Viral Pandemics as Possible Psycho-immunological Causes of Psychiatric Symptoms: From Past to Present

Abstract

Human history has witnessed a wide variety of viral outbreaks from past to present, following these outbreaks, there has been an increase in the frequency of neuropsychiatric, neurodegenerative, neurobehavioral, and autoimmune disorders. Dramatic increases in psychotic disorder, anxiety disorder, depression, mania, and suicide cases after viral pandemics in the 19th and 20th centuries caused great debate. Trying to explain this increase in psychiatric disorders only with panic and trauma experienced by the populations who are caught unprepared for viral outbreaks will be incomplete without addressing the underlying infectious agents and the inflammation triggered in the host. Recent studies show that viral infections and inflammatory mechanisms triggered by them cause uncontrolled activities in microglia and impaired neurotransmitter functions, which leads to many psychiatric disorders based on genetic predisposition. In this review, we discusscase presentations and clinical studies in the literature related to acute psychiatric findings, which are thought to be associated with SARS-CoV-2(the virus that causes COVID-19), the underlying etiological mechanisms, and possible psychoimmunological reflections of these acute symptoms, by considering past viral outbreaks.

Keywords

• COVID-19,SARS-CoV-2,pandemic,inflammation,psychiatric symptom

Psikiyatrik Belirtilerin Olası Psikoimmünolojik Nedenleri Olarak Geçmişten Günümüze Viral Pandemiler

Abstract

İnsanlık tarihi geçmişten günümüze çok çeşitli viral salgınlara tanık olmuş, bu salgınların ardından, etkilenen toplumlarda nöropsikiyatrik, nörodejeneratif, nörodavranışsal ve otoimmün bozuklukların görülme sıklığında artış meydana gelmiştir. 19. ve 20. yüzyıllarda viral pandemilerin ardından psikotik bozukluk, kaygı bozukluğu, depresyon, mani ve intihar olgularında görülen dramatik artışlar büyük tartışmalara yol açmıştır. Psikiyatrik bozukluklarda görülen bu artışın viral salgınlara hazırlıksız yakalanan toplumların yaşadığı panik ve bunun neden olduğu travma ile açıklanmaya çalışılması altta yatan enfeksiyöz ajanları ve konakçıda tetikledikleri inflamasyonu ele almadan eksik kalacaktır. Son dönemde yapılan çalışmalar, viral enfeksiyonların ve tetikledikleri enflamatuvar mekanizmaların mikroglialarda kontrolsüz aktivitelere ve nörotransmitter fonksiyonlarında bozulmalara neden olduğu, bu durumun da genetik yatkınlık zemininde birçok psikiyatrik bozukluğa yol açtığını göstermektedir.Bu derlemede, SARS-CoV-2’nin (COVID-19 etmeni) neden olduğu düşünülen psikiyatrik bulgularla ilgili literatürde yer alan vaka sunumları ve klinik çalışmaları, altta yatan etiyolojik mekanizmaları ve sebep olduğu akut tabloların ileri dönemdeki olası psikoimmünolojik yansımalarını, geçmiş viral salgınları da göz önünde bulundurarak tartıştık.

Keywords

• COVID-19,SARS-CoV-2,pandemi,inflamasyon,psikiyatrik belirti

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