The network structure of psychopathological and resilient responses to the pandemic: A multicountry general population study of depression and anxiety.

Commonly identified patterns of psychological distress in response to adverse events are characterized by resilience (i.e., little to no distress), delayed (i.e., distress that increases over time), recovery (i.e., distress followed by a gradual decrease over time), and sustained (i.e., distress remaining stable over time). This study aimed to examine these response patterns during the COVID-19 pandemic. Anxiety and depressive symptom data collected across four European countries over the first year of the pandemic were analyzed (N = 3,594). Participants were first categorized into groups based on the four described patterns. Network connectivity and symptom clustering were then estimated for each group and compared. Two thirds (63.6%) of the sample displayed a resilience pattern. The sustained distress network (16.3%) showed higher connectivity than the recovery network (10.0%) group, p = .031; however, the resilient network showed higher connectivity than the delayed network (10.1%) group, p = .016. Regarding symptom clustering, more clusters emerged in the recovery network (i.e., three) than the sustained network (i.e., two). These results replicate findings that resilience was the most common mental health pattern over the first pandemic year. Moreover, they suggest that high network connectivity may be indicative of a stable mental health response over time, whereas fewer clusters may be indicative of a sustained distress pattern. Although exploratory, the network perspective provides a useful tool for examining the complexity of psychological responses to adverse events and, if replicated, could be useful in identifying indicators of protection against or vulnerability to future psychological distress.

Digital Intentions in the Fingers: I Know What You Are Doing with Your Smartphone.

Every day, we make thousands of finger movements on the touchscreen of our smartphones. The same movements might be directed at various distal goals. We can type "What is the weather in Rome?" in Google to acquire information from a weather site, or we may type it on WhatsApp to decide whether to visit Rome with a friend. In this study, we show that by watching an agent's typing hands, an observer can infer whether the agent is typing on the smartphone to obtain information or to share it with others. The probability of answering correctly varies with age and typing style. According to embodied cognition, we propose that the recognition process relies on detecting subtle differences in the agent's movement, a skill that grows with sensorimotor competence. We expect that this preliminary work will serve as a starting point for further research on sensorimotor representations of digital actions.

Easy to get, difficult to avoid: Behavioral tendencies toward high-calorie and low-calorie food during a mobile approach-avoidance task interact with body mass index and hunger in a community sample.

In recent years, different studies highlighted the importance of assessing behavioral tendencies toward different food stimuli in healthy and pathological samples. However, heterogeneities in experimental approaches and small sample sizes make this literature rather inconsistent. In this study, we used a mobile approach-avoidance task to investigate the behavioral tendencies toward healthy and unhealthy foods compared to neutral objects in a large community sample. The role of some contextual and stable subjective variables was also explored. The sample included 204 participants. The stimuli comprised 15 pictures of unhealthy foods, 15 pictures of healthy foods, and 15 pictures of neutral objects. Participants were required to approach or avoid stimuli by respectively pull or push the smartphone toward or away from themselves. Accuracy and reaction time of each movement were calculated. The analyses were conducted using a generalized linear mixed-effect model (GLMMs), testing the two-way interaction between the type of movement and the stimulus category and the three-way interactions between type of movement, stimulus, and specific variables (BMI, time passed since the last meal, level of perceived hunger). Our results evidenced faster approaching movement toward food stimuli but not toward neutrals. An effect of BMI was also documented: as the BMI increased, participants became slower in avoiding unhealthy compared to healthy foods, and in approaching healthy compared to unhealthy stimuli. Moreover, as hunger increased, participants became faster in approaching and slower in avoiding healthy compared to unhealthy stimuli. In conclusion, our results show an approach tendency toward food stimuli, independent from caloric content, in the general population. Furthermore, approach tendencies to healthy foods decreased with increasing BMI and increased with perceived hunger, indicating the possible influence of different mechanisms on eating-related behavioral tendencies.

The Expanded Exercise Addiction Inventory (EAI-3): Towards Reliable and International Screening of Exercise-Related Dysfunction.

