Acute psychotic illness triggered by Brexit Referendum

  • BMJ Case Rep

  • curated by Dawn O'Shea
  • UK Medical News
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A report published in BMJ Case Reports details the case of a man who presented with a brief episode of acute psychosis, triggered by the 2016 Brexit Referendum.

The man in his 40s was brought to the accident and emergency department in an acute psychotic state three weeks after the European Union referendum results were declared. His mental health had deteriorated rapidly following the announcement of the results, with significant concerns about Brexit.

He presented with agitation, confusion and thought disorder. He had auditory hallucinations, and paranoid, referential, misidentification and “bizarre delusions”. His wife explained that since the Referendum result he had found it increasingly difficult to come to terms with the nature of political events around him. He became increasingly worried about racially-motivated incidents and found it difficult to sleep, she said.

Despite being prescribed drugs to alleviate his agitation and insomnia, his mental health continued to worsen to the point that he needed urgent hospital treatment. He was admitted to a psychiatric unit and treated with lorazepam and olanzapine for about three weeks. He made a full recovery and was discharged home after two weeks. He has had no further episodes up to the date of his last check-up in June 2019.

He had experienced a similar episode of much less severity 13 years previously after major work-related stress which resolved completely within a few days. The case report says he was experiencing stress related to work and family prior to the current episode, which could potentially have been a contributory factor.

The author of the case report, Dr Mohammad Zia Ul Haq Katshu from the Nottinghamshire NHS Trust, cautioned that political events can act as major stressors and have a significant impact on mental health, especially for those with a predisposition to mental illness.