Depression among physicians in a government designated COVID-center hospital during coronavirus disease-19 pandemic

Objectives: This study aimed to determine the prevalence, most common symptoms and sociodemographic factors associated with depression among physicians in a government COVID-Center in Davao City, Philippines. Methodology: This cross-sectional study collected data from resident physicians from July to August 2020. Result(s): Two hundred fifty-one (251) out of 376 physicians responded (68.39% response rate). The average age was 30 years old, majority were female (58.57%, 147), single (78.88%, 198), frontline workers (77.29%, 194), with average hospital experience of 2.0 years. Ninety-six (38.26%) were assigned in surgical departments while 155 (61.75%) worked in nonsurgical departments. There were twelve respondents (4.78%) who had a history of psychiatric illness and 31 (12.35%) had previous psychiatric intervention, while 66 (26.29%) had a history of medical illness. Eighty-five (33.86%) had depression using PHQ-9;57 (22.71%) as mild, 19 (7.57%) moderate, 7 (2.79%) moderately severe and 2 (0.8%) severe. Out of 85 residents who were depressed, the most common symptoms were: low energy (81, 95.29%);anhedonia (76, 89.41%);and feeling depressed (72, 84.70%). Medical illness was associated with higher levels of depression. Physicians with a history of psychiatric illness, psychiatric intervention and medical illness had significantly higher levels of depression. Conclusion(s): More than a third (33.86%) of physicians screened positive for depression. Current mental health programs must be strengthened and made specific, to prevent and address depression especially among those who have a history of psychiatric and medical illness.Copyright © 2023

NEI 2022 Abstracts

The proceedings contain 96 papers. The topics discussed include: practical pharmacotherapy for opioid use disorder in the age of fentanyl;can COVID-19 cause acute psychosis in pediatric patients? a case report;a survey of bullying experiences in a child and adolescent psychiatric clinic population;acute emergence of suicidal thoughts following Lemborexant initiation: an adverse reaction case report;assessing the unmet clinical need and opportunity for digital therapeutic intervention in schizophrenia: perspective from people with schizophrenia;rapid antidepressant effects and MADRS item improvements with AXS-05 (DEXTROMETHORPHAN-BUPROPION), an oral NMDA receptor antagonist in major depressive disorder: results from two randomized double-blind, controlled trials;targeting lncRNA NEAT1 impedes Alzheimers disease progression via MicroRNA-193a mediated CREB/BDNF and NRF2/NQO1 pathways;and impact of AXS-05 (DEXTROMETHORPHAN-BUPROPION), an Oral NMDA receptor antagonist, on Anhedonic symptoms in major depressive disorder.

Influence of significant stressful events on the course of primary cephalalgia.

Objective. To analyze diagnoses, clinical characteristics, incidence and specifics of comorbid mental and other disorders in Russian patients with a main complaint of headache before and after the novel coronavirus infection (COVID-19) pandemic and special military operation. Material and methods. We have retrospectively analyzed primary medical records of all patients over 16 years old with a main complaint of headache who appealed to the University Headache Clinic between April 1, 2019 and July 1, 2019 (before the COVID-19 pandemic), in 2021 (COVID-19 pandemic) and 2022 (after onset of special military operation). Results. There were more visits of patients diagnosed with migraine in April-June 2021 compared to the same period in 2019. In April-June 2022, the number of patients with migraine and aura significantly increased from 11.7 to 18.5% (p=0.03). Other migraine characteristics remained the same throughout 3 years. Indicators of emotional status changed significantly. In 2021, the number of patients with anxiety increased from 28.0 to 44.9% (p=0.001). In 2022, anxiety continued to be high. Prevalence of depression did not change significantly in 2021 compared to 2019, but its manifestations have changed. Anhedonia and an-ergy became more common. The number of patients with depression significantly increased among people with headache from 28.7 to 43.9% in 2022 (p=0.0001). The proportion of patients with a first-time depressive episode significantly increased (from 2.7% in 2021 to 21.3% in 2022, p=0.0001). The number of patients referred to a psychiatrist was 10.2% in 2022 that is significantly higher compared to 2021. Conclusion. Significant socio-economic events can be triggers for onset or relapse of comorbid anxiety-depressive disorders in patients with primary cephalalgia.Copyright © 2023, Media Sphera Publishing Group. All rights reserved.