Exercise addiction (EA) refers to excessive exercise, lack of control, and health risks. The Exercise Addiction Inventory (EAI) is one of the most widely used tools in its assessment. However, the cross-cultural psychometric properties of the EAI could be improved because it misses three pathological patterns, including guilt, exercise despite injury, and experienced harm. Therefore, the present study tested the psychometric properties of the expanded EAI (EAI-3) in a large international sample. The EAI-3 was administered to 1931 physically active adult exercisers speaking five languages (Chinese, German, Italian, Japanese, and Turkish) and other measures for obsessive-compulsive behavior, eating disorders, and personality traits. The assessment structure and reliability of the EAI-3 were tested with factorial analyses and through measurement invariance across languages and sex. Finally, a cutoff point for dysfunction-proneness was calculated. The EAI-3 comprised two factors, reflecting the positive and pathological sides of exercise. The structure had excellent reliability and goodness-of-fit indices and configural and metric invariances of the scale were supported. However, three items caused violations in scalar invariance. The results of partial measurement invariance testing suggested an adequate fit for the data. Following sensitivity and specificity analysis, the EAI-3's cutoff score was 34 out of a maximum score of 48. This preliminary study suggests that the EAI-3 is a promising tool for screening EA in an international sample, with a robust and reliable structure comparable across languages and sex. In addition, the proposed cutoff could pave the way toward a consensus on a threshold to screen for EA.

The role of the COVID-19 impersonal threat strengthening the associations of right-wing attitudes, nationalism and anti-immigrant sentiments.

Literature showed that the link between right-wing attitudes and ethnocentric attitudes gets stronger under existential threats, but the role exerted by an impersonal threat - as COVID-19 - on right-wing attitudes is still unclear. This study aimed to highlight the role of anxiety exerted by the impersonal COVID-19 threat on the relationship between right-wing attitudes and ethnocentric attitudes, as nationalism and anti-immigrants' sentiments. As part of an international project to evaluate the impact of COVID-19, this study administered an online survey to a representative sample (n 1038). The anxiety generated by an impersonal threat as COVID-19 - thus not exerted by any outgroup - can moderate the relationship among personal Right-Wing Authoritarianism, social dominance orientation, and ethnocentric attitudes. This is the first study demonstrating that existential threat is effective also when exerted by an impersonal agent (as COVID-19) rather than by an outgroup. Second, these findings disclose useful implications for preventive psychological interventions and for social policy makers. Supplementary information: The online version contains supplementary material available at 10.1007/s12144-023-04305-w.

When Corticospinal Inhibition Favors an Efficient Motor Response.

Many daily activities involve responding to the actions of other people. However, the functional relationship between the motor preparation and execution phases still needs to be clarified. With the combination of different and complementary experimental techniques (i.e., motor excitability measures, reaction times, electromyography, and dyadic 3-D kinematics), we investigated the behavioral and neurophysiological signatures characterizing different stages of a motor response in contexts calling for an interactive action. Participants were requested to perform an action (i.e., stirring coffee or lifting a coffee cup) following a co-experimenter's request gesture. Another condition, in which a non-interactive gesture was used, was also included. Greater corticospinal inhibition was found when participants prepared their motor response after observing an interactive request, compared to a non-interactive gesture. This, in turn, was associated with faster and more efficient action execution in kinematic terms (i.e., a social motor priming effect). Our results provide new insights on the inhibitory and facilitatory drives guiding social motor response generation. Altogether, the integration of behavioral and neurophysiological indexes allowed us to demonstrate that a more efficient action execution followed a greater corticospinal inhibition. These indexes provide a full picture of motor activity at both planning and execution stages.

The mediating role of scientifical-medical satisfaction between COVID-19 conspiracy beliefs and vaccine confidence: a two-waves structural equation model.

Vaccine confidence has emerged as one of the most relevant psychological factors implied in the worldwide affecting the fight against COVID-19-as well as public trust in doctors, medicine, and science. Indeed, the vaccine confidence is crucial to maximize the trust in vaccines and their use for prevention, with several implications for public health. This study aimed to analyse the relationships among between vaccine confidence, conspiracy beliefs about COVID-19, and satisfaction with science and medicine in handling the COVID-19 pandemic. A longitudinal observational survey was administered to a convenience sample (n = 544; mean age 52.76 y.o., SD = 15.11; females 46.69%) from the Italian general population. A two-waves mediation model-a structural equation model technique-was used. The survey was part of a larger international project ( https://osf.io/qy65b/ ). The model highlighted that the conspiracy beliefs about COVID-19 had a negative effect on the satisfaction with medicine and science (ß = - 0.13, se = 0.03, p < .001). The latter, in turn, had a positive effect on vaccine confidence (ß = 0.10, se = .05, p < .001). Interestingly, the effect of conspiracy beliefs on vaccine confidence was completely mediated by the scientifical-medical satisfaction (ß = - 0.02, se = 0.01, p < .05). These results highlight how the scientifical-medical satisfaction can fully mediate the relationship between conspiracy beliefs about COVID-19 and vaccine confidence. These findings about vaccine hesitancy and confidence and disclose have implications for psychological and social interventions that could promote vaccine confidence by targeting the satisfaction with science and medicine.

