Vulnerabilities in Mental Health due to Covid-19 Pandemic: The Response of the Italian Physicians.

COVID-19 pandemic has exacerbated the pre-existing vulnerabilities and inequalities in societies. In this paper we analyse the categories that have suffered more than others from the pandemic and the restrictions on social life in terms of mental health. We rely on the Serendipity project based on a survey administered between November 2021 and February 2022 to a sample of Italian physicians (n = 1281). The survey aimed to assess the perception of general practitioners, paediatricians, geriatricians, and mental health specialists (psychiatrists, neurologists, child neuropsychiatrists), about changes in the mental health of the population as an effect of the COVID-19 pandemic and the lockdown. The strategies implemented by the doctors interviewed in terms of the intensity of the prevention, emergence, and treatment of mental health interventions, and their association with physicians' characteristics and their opinions on patient vulnerability have been illustrated by means of a multiple correspondence analysis. An overall result of the survey is the consensus of doctors on the worsening of mental health in general population, especially among their patients, due to the pandemic and on the onset of new discomforts. The most exposed individuals to the risk of onset or worsening of mental disorders include women, young people, and patients with psychiatric comorbidity. The paper also illustrates the interventions put in place by the physicians and deemed necessary from a public heath response perspective, that include providing psychoeducation to the general population, improving telehealth services, and increasing financial and human resources for community-based care.

Trends in the Use of Home LTC Services in Large, Medium and Small Municipalities in Italy: Lessons for the Post-COVID-19 Reappraisal.

Italian Long-Term Care is considered largely inadequate, and the recent COVID-19 pandemic has dramatically exposed its limitations. Public Home Care Services in particular were revealed as under-financed and unable to cover the potential demand for care from the older population. But does the type of municipality and its geographic location play a role in creating or mitigating unmet demand? This is the first study addressing this research question in Italy. Our hypothesis is that older people's care preferences and care possibilities may vary between small, medium and metropolitan areas, as will the organisation, funding and availability of services, and the combination will influence (unmet) demand for public home care services. In this paper, using nationally representative survey data collected by the Italian National Statistical Institute in 2003 and 2016, we investigate changes and differences in the use of public and private home care services among people aged 75 or older in Italy by size of the municipality. Our results reveal inequalities in service use between Northern and Southern areas of the country and in particular between metropolitan areas, medium and small municipalities. Such differences reinforce post-pandemic calls for new investment and changes in the design of the Italian Long-Term Care system.

Effects of Pandemic on Feelings of Depression in Italy: The Role of Age, Gender, and Individual Experiences During the First Lockdown.

The restrictions to physical contacts that have been imposed in different countries to deal with the coronavirus disease 2019 (COVID-19) pandemic may have contributed to an increase in feelings of depression on top of other negative consequences of the pandemic. This study examines the consequences of the COVID-19 pandemic on feelings of depression using original data collected in Italy between April 14 and 24, 2020. Quota sampling (N = 3,026) was performed to target the population of 18+ and, together with post-stratification weights, permitted obtaining a representative sample of the Italian population with respect to key sociodemographic factors. We find that 47% of the respondents have increased depressive feelings during the Covid-19 lockdown. Adopting a life-course perspective, we revealed great heterogeneity in feelings of depression consequences by age, gender, and difficulties experienced during the first national lockdown. Identifying groups of population at higher risk of suffering from feelings of depression as a result of COVID-19 is crucial to limit indirect long-term consequences of the pandemic.

Physically distant but socially close? Changes in non-physical intergenerational contacts at the onset of the COVID-19 pandemic among older people in France, Italy and Spain.

