlates and treatment of these disorders, particularly little interest seems to exist in BPD. The available evidence suggests that short-lived psychotic disorders are rare conditions and more often affect women in early to middle adulthood. They also are neither associated with premorbid dysfunctions nor characteristic family predisposition, while there seems to be greater evidence of environmental factors particularly in developing countries and migrant populations. Follow-up studies report a favourable clinical and functional outcome, but case identification has proved difficult owing to high rates of transition mainly either to schizophrenia and related disorders or, to a lesser extent, affective disorders over the short- and longer-terms.

Although the lack of neurobiological findings and little predictive power argue against the validity of the above diagnostic categories, it is important that they are kept apart from longer-lasting psychotic disorders both for clinical practice and research. Close overlap between ATPDs and BPD could enhance the understanding of these conditions.

Although transient psychotic disorders are currently classified as a category separate from schizophrenia (SZ) and affective disorders, their distinctive features remain uncertain. This study examines the family psychiatric morbidity of the ICD-10 category of ‘acute and transient psychotic disorders’ (ATPDs), pointing out differences from SZ and bipolar disorder (BD).

From a cohort of 2.5 million persons, we identified all patients enrolled in the Danish Psychiatric Register who were ever admitted with ATPDs (n=2537), SZ (n = 10639) and BD disorder (n=5292) between 1996 and 2008. The relative risk (RR) of ATPDs, SZ and BD associated with psychiatric morbidity in first-degree relatives (FDRs) was calculated as the incidence rate ratio using Poisson regression.

The RR of ATPDs [1.93, 95% confidence interval (CI) 1.76–2.11] was higher if patients with ATPDs had at least one FDR admitted with any mental disorder than patients without family psychiatric antecedents. An additional risk arose if they had FDRs admitted not only with ATPDs (RR 1.60, 95% CI 1.33–1.92) but also with SZ (RR 2.06, 95% CI 1.70–2.50) and/or BD (RR 1.55, 95% CI 1.23–1.96). Despite some overlap, the risk of SZ (RR 2.80, 95% CI 2.58–3.04) and BD (RR 3.68, 95% CI 3.29–4.12) was markedly higher if patients with SZ and BD had FDRs admitted with the same condition.

These findings suggest that family psychiatric predisposition has a relatively modest impact on ATPDs and argue against a sharp differentiation of ATPDs from SZ and BD.