Influence of significant stressful events on the course of primary cephalalgia.

Objective. To analyze diagnoses, clinical characteristics, incidence and specifics of comorbid mental and other disorders in Russian patients with a main complaint of headache before and after the novel coronavirus infection (COVID-19) pandemic and special military operation. Material and methods. We have retrospectively analyzed primary medical records of all patients over 16 years old with a main complaint of headache who appealed to the University Headache Clinic between April 1, 2019 and July 1, 2019 (before the COVID-19 pandemic), in 2021 (COVID-19 pandemic) and 2022 (after onset of special military operation). Results. There were more visits of patients diagnosed with migraine in April-June 2021 compared to the same period in 2019. In April-June 2022, the number of patients with migraine and aura significantly increased from 11.7 to 18.5% (p=0.03). Other migraine characteristics remained the same throughout 3 years. Indicators of emotional status changed significantly. In 2021, the number of patients with anxiety increased from 28.0 to 44.9% (p=0.001). In 2022, anxiety continued to be high. Prevalence of depression did not change significantly in 2021 compared to 2019, but its manifestations have changed. Anhedonia and an-ergy became more common. The number of patients with depression significantly increased among people with headache from 28.7 to 43.9% in 2022 (p=0.0001). The proportion of patients with a first-time depressive episode significantly increased (from 2.7% in 2021 to 21.3% in 2022, p=0.0001). The number of patients referred to a psychiatrist was 10.2% in 2022 that is significantly higher compared to 2021. Conclusion. Significant socio-economic events can be triggers for onset or relapse of comorbid anxiety-depressive disorders in patients with primary cephalalgia.Copyright © 2023, Media Sphera Publishing Group. All rights reserved.

New antidepressants: monoamines and beyond

The monoamine hypothesis of depression has dominated treatment for decades, but for some with treatment-resistant depression, alternative approaches are needed. This article discusses some of the other mechanisms involved in depression and how novel treatments could address these.Copyright © 2023 Wiley Interface Ltd.

Beyond pleasure: Effects of depression, anhedonia, and COVID-19 stress on hedonic and eudaimonic reward functioning

Reward processing encompasses multiple psychological processes, including appraisals of the incentive value of a reward (reward valuation), behavioral motivation to earn it (reward wanting), and affective responses to its receipt (reward liking). Disruptions in reward processing and the vulnerability of this system to chronic stress are argued to contribute to the development of a depressive disorder and anhedonia specifically. However, research has been limited to examining responses to "hedonic" rewards as the study of "eudaimonic" reward processing presents methodological challenges. Addressing these aims, this study developed the Hedonic and Eudaimonic Incentive Delay Task (HEID) for a comprehensive assessment of reward processing across multiple reward domains, including hedonic (HE), eudaimonic (EU), and neutral-intrinsic (NT-I) rewards. The central objectives were to examine the effects of (1) depression and anhedonia-related symptoms (e.g., wellbeing, anhedonia), (2) chronic stress exposure, using the COVID-19 pandemic and case fatality rates (CFR) as objective stress measures, and (3) interventions, such as the cultivation of dispositional mindfulness and self-affirmation, on reward processing across multiple reward domains. Two samples of participants were recruited, before (N = 180) and during the COVID-19 pandemic (N = 189), completing self-report measures of depression, anhedonia, wellbeing, and mindfulness, and the HEID. Participants during COVID-19 were also randomly assigned to one of three induction conditions (Stressor Salience, Self-Affirmation, Control) to investigate stress and intervention effects. Consistent with hypotheses, (1) depression and anhedonia were associated with impaired reward processing;however, depression was more robustly associated with impairments in reward wanting, particularly the wanting of EU rewards, while reward valuation and liking were uniquely implicated in anhedonia. Chronic stress hypotheses (2) were partially supported, such that COVID-19 was associated with blunted reward wanting across reward domains (particularly NT-I), but not reward valuation and liking. Consistent with theory (3), self-affirmation helped buffer the effects of stress on reward wanting, but only at high CFR, while dispositional mindfulness was associated with greater wellbeing during COVID-19 by virtue of enhanced reward valuation and liking. This study provides new insights into reward pathways underlying stress, depression, and wellbeing/anhedonia, shedding light on disruptions to target in treatment. (PsycInfo Database Record (c) 2022 APA, all rights reserved)