Physical distancing is intended to mitigate the spread of the SARS-CoV-2 virus. However, the impact of a decrease in face-to-face contacts on non-physical social contacts of older people remains unclear. In particular, we focus on intergenerational contacts that are especially relevant for older people's mental health. Our analyses rely on an online quota sampling survey conducted in France, Italy and Spain during April 14-24, 2020. We considered the subsample of individuals aged 50 + (N = 4207). We calculated post-stratification weights based on official statistics and used logistic regressions to analyze how changes in intergenerational contacts differed by socioeconomic factors and to what extent non-physical contacts (via phone, social media, etc.) have compensated the reduction in face-to-face contacts. Finally, the change in digital devices' use has been explored as a consequence of both decreased physical intergenerational contacts (PIC) and increased non-physical intergenerational contacts (NPIC). We found that about 50% of older people have increased their NPIC during the first lockdown. Younger individuals, those with medium level of education, and those economically better off displayed higher probabilities of increased NPIC as compared to their counterparts. NPIC increased especially for individuals whose face-to-face contacts decreased, particularly so if this happened with respect to contacts with children. A large share of older people has increased their use of video calls and instant messages, while only some increased the use of social media. These findings are relevant to understand how intergenerational contacts changed during the pandemic and may be central to better plan future outbreak responses. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s10433-021-00621-x.

Older People's Nonphysical Contacts and Depression During the COVID-19 Lockdown.

BACKGROUND AND OBJECTIVES: With the goal of slowing down the spread of the SARS-CoV-2 virus, restrictions to physical contacts have been taken in many countries. We examine to what extent intergenerational and other types of nonphysical contacts have reduced the risk of increased perceived depressive feelings during the lockdown for people aged 50+. RESEARCH DESIGN AND METHODS: We implemented an online panel survey based on quota sampling in France, Italy, and Spain in April 2020, about 1 month after the start of the lockdown. Our analyses are based on logistic regression models and use post-stratification weights. RESULTS: About 50% of individuals aged 50+ felt sad or depressed more often than usual during the lockdown in the 3 considered countries. Older people who increased or maintained unchanged nonphysical contacts with noncoresident individuals during the lockdown were at a lower risk of increased perceived depressive feelings compared to those who experienced a reduction in nonphysical contacts. The beneficial effect of nonphysical contacts was stronger for intergenerational relationships. The effects were similar by gender and stronger among individuals aged 70+, living in Spain and not living alone before the start of the lockdown. DISCUSSION AND IMPLICATIONS: In the next phases of the COVID-19 pandemic, or during any future similar pandemic, policy makers may implement measures that balance the need to reduce the spread of the virus with the necessity of allowing for limited physical contacts. Social contacts at a distance may be encouraged as a means to keep social closeness, while being physically distant.

No clear association emerges between intergenerational relationships and COVID-19 fatality rates from macro-level analyses.

The severe acute respiratory syndrome coronavirus 2 originated in Wuhan, China at the end of 2019 and rapidly spread in more than 100 countries. Researchers in different fields have been working on finding explanations for the unequal impact of the virus and deaths from the associated coronavirus disease 2019 (COVID-19) across geographical areas. Demographers and other social scientists have hinted at the importance of demographic factors, such as age structure and intergenerational relationships. Our aim is to reflect on the possible link between intergenerational relationships and spread and lethality of COVID-19 in a critical way. We show that with available aggregate data it is not possible to draw robust evidence to support these links. In fact, despite a higher prevalence of intergenerational coresidence and contacts that is broadly positively associated with COVID-19 case fatality rates at the country level, the opposite is generally true at the subnational level. While this inconsistent evidence demonstrates neither the existence nor the absence of a causal link between intergenerational relationships and the severity of COVID-19, we warn against simplistic interpretations of the available data, which suffer from many shortcomings. We conclude by arguing that intergenerational relationships are not only about physical contacts between family members. Theoretically, different forms of intergenerational relationships may have causal effects of opposite sign on the diffusion of COVID-19. Policies should also take into account that intergenerational ties are a source of instrumental and emotional support, which may favor compliance to the lockdown and "phase-2" restrictions and may buffer their negative consequences on mental health.