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. 2020 May:5:100073.
doi: 10.1016/j.bbih.2020.100073. Epub 2020 Apr 19.

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

Marco Colizzi  1   2   3 , Riccardo Bortoletto  3 , Marta Silvestri  3 , Federica Mondini  3 , Elena Puttini  3 , Chiara Cainelli  3 , Rossella Gaudino  4 , Mirella Ruggeri  1 , Leonardo Zoccante  3
Affiliations

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

Marco Colizzi et al. Brain Behav Immun Health. 2020 May.

Abstract

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.

Keywords: 2019-nCoV; Anxiety; Child and adolescent psychiatry; Coronavirus; Obsessive compulsive symptoms; Somatic symptom disorder.

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Conflict of interest statement

None.

Figures

Fig. 1
Fig. 1
Developmental cascade towards the manifestation of an acute episode of Somatic Symptom Disorder in a patient worried about having COVID-19.
See this image and copyright information in PMC

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