Journal Article Annotations
2022, 4th Quarter
Annotations by Aum Pathare, MD
This study finds that about 2-3% of patients infected with monkeypox manifest severe neuropsychiatric complications including seizures, confusion, and encephalitis. At least half of the infected patients were noted to have less severe symptoms such as myalgia, fatigue, headache, anxiety and depression, although it is unclear if these represent a systemic response to viral illness verses direct neurological changes due to infection.
Strength and weaknesses:
Dermatological manifestations of monkeypox infection have been studied more than the potential neuropsychiatric sequelae of this entity. This systematic review and metanalysis provides a preliminary understanding of the latter and uncovers the current gaps in its understanding. Limitations include the medium to low quality cohort and cross-sectional studies included in the analysis, which had small sample sizes and considerable methodological heterogeneity.
Monkeypox is a systemic viral zoonotic illness with prominent and well characterized cutaneous manifestations. At this time, we have limited evidence for direct neuropsychiatric problems arising from the infection outside of seizures, possible delirium, and encephalitis. However, viral illnesses also carry a psychological burden, which has only been amplified over the course of the COVID-19 pandemic. Potentially disfiguring scarring, misinformation about communicability, stigma associated with the focus on sexual transmission of illness, and harmful emphasis on the LGBTQ+ community are other factors of concern with monkeypox. C-L psychiatrists are positioned to be at the forefront of care for these patients, and their observations may help guide further understanding and research about the psychiatric sequelae of this disease. C-L involvement in relieving distress associated with such infections may also be important in developing outreach for at risk populations.