An Acute Manic Episode During 2019-nCoV Quarantine

J Affect Disord. 2020 Nov 1;276:623-625. doi: 10.1016/j.jad.2020.07.112. Epub 2020 Jul 20.


Background: The 2019-nCov pandemic is currently a stressor for the general public worldwide. In China, people who have a history of contact with infected or suspected individuals need to quarantine for at least 2 weeks. Many people experienced anxiety, panic and depression in the quarantine period. However, acute manic episode triggered by stressful events is not common and was neglected.

Case presentation: A 32-year-old woman with direct contact history with her infected colleagues showed elevated mood and increased activity when she was identified negative of nuclear acid amplification test, after experiencing extreme stress in quarantine. She was diagnosed with acute manic episode finally. The social zeitgeber and reward hypersensitivity theoretical models have attempted to use psychobiological perspectives to determine why life stress can trigger a mood episode, including (hypo)mania. Besides, the temporal correlation between her somatic symptoms and psychological stimuli indicated a possibility of functional disturbance under acute stress.

Conclusion: Quarantine is a major stressful event disrupting social zeitgebers for people who have had contact with infected individuals, especially for vulnerable individuals with a hypersensitive reward system. Stress could act as a trigger in the onset of manic episode, so psychological support should be more targeted at the vulnerable individuals in the initial phase of emergent crisis.

Keywords: 2019-nCoV; Manic episode; Quarantine; Reward hypersensitivity; Social zeitgebers; Stressful events.

Publication types

  • Case Reports
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Betacoronavirus*
  • Bipolar Disorder* / psychology
  • Coronavirus Infections*
  • Female
  • Humans
  • Pandemics*
  • Pneumonia, Viral*
  • Quarantine
  • Stress, Psychological

Supplementary concepts

  • COVID-19
  • severe acute respiratory syndrome coronavirus 2