Factors associated with psychopathological symptoms among nurses at a university hospital.

OBJECTIVES: to analyze the factors associated with psychopathological symptoms among nurses at a university hospital. METHODS: a cross-sectional study developed at a university hospital in Pernambuco, in which 90 nurses participated. A questionnaire with social and professional characteristics and the Symptom Assessment Scale were used. RESULTS: an association was found between the variable changing profession and the presence of characteristic symptoms of psychoticism, somatization and anxiety among nurses. CONCLUSIONS: the emergence of psychopathological symptoms has influenced nurses' desire to search for another profession. This evidence reinforces the need for greater investments in better working conditions and welcoming actions in the work environment, in order to provide a better quality of professional life and promote the health of these workers.

Commentary: The impact of Covid-19 on psychopathology in children and young people worldwide - reflections on Newlove-Delgado et al. (2023).

In the past 3 years, since the beginning of the Covid-19 pandemic, there has been an impressive flourishing body of publications on the impact of the pandemic and related restrictions on the mental health of children and young people. It was about time for a rigorous quantitative evidence synthesis of this large body of research. Newlove-Delgado et al. (J Child Psychol Psychiatry, 2022) took on this challenge by completing a systematic review with meta-analysis of epidemiological studies on the impact of Covid-19 on psychopathology in children and adolescents, featured in the 2023 Annual Research Review series of the Journal. Overall, this meta-analysis shows that the relationship between mental health and Covid-19 pandemic in children and adolescents is complex and, as such, it ought to be addressed by studies using rigorous methods and advanced analytic strategies. Collectively, as a field, we should and could do better with regards to the scope and quality of the studies in this area.

Stress-related psychopathology during the COVID-19 pandemic.

The COVID-19 pandemic has introduced widespread societal changes that have required ongoing adaptation. Unsurprisingly, stress-related psychopathology has increased during the pandemic, in both children and adults. We review these patterns through the lens of several leading conceptual models of the link between stress and psychopathology. Some of these models focus on characteristics of environmental stressors-including cumulative risk, specific stressor types, and stress sensitization approaches. Understanding the specific aspects of environmental stressors that are most likely to lead to psychopathology can shed light on who may be in most need of clinical intervention. Other models center on factors that can buffer against the onset of psychopathology following stress and the mechanisms through which stressors contribute to emergent psychopathology. These models highlight specific psychosocial processes that may be most usefully targeted by interventions to reduce stress-related psychopathology. We review evidence for each of these stress models in the context of other widescale community-level disruptions, like natural disasters and terrorist attacks, alongside emerging evidence for these stress pathways from the COVID-19 pandemic. We discuss clinical implications for developing interventions to reduce stress-related psychopathology during the pandemic, with a focus on brief, digital interventions that may be more accessible than traditional clinical services.

Clinical science can address rising eating disorder psychopathology during the COVID-19 pandemic: Comment on Gruber et al. (2020).

Eating disorders (EDs) are serious psychiatric disorders that affect 13%-18% of young men and women. EDs are associated with substantial psychiatric and medical morbidity and mortality, indicating a critical need for improved identification and treatment. Despite the relatively high prevalence and severity of EDs, they are often omitted from discussions of mental health. This comment is in response to Gruber et al. (2020), who wrote an important article on the challenges and opportunities facing clinical scientists in the time of COVID-19. Our response extends Gruber et al.'s article by noting additional challenges facing people with an ED during COVID-19 and recognizing opportunities for improved evidence-based assessment and treatment of this important population. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Social Safety Theory: Understanding social stress, disease risk, resilience, and behavior during the COVID-19 pandemic and beyond.

Many of life's most impactful experiences involve either social safety (e.g., acceptance, affiliation, belonging, inclusion) or social threat (e.g., conflict, isolation, rejection, exclusion). According to Social Safety Theory, these experiences greatly impact human health and behavior because a fundamental goal of the brain and immune system is to keep the body biologically safe. To achieve this crucial goal, social threats likely gained the ability to activate anticipatory neural-immune responses that would have historically benefited reproduction and survival; the presence of social safety, in turn, likely dampened these responses. Viewing positive and negative social experiences through this lens affords a biologically based evolutionary account for why certain stressors are particularly impactful. It also provides an integrated, multi-level framework for investigating the biopsychosocial roots of psychopathology, health disparities, aging, longevity, and interpersonal cognition and behavior. Ultimately, this work has the potential to inform new strategies for reducing disease risk and promoting resilience.