The influence of visual illusion perception on numerosity estimation could be evolutionarily conserved: exploring the numerical Delboeuf illusion in humans (Homo sapiens) and fish (Poecilia reticulata).

Discriminating between different quantities is an essential ability in daily life that has been demonstrated in a variety of non-human vertebrates. Nonetheless, what drives the estimation of numerosity is not fully understood, as numerosity intrinsically covaries with several other physical characteristics. There is wide debate as to whether the numerical and spatial abilities of vertebrates are processed by a single magnitude system or two different cognitive systems. Adopting a novel approach, we aimed to investigate this issue by assessing the interaction between area size and numerosity, which has never been conceptualized with consideration for subjective experience in non-human animals. We examined whether the same perceptual biases underlying one of the best-known size illusions, the Delboeuf illusion, can be also identified in numerical estimation tasks. We instructed or trained human participants and guppies, small teleost fish, to select a target numerosity (larger or smaller) of squares between two sets that actually differed in their numerosity. Subjects were also presented with illusory trials in which the same numerosity was presented in two different contexts, against a large and a small background, resembling the Delboeuf illusion. In these trials, both humans and fish demonstrated numerical biases in agreement with the perception of the classical version of the Delboeuf illusion, with the array perceived as larger appearing more numerous. Thus, our results support the hypothesis of a single magnitude system, as perceptual biases that influence spatial decisions seem to affect numerosity judgements in the same way.

Relationships between personality traits and disordered eating among Chinese female exercisers: the role of symptoms of exercise dependence and obsessive-compulsiveness.

BACKGROUND: Although numerous studies have examined associations between personality traits and eating disorders in females, few studies have been conducted on female exercisers. Given the high risk of disordered eating in female exercisers, this study investigated the associations between the Big Five personality traits and disordered eating in female exercisers, and further explored the potential mediators, namely exercise dependence symptoms, and obsessive-compulsive symptoms underlying this association. METHODS: A total of 295 female exercisers aged between 18 to 67 years (M =  22.11, SD =  6.65) participated in this study. RESULTS: Negative and statistically significant correlations between conscientiousness (r = - 0.17, p < 0.01), emotional stability (r = - 0.27, p < 0.001) and agreeableness (r = - 0.18, p < 0.01) and disordered eating were observed in our sample of female exercisers. The multiple mediation analyses revealed that exercise dependence symptoms and obsessive-compulsive symptoms mediate the relationship between conscientiousness (ß = 0.016, CI = [0.003, 0.031]), emotional stability (ß = -0.012, CI = [- 0.028, - 0.002]), and disordered eating in female exercisers, whereas obsessive-compulsive symptoms (ß = - 0.041, CI = [- 0.088, - 0.001]) but not exercise dependence symptoms are a mediator of the relationship between agreeableness and disordered eating. CONCLUSIONS: Our findings can be used to improve the screening procedures for eating disorders in female exercisers as they contribute to a better understanding of the psychological mechanisms that underlie the associations between the Big Five personality traits and disordered eating.

Only a few studies have examined the associations between personality traits and disordered eating in female exercisers which, in turn, limits our current knowledge about this research topic. Given the high risk of disordered eating in female exercisers, this study investigated the associations between the Big Five personality traits (i.e., extraversion, agreeableness, conscientiousness,  emotion stability, and openness to experience) and disordered eating in female exercisers, and further explored the potential mediators, namely exercise dependence symptoms and obsessive­compulsive symptoms underlying this association. A total of 295 female exercisers aged between 18 to 67 years participated in this study. We found that in female exercisers, the level of conscientiousness, emotional stability, and agreeableness are significantly and negatively associated with the level of disordered eating. Additionally, emotional stability and conscientiousness were related to exercise dependence and obsessive­compulsive symptoms among female exercisers and could lead to disordered eating. These findings can be used to improve screening procedures for eating disorders in female exercisers as they contribute to a better understanding of the psychological mechanism underlying the associations between the Big Five personality traits and disordered eating.

