The uncontrolled spread of the coronavirus disease 2019 (COVID-19) has called for unprecedented measures, to the extent that the Italian government has imposed a quarantine on the entire country. Quarantine has a huge impact and can cause considerable psychological strain. The present study aims to establish the prevalence of psychiatric symptoms and identify risk and protective factors for psychological distress in the general population. An online survey was administered from 18-22 March 2020 to 2766 participants. Multivariate ordinal logistic regression models were constructed to examine the associations between sociodemographic variables; personality traits; depression, anxiety, and stress. Female gender, negative affect, and detachment were associated with higher levels of depression, anxiety, and stress. Having an acquaintance infected was associated with increased levels of both depression and stress, whereas a history of stressful situations and medical problems was associated with higher levels of depression and anxiety. Finally, those with a family member infected and young person who had to work outside their domicile presented higher levels of anxiety and stress, respectively. This epidemiological picture is an important benchmark for identifying persons at greater risk of suffering from psychological distress and the results are useful for tailoring psychological interventions targeting the post-traumatic nature of the distress.
The spread of coronavirus disease 2019 (COVID-19) has called for unprecedented measures, including a national lockdown in Italy. The present study aimed at identifying psychological changes (e.g., changes in depression, stress, and anxiety levels) among the Italian public during the lockdown period, in addition to factors associated with these changes. An online follow-up survey was administered to 439 participants (original sample = 2766), between 28 April and 3 May 2020. A paired sample t-test tested for differences in stress, anxiety, and depression over the period. Multivariate regression models examined associations between sociodemographic variables, personality traits, coping strategies, depression, and stress. Results showed an increase in stress and depression over the lockdown, but not anxiety. Negative affect and detachment were associated with higher levels of depression and stress. Higher levels of depression at the start of the lockdown, as well as fewer coping strategies and childlessness, were associated with increased depression at follow-up, whereas higher levels of stress at the start of the lockdown and younger age were associated with higher stress at follow-up. These results may help us to identify persons at greater risk of suffering from psychological distress as a result lockdown conditions, and inform psychological interventions targeting post-traumatic symptoms.
In the wake of the sudden spread of COVID-19, a large amount of the Italian population practiced incongruous behaviors with the protective health measures. The present study aimed at examining psychological and psychosocial variables that could predict behavioral compliance. An online survey was administered from 18–22 March 2020 to 2766 participants. Paired sample t-tests were run to compare efficacy perception with behavioral compliance. Mediation and moderated mediation models were constructed to explore the association between perceived efficacy and compliance, mediated by self-efficacy and moderated by risk perception and civic attitudes. Machine learning algorithms were trained to predict which individuals would be more likely to comply with protective measures. Results indicated significantly lower scores in behavioral compliance than efficacy perception. Risk perception and civic attitudes as moderators rendered the mediating effect of self-efficacy insignificant. Perceived efficacy on the adoption of recommended behaviors varied in accordance with risk perception and civic engagement. The 14 collected variables, entered as predictors in machine learning models, produced an ROC area in the range of 0.82–0.91 classifying individuals as high versus low compliance. Overall, these findings could be helpful in guiding age-tailored information/advertising campaigns in countries affected by COVID-19 and directing further research on behavioral compliance.
The present study aimed at identifying psychological and psychosocial variables that might predict weight gain during the COVID-19 lockdown in patients affected by overweight/obesity with and without a psychiatric diagnosis. An online survey was administered between 25 April and 10 May 2020, to investigate participants’ changes in dietary habits during the lockdown period. 110 participants were recruited and allocated to two groups, 63 patients had no psychiatric diagnosis; there were 47 patients with psychiatric diagnosis. ANOVA analyses compared the groups with respect to psychological distress levels, risk perception, social support, emotion regulation, and eating behaviors. For each group, a binary logistic regression analysis was conducted, including the factors that were found to significantly differ between groups. Weight gain during lockdown was reported by 31 of the participants affected by overweight/obesity without a psychiatric diagnosis and by 31 patients with a psychiatric diagnosis. Weight gain predictors were stress and low depression for patients without a psychiatric diagnosis and binge eating behaviors for patients with a psychiatric diagnosis. Of patients without a psychiatric diagnosis, 60% reported much more frequent night eating episodes. The risk of night eating syndrome in persons affected by overweight/obesity with no psychiatric diagnosis should be further investigated to inform the development of tailored medical, psychological, and psychosocial interventions.