Is talk cheap? Correspondence between self-attributions about changes in drinking and longitudinal changes in drinking during the 2019 coronavirus pandemic.

BACKGROUND: There are concerns that the coronavirus disease 2019 (COVID-19) pandemic may increase drinking, but most accounts to date are cross-sectional studies of self-attributions about alcohol-related impacts and the accuracy of those perceptions has not been investigated. The current study examined the correspondence between self-attributions of pandemic-related changes in drinking and longitudinally-measured changes in drinking and alcohol-related consequences in a sample of emerging adults. METHODS: In an existing ongoing longitudinal study on alcohol misuse (≥1 heavy episodic drinking day/month) in emerging adults, 473 individuals (Mage  = 23.8; 41.7% male) received a supplemental assessment from June 17th to July 1st, 2020, during public health restrictions in Ontario, Canada. These intrapandemic data were matched to the most recent assessment prior to the pandemic (~8 months earlier). Self-attributions about changes in drinking were assessed globally (i.e., increases/decreases/no change) and with higher resolution questions clarifying the magnitude of changes. RESULTS: Global self-attributions about changes in drinking substantively paralleled longitudinal changes in weekly drinking days (DD). In the longitudinal data, individuals' who self-reported increases in drinking exhibited significant increases; individuals' who self-reported decreases exhibited significant decreases; and individuals who self-reported no change exhibited nonsignificant changes. Higher resolution items likewise revealed longitudinal patterns of weekly drinking that were substantively consistent with self-attributions. Heavy DD and alcohol-related consequences exhibited similar patterns, but only individuals who self-reported large increases in drinking exhibited increases on these outcomes. Individuals who reported large increases in drinking also exhibited significant increases in depression and posttraumatic stress disorder symptoms. CONCLUSIONS: Self-attributions about drinking closely corresponded to longitudinal changes in drinking, supporting the validity of self-attributions in population-level surveys, particularly in young adults. Notably, a subgroup was identified that exhibited pronounced increases for all alcohol-related outcomes and concurrent increases in internalizing psychopathology.

A profile analysis of COVID-19 stress-related reactions: The importance of early childhood abuse, psychopathology, and interpersonal relationships.

BACKGROUND: There is little argument that COVID-19 is potentially highly stressful for many people, however, little research has broken down COVID-19-related distress into different aspects clustering together, and how these clusters differ in terms of the vulnerability of the individuals. OBJECTIVE: The primary aim of the present study was to identify distinct profiles of individuals' reactions to COVID-19-related stress, and analyze potential differences and risk and protective factors associated with these profiles in relation to childhood abuse, psychopathology, and interpersonal relationships. PARTICIPANTS AND SETTING: Data was collected online among a convenience sample of 914 men and women in Israel. METHODS: A Latent Profile Analysis (LPA) for estimating distinct profiles in people's COVID-19-related distress was applied. Next, profiles were compared in childhood abuse, psychopathology, perceived social support and relationship satisfaction. RESULTS: Five distinct profiles were identified: The distressed (23.75%), the worried (38.96%), the financially and socially distressed (15.20%), the caregivers (13.65%), and the untroubled (8.44Profiles in which individuals had more COVID-19 related distress are characterized by more childhood abuse, psychopathology, and less social support and relationship satisfaction. CONCLUSION: An assessment of the psychological implications of COVID-19 (when screening the population and creating prevention/intervention programs) should take into account the different responses individuals have when facing COVID-19, and their vulnerability, including their history of abuse, psychopathology, social support and relationship satisfaction, so that these programs will be better tailored to each type of distress experienced.

Understanding the mental health impacts of COVID-19 through a trauma lens.

This special issue of the European Journal of Psychotraumatology (EJPT) presents the first studies published by EJPT on COVID-19. We present 26 qualitative and quantitative studies assessing the prevalence of trauma-related symptoms and psychopathology within specific vulnerable populations such as health-care workers, students, children, and managers, or more broadly at a country level with a diverse set of outcomes including post-traumatic stress, moral injury, grief and post-traumatic growth. Intervention studies focus on whether telehealth delivery of mental health therapy in the pandemic environment was useful and effective. It is clear that the pandemic has brought with it a rise in trauma exposure and consequently impacted on trauma-related mental health. While for many individuals, COVID-19-related events met criteria for a DSM-5 Criterion A event, challenges remain in disentangling trauma exposure from stress, anxiety, and other phenomena. It is important to determine the contexts in which a trauma lens makes a useful contribution to understanding the mental health impacts of COVID-19 and the ways in which this may facilitate recovery. The papers included in this Special Issue provide an important and much-needed evidence-based foundation for developing trauma-informed understanding and responses to the pandemic.

