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The COVID-19 pandemic resulted in severe disruption to people's lives as governments imposed national ‘lockdowns’. Several large surveys have underlined the detrimental short- and long-term mental health consequences resulting from this disruption, but survey findings are only informative of individuals' retrospectively reported psychological states. Furthermore, knowledge on psychobiological responses to lockdown restrictions is scarce. We used smartphone-based real-time assessments in 731 participants for 7 days and investigated how individuals’ self-reported stress and mood fluctuated diurnally during lockdown in spring 2020. We found that age, gender, financial security, depressive symptoms and trait loneliness modulated the diurnal dynamics of participants' momentary stress and mood. For example, younger and less financially secure individuals showed an attenuated decline in stress as the day progressed, and similarly, more lonely individuals showed a diminished increase in calmness throughout the day. Hair collected from a subsample ( n = 140) indicated a decrease in cortisol concentrations following lockdown, but these changes were not related to any of the assessed person-related characteristics. Our findings provide novel insights into the psychobiological impact of lockdown and have implications for how, when and which individuals might benefit most from interventions during psychologically demanding periods.

Currently, more than 14% of the world’s population is pre-obese or obese. The percentage is even higher in developed countries. Obesity is an important risk factor for a vast number of nonmalignant and malignant digestive diseases. Some of the more important examples are cholelithiasis, nonalcoholic fatty liver disease, and gastroesophageal reflux disease on the one hand and esophageal adenocarcinoma, gastric cardia adenocarcinoma, pancreatic cancer, liver cancer, gallbladder cancer, and colorectal cancer on the other hand. Their epidemic trends as reported in recent studies are reviewed here. Knowledge of their dependencies on obesity will yield a deeper understanding which is necessary to improve prevention and treatment concepts of this epidemic.

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BACKGROUND: Social interactions are vital for our wellbeing, particularly during times of stress. PURPOSE: We investigated the real-time effect of social interactions on changes in stress and mood using an ecological momentary assessment approach in 732 participants during COVID-19 lockdown in spring 2020 and in a subsample of these participants (n= 281) during a further lockdown in winter 2020. METHODS: Participants reported their stress and mood in a smartphone app five times per day for seven days and indicated the nature and frequency of their recent social interactions. RESULTS: Overall, social interactions and their frequency were associated with enhanced momentary mood. In person interactions, but not those that were not in person (e.g., via audio, video, or text), were linked to lower stress, especially if they were with closer others. Individuals scoring high on trait loneliness benefited least from social interactions in terms of their momentary mood, whereas those scoring high on trait depressive symptoms benefited the most. Our key findings replicated across both lockdowns. CONCLUSIONS: This study demonstrates the benefits and limits of social interactions for improving momentary mood and stress during psychologically demanding periods and highlight how clinically relevant individual differences can modulate these effects.

Psychobiological responses to music have been examined previously in various naturalistic settings in adults. Choir singing seems to be associated with positive psychobiological outcomes in adults. However, evidence on the effectiveness of singing in children and adolescents is sparse. The COVID-19 outbreak is significantly affecting society now and in the future, including how individuals engage with music. The COVID-19 pandemic is occurring at a time when virtual participation in musical experiences such as singing in a virtual choir has become more prevalent. However, it remains unclear whether virtual singing leads to different responses in comparison with in-person singing. We evaluated the psychobiological effects of in-person choral singing (7 weeks, from January to March 2020, before the COVID-19 outbreak) in comparison with the effects of virtual choral singing (7 weeks, from May to July 2020, after schools partly re-opened in Austria) in a naturalistic pilot within-subject study. A group of children and young adolescents (N = 5, age range 10–13, female = 2) from a school in Salzburg, Austria were recruited to take part in the study. Subjective measures (momentary mood, stress) were taken pre- and post-singing sessions once a week. Additionally, salivary biomarkers (cortisol and alpha-amylase) and quantity of social contacts were assessed pre- and post-singing sessions every second week. Psychological stability, self-esteem, emotional competences, and chronic stress levels were measured at the beginning of in-person singing as well as at the beginning and the end of the virtual singing. We observed a positive impact on mood after both in-person and virtual singing. Over time, in-person singing showed a pre-post decrease in salivary cortisol, while virtual singing showed a moderate increase. Moreover, a greater reduction in stress, positive change in calmness, and higher values of social contacts could be observed for the in-person setting compared to the virtual one. In addition, we observed positive changes in psychological stability, maladaptive emotional competences, chronic stress levels, hair cortisol, self-contingency and quality of life. Our preliminary findings suggest that group singing may provide benefits for children and adolescents. In-person singing in particular seems to have a stronger psychobiological effect.