Since the initiation of the COVID-19 lockdown, Italian parents have been forced to manage their children at home. The present study aimed at investigating the psychological distress of parents during the lockdown, identifying contributing factors. An online survey was administered to 833 participants from 3 to 15 April 2020. Mediation and moderated mediation models were run to explore the association between parent neuroticism and parent distress, mediated by child hyperactivity–inattention and child emotional symptoms, and the moderating effect of living only with child(ren) on the direct and indirect effects of parent neuroticism on parent distress. For parents living only with child(ren), high levels of psychological distress depended exclusively on their levels of neuroticism. For parents living with at least one other person in addition to child(ren), distress levels were also mediated by child behavioral and emotional difficulties. Motherhood emerged as a significant factor contributing to greater distress. Furthermore, parent psychological distress decreased in line with increased child age. The results confirm that neuroticism is an important risk factor for mental health. Preventive measures should be primarily target multicomponent families with younger children and directed towards parents who are already known to present emotional instability and to parents of children who have received local mental health assistance for behavioral and/or emotional difficulties.
Although less frequently than in individuals with better cognitive function, walking independence is achievable after HF surgery rehabilitation, and can be maintained at 1 year also in those with moderately severe or severe CI.
Sustained cognitive demands may result in cognitive fatigue (CF), eventually leading to decreased behavioral performance and compromised brain resources. In the present study, we tested the hypothesis that transcranial direct current stimulation (tDCS) would counteract the behavioral and neurophysiological effects of CF. Twenty young healthy participants were tested in a within-subject counterbalanced order across two different days. Anodal tDCS (real vs. sham) was applied over the left prefrontal cortex. In the real tDCS condition, a current of 1.5 mA was delivered for 25 min. Cortical oxygenation changes were measured using functional Near Infrared Spectroscopy (fNIRS) on the frontal cortices. CF was triggered using the TloadDback task, a sustained working memory paradigm that allows tailoring task demands according to each individual’s maximal cognitive capacity. Sustained cognitive load-related effects were assessed using pre- versus post-task subjective fatigue and sleepiness scales, evolution of performance accuracy within the task, indirect markers of dopaminergic activity (eye blinks), and cortical oxygenation changes (fNIRS) both during the task and pre- and post-task resting state periods. Results consistently disclosed significant CF-related effects on performance. Transcranial DCS was not effective to counteract the behavioral effects of CF. In the control (sham tDCS) condition, cerebral oxygen exchange (COE) levels significantly increased in the right hemisphere during the resting state immediately after the induction of CF, suggesting a depletion of brain resources. In contrast, tDCS combined with CF induction significantly shifted interhemispheric oxygenation balance during the post-training resting state. Additionally, increased self-reported sleepiness was associated with brain activity in the stimulated hemisphere after recovery from CF during the tDCS condition only, which might reflect a negative middle-term effect of tDCS application.
Neurological sequelae of SARS-CoV-2 infection have already been reported, but there is insufficient data about the impact of the pandemic on the management of the patients with chronic neurological diseases. We aim to analyze the effect of COVID-19 pandemic and social restriction rules on these fragile patients. Methods: Patients with chronic neurologic diseases routinely followed at the outpatient clinic of Gemelli University Hospital, Rome, were assessed for symptoms suggestive of SARS-CoV-2 infection in the pandemic period, consequences of social restrictions, and neurological disease features, concomitant medical conditions, current medical and disease-specific treatments. Data source: a dedicated telephone survey designed to encompass questions on COVID-19 symptoms and on pandemic effects in chronic neurologic conditions. Results: Overall, 2,167 individuals were analyzed: 63 patients reported contact with COVID-19 positive cases, 41 performed the swab, and 2 symptomatic patients tested positive for COVID-19 (0.09%). One hundred fifty-eight individuals (7%) needed urgent neurological care, deferred due to the pandemic; 641 patients (30%) suspended hospital treatments, physiotherapy or other support interventions; 405 individuals (19%) reported a subjective worsening of neurological symptoms. Conclusions: In our population, the presence of neurological chronic diseases did not increase the prevalence of COVID-19 infection. Nevertheless, the burden of neurological disorders has been worsened by the lockdown.
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