Este número especial de la Revista Europea de Psicotraumatología(European Journal of Psychotraumatology­EJPT) presenta los primeros estudios publicados por EJPT sobre COVID-19. Presentamos 26 estudios cualitativos y cuantitativos que evalúan la prevalencia de los síntomas y la psicopatología relacionados con el trauma en poblaciones vulnerables específicas, como trabajadores de la salud, estudiantes, niños y niñas, administradores o, en general, a nivel de país con un conjunto diverso de resultados que incluyen el estrés postraumático, el daño moral, el dolour, y el crecimiento postraumático. Los estudios de intervenciones se centran en si la prestación de telesalud de terapia de salud mental en el entorno pandémico fue útil y eficaz.Está claro que la pandemia ha traído consigo un aumento en la exposición al trauma y, en consecuencia, ha tenido un impacto en la salud mental relacionada con el trauma. Si bien para muchas personas los eventos relacionados con el COVID-19 cumplieron los criterios para un evento del Criterio A del DSM-5, persisten los desafíos para desenredar la exposición al trauma del estrés, la ansiedad, y otros fenómenos. Es importante determinar los contextos en los que un lente de trauma hace una contribución útil para comprender los impactos de COVID-19 en la salud mental y las formas en que esto puede facilitar la recuperación. Los artículos incluidos en este Número Especial brindan una base importante y muy necesaria, basada en la evidencia, para desarrollar una comprensión y respuestas a la pandemia informadas sobre el trauma.

COVID-19 Pandemic and Eating Disorders: What Can We Learn About Psychopathology and Treatment? A Systematic Review.

PURPOSE OF REVIEW: This systematic review aims to collect evidence regarding the impact of the SarsCov-2 pandemic on people affected by eating disorders (EDs) targeting the following variables: psychopathology changes, mechanisms of vulnerability or resilience, and perception of treatment modifications during the pandemic. RECENT FINDINGS: Since the beginning of the pandemic, a mental health deterioration has been detected in the general population and especially in people affected by pre-existing psychiatric conditions. Furthermore, mental healthcare has moved toward online treatment. ED people showed a trend toward worsening of ED-specific psychopathology and impairment in general psychopathology. The most common vulnerability mechanisms were social isolation and feelings of uncertainty, while heightened self-care and reduced social pressure were resilience factors. The online treatment, although raising many concerns related to its quality, was considered the best alternative to the face-to-face approach. These findings may support the idea that stressful events contribute to the exacerbation of ED psychopathology and highlight the relevance of internalizing symptoms in EDs. The identification of putative risk and resilience variables as well as of subjective factors affecting online treatment perception may inform healthcare professionals and may promote more personalized approaches.

Everything is going to be all right. Psychopathology in the time of an epidemic in Italy.

Scopo del presente lavoro è descrivere alcune reazioni umane e alcuni elementi di psicopatologia durante la pandemia. La pandemia ha messo in luce diversi aspetti dell'animo umano negli operatori sanitari, nei pazienti e nelle altre persone. Vi sono medici, infermieri, operatori che lavorano 24 ore su 24 per curare e assistere i malati, accompagnare chi non ce la fa. Incuranti del rischio di contagio, della fatica, dei propri bisogni hanno un'unica priorità : aiutare, fare il proprio dovere. Molti di loro si sono ammalati, molti sono morti. Tra loro vi è un alto tasso di contagiati, malati, qualcuno muore. Tutti sono stremati. Sono stati chiamati eroi, ma non tutti sono eroi. I nostri pazienti psichiatrici, inizialmente, sono i più adeguati, prudenti, saggi, responsabili. Con poche, semplici parole esprimono tanta consapevolezza e sana umanità. Al contrario, altre persone, quelle che normalmente si sentono "al di sopra delle cose", entrano nel panico Questa pandemia ci ha fatto capire (se ancora lo ignoravamo) che la vita è fragile, che tutto ciò che ci circonda e su cui costruiamo le nostre sicurezze è precario e incerto.

Rapid response to selective serotonin reuptake inhibitors in post-COVID depression.

