Risk and Protective Factors of Psychological Distress in Patients Who Recovered From COVID-19: The Role of Cognitive Reserve.

Recent studies reported the development of psychological distress symptoms in patients who recovered from COVID-19. However, evidence is still scarce and new data are needed to define the exact risk and protective factors that can explain the variability in symptoms manifestation. In this study, we enrolled 257 patients who recovered from COVID-19 and we evaluated the levels of psychological distress through the Symptoms Checklist-90-R scale. Data concerning illness-related variables were collected from medical records, while the presence of subjective cognitive difficulties, both before and after the illness, as well as the level of the cognitive reserve (CR), were assessed over a clinical interview. Results revealed that being female and reporting the presence of subjective cognitive difficulties after COVID-19 were associated with higher levels of psychological distress. At the same time, being admitted to the hospital and having a high CR were protective factors. Adding new information to this emerging research field, our results highlight the importance of a complete psychological and cognitive assessment in patients with COVID-19.

Psychological Well-Being of Older Adults With Cognitive Deterioration During Quarantine: Preliminary Results From the GeroCovid Initiative.

Objectives: The spread of COVID-19 has undeniably unsettled the social, psychological and emotional life of the entire world population. Particular attention should be paid to older adults with dementia, given their vulnerability to emotional stressors. The aim of this retrospective study is to evaluate the impact of the first wave quarantine related to Covid-19 on psychological and affective well-being of older adults with mild/major neurocognitive disorders and of their caregivers. Methods: Data on participants' assessment before the quarantine (PREQ) were retrospectively collected. Patients with Mild Cognitive Impairment (MCI) or dementia were recruited from different Centers for Cognitive Decline and Dementia in Italy. During the quarantine, psychological and affective well-being were evaluated by phone through the administrations of scales measuring anxiety and depression (DASS), perceived stress (PSS), coping strategies (COPE) and the caregivers' burden (CBI). The scales' results were compared across participants' PREQ cognitive level (Mini Mental State Examination, MMSE ≥25, 23-24, and ≤ 22) with multiple linear regression models. Results: The sample included 168 patients (64% women) with a mean age of 79 ± 7 years. After adjusting for potential confounders, more severe cognitive impairment was independently associated with higher DASS and PSS score, and poorer coping strategies (p < 0.05). Cognitive functioning was also inversely associated with CBI. Conclusions: The impact of the quarantine on the psycho-affective well-being of individuals with MCI and dementia and on caregivers' burden varies according to the PREQ cognitive functioning with more severely impaired patients having worse outcomes.

Cognitive and Psychological Sequelae of COVID-19: Age Differences in Facing the Pandemic.

Literature about the novel Coronavirus (COVID-19) is currently focusing on the potential cognitive and neuropsychiatric sequelae observed in individuals receiving intensive care unit (ICU) treatments. The aim of the present study is to evaluate the differences in cognitive and psychological sequelae of COVID-19 between younger and older adults, regardless of being admitted to the ICU or not. The study involved 299 recovered individuals (from 18 to 90 years old), who underwent a comprehensive cognitive and psychological assessment. Linear regression models were conducted separately for Montreal Cognitive Assessment (MoCA) test and Post-traumatic Stress Disorder Checklist (PCL) scores to investigate the effect of socio-demographic and clinical characteristics on them. Separate linear regression models were then applied sorting participants by age: younger adults (<65 years) and older adults (≥65 years). In the whole sample, PCL scores were predicted by the intensity of care received, by being intubated, and by the persistence of cough after 1 month after hospitalization. Only age had instead an effect on cognition. In younger adults, PCL scores were predicted by the presence of neurological symptoms, by the intensity of care received, and by being intubated; MoCA scores were only predicted by the intensity of care received. No significant associations were found in older adults. Psychological negative effects of the COVID-19 pandemic particularly affect individuals under 65 years old, who also subjectively report cognitive sequelae associated with the infection. Individuals over 65 years old, instead, seem to be free from psychological and cognitive difficulties due to COVID-19.

Introduction to the special section: A call to action to address psychiatric rehabilitation workers' well-being.

The well-being of the psychiatric rehabilitation workforce is a growing concern, particularly as a result of the stresses of the COVID-19 pandemic on demand for mental health services. Research focusing on this aspect of psychiatric rehabilitation services remains limited but is important in supporting a resilient mental health workforce. This special section presents four papers that focus on aspects of worker well-being and burnout, including drivers of well-being and other outcomes, as well as exploring potential action steps and contexts that organizations could consider in their efforts to bolster well-being. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Perception of stress and cognitive efficiency in older adults with mild and moderate dementia during the COVID-19-related lockdown.

AIM: Many studies have been carried out with the aim of understanding the manifold effects of the novel coronavirus (Covid-19) on individuals' clinical and psychological states. This paper deals with perceived stress (PS) and cognitive efficiency (CE) in older adults with dementia during the first wave of the pandemic. The study also investigated the potential effects of PS and CE on participants' cognitive functioning. The modulating effect of cognitive reserve (CR) on these variables was also considered, given its well-known role in the onset and evolution of neurodegenerative diseases. METHOD: Thirty-eight older adults with mild/moderate dementia (mean age: 81.47 ± 5.05; mean MMSE pre-lockdown: 24.03 ± 3.14) were recruited for this study from March to May [4]. Two questionnaires, the Perceived Stress Scale (PSS) and the FLEI Mental Ability Questionnaire (FLEI), were administered to all participants by telephone every two weeks during lockdown (T1: early April, T2: mid-April, T3: early May). After lockdown, their neuropsychological and psychological profiles were assessed. Linear mixed-effects models were used to investigate changes over time. RESULTS: The level of PS increased at both Time 2 and Time 3 (f2 = 0.10). Cognitive functioning worsened during lockdown, resulting in lower scores at the post-lockdown evaluation (f2s = 0.09 and 0.06 for MMSE and ENB-2, respectively). The decrease in these scores was not associated with either PS or CE. Although the size of these effects was rather small, their clinical relevance is not negligible. CONCLUSION: Individuals with dementia seem to have experienced stress (S) during the first-wave of lockdown related to Covid-19. Cognition worsened during the pandemic, in accordance with the neurodegenerative nature of the disease, but it was unrelated to PS and CE.

Community Mental Health Care Delivery During the COVID-19 Pandemic: Practical Strategies for Improving Care for People with Serious Mental Illness.

The COVID-19 pandemic has presented a formidable challenge to care continuity for community mental health clients with serious mental illness and for providers who have had to quickly pivot the modes of delivering critical services. Despite these challenges, many of the changes implemented during the pandemic can and should be maintained. These include offering a spectrum of options for remote and in-person care, greater integration of behavioral and physical healthcare, prevention of viral exposure, increased collaborative decision-making related to long-acting injectable and clozapine use, modifying safety plans and psychiatric advance directives to include new technologies and broader support systems, leveraging natural supports, and integration of digital health interventions. This paper represents the authors' collaborative attempt to both reflect the changes to clinical practice we have observed in CMHCs across the US during this pandemic and to suggest how these changes can align with best practices identified in the empirical literature.