Does COVID-19 psychological fatigue exist? Results of three online cross-sectional studies conducted in Spain from April 2020 to March 2021.

Background: A previously published meta-analysis found that about one-third of the general population experienced some mental health problem during the early phase of the COVID-19 pandemic, potentially leading to a late mental health crisis. We aimed to describe the acute, short-term, and long-term effects of the COVID-19 pandemic on mental health. Methods: A one-year online survey (S) was conducted in Spain (April 2020 - March 2021). We recruited 18 180 subjects using a virtual respondent-driven snowball sampling method (S1 April 2020, n = 6108; S2 October-November 2020, n = 6418; S3 March 2021, n = 5654). Participants completed the Spanish Depression, Anxiety, and Stress Scale (DASS-21). Results: Overall, our results suggest a progressive increase in the prevalence of anxiety and stress throughout the pandemic waves and relative stability of depression. Women had a greater probability of having depression, anxiety, or stress than men in each survey (P < 0.001). The youngest group (aged 18-24) reported a higher probability (P < 0.05) of having depression, anxiety, or stress than the older groups in S1 and S2. Middle-aged people (25-59) had a greater probability of being a case in the DASS-21 scales than the oldest group (60+), except for depression in men (P = 0.179). In S3, the trend changed: the youngest group showed a decrease in depression and stress while the oldest group showed a dramatic increase (anxiety: men = 664.5%, women = 273.52%; stress: men = 786%, women = 431.37%). Conclusions: It is plausible to conclude that COVID-19 psychological fatigue exists, especially in middle-aged and older adults. Strategies to assist people who have fewer coping skills should be implemented in the near future.

Elevated C-reactive protein as a predictor of a random one-year clinical course in the first ten years of schizophrenia.

We investigate whether C-reactive protein (CRP) levels could predict the clinical course of patients with schizophrenia in a prospective study of 50 stable outpatients during a random 1-year period within the first 10 years of illness. Positive, negative, depressive, and cognitive symptoms were evaluated. Patients with low-grade inflammation (CRP = 3-10 mg/L; 28%) at baseline showed significant worsening of PANSS-positive and general psychopathology at 1-year follow-up compared with those with CRP ≤ 3 mg/L. Elevated CRP may be a biomarker of poor 1-year clinical course in patients with schizophrenia.

Effectiveness of a psychoeducational intervention program in the reduction of caregiver burden in Alzheimer's disease patients' caregivers.

OBJECTIVES: Caregivers of patients with Alzheimer's disease (AD) experience physical and psychological stress due to the caring experience. This study evaluated the benefits of a Psychoeducational Intervention Program (PIP) on caregiver burden in southern Europe. METHODS: A multicentre, prospective, randomised study was conducted. One hundred and fifteen caregivers of patients with clinical diagnosis of AD (DSM-IV-TR criteria, mini-mental score = 10-26) and functional impairment (Lawton and Brody Scale and Katz Index) were recruited. Caregivers were randomised to receive either PIP (IG: intervention group, n = 60) or standard care (CG: control group, n = 55). PIP consisted of eight individual sessions over 4 months for teaching strategies for confronting problems of AD patient care. Caregivers' stress, quality of life and perceived health were measured using validated scales (Zarit, SF-36, GHQ-28, respectively) at baseline and after 4 and 10-months follow-up. RESULTS: Mean change in caregiver burden (Zarit baseline-Zarit final scores) was statistically significant (p = 0.0083) showing an improvement in the IG (-8.09 points) and a worsening in the CG (2.08 points). The IG showed significant improvements in all the well-being perception areas measured by the SF-36 and a significantly lower score in the GHQ-28 (p = 0.0004). 97.7% of caregivers and 88.6% of therapists considered PIP 'useful/very useful' at 4 months (the end of PIP) whereas at 10 months the estimates were 93.2% and 86.3%, respectively. CONCLUSIONS: Psychosocial training of caregivers can minimise caregiver distress and help them to develop problem-solving strategies. A PIP improves quality of life and the perceived health of caregivers of patients with AD.