Is Future Mental Imagery Associated with Reduced Impact of the COVID-19 Pandemic on Negative Affect and Anhedonic Symptoms in Young People?

Background: Difficulties with prospective mental images are associated with adolescent depression. Current treatments mainly focus on verbal techniques to reduce negative affect (e.g. low mood) rather than enhancing positive affect, despite anhedonia being present in adolescents. We investigated the concurrent relationships between the vividness of negative and positive prospective mental imagery and negative affect and positive affect; and examined whether negative and positive prospective mental imagery moderated the impact of recent stress (COVID-19-linked stress) on negative and positive affect. Methods: 2602 young people (12-25 years) completed the Prospective Imagery Task and self-reported on symptoms of negative affect, anhedonia and COVID-19 linked stress. Results: Elevated vividness of negative future mental imagery and reduced vividness of positive future mental imagery were associated with increased negative affect, whereas only reduced vividness of positive future imagery was associated with increased symptoms of anhedonia. Elevated vividness of negative future images amplified the association between COVID-19 linked stress and negative affect, while elevated vividness of positive future images attenuated the association between COVID-19 linked stress and anhedonia. Conclusions: Future mental imagery may be differentially associated with negative and positive affect, but this needs to be replicated in clinical populations to support novel adolescent psychological treatments. Supplementary Information: The online version contains supplementary material available at 10.1007/s10608-023-10352-1.

Momentary gustative-olfactory sensitivity and tonic heart rate variability are independently associated with motivational behavior.

Deficits in motivational functioning including impairments in reward learning or reward sensitivity are common in psychiatric disorders characterized by anhedonia. Recently, anhedonic symptoms have been exacerbated by the pandemic caused by the Coronavirus disease 2019 (COVID-19) in the general population. The present study examined the putative associations between loss of smell (anosmia) and taste (ageusia) sensitivity, irrespective of COVID-19 infection, and anhedonia, measured by a signal-detection task probing the ability to modify behavior as a function of rewards (Probabilistic Reward Task; PRT). Tonic heart rate variability (HRV) was included in the model, due to its association with both smell and taste sensitivity as well as motivational functioning. The sample included 114 healthy individuals (81 females; mean age 22.2 years), who underwent a laboratory session in which dispositional traits, resting HRV and PRT performance were assessed, followed by a 4-days ecological momentary assessment to obtain daily measures of anosmia and ageusia. Lower levels of tonic HRV and lower momentary levels of smell and taste sensitivity were associated with impaired reward responsiveness and ability to shape future behavioral choices based on prior reinforcement experiences. Overall, the current results provide initial correlational evidence that could be fruitfully used to inform future experimental investigations aimed at elucidating the disruptive worldwide mental health consequences triggered by the pandemic.

Beyond pleasure: Effects of depression, anhedonia, and COVID-19 stress on hedonic and eudaimonic reward functioning