Guilt Feelings in Obsessive Compulsive Disorder: An Investigation between Diagnostic Groups.

Guilt plays a role in various forms of psychopathology. However, different types of guilt might be involved in different mental disorders. Obsessive-compulsive (OC) patients are prone to a type of guilt in which the violation of an internalized moral norm is necessary and sufficient, whereas data suggest that depression might be linked to more interpersonal types of guilt. However, the extent to which a specific guilt phenomenology is involved in each condition is yet to be determined. Here we assessed the association between different types of guilt and different diagnostic groups. Two clinical samples (33 OCD and 35 non-OCD) filled in the Moral Orientation Guilt Scale (MOGS) along with other OCD and depression measures. Regression was employed to test group differences in the MOGS subscales and to test the influence of MOGS subscales on OCD and depression levels. Results confirm that different types of guilt might be implicated in different psychopathological conditions. Specifically, moral norm violation guilt is more present in OC patients than in other disorders. Depression seems to be associated with different guilt feelings depending on the psychopathological condition, specifically in non-OC patients, with types of guilt involving a "victim", supporting the accounts viewing interpersonal guilt as involved in the emergence of depressive symptomatology and hyper-altruistic behavior as a vulnerability factor for depression.

Doing Experimental Psychological Research from Remote: How Alerting Differently Impacts Online vs. Lab Setting.

Due to pandemic-imposed restrictions on lab-based research, we have recently witnessed a flourishing of online studies in experimental psychology, based on the collection of fine behavioral measures such as reaction times (RTs) and accuracy. However, it remains unclear whether participants' alerting levels may have a different impact on behavioral performance in the online vs. lab setting. In this work we administered online and in-lab the dynamic temporal prediction (DTP) task, which requires an implicit modulation of participants' alerting by alternating experimental conditions implying either slower or faster response rates. We then compared data distribution, RTs, accuracy, and time-on-task effects across the adult lifespan between the settings. We replicated online and across the whole age range considered (19-69 y) all the task-specific effects already found in-lab (both in terms of RTs and accuracy) beyond the overall RTs delay typical of the online setting. Moreover, we found an interaction between the setting and task-specific features so that participants showed slower RTs only in experimental conditions implying a less urgent response rate, while no RTs delay and a slight accuracy increase emerged in faster conditions. Thus, the online setting has been shown to be methodologically sound in eliciting comparable effects to those found in-lab. Moreover, behavioral performance seems to be more sensitive to task-induced alerting shifts in the online as compared to the lab setting, leading to either a heightened or reduced efficiency depending on a faster or slower response rate of experimental conditions, respectively.

Measurement invariance of the Patient Health Questionnaire (PHQ-9) and Generalized Anxiety Disorder scale (GAD-7) across four European countries during the COVID-19 pandemic.

BACKGROUND: The Patient Health Questionnaire (PHQ-9) and Generalized Anxiety Disorder scale (GAD-7) are self-report measures of major depressive disorder and generalised anxiety disorder. The primary aim of this study was to test for differential item functioning (DIF) on the PHQ-9 and GAD-7 items based on age, sex (males and females), and country. METHOD: Data from nationally representative surveys in UK, Ireland, Spain, and Italy (combined N = 6,054) were used to fit confirmatory factor analytic and multiple-indictor multiple-causes models. RESULTS: Spain and Italy had higher latent variable means than the UK and Ireland for both anxiety and depression, but there was no evidence for differential items functioning. CONCLUSIONS: The PHQ-9 and GAD-7 scores were found to be unidimensional, reliable, and largely free of DIF in data from four large nationally representative samples of the general population in the UK, Ireland, Italy and Spain.

On the Implementation of Computerized Adaptive Observations for Psychological Assessment.

