ABSTRACT
Introduction: The sudden changes in daily routine due to the containment measures adopted for facing the COVID-19 pandemic have had an impact on the mental health of the general population. In particular, young adults are exposed to a higher risk compared to the general population to suffer from the consequences of the pandemic, in terms of anger and irritability, depressive symptoms and somatic complaints, insomnia, lack of motivation and loneliness. In particular, loneliness can be particularly pronounced during young adulthood. Objective(s): This study aimed to describe the levels of loneliness in a sample of Italian young people during the national lockdown in 2020, evaluating clinical and socio-demographic differences and the role of coping strategies and levels of resilience. Method(s): A sub-analysis of a sample of adults aged 18-34 years has been drawn on a larger cross-sectional observational national trial (COMET, 2020) in which, among other psychopathological dimensions, the levels of loneliness have been assessed by the UCLA scale short version. Result(s): Levels of lonelinesswere particularly severe in a third of cases (risk factors: unemployment, low income and vulnerability inmental health), in association with depression, anxiety, stress, OCD symptoms, higher rates of suicidal ideation, sleep disturbance and excessive use of Internet. Levels of loneliness tended to increase over time. Conclusion(s): Overall, during the Italian COVID-19 lockdown young people have experienced quite high levels of loneliness: this dimension could represent a useful domain to assess in routine clinical practice.
ABSTRACT
Introduction: The COVID-19 pandemic represents a new form of trauma, which is impacting on the mental health of the general population. However, the effects of this new trauma are variable, being mediated by individual factors such as the levels of resilience and the coping strategies. Objective(s): The aims of the present study are: 1) describe the levels of resilience and the type of coping strategies adopted by the Italian general adult population during the first wave of the pandemic;2) evaluate the protective role of coping strategies and resilience on the levels of depressive, anxiety and stress symptoms. Method(s): An online survey has been developed, which includes several validated self-reported questionnaires for the evaluation of participants' mental health condition, coping strategies and levels of resilience. The main outcome measure is the Depression Anxiety and Stress Scale-21 (DASS-21). Result(s): The finale sample consists of 20,720 participants, more than half reported low levels of resilience, which were not associated with age or gender. The levels of resilience did not differ among the general population, patients with pre-existing mental disorders and those infected by COVID-19. People with low levels of resilience rarely used adaptive coping strategies. The levels of resilience did not have any influence on stress, depressive or anxiety symptoms. Conclusion(s): The presence of low levels of resilience in the general population may be the missing link between the pandemic and increasing concerns on mental health problems. This could be important for the development of ad-hoc supportive and preventive psychosocial interventions.
ABSTRACT
Accumulating scientific and clinical evidence highlighted pathological hyperinflammation as a cardinal feature of SARS-CoV-2 infection and acute COVID-19 disease. With the emergence of long COVID-19 syndrome, several chronic health consequences, including neuropsychiatric sequelae, have gained attention from the public and medical communities. Since inflammatory mediators have also been accredited as putative biomarkers of suicidal ideations and behaviors, hyper- and neuroinflammation might share some colliding points, overlapping and being interconnected in the context of COVID-19. This review aims to provide a summary of current knowledge on the molecular and cellular mechanisms of COVID-19-associated hyper/neuroinflammation with focus on their relevance to the inflammatory hypothesis of suicide development. Subsequently, strategies to alleviate COVID-19 hyper/neuroinflammation by immunomodulatory agents (many of which at experimental stages) as well as psychopharmacologic/psychotherapeutic approaches are also mentioned. While suicide risk in COVID-19 survivors - until now little known - needs further analysis through longitudinal studies, current observations and mechanistic postulates warrant additional attention to this possibly emerging mental health concern.
ABSTRACT
BodyThe COVID-19 pandemic with the related containment measures is having a negative impact on the mental health of the general population worldwide. This event has been described as a new form of trauma, which is influencing not only physical and mental health, but also the society as a whole. Among Western countries, Italy has been one of the first severely hit by the pandemic in terms of number of cases and mortality rates. In March, 2020, strictly restrictive measures has been issued in order to contain the spread of the disease. This period has been known as “Phase one” of the national health emergency, where all not necessary activities were closed, almost 30,000 people died and almost 100,000 people were home-isolated. In this context, the COvid Mental hEalth Trial (COMET) network, including ten university Italian sites and the National Institute of Health, has been established in order to promote a national online survey for assessing the impact of lockdown measures on the mental health of the Italian general population. In the COMET survey, it has been included a specific focus on young people, which are expected to be the most vulnerable to the consequences of the pandemic and of the strict containment measures. Findings from this study can be useful to inform national and international associations on the importance to provide adequate support to the mental health of the young people.DisclosureNo significant relationships.
