Impact of psychological intervention on anxiety, depression, and post-traumatic stress disorder: results from a longitudinal study of hospitalized Covid-19 patients.

OBJECTIVE: Hospitalization for Covid-19 has been recognized as a potentially traumatic experience. This longitudinal cohort study assessed the impact of psychological intervention for Covid-19 patients on anxiety, depression, and post-traumatic stress disorder (PTSD). MATERIALS AND METHODS: Of 386 Covid-19 patients enrolled, 127 completed HADS and PCL-5 questionnaires at 2 months (T1), 6 months (T2) and 12 months (T3) after hospital discharge. Between T1 and T2, patients were offered the opportunity to receive psychological intervention: 92 did not request any psychological support (No support group), 15 received only one psychological consultation (Consultation group) and 20 received longer psychological support (Support group). Mixed ANOVAs were used to assess the psychological symptoms of the 3 Groups over Time. RESULTS: The No support group reported lower anxiety, depression, and PTSD than the other two groups. Anxiety and PTSD increased over time across groups. A Time x Group interaction was found for depression (F(2.124)=3.72, p<.05, pη2=.06). The Support group reported a decrease in depression from T1 (M=7.85) to T2 (M=7.05) and an increase from T2 to T3 (M=8.05), although not significant. The No support (T1 M=2.84; T3 M=4.36; p<.001) and the Consultation groups (T1 M=4.73; T3 M=6.33; p<.05) reported an increase in depression from T1 to T3. CONCLUSIONS: Psychological interventions were appropriately allocated to patients with more severe symptoms. Most of the patients did not request psychological intervention. Long-term psychological support may have helped Covid-19 patients to contain depressive symptoms over time.

Quality of Life Changes in Early-Onset Multiple Sclerosis: A 4-Year Follow-Up Study.

This study investigates longitudinal changes in health-related quality of life (HRQoL) in early-onset multiple sclerosis (MS) patients and explores the impact of disease activity (relapses) on such changes. People with MS (PwMS) onset between 12 and 25 years of age were followed longitudinally. At baseline and at year 4, patients were asked to fill the Paediatric Quality of life inventory (PedsQL). Demographic and clinical features were collected at both time points. Longitudinal within-group comparison of HRQoL total score and sub-scores was performed via paired samples t-test. The effect of relapses on the HRQoL changes over time was explored via linear mixed-effects analysis. No longitudinal changes were observed in the overall PedsQL score, nor in the physical, school and psychological functioning. An increase in the social functioning subscale (p < 0.001) and a decrease in the emotional subscale (p = 0.006) were observed. The change in social functioning, but not the one in the emotional subscale, was affected by the occurrence of relapses (p = 0.044). In conclusion, stimulating the patients to accept their emotional responses to health-related limitations, while preserving their social and relational resources seems key to the preservation of an adequate QoL over time in juvenile-onset MS.

Recovering from COVID-19: psychological sequelae and post-traumatic growth six months after discharge.

Background: Clinical and scientific evidence has shown that a range of long-lasting symptoms can persist in the post-virological period. However, little is known about the psychological sequelae of patients hospitalized for coronavirus disease 2019 (COVID-19). Objective: This study aims to assess the prevalence of anxiety-depressive symptoms, post-traumatic stress disorder (PTSD), and post-traumatic growth among patients hospitalized for COVID-19 during the first wave of the pandemic 6 months after discharge, and to identify sociodemographic and clinical factors associated with psychological outcomes. Method: This cross-sectional cohort study enrolled recovered COVID-19 patients during a multidisciplinary follow-up screening. At 6 months post-discharge, participants underwent a remote assessment with the Mini-International Neuropsychiatric Interview Plus and completed the Hospital Anxiety and Depression Scale, PTSD Checklist for DSM-5, and Post-Traumatic Growth Inventory. Descriptive and regression analyses were conducted. Results: The sample was composed of 100 patients, mainly males (72%), with a mean ± SD age of 58.7 ± 11.8 years. Regarding psychological symptoms, 34% and 24% of patients, respectively, reported anxiety and depression over the clinical threshold, and 20% met the criteria for a possible PTSD diagnosis. Psychological symptoms were associated with the presence of a mood disorder in the patient's clinical history and having received a psychological consultation after discharge. Post-traumatic growth was associated with younger age and having received a psychological consultation after discharge. Conclusions: A high prevalence of anxiety and depressive symptoms, potentially indicative for a mood or anxiety disorder, and PTSD was confirmed among COVID-19 survivors after 6 months. Anxiety and depressive symptoms and PTSD were associated with a previous diagnosis of a mood disorder and having received psychological consultation. Post-traumatic growth was associated with younger age and having received psychological consultation. Tailored psychological interventions could help to elaborate the psychological suffering and foster post-traumatic growth after a traumatic experience such as COVID-19 hospitalization. HIGHLIGHTS: A high prevalence of psychological symptoms has been observed among COVID-19 survivors 6 months after hospitalization.Tailored psychological interventions could help to contain the psychological sequelae and facilitate post-traumatic growth.