The use of observational tools in psychological assessment has decreased in recent years, mainly due to its personnel and time costs, and researchers have not explored methodological innovations like adaptive algorithms in observational assessment. In the present study, we introduce the behavior-driven observation procedure to develop, test, and implement observational adaptive instruments. In Study 1, we use a preexisting observational checklist to evaluate nonverbal behaviors related to psychotic symptoms and to specify the adaptive algorithm's model. We fit the model to observational data collected from 114 participants. The results support the model's goodness of fit. In Study 2, we use the estimated model parameters to calibrate the adaptive procedure and test the algorithm for accuracy and efficiency in adaptively reconstructing 58 nonadaptively collected response patterns. The results show the algorithm's good accuracy and efficiency, with a 40% average reduction in the number of administered items. In Study 3, we used real raters to test the adaptive checklist built with behavior-driven observation. The results indicate adequate intrarater agreement and good consistency of the observed response patterns. In conclusion, the results support the possibility of using behavior-driven observation to create accurate and affordable (in terms of resources) observational assessment tools.

Stigma and attitudes towards restrictive practices in psychiatry among psychology students: a network and path analysis study in an Italian sample.

Background: People suffering from mental disorders are affected by public stigma in many areas of daily life, including mental health services. Stigma among mental health professionals needs to be addressed.Aims: This study explores the path leading to attitudes toward seclusion and restraint practices among future mental health professionals, considering the complex interplay among demographic variables, personality, stigma, and experience in psychiatric services.Method: Network analysis and Structural Equation Modeling were used to explore 1512 Psychology students. The survey instrument included a form for demographic and academic variables, the Attribution Questionnaire-9, the Ten Items Personality Inventory, and few questions exploring attitudes toward open-door and restraint-free policies in Psychiatry.Results: The personality trait of Openness and previous experience with psychiatric patients resulted to play a positive effect on stigma. Openness was also associated with a better disposition towards restraint-free policies. Conversely, higher levels of stigma predicted a negative attitude toward no restraint, decreasing the positive effect of Openness.Conclusions: In conclusion, some personality traits may be associated with lower levels of stigma and a more open view about treatment policies in Psychiatry. Direct educational or professional experience with patients suffering from mental disorders may be a crucial factor in reducing the risk of stigmatizing attitudes in future professionals.

Exercise addiction in athletes: Comparing two assessment instruments and willingness to stop exercise after medical advice.

Exercise is overwhelmingly beneficial for physical and mental health, but for some people exercise addiction (EA) can develop and negatively impact an individual. This study sought to (a) compare the latent structure of two instruments assessing EA and (b) examine differences in attitudes toward stopping exercise, if required to on medical grounds, among exercise-addicted and non-addicted athletes. In a cross-sectional study, 1,011 athletes competing at different levels completed an anonymous on-line survey. The survey contained Exercise Dependence Scale-Revised (EDS-R), Exercise Addiction Inventory (EAI), and questions on adherence to medical prescriptions to stop exercise. We tested the latent structure of EDS-R and EAI with multigroup confirmatory factor analyses (CFA), across gender and competition level. Finally, we measured the difference of athletes' attitudes toward stopping exercise, if prescribed by a physician. Both instruments showed good fit indexes, even across gender. CFAs on EAI scores showed some violations of measurement invariance across competition level (ΔCFI = .03; ΔRMSEA = .02). On the contrary, CFAs on EDS-R scores did not show invariance violations across competition level (ΔCFI = <.01; ΔRMSEA = <.01). Finally, athletes who reached thresholds for exercise addiction, by means of EDS-R, were more prone to not follow medical prescriptions to cease exercise, independently of the competition level. These results suggest that athletes' answers on the EDS-R seem to be less affected by competition level, compared to EAI. Moreover, EDS-R outcomes could be used to identify individuals who may be unlikely to cease exercise for medical reasons, independently of their competition level. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Assessing the quality of studies in meta-research: Review/guidelines on the most important quality assessment tools.