Reward processing encompasses multiple psychological processes, including appraisals of the incentive value of a reward (reward valuation), behavioral motivation to earn it (reward wanting), and affective responses to its receipt (reward liking). Disruptions in reward processing and the vulnerability of this system to chronic stress are argued to contribute to the development of a depressive disorder and anhedonia specifically. However, research has been limited to examining responses to "hedonic" rewards as the study of "eudaimonic" reward processing presents methodological challenges. Addressing these aims, this study developed the Hedonic and Eudaimonic Incentive Delay Task (HEID) for a comprehensive assessment of reward processing across multiple reward domains, including hedonic (HE), eudaimonic (EU), and neutral-intrinsic (NT-I) rewards. The central objectives were to examine the effects of (1) depression and anhedonia-related symptoms (e.g., wellbeing, anhedonia), (2) chronic stress exposure, using the COVID-19 pandemic and case fatality rates (CFR) as objective stress measures, and (3) interventions, such as the cultivation of dispositional mindfulness and self-affirmation, on reward processing across multiple reward domains. Two samples of participants were recruited, before (N = 180) and during the COVID-19 pandemic (N = 189), completing self-report measures of depression, anhedonia, wellbeing, and mindfulness, and the HEID. Participants during COVID-19 were also randomly assigned to one of three induction conditions (Stressor Salience, Self-Affirmation, Control) to investigate stress and intervention effects. Consistent with hypotheses, (1) depression and anhedonia were associated with impaired reward processing;however, depression was more robustly associated with impairments in reward wanting, particularly the wanting of EU rewards, while reward valuation and liking were uniquely implicated in anhedonia. Chronic stress hypotheses (2) were partially supported, such that COVID-19 was associated with blunted reward wanting across reward domains (particularly NT-I), but not reward valuation and liking. Consistent with theory (3), self-affirmation helped buffer the effects of stress on reward wanting, but only at high CFR, while dispositional mindfulness was associated with greater wellbeing during COVID-19 by virtue of enhanced reward valuation and liking. This study provides new insights into reward pathways underlying stress, depression, and wellbeing/anhedonia, shedding light on disruptions to target in treatment. (PsycInfo Database Record (c) 2022 APA, all rights reserved)

High Resolution Covid Program. Purposely a case

Introduction: The covid pandemic has become a unique phenomenon in world history with great impact on mental health. Objective(s): A great growth of anxious depressive pathology in relation to the Covid situation has appeared with the need to increase the psychiatric approach in the general population Methods: A 58-year-old woman with no personal medical story of interest is referred to the high-resolution Covid program due to severe depressive symptoms: intense apathy, abulia, anhedonia, weight loss, insomnia and important social distancing after the beginning of the confinement due to the Covid Pandemic. 4 psychotherapy sessions are performed, with a maximum duration of 45 minutes. It is necessary to add antidepressant medication with sertraline up to 100mg to improve psychotherapeutic work. Result(s): A complete recovery of symptoms is achieved even their severity with normalization of daily life. Conclusion(s): Small psychotherapeutic interventions have been shown, even with critically ill patients, to be very effective in helping patients regain their baseline status.

The Aversive Lens: Stress effects on the prefrontal-cingulate cortical pathways that regulate emotion.

ARNSTEN, A.F.T., M.K.P. Joyce and A.C. Roberts. The Aversive Lens: Stress effects on the prefrontal-cingulate cortical pathways that regulate emotion. NEUROSCI BIOBEHAV REV XXX-XXX, 2022. The symptoms of major-depressive-disorder include psychic pain and anhedonia, i.e. seeing the world through an "aversive lens". The neurobiology underlying this shift in worldview is emerging. Here these data are reviewed, focusing on how activation of subgenual cingulate (BA25) induces an "aversive lens", and how higher prefrontal cortical (PFC) areas (BA46/10/32) provide top-down regulation of BA25 but are weakened by excessive dopamine and norepinephrine release during stress exposure, and dendritic spine loss with chronic stress exposure. These changes may generate an attractor state, which maintains the brain under the control of BA25, requiring medication or neuromodulatory treatments to return connectivity to a more flexible state. In line with this hypothesis, effective anti-depressant treatments reduce the activity of BA25 and restore top-down regulation by higher circuits, e.g. as seen with SSRI medications, ketamine, deep brain stimulation of BA25, or rTMS to strengthen dorsolateral PFC. This research has special relevance in an era of chronic stress caused by the COVID19 pandemic, political unrest and threat of climate change.

Suicide ideation and anhedonia among clinically stable adolescents with the recurrent depressive disorder during the COVID-19 pandemic: A network perspective.

