Relationship between depression, anxiety, stress, and SARS-CoV-2 infection: a longitudinal study.

Objectives: We aimed to (1) describe the course of the emotional burden (i.e., depression, anxiety, and stress) in a general population sample during the coronavirus pandemic in 2020 and 2021 and (2) explore the association between emotional burden and a serologically proven infection with SARS-CoV-2. Study design: This longitudinal study involved a sample of community-dwelling persons aged ≥14 years from the general population of South Tyrol (Province of Bolzano-Bozen, Northern Italy). Data were collected at two stages over a 1-year period in 2020 and 2021. Methods: Persons were invited to participate in a survey on socio-demographic, health-related and psychosocial variables (e.g., age, chronic diseases, Depression Anxiety Stress Scale, DASS-21), as well as in the serological testing for of SARS-CoV-2-specific immunoglobulins. Results: In 2020, 855 (23.8%) out of 3,600 persons participated; in 2021, 305 (35.7%) out of 855 were tested again. We observed a statistically significant decrease in mean DASS-21 scores for depression, stress, and total scores between 2020 and 2021, yet not for anxiety. Persons with a confirmed SARS-CoV-2-infection between the first and second data collection exhibited increased emotional burden compared to those without SARS-CoV-2-infection. The odds of participants with a self-reported diagnosis of mental disorder for future infection with SARS-CoV-2 was almost four times higher than that of participants without mental disorders (OR:3.75; 95%CI:1.79-7.83). Conclusion: Our findings support to the hypothesis of a psycho-neuroendocrine-immune interplay in COVID-19. Further research is necessary to explore the mechanisms underlying the interplay between mental health and SARS-CoV-2 infections.

The Impact of the SARS-CoV-2 Outbreak on the Psychological Flexibility and Behaviour of Cancelling Medical Appointments of Italian Patients with Pre-Existing Medical Condition: The "ImpACT-COVID-19 for Patients" Multi-Centre Observational Study.

Psychological distress imposed by the SARS-CoV-2 outbreak particularly affects patients with pre-existing medical conditions, and the progression of their diseases. Patients who fail to keep scheduled medical appointments experience a negative impact on care. The aim of this study is to investigate the psychosocial factors contributing to the cancellation of medical appointments during the pandemic by patients with pre-existing health conditions. Data were collected in eleven Italian hospitals during the last week of lockdown, and one month later. In order to assess the emotional impact of the SARS-CoV-2 outbreak and the subject's degree of psychological flexibility, we developed an ad hoc questionnaire (ImpACT), referring to the Acceptance and Commitment Therapy (ACT) model. The Impact of Event Scale-Revised (IES-R), the Depression, Anxiety and Stress Scale (DASS) and the Cognitive Fusion Questionnaire (CFQ) were also used. Pervasive dysfunctional use of experiential avoidance behaviours (used with the function to avoid thought, emotions, sensations), feelings of loneliness and high post-traumatic stress scores were found to correlate with the fear of COVID-19, increasing the likelihood of cancelling medical appointments. Responding promptly to the information and psychological needs of patients who cancel medical appointments can have positive effects in terms of psychological and physical health.

The role of the left putamen in multilingual language production.

Subcortical structures are a key component of bilingual language processing. For instance, there is now evidence that the head of the left caudate is involved in controlling languages in bilingual individuals. On the other hand, the left putamen is hypothesized to be involved in articulatory processes but little is known on its engagement in bilingual language processing. Here, our hypothesis was that the left putamen of multilinguals is engaged when producing words in the less proficient language. We investigated this issue with event-related functional Magnetic Resonance (er-fMRI) in a group of multilinguals (n = 14) and in monolinguals (n = 14) during a picture-naming task. Further, we hypothesized increased grey matter density in the left putamen as an effect of experience since multilinguals constantly face a major articulatory load (i.e., speaking multiple languages) during life. To test these hypotheses we measured structural differences between multilinguals and monolinguals using voxel-based morphometry (VBM). Our results indicate that multilinguals have increased activation in the left putamen for a non-native language, but only if they are not highly proficient in that language. In addition, we found increased grey matter density in the left putamen of multilinguals compared to monolinguals. These findings highlight that the multilingual brain handles a complex articulatory repertoire (i.e., dealing with multiple languages) by inducing structural plasticity in the left putamen.

Bilingualism tunes the anterior cingulate cortex for conflict monitoring.

Monitoring and controlling 2 language systems is fundamental to language use in bilinguals. Here, we reveal in a combined functional (event-related functional magnetic resonance imaging) and structural neuroimaging (voxel-based morphometry) study that dorsal anterior cingulate cortex (ACC), a structure tightly bound to domain-general executive control functions, is a common locus for language control and resolving nonverbal conflict. We also show an experience-dependent effect in the same region: Bilinguals use this structure more efficiently than monolinguals to monitor nonlinguistic cognitive conflicts. They adapted better to conflicting situations showing less ACC activity while outperforming monolinguals. Importantly, for bilinguals, brain activity in the ACC, as well as behavioral measures, also correlated positively with local gray matter volume. These results suggest that early learning and lifelong practice of 2 languages exert a strong impact upon human neocortical development. The bilingual brain adapts better to resolve cognitive conflicts in domain-general cognitive tasks.

Late acquisition of literacy in a native language.

With event-related functional MRI (fMRI) and with behavioral measures we studied the brain processes underlying the acquisition of native language literacy. Adult dialect speakers were scanned while reading words belonging to three different conditions: dialect words, i.e., the native language in which subjects are illiterate (dialect), German words, i.e., the second language in which subjects are literate, and pseudo-words. Investigating literacy acquisition of a dialect may reveal how novel readers of a language build an orthographic lexicon, i.e., establish a link between already available semantic and phonological representations and new orthographic word forms. The main results of the study indicate that a set of regions, including the left anterior hippocampal formation and subcortical nuclei, is involved in the buildup of orthographic representations. The repeated exposure to written dialect words resulted in a convergence of the neural substrate to that of the language in which these subjects were already proficient readers. The latter result is compatible with a "fast" brain plasticity process that may be related to a shift of reading strategies.