ABSTRACT
The COVID-19 pandemic and its related containment measures, such as lockdown, is affecting mental health of the general population worldwide. This is an unprecedented event, which is influencing the health care, political, economic, and social welfare systems. Among Western countries, Italy has been one of the first severely hit by the pandemic in terms of number of cases and mortality rates. Therefore, on March 8, 2020, the Italian Prime Minister issued restrictive measures in order to limit the spread of the disease. During this period known as “Phase one” of the national health emergency, all not necessary activities have been closed, more than 29,000 people have died and almost 100,000 people have been home-isolated, with strict lockdown measures. The COvid Mental hEalth Trial (COMET) network, including ten university Italian sites and the National Institute of Health, has promoted a national online survey in order to evaluate the impact of lockdown measures on the mental health of the Italian general population. The COMET survey reports data from a large sample of more than 20.000 people from Italian general population, showing that lockdown has had a detrimental impact on mental health, in terms of worsening of anxiety, depressive and stress symptoms. Findings from this study can be useful to inform national and international associations, policy makers and stakeholders on the importance to provide adequate support to the mental health of the general population.DisclosureNo significant relationships.
ABSTRACT
Introduction: At the beginning of 2020, the healthcare community was under pressure because of the Coronavirus disease 2019 (COVID-19). When we resumed our regular activity, we should face with significant limits: restricted access, patient distancing, avoiding crowds, and patients’ willing to avoid hospitals. Therefore, we started telemedicine for follow-up visits. The aim of this study was to report our workflow and initial results associated with telemedicine by a tertiary referral neurourology center. Materials and methods: We prospectively collected the data from our adult patients with a planned visit for neurogenic bladder by our center from March 9th to May 22nd, 2020. Our workflow started with a phone call to evaluate patients’ feasibility to undertake telemedicine due to COVID-19 pandemic. If they accepted, we asked patients to fill in an online, pseudonymous module. The first section collected demographic characteristics. The second section analysed COVID-19 testing and related signs and symptoms (S&S). The third section investigated urinary S&S. We assessed urinary incontinence trough the International Consultation of Incontinence Questionnaire – Short Form (ICIQ-SF). The fourth section screened for neurogenic bowel dysfunction (NBD) with the decision-making MENTOR tool. The final result corresponded to a “traffic light” system (green, yellow, or red) to determine need for treatment changes. The online platform was delivered as a progressive web app to avoid installation and adapt automatically to different systems. We asked patients to send us performed blood tests, radiological imaging, and bladder/bowel diaries. After reviewing all patients’ documentation, we called again each patient to discuss final indications. Results: We called 96 patients. Four cases declined telemedicine, while 95.8% patients – 66 men and 26 women – accepted this service. All of them accomplished all telemedicine phases without needing our help. The median age was 43.5 years (range: 19–85). The neurogenic bladder etiology was the following: acquired spinal cord injury (n = 37), congenital malformations (n = 19), autoimmune (n = 14), peripheral neuropathy (n = 8), idiopathic (n = 7), and others (n = 7). As for COVID-19, 3.3% patients reported a negative nasopharyngeal swab, while 17.4% cases referred potential S&S. Patients experienced macrohematuria (n = 9), renal colic (n = 9), difficulties with catherization (n = 17), and symptomatic urinary tract infections (n = 21). The median ICIQ-SF was 5 (range: 0–21). Based on MENTOR tool, we addressed 31 patients (red = 22;yellow= 9) to our gastroenterologists. All patients received a final medical report via telemedicine. Conclusions: Our telemedicine workflow proved to be feasible and effective. Both authors and most patients advocated the prosecution of this service beyond the COVID-19 pandemic, reducing hospital infections, in-hospital injuries, waiting lists for urgencies and first visits, hospital management costs, and patients’ travels (specially in case of mobility-impaired people).