In a previous clinical study, a probiotic formulation (PF) consisting of Lactobacillus helveticus R0052 and Bifidobacterium longum R0175 (PF) decreased stress-induced gastrointestinal discomfort. Emerging evidence of a role for gut microbiota on central nervous system functions therefore suggests that oral intake of probiotics may have beneficial consequences on mood and psychological distress. The aim of the present study was to investigate the anxiolytic-like activity of PF in rats, and its possible effects on anxiety, depression, stress and coping strategies in healthy human volunteers. In the preclinical study, rats were daily administered PF for 2 weeks and subsequently tested in the conditioned defensive burying test, a screening model for anti-anxiety agents. In the clinical trial, volunteers participated in a double-blind, placebo-controlled, randomised parallel group study with PF administered for 30 d and assessed with the Hopkins Symptom Checklist (HSCL-90), the Hospital Anxiety and Depression Scale (HADS), the Perceived Stress Scale, the Coping Checklist (CCL) and 24 h urinary free cortisol (UFC). Daily subchronic administration of PF significantly reduced anxiety-like behaviour in rats (P,0·05) and alleviated psychological distress in volunteers, as measured particularly by the HSCL-90 scale (global severity index, P, 0·05; somatisation, P, 0·05; depression, P, 0·05; and anger-hostility, P,0·05), the HADS (HADS global score, P, 0·05; and HADSanxiety, P,0·06), and by the CCL (problem solving, P, 0·05) and the UFC level (P,0·05). L. helveticus R0052 and B. longum R0175 taken in combination display anxiolytic-like activity in rats and beneficial psychological effects in healthy human volunteers.

I n a recent clinical study, we demonstrated in the general population that Lactobacillus helveticus R0052 and Bifidobacterium longum R0175 (PF) taken in combination for 30 days decreased the global scores of hospital anxiety and depression scale (HADs), and the global severity index of the Hopkins symptoms checklist (HSCL-90), due to the decrease of the sub-scores of somatization, depression and angerhostility spheres. Therefore, oral intake of PF showed beneficial effects on anxiety and depression related behaviors in human volunteers. From there, it is interesting to focus on the role of this probiotic formulation in the subjects with the lowest urinary free cortisol levels at baseline. This addendum presents a secondary analysis of the effects of PF in a subpopulation of 25 subjects with urinary free cortisol (UFC) levels less than 50 ng/ml at baseline, on psychological distress based on the percentage of change of the perceived stress scale (PSs), the HADs and the HSCL-90 scores between baseline and follow-up. The data show that PF improves the same scores as in the general population (the HADs global score, the global severity index of the HSCL-90 and three of its sub-scores, i.e., somatization, depression and anger-hostility), as well as the PSs score and three other subscores of the HSCL-90, i.e., "obsessive compulsive," "anxiety" and "paranoidideation." Moreover, in the HSCL-90, Beneficial psychological effects of a probiotic formulation (Lactobacillus helveticus R0052 and Bifidobacterium longum R0175) in healthy human volunteers

Background Although COVID-19 is a major worldwide health threat, there is another global public health emergency that is becoming a growing challenge. Domestic violence is a public health and human rights issue that primarily affects women and children worldwide. Several countries have reported a significant increase in domestic violence cases since the COVID-19-induced lockdowns and physical distancing measures were implemented. The COVID-19 health crisis is exacerbating another pre-existing public health problem by increasing the severity and frequency of domestic violence, thus demonstrating the need to adopt significant and long-term measures. Objective Therefore, it is urgently necessary to promote and increase actions and policies to guarantee the safety and dignity of all victims of domestic violence worldwide. Methods This paper describes preventive measures and action plans to combat violence against women and children during the COVID-19 pandemic. Conclusion The prevention of domestic violence must indeed be every government’s priority and every citizen’s responsibility.

