DOI: 10.1192/j.eurpsy.2026.11892 ISSN: 0924-9338

Ontological Disintegration and Psychiatric Vulnerability During Pandemics: Ethical Frameworks and Lived Realities

C. Lazzari

Introduction

Pandemics disrupt not only biological systems but also the foundations of identity, perception, and meaning. COVID-19 exposed the fragility of traditional knowledge structures and evidenced the psychiatric consequences of ontological uncertainty. This study positions pandemics as existential crises requiring philosophical engagement to understand their impact on mental health fully.

Objectives

To examine how pandemic-induced ontological instability manifests in psychiatric contexts, and how ethical interpretation—through religious and secular frameworks—shapes clinical understanding and therapeutic response.

Methods

A combined philosophical–clinical methodology was employed. Drawing on process ontology, pragmatism, and phenomenology, the study included an analysis of a documented case report involving reactive psychosis triggered by COVID-19-related existential distress. The focus was placed on disrupted identity, delusional patterns, and the collapse of relational meaning.

Results

The case involved a 50-year-old male presenting with paranoid delusions and identity confusion during the pandemic, including beliefs in impostor family members and conspiracy-driven narratives. Diagnosed with acute paranoid reaction, the patient responded to antipsychotic treatment. The episode illustrates ontological breakdown as a psychiatric event, conditioned by fear, uncertainty, and epistemic instability.

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Conclusions

Pandemics provoke ontological and psychological disintegration, especially in vulnerable individuals. Psychiatric models that integrate existential, phenomenological, and ethical dimensions are essential to address the depth of crisis-induced mental health challenges. Philosophical engagement offers critical insight into how reality, identity, and institutional dynamics interact in times of collective disruption.

Disclosure of Interest

None Declared

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