Antecedentes: La evidencia clínica y científica reciente ha demostrado que una variedad de síntomas duraderos pueden persistir incluso en el periodo post-virológico. Sin embargo, poco se sabe sobre las secuelas psicológicas de los pacientes hospitalizados por COVID-19.Objetivo: Este estudio tiene como objetivo evaluar la prevalencia de síntomas ansioso-depresivos, Trastorno de Estrés Postraumático (TEPT) y crecimiento postraumático entre pacientes hospitalizados por COVID-19 durante la primera ola de pandemia seis meses después del alta e identificar los factores socio-demográficos y clínicos asociados con los resultados psicológicos.Método: Este estudio de cohorte transversal inscribió a pacientes recuperados de COVID-19 durante un tamizaje de seguimiento multidisciplinario. A los seis meses del alta, los participantes se sometieron a una evaluación remota con la Entrevista Neuropsiquiátrica Internacional Mini Plus y completaron la Escala de Depresión y Ansiedad Hospitalaria, la Lista de chequeo-5 para Trastorno de Estrés Postraumático y el Inventario de Crecimiento Postraumático. Se condujeron análisis de regresión y descriptivos.Resultados: La muestra se compuso de 100 pacientes, principalmente varones (72%), con una edad promedio de 58.7 años (DE=11.8). En cuanto a los síntomas psicológicos, 34% y 24% de los pacientes reportaron ansiedad y depresión por encima del umbral clínico y 20% reunía los criterios para un posible diagnóstico de TEPT. Los síntomas psicológicos se asociaron con la presencia de un trastorno del ánimo en la historia clínica del paciente y el haber recibido una consulta psicológica tras el alta. El crecimiento postraumático se asoció con ser más joven y haber recibido una consulta psicológica tras el alta.`Conclusiones: Se confirmó una alta prevalencia de síntomas ansiosos y depresivos, potencialmente indicativo de un trastorno del estado de ánimo y TEPT entre los sobrevivientes al COVID-19 después de seis meses. Los síntomas ansiosos y depresivos y el TEPT se asociaron con un diagnóstico previo de un trastorno del ánimo y haber recibido consulta psicológica. Se encontró que el crecimiento postraumático se asociaba con ser más joven y haber recibido consulta psicológica. Las intervenciones psicológicas "a la medida" podrían ayudar a elaborar el sufrimiento psicológico y fomentar el crecimiento postraumático tras una experiencia traumática como la hospitalización por COVID-19.

Female gender is associated with long COVID syndrome: a prospective cohort study.

OBJECTIVE: We explored the association between female gender and long COVID syndrome, defined as persistence of physical and/or psychological symptoms for more than 4 weeks after recovery from acute COVID-19 disease. The secondary aim was to identify predictors of long COVID syndrome by multivariable logistic regression analysis. METHODS: This was a single-centre prospective cohort study conducted at San Paolo Hospital in Milan, Italy. We enrolled adult patients who were evaluated at the post-COVID outpatient service of our Infectious Diseases Unit between 15 April 2020 and 15 December 2020. Participants were individuals who had clinically recovered from COVID-19 and in whom virological clearance had occurred. Previous infection by SARS-CoV-2 was microbiologically documented by positivity using a reverse-transcriptase polymerase chain reaction (RT-PCR) assay of nasopharyngeal swab. All enrolled patients underwent blood tests and a comprehensive medical examination at follow-up. Individuals were interviewed about resolved and persisting symptoms and were asked to fill in two questionnaires to allow assessment of the Hospital Anxiety and Depression symptoms (HADS) score and of the Impact of Event Scale-Revised (IES-R) score. RESULTS: A total of 377 patients were enrolled in the study. The median time from symtpom onset to virological clerance was 44 (37-53) days. A diagnosis of long COVID syndrome was made in 260/377 (69%) patients. The most common reported symptoms were fatigue (149/377, 39.5%), exertional dyspnoea (109/377, 28.9%), musculoskeletal pain (80/377, 21.2%) and "brain fog" (76/377, 20.2%). Anxiety symptoms were ascertained in 71/377 (18.8%) individuals, whereas 40/377 (10.6%) patients presented symptoms of depression. Post-traumatic stress disorder (defined by a pathological IES-R score) was diagnosed in one-third of patients (85/275, 31%). Female gender was independently associated with long COVID syndrome at multivariable analysis (AOR 3.3 vs. males, 95% CI 1.8-6.2, p < 0.0001). Advanced age (adjusted (A)OR 1.03 for 10 years older, 95% CI 1.01-1.05, p 0.01) and active smoking (AOR 0.19 for former smokers vs. active smokers, 95% CI 0.06-0.62, p 0.002) were also associated with a higher risk of long COVID, while no association was found between severity of disease and long COVID (AOR 0.67 for continuous positive airway pressure (CPAP)/non-invasive mechanical ventilation (NIMV)/orotracheal intubation (OTI) vs. no 02 therapy, 95% CI 0.29-1.55, p 0.85). DISCUSSION: Factors that were found to be associated with a higher risk of developing "long COVID" syndrome were female gender, older age and active smoking, but not severity of the acute disease. Individuals affected by SARS-CoV-2 infection with the aforementioned features should be early identified and involved in follow-up programmes.

