Background: The psychological impact of the COronaVIrus Disease 2019 (COVID-19) outbreak and lockdown measures on the Italian population are unknown. The current study assesses rates of mental health outcomes in the Italian general population three to 4 weeks into lockdown measures and explores the impact of COVID-19 related potential risk factors. Methods: A web-based survey spread throughout the internet between March 27 th and April 6 th 2020. Eighteen thousand one hundred forty-seven individuals completed the questionnaire, 79.6% women. Selected outcomes were post-traumatic stress symptoms (PTSS), depression, anxiety, insomnia, perceived stress, and adjustment disorder symptoms (ADS). Seemingly unrelated logistic regression analysis was performed to identify COVID-19 related risk factors. Results: Endorsement rates for PTSS were 6,604 (37%), 3,084 (17.3%) for depression, 3,700 (20.8%) for anxiety, 1,301 (7.3%) for insomnia, 3,895 (21.8%) for high perceived stress and 4,092 (22.9%) for adjustment disorder. Being woman and younger age were associated with all of the selected outcomes. Quarantine was associated with PTSS, anxiety and ADS. Any recent COVID-related stressful life event was associated with all the selected outcomes. Discontinued working activity due to the COVID-19 was associated with all the selected outcomes, except for ADS; working more than usual was associated with PTSS, Perceived stress and ADS. Having a loved one deceased by COVID-19 was associated with PTSS, depression, perceived stress, and insomnia. Conclusion: We found high rates of negative mental health outcomes in the Italian general population 3 weeks into the COVID-19 lockdown measures and different COVID

Health care workers (HCWs) involved in the coronavirus disease 2019 (COVID-19) pandemic are exposed to high levels of stressful or traumatic events and express substantial negative mental health outcomes, 1 including stress-related symptoms and symptoms of depression, anxiety, and insomnia. In this cross-sectional study, we report on mental health outcomes among HCWs in Italy. Methods This cross-sectional, web-based study collected data between March 27 and March 31, 2020, using an online questionnaire spread via social networks using a snowball technique and sponsored social network advertisements. Approval for this study was obtained from the local institutional review board at University of L'Aquila. Online consent was obtained from the participants. The sampling period corresponded to the days immediately preceding the COVID-19 contagion peak, associated with the highest level of health care system utilization. All HCWs reporting that they work in Italy were eligible. Because of the self-selected and nonprobabilistic nature of the sample, invitations and response rates could not be quantifiable, as reported by American Association for Public Opinion Research (AAPOR) reporting guideline. The questionnaire investigated demographic variables, workplace characteristics (ie, being a frontline or second-line worker), and information regarding the direct consequences of COVID-19, including having colleagues infected or deceased. Frontline and second-line HCWs were defined by a single yes or no question, "Are you currently working with COVID-19 patients?" Key mental health outcomes were posttraumatic stress symptoms (PTSS), symptoms of depression, anxiety, insomnia, and perceived stress, assessed using the Italian version of the Global Psychotrauma Screen (GPS), 2 the 9-item Patient Health Questionnaire (PHQ-9), 3 the 7-item Generalized Anxiety Disorder scale (GAD-7), 4 the 7-item Insomnia Severity Index (ISI), 5 and the 10-item Perceived Stress Scale (PSS). 6 Participants were classified as endorsing the previously listed symptoms according to the following cutoffs: at least 3 on the 5 item GPS-posttraumatic stress disorder subscale, at least 15 on the PHQ-9, at least 15 on the GAD-7, and at least 22 on the ISI. Cutoffs were extracted from the original articles describing each measure. Because no official cutoff for the PSS was available, a quartile split was used. Age was standardized to a mean (SD) of 0 (1) and then reversed (ie, multiplied by −1) to show a positive coefficient. A multivariable logistic regression model was fitted to explore the association of the selected outcomes with sex, age, frontline working position, occupation, and self and colleagues' exposure to contagion. The association between outcomes and potential risk factors was assessed by seemingly unrelated regression models that allow joint modelling of correlated outcomes. Analyses were conducted in Stata version 16 (StataCorp). Statistical significance was set at P < .05, and all tests were 2-tailed. Results A total of 1379 HCWs completed th...

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Improving real‐life functioning is the main goal of the most advanced integrated treatment programs in people with schizophrenia. The Italian Network for Research on Psychoses previously explored, by using network analysis, the interplay among illness‐related variables, personal resources, context‐related factors and real‐life functioning in a large sample of patients with schizophrenia. The same research network has now completed a 4‐year follow‐up of the original sample. In the present study, we used network analysis to test whether the pattern of relationships among all variables investigated at baseline was similar at follow‐up. In addition, we compared the network structure of patients who were classified as recovered at follow‐up versus those who did not recover. Six hundred eighteen subjects recruited at baseline could be assessed in the follow‐up study. The network structure did not change significantly from baseline to follow‐up, and the overall strength of the connections among variables increased slightly, but not significantly. Functional capacity and everyday life skills had a high betweenness and closeness in the network at follow‐up, as they had at baseline, while psychopathological variables remained more peripheral. The network structure and connectivity of non‐recovered patients were similar to those observed in the whole sample, but very different from those in recovered subjects, in which we found few connections only. These data strongly suggest that tightly coupled symptoms/dysfunctions tend to maintain each other's activation, contributing to poor outcome in schizophrenia. Early and integrated treatment plans, targeting variables with high centrality, might prevent the emergence of self‐reinforcing networks of symptoms and dysfunctions in people with schizophrenia.