BACKGROUND: Anhedonia is a suicide risk factor among adolescent patients with recurrent depressive disorder (depression hereafter). This study examined associations between suicidal ideation (SI) and residual depressive symptoms (RSD), including anhedonia, among clinically stable adolescents with depression. METHOD: A network analysis was performed to examine the association between RDS and SI among adolescents with depression. Node-specific predictive betweenness was computed to examine short paths between anhedonia and SI. Additionally, a Network Comparison Test (NCT) was conducted to examine gender differences in derived network model characteristics. RESULTS: The network analysis identified close associations of PHQ9 ("Suicide ideation") with PHQ1 ("Anhedonia") as well as some other RDS including PHQ6 ("Guilt"), PHQ2 ("Sad mood") and PHQ8 ("Motor disturbances"). Additionally, PHQ2 ("Sad mood") and PHQ4 ("Fatigue") were the main bridge nodes linking anhedonia and SI. Comparisons of network models did not find significant differences in network global strength or edge weights. LIMITATION: Causal relations between anhedonia and SI could not be determined due to the cross-sectional study design. CONCLUSIONS: SI was directly related to Anhedonia in addition to Guilt, Sad mood and Motor disturbances. Sad mood and Fatigue were the main bridge nodes linking Anhedonia and SI. To reduce the risk of SI among clinically stable adolescents with depression during the COVID-19 pandemic, specific RDS including Anhedonia, Guilt, Sad mood, Motor disturbances and Fatigue should be targeted in interventions.

Prevalence and Relationships between Alexithymia, Anhedonia, Depression and Anxiety during the Belgian COVID-19 Pandemic Lockdown.

Alexithymia and anhedonia are associated with psychiatric disorders, such as depression and anxiety. The COVID-19 pandemic lead to a significant deterioration in the mental health of the population. It is therefore important to examine the effects of lockdown on alexithymia and anhedonia and their relationships with anxiety and depression. We compared the scores and characteristics of 286 patients divided into two groups: one before lockdown (group 1, N = 127), the other during the progressive lockdown release (group 2, N = 159). The groups were homogeneous in terms of age, sex ratio, socio-professional categories, and somatic and psychiatric comorbidities. The groups were compared on the Toronto Alexithymia Scale (TAS-20) measuring alexithymia, the Beck Depression Inventory (BDI-II) measuring depression, the anhedonia subscale of the BDI-II measuring state-anhedonia and the State Trait Anxiety Inventory (STAI) measuring state and trait anxiety. The ratio of alexithymic subjects in group 1 is 22.83% to 33.33% in group 2 (p-value = 0.034). This suggests a significant increase in the number of alexithymic patients after lockdown. We did not observe any difference in the proportion of depressed and anxious subjects before or after lockdown. Among the different scales, higher scores were only found on the cognitive factor of alexithymia on group 2 comparatively to group 1. This study indicates an increase in the proportion of alexithymic subjects following lockdown. Unexpectedly, this was unrelated to depression, anxiety or anhedonia levels, which remained stable. Further studies are needed to confirm this result and to evaluate precisely which factors related to the lockdown context are responsible for such an increase.

Is it Time to Revisit Neuroinflammatory Depression? A Case of COVID-19 Associated Depression and the Role of ECT

