Anxiety and Depression during the Second Wave of the COVID-19 Pandemic: The Role of Coping Strategies.

BACKGROUND: Evidence suggests increased anxious-depressive symptoms in the general population during the COVID-19 pandemic, also in its second wave. High symptom variability across individuals suggests that risk and protective factors, including coping strategies, can play a mediating role. METHODS: General Anxiety Disorder-7, Patient Health Questionnaire-9, and Brief-COPE questionnaires were administered to people attending a COVID-19 point-of-care. Univariate and multivariate methods were used to test the association of symptoms with risk and protective factors. RESULTS: A total of 3509 participants (27.5% with moderate-severe anxiety; 12% with depressive symptoms) were recruited. Sociodemographic and lifestyle factors, including age, sex, sleep, physical activity, psychiatric treatments, parenthood, employment, and religiosity were associated with affective symptoms. Avoidant (self-distraction, venting, behavioral disengagement) and approach (emotional support, self-blame but not positive reframing and acceptance) coping strategies predicted greater anxiety. Avoidant strategies, including venting, denial, behavioral disengagement, substance use, and self-blame, and the humor strategy were associated with more severe depressive symptoms, while the planning predicted the opposite. CONCLUSIONS: Coping strategies, in addition to socio-demographic and life-habit factors, could have contributed to modulating anxious and depressive symptoms during the second-wave of the COVID-19 pandemic, thus advocating for interventions aimed at promoting positive coping strategies to reduce the psychosocial toll of the pandemic.

Altered brain regional homogeneity is associated with depressive symptoms in COVID-19.

BACKGROUND: COVID-19 is an infectious disease that has spread worldwide in 2020, causing a severe pandemic. In addition to respiratory symptoms, neuropsychiatric manifestations are commonly observed, including chronic fatigue, depression, and anxiety. The neural correlates of neuropsychiatric symptoms in COVID-19 are still largely unknown. METHODS: A total of 79 patients with COVID-19 (COV) and 17 healthy controls (HC) underwent 3 T functional magnetic resonance imaging at rest, as well as structural imaging. Regional homogeneity (ReHo) was calculated. We also measured depressive symptoms with the Patient Health Questionnaire (PHQ-9), anxiety using the General Anxiety Disorder 7-item scale, and fatigue with the Multidimension Fatigue Inventory. RESULTS: In comparison with HC, COV showed significantly higher depressive scores. Moreover, COV presented reduced ReHo in the left angular gyrus, the right superior/middle temporal gyrus and the left inferior temporal gyrus, and higher ReHo in the right hippocampus. No differences in gray matter were detected in these areas. Furthermore, we observed a negative correlation between ReHo in the left angular gyrus and PHQ-9 scores and a trend toward a positive correlation between ReHo in the right hippocampus and PHQ-9 scores. LIMITATIONS: Heterogeneity in the clinical presentation in COV, the different timing from the first positive molecular swab test to the MRI, and the cross-sectional design of the study limit the generalizability of our findings. CONCLUSIONS: Our results suggest that COVID-19 infection may contribute to depressive symptoms via a modulation of local functional connectivity in cortico-limbic circuits.

Evaluation of peritraumatic distress at the point of care: A cross-sectional study.

BACKGROUND: COVID-19 related peritraumatic distress has been investigated in the general population with contrasting results probably due to the perceived risk of developing COVID-19. Our study aims to investigate this condition in individuals with ascertained or probable SARS-CoV-2 exposure. METHODS: The Coronavirus Peritraumatic Distress Index (CPDI) was administered to people attending a COVID-19 point of care. The sample was stratified for perceived risk in SARS-CoV-2 positive cases, close contacts, case relatives, undergoing screening subjects, and symptomatic subjects. RESULTS: 1463 subjects participated, and with a mean CPDI Score of 28.2 (SD 16.9). CPDI Scores in SARS-CoV-2 positive cases were significantly higher than case relatives (p = 0.02). Multiple logistic regression revealed that having had work changes (p = 0.001), night sleep changes (p < 0.001), physical activity reduction (p = 0.002), alcohol consumption changes (p = 0.003), and at least one relative lost to COVID-19 (p < 0.001) independently predicted higher CPDI Scores. Male sex (p < 0.001), age ≥ 35 years (p < 0.001), higher educational level (p = 0.002), night sleep >7 hours (p = 0.002), and being physically active (p = 0.018) were identified as protective factors. LIMITATIONS: Cross-sectional design and the regional recruitment area limit the generalizability of results. CONCLUSIONS: Mean CPDI values were above the threshold for medium grade peritraumatic distress, with greater CPDI Scores in subjects who tested positive for SARS-CoV-2, compared to family members or caregivers without a clear indication to undergo the swab. Specific demographics, physical and mental health events could help in identifying individuals at greater risk of COVID-19 related peritraumatic distress that may benefit from early treatment.