Exploring the mental health impact of chikungunya fever: a scoping review

Chikungunya is a public health concern and presents predominantly with fever and arthralgia. However, recent studies suggest psychiatric manifestations such as mood disorders, anxiety and somatoform disorders after chikungunya infection. These neurodevelopmental and psychiatric sequelae of chikungunya remain an overlooked aspect and may contribute to long-term disease burden.

This scoping review aims to assess the association between chikungunya infection and psychiatric manifestations, along with the underlying pathophysiological mechanisms.

A search through PubMed, Embase, and Scopus databases on chikungunya infection and psychiatric manifestations identified twenty-three studies. Among them, two were case reports, twenty studies were quantitative design, and one was a qualitative study involving in-depth interviews and focus group discussions. Two of those studies focused on perinatal exposure to the chikungunya virus.

Perinatal and intrauterine exposure has been linked to neurodevelopmental complications in children, highlighting the virus's potential impact across the lifespan. Among adults, depressive, anxiety, and somatoform symptoms often persist well beyond the acute phase. In many patients, these symptoms appear to be reactive psychological responses to chronic arthralgia and functional disability rather than direct viral neuro-invasion, though the distinction remains poorly defined in current literature. The underlying mechanisms are likely multifactorial. Persistent arthralgia, poor sleep quality and fatigue due to long-term manifestations of chikungunya may influence the course of the psychiatric illness.

Recognition of psychiatric manifestations is essential for comprehensive post-chikungunya care. Integrating mental health assessment into routine follow-up and adopting a multidisciplinary approach can improve outcomes, reduce the morbidity associated with chikungunya infection.