Attachment Style and Childhood Traumatic Experiences Moderate the Impact of Initial and Prolonged COVID-19 Pandemic: Mental Health Longitudinal Trajectories in a Sample of Italian Women.

The impact of the COVID-19 pandemic on mental health has not been clarified yet, with multiple studies warranting a special focus on women and young adults. A sample of 101 Italian women recruited from the general population was evaluated a few weeks before the onset of the pandemic and during the first and the second wave of the pandemic. Depression values at the Brief Symptom Inventory showed an initial increase followed by a stabilization on higher values in respect to the baseline, whereas Phobic Anxiety was stably worsened. Participants with insecure attachment styles and childhood trauma showed higher levels of distress at all timepoints. In many psychopathological domains, moderation analysis showed an unfavorable trend over time for younger participants. The present study seems to confirm a high burden on mental health for women during the COVID-19 pandemic, highlighting young age, insecure attachment style, and childhood trauma as negative prognostic factors.

Can SSRI/SNRI antidepressants decrease the 'cytokine storm' in the course of COVID-19 pneumonia?

BACKGROUND: Lots of research has been conducted to fight COVID-19 since the outbreak of the pandemic in 2020. The role of 'cytokine storm' in the pathogenesis of COVID-19 pneumonia is well known. Relationship between interleukins and depression is still subject matter of the research, but a correlation between interleukin-6 and depressive disorders is proven by now. The aim of this study is to verify differences among interleukin-6 blood levels of inpatients treated with SSRI and/or SNRI before and during hospitalization and of inpatients not treated with these drugs. METHODS: This is an observational study performed during the first wave of SARS Cov-2 pandemic in Italy for three months. The hospitalized patients of Internal Medicine wards and Infectious and Tropical Diseases ward of Azienda Ospedaliero-Universitaria Careggi of Florence for COVID-19 pneumonia have been divided into two subgroups (treated / not treated with antidepressants). Patients admitted to Intensive Care Unit previously have been excluded. Each patient has been evaluated concerning demographic, clinical and therapeutic features. The first dosage of interleukin-6 detected during hospitalization has been noticed. RESULTS: 8,5% (n=34 patients) of the entire sample (n=402) had been treated with an antidepressant of the two considered categories before admission until discharge from hospital. Significant lower levels of interleukin-6 of recovered patients of the treated subgroup have been highlighted as compared to recovered patients of not-treated subgroup (12,1 vs 25,4 p<0,001). These results have been pointed out in spite of higher mean age and more serious comorbidities of the treated subgroup. Nevertheless the incidence of severe Acute Respiratory Distress Syndrome is significantly lower in the subgroup of patients with antidepressant treatment (20,6% vs 43,2% p<0,02) as well as endotracheal intubation employment (0,0% vs 11,7% p<0,04). The rate of deceased patients of treated-subgroup is not significant lower than the rate of not-treated subgroup (23,5% vs 26,4% p=0,13). CONCLUSIONS: During COVID-19 pneumonia, the production of interleukin-6 seems to be modulated in presence of antidepressant therapy. Further proofs and broader surveys are necessary.

A longitudinal observation of general psychopathology before the COVID-19 outbreak and during lockdown in Italy.

OBJECTIVE: Italy has been largely involved by the COVID-19 pandemic. The present study aimed at evaluating the impact of the lockdown during the pandemic on mental health adopting both a longitudinal and a cross-sectional design. Accordingly, the study investigated general psychopathology a few weeks before the COVID-19 outbreak (T0) and during lockdown (T1), and the associations between lockdown-related environmental conditions, self-perceived worsening in daily living and psychopathology. METHODS: 130 subjects (aged 18-60 years) were included in the longitudinal design, and an additional subsample of 541 subjects was recruited for the in-lockdown evaluation. Socio-demographic data and the Brief Symptom Inventory were collected both at T0 and T1. Moreover, at T1 an online survey was administered for the evaluation of lockdown-related environmental conditions and self-perceived variations in daily living induced by quarantine, along with the Impact of Event Scale-Revised. RESULTS: Longitudinal analysis showed that phobic anxiety and depressive symptoms increased at T1 as compared with T0, whereas interpersonal sensitivity and paranoid ideation decreased. Pre-existing general psychopathology predicted COVID-19-related post-traumatic symptomatology. Cross-sectional analyses underlined that self-perceived deteriorations in various areas of daily living were associated with general and post-traumatic psychopathology, and with several lockdown-related conditions, especially economic damage. CONCLUSION: The present study underlined a different trend of increased internalizing and decreased interpersonal symptoms during COVID-19 quarantine in Italy. Furthermore, the results showed that subjects with pre-existing psychopathology and those reporting economic damage during the pandemic were more likely to develop deterioration of their mental health.

The impact of COVID-19 epidemic on eating disorders: A longitudinal observation of pre versus post psychopathological features in a sample of patients with eating disorders and a group of healthy controls.

OBJECTIVE: the aim of this longitudinal study was to evaluate the impact of COVID-19 epidemic on Eating Disorders (EDs) patients, considering the role of pre-existing vulnerabilities. METHOD: 74 patients with Anorexia Nervosa (AN) or Bulimia Nervosa (BN) and 97 healthy controls (HCs) were evaluated before lockdown (T1) and during lockdown (T2). Patients were also evaluated at the beginning of treatment (T0). Questionnaires were collected to assess psychopathology, childhood trauma, attachment style, and COVID-19-related post-traumatic symptoms. RESULTS: A different trend between patients and HCs was observed only for pathological eating behaviors. Patients experienced increased compensatory exercise during lockdown; BN patients also exacerbated binge eating. Lockdown interfered with treatment outcomes: the descending trend of ED-specific psychopathology was interrupted during the epidemic in BN patients. Previously remitted patients showed re-exacerbation of binge eating after lockdown. Household arguments and fear for the safety of loved ones predicted increased symptoms during the lockdown. BN patients reported more severe COVID-19-related post-traumatic symptomatology than AN and HCs, and these symptoms were predicted by childhood trauma and insecure attachment. DISCUSSION: COVID-19 epidemic significantly impacted on EDs, both in terms of post-traumatic symptomatology and interference with the recovery process. Individuals with early trauma or insecure attachment were particularly vulnerable.