The spreading of the Severe Acute Respiratory Syndrome Coronavirus (COVID-19) pandemic could be associated with psychiatric implications. After COVID-19, depression was reported in 40% of patients at one-, three-, and six-months follow-up. Emerging literature suggests anti-inflammatory and antiviral properties of antidepressants in the treatment of SARS-CoV-2. We aim to investigate the efficacy of Selective Serotonin Reuptake Inhibitor (SSRI) in treating post-COVID depression. We included 60 patients affected by a major depressive episode and treated with SSRI in the six months following recovery from COVID. The severity of depression was rated at baseline and after four weeks on the Hamilton Depression Rating Scale (HDRS). Response to treatment was considered when the patients achieved a 50% HDRS reduction. To investigate changes of depressive symptomatology over time, repeated measures ANOVAs according to clinical variables were performed. We found that 55 (92%) patients showed a clinical response to antidepressant. Patients showed a significant decrease over time of HDRS score (baseline HDRS = 23.37 ± 3.94, post-treatment HDRS = 6.71±4.41, F = 618.90, p < 0.001), irrespectively of sex, previous psychiatric history, previous history of mood disorder, and SSRI type. This is the first study to explore the SSRI efficacy in post-COVID depression, suggesting rapid antidepressant effects in most patients. SSRIs treatment could contribute to the rapid antidepressant response by directly targeting the neuroinflammation triggered by SARS-CoV-2. We suggest screening psychopathology of COVID-19 survivors to diagnose emergent depression and pharmacologically treat it to reduce the disease burden and related years of life lived with disability.

Adolescent psychopathological profiles and the outcome of the COVID-19 pandemic: Longitudinal findings from the UK Millennium Cohort Study.

BACKGROUND: Public health measures to contain the spread of COVID-19 have resulted in adverse effects, including high level of psychological distress, anxiety, and depression. AIMS: This study explored adolescent psychopathological profiles at age 17, and their role in predicting the impact of the COVID-19 pandemic at age 19. METHODS: The analyses used a sample of 904 participants (mean age = 19.17 years) from the Millennium Cohort Study (MCS) sweep 7 who completed the mental health questions from January 2018 to March 2019 (mean age = 17.18 years) and the COVID-19 Survey in May 2020. Adolescent psychopathological profiles were identified by means of latent class analysis. RESULTS: Four psychopathological profiles were identified: "low-symptom class" (60.17% of participants), "high-symptom class" (23.01% of participants), "substance/behavioural addictions class" (12.03% of participants), and "emotion-dysregulation class" (4.79% of participants). Adolescents in the high-symptom and emotional-dysregulation classes had the worst outcome during the lockdown. Specifically, they experienced more stress, conflict and loneliness, and lower levels of perceived social support than adolescents in the other psychopathological classes. Adolescents in the emotional-dysregulation class also consumed more alcohol and had worse financial situation during the lockdown compared to pre- lockdown period. CONCLUSION: Adolescent psychopathological profiles predicted mental health impacts of the COVID-19 outbreak.

The impact of COVID-19 lockdown and of the following "re-opening" period on specific and general psychopathology in people with Eating Disorders: the emergent role of internalizing symptoms.

BACKGROUND: We assessed the impact of the coronavirus disease 2019 (COVID-19) pandemic on specific Eating Disorder (ED) and general psychopathology in people with an ED diagnosis during the lockdown period and after the end of the related containment measures. METHODS: People with clinically defined diagnosis and undergoing treatment for an ED completed an online survey, which included adapted questions from standardized psychometric scales. Data relative to three different time periods (before, during and after the end of lockdown) were collected. Psychopathological changes over these periods were investigated and compared through one-way analysis of variance or covariance with repeated measures. RESULTS: Three hundred twelve people completed the survey (57.4% diagnosed with Anorexia Nervosa (AN) or atypical AN, 20.2% with Bulimia Nervosa, 15.4% with Binge Eating Disorder, 7.05% with Other Specified Feeding or Eating Disorders). The severity of both specific and general psychopathology increased during the lockdown and the rise of general symptoms persisted in the following re-opening phase, except for suicide ideation. Almost all of these findings were not affected by ED diagnosis, participants' age and illness duration. LIMITATIONS: The retrospective nature of data collection is the main limitation of the study. CONCLUSIONS: People with EDs showed a COVID-19 emergency-induced worsening of both general and specific psychopathology. The effect on general psychopathology persisted in the re-opening period. These findings suggest a high stress vulnerability of ED individuals with important effects on internalizing symptoms, which are worth of attention by clinicians.

A real-world ten-week follow-up of the COVID outbreak in an outpatient drug clinic in Salamanca (Spain).