Background: The neurobiology of depression can be heterogeneous with multiple hypotheses proposed, including serotonin and neuroinflammatory pathways, each falling short of explaining the complete picture. Several reports describe the increased frequency of depression in the community following the COVID-19 pandemic and reports about neuropsychiatric sequela of the virus are emerging and the possible role of neuroinflammation. We present a patient who developed severe depression with psychotic features subsequent to his COVID-19 infection and was treated successfully with ECT following several failed medication trials. Case: A 49-year-old male with a past medical history of type II diabetes, hyperlipidemia, hypertension, chronic kidney disease, and gastroesophageal reflux disease was diagnosed with COVID-19 in January 2021. Upon initial diagnosis, neither admission nor treatment with steroids was required. He presented to the emergency department four days later with sepsis, pneumonia, and AKI secondary to COVID-19 along with the new onset of suicidal ideations with plans to cut himself and significant psychomotor features despite no previous history of mental illness or treatment. His EEG showed diffuse slow waves, consistent with encephalopathy, but no delirium was noted. He exhibited irritability, anger, anhedonia, negativism, and isolated himself in his room. He demonstrated delusional fear about his apartment exploding due to electricity disconnected for not paying his bills. He misinterpreted the blood draws as someone suspecting he has HIV. Treatment started on the medical floor and he was later transferred to the psychiatric floor. Several psychotropic medications were tried separately including citalopram 20mg, escitalopram 20mg, and bupropion (titrated to 300mg) with the addition of aripiprazole 5 mg without improvement. ECT was considered and his depression and psychosis improved following 6 treatments of bilateral ECT. He was discharged following completion of 10 ECT treatments on 300 mg of bupropion daily and 5mg olanzapine at night. Discussion: Viral infections such as HIV, Hepatitis C, and Influenza are associated with neuropsychiatric sequelae, including depression. COVID-19 infection is occasionally associated with ‘cytokine storm’ which may exacerbate neuroinflammation via increases in cytokines and possible activation of mast cells and microglia.[1] The role of elevated pro-inflammatory cytokines and glucocorticoid receptor resistance is widely studied. Interleukin-6 and CRP are the most strongly linked to depression with a high correlation for anhedonia and psychomotor retardation, prominent features of depression in our case, hinting at a possible role of neuroinflammation. [2] Psychotic features and psychomotor retardation are predictors of ECT response which matched the response to ECT in this case. References: 1. Kempuraj, Duraisamy, et al. COVID-19, mast cells, cytokine storm, psychological stress, and neuroinflammation. The Neuroscientist 2020: 402-414. 2. Tiemeier, Henning, et al. Inflammatory proteins and depression in the elderly. Epidemiology 2003: 103-107.

Dysgeusia and Appetite Loss: Thinking Beyond MDD and COVID-19

Background: Dysgeusia is a distortion of taste sensation. Etiologies can include medications and Covid-19, among others. Dysgeusia may lead to appetite loss which is nonspecific and can have multiple causes, including major depressive disorder (MDD) (Coulter, 1988). Although post-marketing data revealed no association between nifedipine and dysgeusia (Ackerman, 1997), case reports of dysgeusia from nifedipine exist (Ackerman, 1997). We present a case of nifedipine-induced dysgeusia mistaken for depression. Case Report: A 42-year-old man with hypertension and diabetes was admitted to the hospital following right thalamocapsular and intraventricular hemorrhages. Hypertension was managed with metoprolol, lisinopril, nifedipine, and chlorthalidone. Levetiracetam was started for seizure prophylaxis. Medications included pantoprazole, simethicone, transdermal lidocaine, insulin, metformin, docusate, senna, and subcutaneous heparin. Psychiatric consultation was requested out of concern that appetite loss indicated depression. The day before psychiatric evaluation, mirtazapine 15 mg at bedtime for mood and appetite was started. Nifedipine 90 mg daily had been started 9 days prior to his first complaint of decreased appetite. The patient reported feeling disconnected from his family and “sad" for ∼10 years, complaining that family members “talk behind his back.” He was otherwise without paranoia. He denied insomnia, anhedonia, hopelessness, poor concentration, suicidal ideation, homicidal ideation, guilt, mania, or hallucinations. He reported poor appetite due to epigastric discomfort and bad taste to foods. Covid-19 testing was not yet widely available. No other signs or symptoms suggestive of Covid-19 were present. Although alert and fully oriented, concentration was impaired with sometimes tangential thought processes. Affect was full without depression. A diagnosis of adjustment disorder was made. The psychiatry team suspected nifedipine-induced dysgeusia and advised discontinuing nifedipine. Appetite improved two days later. Discussion: This case highlights the importance of considering alternative causes of nonspecific symptoms of depression, including decreased appetite, that may have non-psychiatric causes. Dysgeusia is widely recognized as a symptom of Covid-19. Other causes, including medications may be underrecognized and amenable to intervention. Conclusion: It would be helpful to consider medication side-effects as potential causes for taste distortion alongside psychiatric diagnoses, and COVID-19. References: 1. Coulter DM: Eye pain with nifedipine and disturbance of taste with captopril: a mutually controlled study showing a method of post marketing surveillance BMJ 1988;296: 1086–8. 2. Ackerman BH, Kasbekar N: Disturbances of taste and smell induced by drugs. Pharmacotherapy 1997;17(3):482-96.

