Are healthcare workers during the COVID-19 pandemic at risk of psychosis? Findings from a scoping review

The letter presents a review on the likelihood of healthcare workers (HCWs) developing psychotic symptoms as a result of the psychological distress derived from the current coronavirus pandemic. A scoping review of the literature on the issue above was conducted to appraise the current state of evidence, and four articles were found reporting on new-onset psychotic experiences among HCWs during the COVID-19 pandemic. The high risk of contagion, excessive workload, longer shifts, and ethical dilemmas in decision-making due to limited medical resources are exposing HCWs to unprecedented psychological distress, to the point where such individuals should be considered to be at risk of psychosis. Along this line, although within the psychosis spectrum, brief stress-related psychoses are self-limited syndromes with a generally good prognosis, they are also associated with a high risk of suicidal behaviour, high relapse rate, and increased risk of developing severe mental disorders in the long-term. Therefore, in light of these concerns, we advocate preventive intervention and psychological support initiatives, such as the Covid-Psy Hotline, aimed at reducing the burden and distress of the healthcare staff during the pandemic. We further recommend active screening for psychotic symptoms in HCWs, particularly among those professionals in the frontline against COVID-19. Lastly, we emphasize the need for close monitoring and prolonged follow-up of any HCW who has a short-lived psychotic disorder to avoid relapses and unfavorable outcomes. (PsycInfo Database Record (c) 2022 APA, all rights reserved)