Objective: Persistent somatic symptoms cause strong impairment in persons with somatic symptom disorder (SSD) and depressive disorders (DDs). Specific negative psychological factors (NPFs), such as catastrophizing, negative affectivity, and behavioral avoidance, are assumed to contribute to this impairment and may maintain symptoms via dysregulations of biological stress systems. We examined the associations between NPF and somatic symptoms in the daily life of women with SSD or DD and investigated the mediating role of psychobiological stress responses. Methods: Twenty-nine women with SSD and 29 women with DD participated in an ecological momentary assessment study. For 14 days, intensity of and impairment by somatic symptoms, NPF, and stress-related biological measures (cortisol, alpha-amylase) were assessed five times per day using an electronic device and saliva samples. Multilevel models were conducted. Results: The greater the number of NPF, the higher the concurrent and time-lagged intensity of and impairment by somatic symptoms in both groups (12.0%-38.6% of variance explained; χ 2 (12) p < .001 for all models). NPFs were associated with higher cortisol levels in women with DD and with lower levels in women with SSD (interaction NPF by group: B = −0.04, p = .042 for concurrent; B = −0.06, p = .019 for time-lagged). In women with SSD, lower cortisol levels were associated with higher intensity at the next measurement time point (group by cortisol: B = −1.71, p = .020). No mediation effects were found. Conclusions: NPFs may be considered as transdiagnostic factors in the development and treatment of impairing somatic symptoms. Our findings will allow the development of new treatment strategies that use ecological momentary intervention approaches focusing on NPF.

ImportanceMusic listening is a universal human experience. People of all ages and cultures often use music to reduce stress and improve mood, particularly in times of crisis. However, ecologically valid research examining the real-time association of music listening with stress and mood during the COVID-19 pandemic is scarce.ObjectiveTo explore the associations between listening to music and the perceptions of stress and mood using ecological momentary assessment during the COVID-19 lockdown period.Design, Setting, and ParticipantsIn this cohort study conducted between April 1 and May 8, 2020, adults from the general population residing in Austria and Italy were prompted by an app on their smartphone to report data 5 times per day across 7 consecutive days. Participants provided data on their real-time and real-life experiences in their natural environment while strict lockdown measures were in place. Data analysis was performed from March 2021 to February 2022.ExposuresData on self-reported music listening were recorded by means of mobile-based assessments. Perceived chronic stress was assessed once at the end of the study.Main Outcomes and MeasuresPerceptions of momentary stress and mood were measured using visual analog scales (score range, 0-100, where 0 indicates not at all and 100 indicates very much) by means of mobile app–based assessments.ResultsThe final sample comprised 711 participants (497 women [69.9%]; median age, 27.0 years [IQR, 24.0-36.0 years]). Participants provided a total of 19 641 data points, including 4677 music listening reports. Music listening was prospectively associated with lower momentary stress levels (β, −0.92; 95% CI, −1.80 to −0.04; P = .04) and improvements in mood valence (β, 1.90; 95% CI, 1.17-2.63; P &amp;lt; .001), especially if the music was perceived as happy. Individuals with higher levels of chronic stress reported improved mood valence after music listening (β, 0.12; 95% CI, 0.02-0.22; P = .02).Conclusions and RelevanceThe present findings suggest that music listening may be a means to modulate stress and mood during psychologically demanding periods. Individuals experiencing heightened momentary and/or chronic stress because of the challenges brought about by COVID-19 pandemic–related restrictions might consider music as an easily accessible tool for the management of stress and mood in daily life.