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Although the ‘panic’ word has been abundantly linked to the SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2) pandemic in the press, in the scientific literature very few studies have considered whether the current epidemic could predispose to the onset or the aggravation of panic attacks or panic disorder. Indeed, most studies thus far have focused on the risk of increase and aggravation of other psychiatric disorders as a consequence of the SARS-CoV-2 epidemic, such as obsessive-compulsive disorder (OCD), post-traumatic stress disorder (PTSD), and generalized anxiety disorder (GAD). Yet, risk of onset or aggravation of panic disorder, especially the subtype with prominent respiratory symptoms, which is characterized by a fear response conditioning to interoceptive sensations (e.g., respiratory), and hypervigilance to these interoceptive signals, could be expected in the current situation. Indeed, respiratory symptoms, such as coughs and dyspnea, are among the most commonly associated with the SARS-CoV-2 (59-82% and 31-55%, respectively), and respiratory symptoms are associated with a poor illness prognosis. Hence given that some etiological and maintenance factors associated with panic disorder – i.e., fear conditioning to abnormal breathing patterns attributable or not to the COVID-19 ( coronavirus disease 2019 ), as well as hypervigilance towards breathing abnormalities – are supposedly more prevalent, one could expect an increased risk of panic disorder onset or aggravation following the COVID-19 pandemic in people who were affected by the virus, but also those who were not. In people with the comorbidity (i.e., panic disorder or panic attacks and the COVID-19), it is particularly important to be aware of the risk of hypokalemia in specific at-risk situations or prescriptions. For instance, in the case of salbutamol prescription, which might be overly used in patients with anxiety disorders and COVID-19, or in patients presenting with diarrhea and vomiting. Hypokalemia is associated with an increased risk of torsade de pointe, thus caution is required when prescribing specific psychotropic drugs, such as the antidepressants citalopram and escitalopram, which are first-line treatments for panic disorder, but also hydroxyzine, aiming at anxiety relief. The results reviewed here highlight the importance of considering and further investigating the impact of the current pandemic on the diagnosis and treatment of panic disorder (alone or comorbid with the COVID-19).

Depression is a major public health problem affecting about 12% of the world population. Drugs exist but they have many side effects. In the last few years, natural substances (e.g. flavonoids) have been tested to cure such disorders. Cocoa polyphenolic extract is a complex compound prepared from non-roasted cocoa beans containing high levels of flavonoids. The antidepressant-like effect of cocoa polyphenolic extract was evaluated using the forced swimming test in rats. Cocoa polyphenolic extract significantly reduced the duration of immobility at both doses of 24 mg/kg/14 days and 48 mg/kg/14 days, although no change of motor dysfunction was observed with the two doses tested in the open field. The results of the forced swimming test after a subchronic treatment and after an additional locomotor activity test confirm the assumption that the antidepressant-like effect of cocoa polyphenolic extract in the forced swimming test model is specific. Further, it can be speculated that this effect might be related to its content of active polyphenols.

The coronavirus disease 2019 pandemic has caught the scientific community and hospitals off-guard, and the race is on as clinicians grapple with novel treatment strategies and constantly changing recommendations. Patients with mental health disorders are particularly vulnerable to the coronavirus outbreak for various reasons, including cognitive impairment, little awareness of risk, diminished efforts regarding personal protection and more barriers in accessing timely health services. 1Only few therapeutic options are being tested for COVID-19 with no evidence yet of effectiveness or safety. One of the options presently under evaluation is the combination of (hydroxy)chloroquine with azithromycin. 2 Despite the limited clinical data on the use of (hydroxy)chloroquine in COVID-19, this drug is attracting considerable attention from the media. Individuals and lobby groups have called for widespread prescription of these drugs. This attention is undermining the structured approach with which any drug should be evaluated.In this rapidly evolving situation, we need to alert prescribers that the extensive use of (hydroxy)chloroquine-azithromycin would place patients, and particularly those with mental health conditions, at an important increased risk of QTc-prolonging and, consequently, torsade de pointes (TdP) and death. Only a few clinical studies have analysed the cardiovascular effects of these drugs, 3 although they are clearly acknowledged with a known risk for QTc-prolonging according to CredibleMeds (on the list 1 of drugs with a known risk for TdP).CredibleMeds provides the American official lists of drugs associated with a risk of QTc-prolongation, powered by international pharmacovigilance data. 4,5 However, patients with mental health problems are already highly exposed to the risk of increased QT for a number of reasons. First, many psychoactive substances are associated with an increased risk of QTc-prolonging, such as antipsychotics (chlorpromazine, levomepromazine, haloperidol, pimozide, sulpiride, sultopride and thioridazine), antidepressants (citalopram and escitalopram), methadone, cocaine or donepezil. Second, our patients have often numerous comorbidities and underlying risk factors making cases of COVID-19 more challenging to treat. For instance, patients on antipsychotics are more likely to be men, at a higher risk of obesity, hypertension, metabolic syndrome and for more serious health outcomes. Moreover, their sedentary lifestyle and other risk factors, such as smoking and poor diet, put them at an elevated risk of respiratory failure and early death. Thus, a careful and thorough assessment of risk factors is crucial in these patients, including sex, age, smoking, acute electrolytes disturbances, metabolic syndrome, cardiac and pulmonary disease.The COVID-19 pandemic calls for rapid testing of new treatment strategies. However, special care is needed when treating vulnerable populations. If the combination of (hydroxyl)chloroquineazithromycin is recommended in the near future for COVID-19, we ...