First reported case of Brexit-triggered psychosis presented by doctor

A doctor has warned that political upheaval can take a serious toll on mental health as he revealed details about the first reported case of Brexit-triggered psychosis.

The male patient, in his forties, suffered hallucinations and delusions when his mental health “deteriorated rapidly” shortly after the results of the EU referendum in summer 2016.

He also became increasingly worried about racial incidents and, after being admitted on to a psychiatric ward, said he felt ashamed to be British.

Dr Mohammad Zia Ul Haq Katshu, who treated the patient, wrote: “His wife reported that since the EU referendum results were declared on 24 June 2016, he started spending more time putting his thoughts across on social media.

“He found it difficult to reconcile with the political events happening around him. He became increasingly worried about racial incidents. His sleep deteriorated.”

Once admitted, the unnamed patient was described as agitated, attempting to “burrow” through the hospital floor with his hands to “get the hell out of this place”.

He believed he was being spied on and that talks on the radio were directed at him.

He later said: “I was looking at the electoral map of voting for the EU. I am in a constituency that reflects an opinion that is not for me.”

Dr Katshu warned that political events can act as “major psychological stressors” in the article published in BMJ Case Reports.

Previous surveys have shown that concerns over the future of the US after the 2016 presidential elections and the Brexit referendum were significant sources of stress.

Dr Katshu added: “His mental health had deteriorated rapidly following the announcement of the results, with significant concerns about Brexit.

“He presented as agitated, confused and thought disordered. He had auditory hallucinations, and paranoid, referential, misidentification and bizarre delusions.”

The patient also reported experiencing family pressures and it is possible these and work-related stress also contributed to his illness.

The patient was diagnosed with acute schizophrenia-like psychotic disorder, a category of acute and transient psychotic disorder (ATPD) – the first case believed to have been triggered by Brexit.

The illness is characterised by an acute onset of symptoms and complete recovery within three months.

The patient described his experiences as “intense periods of accelerated thinking, of being distracted and consumed by my own thoughts, and of a series of theatrical episodes of which I am at the centre”.

He recovered completely within a fortnight after a brief admission and treatment with olanzapine, an anti-psychotic.

He had experienced a similar episode 13 years previously following work-related stress.

But he had no family history of mental health problems, history of alcohol or substance misuse, or physical health issues barring mildly impaired hearing in one ear.

He has remained well up to June 2019, when doctors last had contact with him.

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