“Long COVID” features: incidence and risk factors

Introduction and Purpose of the study: COVID-19 has been associated with long-term symptoms. The aim of this study was to describe the incidence of long-term health consequences and investigate the associated risk factors. Materials and Methods: We organized a multidisciplinary assessment for Covid-19 pts discharged from Covid Department of Jesi H. All pts underwent clinical examination, laboratory and instrumental examinations (HRTC and spirometry+DLCO, walking test). All pts were interviewed with questionnaires (MMSE, IES-R and SF-36) for evaluation of cognitive order, psychiatric symptoms and health-related quality of life.Statistical tests (Fisher's exact test for qualitative variables;Wilcoxon test for quantitative) were used to evaluate the association between the long syndrome and all variables. Results: During the study (June 20-September 21) the first 358 pts had completed the post-discharge multidisciplinary assessment. Among them, 56% have experienced long Covid symptoms: 35,8% still complained fatigue, 15.4% dyspnea, 9% alopecia, and 45.2% experienced post-traumatic psychological consequences (insomnia, anhedonia and irritability the most frequent). The statistical analysis showed that “Long Covid” is significantly associated with gender (female), age (youth), employment status (employed more than unemployed), HRTC findings and the results of SF-36 and IES-R neuropsychiatric tests. Conclusions: These findings highlight the importance of following up survivors of COVID-19. A multidisciplinary approach is fundamental to respond to a complex array of “long Covid”.

Vitamin B6 Antidepressant Effects Are Comparable to Common Antidepressant Drugs in Bacillus-Calmette-Guerin Induced Depression Model in Mice.

Objective: Bacillus-Calmette-Guerin (BCG) inoculation in mice produces an acute period of illness followed by a chronic depressive-like behavior period that lasts for few weeks. The aim was to evaluate vitamin B6 antidepressant effect in comparison with common antidepressants. Method : BCG (0.2 ml/mouse) single dose was intraperitoneally inoculated in male mice. Vitamin B6 (100 mg/kg), fluoxetine, imipramine, or venlafaxine (10 mg/kg each) were intraperitoneally injected for 14 consecutive days following BCG administration. Illness was evaluated following inoculation and depressive-like behaviors were assessed on days 7 and 14. Results: Illness was induced by BCG since mice lost weight and locomotor activity was reduced. Illness was prevented by vitamin B6 similar to antidepressant drugs. Despair was measured by immobility time during the forced swim test and BCG increased it compared to control (193 ± 3s vs 151 ± 7s, P < 0.01) on day 7, and (200 ± 5s vs 147 ± 6s, P < 0.001) on day 14. Vitamin B6, like antidepressants, reduced despair. BCG clearly induced anhedonia evaluated by sucrose preference test (47.5%), and it was soothed by B6 and the antidepressants. Novelty-suppressed feeding test evaluated long term depressive behavior after 14 days. BCG increased the latency to first feeding (222 ± 41s vs control 87 ± 2.6s, P < 0.001) and reduced food consumption per body weight (13 ± 1 mg/g vs control 19 ± 2 mg/g, P < 0.001) while B6 like antidepressants reduced latency and improved food consumption. Conclusion: Vitamin B6 efficiently prevented BCG sickness and depression that was comparable to common antidepressant drugs. Therefore, B6 supplement for preventing depression in high-risk individuals is suggested for further clinical research.

Effects of the COVID-19 pandemic on anhedonia, reward exposure and responsiveness, and sleep in college students.