OBJECTIVE: To compare over ten weeks the number of relapses, hospital admissions, calls made, admissions to therapeutic communities, face-to-face visits, treatment adjustment, number of injectables administered, and number of emergencies attended due to emotional and behavioral alterations and/or substance use disorder, and to describe and quantify social emergencies in an outpatient drug clinic (ODC) in Salamanca (Spain) from March 16, 2020, to May 22, 2020. METHODS: This is an ecological study of the COVID pandemic over ten weeks. The study examines the set of alcohol or other drug-dependent or dual disorder patients in the population of Salamanca, Spain. The measurements were: professionals; calls made; percentage of successful calls; face-to-face visits; first visits made; reviews made; techniques; injectable treatments; other treatments; evolution; relapses. The ODC includes about 375 new patients each year and another 650 other patients annually. RESULTS: The study found the number of relapses to be greater in the last five weeks of the 10-week study period. Patients' psychopathological instability also increased, and face-to-face visits were necessary. The most frequent psychopathology that required face-to-face intervention was depressive disorder. The number of interventions with patients increased. In parallel, social workers' efforts were greater after the seventh week. There was a decrease in response to calls. Throughout this time, the ODC attended to patients who needed to be treated for the first time. CONCLUSIONS: Confinement due to the coronavirus pandemic generated maladaptive emotional responses and other behaviors, such as excessive alcohol consumption. The number of face-to-face consultations, admissions, and referrals to therapeutic communities increased. Patients under stress and in social isolation resorted more often to substance use. The ODC had to adopt a flexible approach to evaluate patients with more serious problems, by using face-to-face assessments.

Coping and psychopathology in children with malignancy and bronchiectasis.

AIM: We aimed to evaluate the coping styles and social support perceived by the children with two different chronic diseases (cancer and bronchiectasis), their mothers' coping styles and compare them with a control group without any chronic physical or psychiatric disorder. METHODS: Our sample consisted of 114 children and adolescents, with an age range from 9 to 15 years. The data were collected by using schedule for affective disorders and schizophrenia for school-age children-present and lifetime version, kid-coping orientation to problems experienced (Kid-COPE), social support appraisals scale (SSAS), and COPE. RESULTS: All three groups were similar with respect to age and sex distribution. Around 50% to 60% of the children in both patient groups had a psychiatric diagnosis. Remarkably, 30% of the children had an internalizing disorder. The most commonly used coping style by the mothers was religious coping in all groups. Kid-COPE scores did not significantly differ between groups. The scores on Family and Friend subscales of SSAS in the bronchiectasis group were significantly lower when compared with those of participants in hematology-oncology and control groups. CONCLUSION: Chronic medical illnesses may have a similar psychological impact on children regardless of disease-specific clinical presentations and outcomes. Future studies need to focus on identifying protective and risk factors that potentially mediate psychosocial well-being.

Previous psychopathology predicted severe COVID-19 concern, anxiety, and PTSD symptoms in pregnant women during "lockdown" in Italy.

Italy was the first COVID-19 pandemic epicenter among European countries and established a period of full "lockdown", consisting of travel bans, mandatory staying at home, and temporary closure of nonessential businesses. Similar measures are known risk factors for psychological disturbances in the general population; still, little is known about their impact on pregnant women's mental health during COVID-19 pandemic. The cross-sectional, web-based, national survey "COVID-19 related Anxiety and StreSs in prEgnancy, poSt-partum and breaStfeeding" (COVID-ASSESS) was conducted during the first month of full "lockdown" in Italy. Participants were recruited via social networks with a snowball technique. The questionnaire was specifically developed to examine COVID-19 concerns and included the psychometric tests National Stressful Events Survey (NSESSS) for posttraumatic stress disorder (PTSD) and State-Trait Anxiety Inventory. A multivariable logistic regression model was fitted to explore the association of the concern, anxiety and PTSD symptoms with age, gestational weeks, parity, days of "lockdown", assisted reproductive technology use, psychopathological history, and previous perinatal losses. Out of 1015 pregnant women reached, 737 (72.6%) fully answered the questionnaire; no woman reported a COVID-19 infection. Median age was 34.4 years [quartiles 31.7, 37.2], median days in "lockdown" were 13.1 [11.0, 17.0], median gestational weeks were 27.8 [19.8, 34.0]. Clinically significant PTSD symptoms were present in 75 women (10.2%, NSESSS cutoff 24) and clinically significant anxiety symptoms were present in 160 women (21.7%, STAI-Y1 cutoff 50). Women were particularly worried about the health of their baby and of their elderly relatives, as well as of the possible impact of pandemic in the future of society. Previous anxiety predicted higher concern and PTSD symptoms; previous depression and anxiety were independently associated with current PTSD symptoms.