Systematic reviews and meta-analyses pool data from individual studies to generate a higher level of evidence to be evaluated by guidelines. These reviews ultimately guide clinicians and stakeholders in health-related decisions. However, the informativeness and quality of evidence synthesis inherently depend on the quality of what has been pooled into meta-research projects. Moreover, beyond the quality of included individual studies, only a methodologically correct process, in relation to systematic reviews and meta-analyses themselves, can produce a reliable and valid evidence synthesis. Hence, quality of meta-research projects also affects evidence synthesis reliability. In this overview, the authors provide a synthesis of advantages and disadvantages and main characteristics of some of the most frequently used tools to assess quality of individual studies, systematic reviews, and meta-analyses. Specifically, the tools considered in this work are the Newcastle-Ottawa scale (NOS) and the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) for observational studies, the Consolidated Standards of Reporting Trials (CONSORT), the Jadad scale, the Cochrane risk of bias tool 2 (RoB2) for randomized controlled trials, the Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) and the Assessment of Multiple Systematic Reviews 2 (AMSTAR2), and AMSTAR-PLUS for meta-analyses. WHAT IS ALREADY KNOWN?: The informativeness and quality of evidence synthesis inherently depend on the quality of what has been pooled into meta-research projects. Beyond the quality of included individual studies, only a methodologically correct process, in relation to systematic reviews and meta-analyses themselves, can produce a reliable and valid evidence synthesis. WHAT IS NEW?: In this overview, the authors provide a synthesis of advantages and disadvantages and main characteristics of some of the most frequently used tools to assess quality of individual studies, systematic reviews, and meta-analyses. POTENTIAL IMPACT: This overview serves as a starting point and a brief guide to identify and understand the main and most frequently used tools for assessing the quality of studies included in meta-research. The authors here share their experience in publishing several meta-research-related articles covering different areas of medical sciences.

Increasing referrals to emergency department for psychiatric consultation and treatment among 50,056 adolescents and young adults: Predictors and implications.

Objectives: To identify predictors and time trends over 10 years of psychiatric consultation or treatment in adolescents and young adults referring to Emergency Department (ED). Methods: Real-world cohort data from 50,056 adolescents and young adults referring 105,596 times to ED between 2007 and 2016. We tested whether gender, age, triage code (red, yellow, green, white with decreasing severity), and referral modality predicted primary (psychiatric consultation) or secondary outcomes (anxiolytic treatment, sedative treatment, psychiatric admission), and whether these outcomes increased over the last 10 years. Results: Mean age was 19.57(SD = 2.52), female percentage was 48.77%. Overall, 6.93% underwent psychiatric consultation, treatment, or admission. Among 2,547 adolescents and young adults undergoing a psychiatric consultation, 58.07% had either yellow or red triage code, and 47.2% were brought by ambulance. Female gender predicted psychiatric consultation and anxiolytic treatment, male gender predicted sedative treatment, suggesting gender differences in help-seeking behaviors. Older age predicted all outcomes. Severe triage presentation and being brought by ambulance increased the risk of primary and secondary outcomes. Psychiatric consultation (1.77% to 3.64%), anxiolytic (3.04% to 6.15%), or admission (0.40% to 0.98%) roughly doubled, and sedative (0.27% to 1.23%) treatment had a four-fold increase from 2007 to 2016. Conclusions: Among adolescents and young adults aged 15 to 24 years old ED appears to be necessary for young help-seeking subjects given the severe presentations and the increasing number of adolescents referring to ED. More studies should assess whether ED might be helpful in detecting subjects with sub-threshold or early psychiatric symptoms, or at risk for severe mental illness.

Longitudinal Course of Depressive, Anxiety, and Posttraumatic Stress Disorder Symptoms After Heart Surgery: A Meta-Analysis of 94 Studies.

OBJECTIVE: This study aimed to analyze the longitudinal course of depression, anxiety, and posttraumatic stress disorder (PTSD) symptoms in patients with cardiac disease after heart surgery (HS). METHODS: We conducted a systematic review and random-effects meta-analysis of cohort studies in patients undergoing HS, measuring anxiety, depressive, and PTSD symptoms before and at least 30 days thereafter. Subgroup and meta-regression analyses, investigation of publication bias, and quality assessment were undertaken. RESULTS: We included 94 studies relating to 15,561 patients. HS included coronary artery bypass graft surgery, valve replacement, implantable cardioverter-defibrillator placement, left ventricular assist device placement, heart transplantation, and other types of HS. Across studies, symptoms of depression (g = 0.32; 95% confidence interval [CI] = 0.25 to 0.39; p < .001) and anxiety improved after HS (g = 0.52; 95% CI = 0.43 to 0.62; p < .001), whereas PTSD symptoms worsened (g = -0.42; 95% CI = -0.80 to -0.04; p = .032). The reduction of depression and anxiety levels was more pronounced for patients with underlying coronary artery disease and heart failure and persisted for 1 year after HS, whereas the increase in PTSD symptoms returned to baseline after 6 months. Depression improvement was inversely associated with older age, diabetes, hypertension, and dyslipidemia and positively with baseline heart failure. No additional clinical or demographic variables were associated with the course of anxiety symptoms. Quality of included studies was low overall. Publication bias was nonsignificant. CONCLUSIONS: Depressive and anxiety symptoms improve for 1 year after HS, whereas PTSD symptoms might worsen. Older patients and those with metabolic comorbidities, valve disease, or ventricular arrhythmias are at higher risk for continued depressive and anxiety symptoms and should be monitored closely.