Objective: The COVID-19 pandemic's effects on college student mental health and its underlying mechanisms are not fully understood. Although necessary, physical distancing abruptly restricts interaction with environmental rewards and disrupts sleep patterns, both of which may contribute to psychological symptoms (eg, depression and anhedonia). This study explored differences in psychological symptoms, reward exposure and responsiveness, and sleep before versus during the pandemic. Methods: Eighty-seven college students completed baseline questionnaires and a one-week daily diary paradigm. The sample was divided into two groups based on data collection before (pre-) or after (post-COVID-19) implementation of state-wide COVID-19 physical distancing measures. Results: Findings highlight higher anhedonia, decrements in exposure to social, professional, and exercise related rewards, lower aniticipatory reward responsiveness, and lower sleep efficiency among college students during the initial months of the pandemic. Conclusions: Findings suggest anhedonia, reward system functioning, and sleep may be important targets to mitigate against college student mental health sequelae during COVID-19.

The Short- and Long-Term Impact of COVID-19 Lockdown on Child Maltreatment.

BACKGROUND: The COVID-19 pandemic has brought a new threat to child health and safety. Some studies suggest that social isolation and economic stress have exacerbated child abuse and neglect, whereas other studies argue that orders to stay at home are likely to promote parent-child relationships during this stressful time. Due to a lack of prospective studies including before-during-after lockdown assessments, the impacts of lockdown measures on child maltreatment are unclear. METHODS: This study retrospectively investigated child maltreatment of 2821 Chinese children and adolescents from 12 to 18 (female, 59%) before, during and after lockdown, and identified risk factors. Potential predictors including socio-economic and individual mental health status were collected. RESULTS: During Chinese lockdown, children and adolescents reported that the proportions of decrease (range 18-47.5%) in emotional abuse and neglect, physical abuse and neglect, sexual abuse, and witnessing domestic violence were greater than that of increase (range 5.1-9.1%). Compared with before lockdown (1.6%), the prevalence of sexual abuse significantly increased 8 months (2.9%) after the lifting of lockdown (p = 0.002). Being male, suffering from depression, state anhedonia, and experiencing psychotic symptoms at baseline were associated with increased sexual abuse after lockdown. CONCLUSIONS: The impact of lockdown on child maltreatment was beneficial in the short-term but detrimental in the long-term in China.

Hippocampal Over-Expression of Cyclooxygenase-2 (COX-2) Is Associated with Susceptibility to Stress-Induced Anhedonia in Mice.

The phenomenon of individual variability in susceptibility/resilience to stress and depression, in which the hippocampus plays a pivotal role, is attracting increasing attention. We investigated the potential role of hippocampal cyclooxygenase-2 (COX-2), which regulates plasticity, neuroimmune function, and stress responses that are all linked to this risk dichotomy. We used a four-week-long chronic mild stress (CMS) paradigm, in which mice could be stratified according to their susceptibility/resilience to anhedonia, a key feature of depression, to investigate hippocampal expression of COX-2, a marker of microglial activation Iba-1, and the proliferation marker Ki67. Rat exposure, social defeat, restraints, and tail suspension were used as stressors. We compared the effects of treatment with either the selective COX-2 inhibitor celecoxib (30 mg/kg/day) or citalopram (15 mg/kg/day). For the celecoxib and vehicle-treated mice, the Porsolt test was used. Anhedonic (susceptible) but not non-anhedonic (resilient) animals exhibited elevated COX-2 mRNA levels, increased numbers of COX-2 and Iba-1-positive cells in the dentate gyrus and the CA1 area, and decreased numbers of Ki67-positive cells in the subgranular zone of the hippocampus. Drug treatment decreased the percentage of anhedonic mice, normalized swimming activity, reduced behavioral despair, and improved conditioned fear memory. Hippocampal over-expression of COX-2 is associated with susceptibility to stress-induced anhedonia, and its pharmacological inhibition with celecoxib has antidepressant effects that are similar in size to those of citalopram.