Case series associated with COVID-19 pandemic in causing psychiatric morbidity

The COVID-19 has emerged as a public health emergency across the globe. Countries all over the world have been forced to enforce nationwide lockdowns to curb the transmission of this illness, affecting millions of people. The disorder and the lockdowns enforced have resulted in a complex set of psychosocial stressors in the lives of people, affecting their resilience and causing psychological stress and mental health issues. In this case series, we aim to highlight the role of such psychosocial stressors in causing mental health problems, especially in a vulnerable individual. The first case reports the onset of first-episode mania in a healthy individual with a family history of mental illness, after the sudden demise of the patient's mother due to COVID-19. The second case highlights the onset of psychosis in an adolescent girl following academic stress due to the inability to carry on her education through online classes. The third case demonstrates the exacerbation of dissociative episodes in a child following the financial crisis in the family during the lockdown period. In low-income to middle-income countries such as India, there is a complex interplay of the psychosocial stressors due to the COVID-19 pandemic with pre-existing issues such as poverty, socioeconomic disparity and inequity of resources leading to a 'double hit' for people from disadvantaged sections of the society and individuals with pre-existing mental illness or vulnerability for mental illness.