The Italian COVID-19 Psychological Research Consortium (IT C19PRC): General Overview and Replication of the UK Study.

The COVID-19 pandemic represents a major stressor for the psychological health of people worldwide. In the UK, the COVID19-Psychological Research Consortium Study (C19PRC) launched to evaluate the psychological impact of COVID-19 in the general population and its implications. The project was then extended to Italy and several other countries. This article provides an overview of the Italian C19PRC study and its replication of two specific findings from the UK C19PRC. In the first part, the relationship between anxiety and somatic symptomatology is examined. In the second part, we analyze the association between several factors and psychological health outcomes: depression/anxiety, traumatic stress, COVID-19 anxiety. In line with the study conducted in the UK, an online survey was administered to the adult Italian general population. The sample included 1038 respondents (age, mean = 49.94, SD = 16.14, 51.15% females) taken from four regions: Lombardia, Veneto, Lazio, and Campania. The relationship between predictors and outcomes was evaluated by means of logistic regression models. Somatic indices showed a positive association with anxiety, worse somatic symptoms were associated with mourning a loss of a beloved one due to COVID-19 and with precarious health conditions. Females showed a higher incidence of psychological issues. No differences in anxiety, depression, and traumatic stress were found across regions but the Campania region showed the most severe somatic symptomatology. In the second analysis, the factors associated with more severe psychological outcomes (i.e., anxiety and/or depression, traumatic stress, and COVID-19 related anxiety) were younger age, the presence of minors in the household, traumatic stressors, and precarious health conditions. No differences across regions emerged. The Italian results correspond to the UK findings for anxiety, depression, and traumatic stress. Both in the UK and Italy, the factors associated with worse psychological health were gender (female), younger age, having children, pre-existing health issues (both for oneself or someone close), and the moderate/high perceived risk of contracting COVID-19 within one month. In Italy, unlike the UK, lower household income and having (had) COVID-19 were not associated with poorer mental health. The psychological impact of COVID-19 can last for months; future research should explore all aspects of the psychological burden of COVID-19 in order to implement psychological interventions and promote psychological health.

Emergency department and early detection of adolescents and young adults at risk of developing mental disorders: an exploratory study.

The objective of this study is to assess the potential role of Emergency Department (ED) for early detection of mental disorders. Two cohorts (6,759 subjects aged 14 to 24 accessing ED, 165 subjects with mental disorders) were matched by ID and merged. Primary outcome was the proportion of individuals accessing ED before receiving a diagnosis of mental disorder in Mental Health Service (MHS). Secondary outcomes were age of first access to ED in subjects later accessing to MHS, and time from first ED access to receiving a diagnosis of mental disorder at MHS. We assessed whether gender, severity of ED presentation, and number of ED accesses predicted primary outcome. Almost half of individuals who later developed mental disorders (49.7%) accessed ED before access to MHS. Mean age of first ED contact among those later accessing to MHS was 17.34 (2.1), and ED access preceded access to MHS by 3.68 (2.11) years. Gender and severity of ED presentation were not associated with the access to MHS, while higher number of ED accesses was associated with later access to MHS (OR range: 1.17-1.36, p<0.05). Despite its limitations, the present study suggests ED might represent a contact point for individuals who later access to MHS. Future early detection programs should involve ED in their outreach and screening approaches. Additional studies are needed to assess if subjects earlier accessing to ED are at risk-of-developing or already suffer from a mental disorder, and to validate screening instruments specifically designed for ED.