Psychological outcomes after hospitalization for COVID-19: data from a multidisciplinary follow-up screening program for recovered patients.

Patients who are hospitalized for coronavirus disease 2019 (COVID-19) face an extremely stressful experience that might challenge their mental health. The study aims to describe the psychological condition of recovered patients, focusing on anxiety and depression symptoms, as well as post-traumatic stress. All the recovered COVID-19 patients who accessed to a multidisciplinary follow-up screening program scheduled within two months after their hospital discharge were included. As far as the psychological assessment, patients completed the Hospital Anxiety and Depression Scale and the Impact of Event Scale- Revised for post-traumatic stress. Socio-demographic and clinical data (days of hospitalization, intensity of received care, and number of supportive sessions with the hospital psychologist after the hospitalization) were collected. Descriptive, correlation and regression analyses were conducted. The sample includes 261 patients (68.2% men), aged between 23 and 90 (mean=58.9 st. dev=13.3). High numbers of patients reported anxiety (28%) and depression symptoms (17%), as well as post-traumatic stress (36.4%). Impaired outcomes were associated with female gender, while patient's age was found to be negatively correlated with anxiety symptoms. 13.8% of patients underwent a psychological visit and 6.1% of them were taken in charge for psychological support. Few months after hospital discharge, individuals recovered by COVID-19 reported negative consequences on their mental health. Understanding the impact that COVID-19 and hospitalization have on recovered patients may provide insights about how to develop an effective psychological intervention to help them deal with such psychological distress and prevent further psychopathological effects.

Correction to: Normative values of the Rao's Brief Repeatable Battery in an Italian young adolescent population: the influence of age, gender, and education.

The published version of this article unfortunately contained a mistake in Table 2.

Normative values of the Rao's Brief Repeatable Battery in an Italian young adolescent population: the influence of age, gender, and education.

AIM: The Brief Repeatable Battery of Neuropsychological Tests (BRB) is frequently used to estimate cognitive function in adults with multiple sclerosis (MS), while it has been included in few studies on young MS, also because of the absence of normative values. We aim to evaluate the impact of age, gender, and education on BRB scores in a young adolescent population. METHODS: We administered the BRB to 76, 14-to-17-year-old, healthy subjects. Linear regression models were used to assess the impact of age, gender, and education on sub-test scores. When statistically significant (p < 0.05), we used the regression coefficient to correct the raw scores. RESULTS: Younger age was associated with better performance on SPART (ß = - 2.54; p < 0.05) and SPART-D (ß = - 1.06; p < 0.05). Male gender was associated with better performance on SPART (ß = 3.40; p < 0.05), SPART-D (ß = 1.41; p < 0.05), PASAT-3 (ß = 5.58; p < 0.05), and PASAT-2 (ß = 5.07; p < 0.05). Educational attainments were associated with better performance on SPART (ß = 3.23; p < 0.05) and SPART-D (ß = 1.28; p < 0.05). Cut-off points were suggested at the 5th lowest percentile. INTERPRETATION: Age, gender, and education must be accounted for when applying the BRB to young population. Present results can prove useful for future clinical and research applications in adolescent MS patients.

Health-Related Coping and Social Interaction in People with Multiple Sclerosis Supported by a Social Network: Pilot Study With a New Methodological Approach.

BACKGROUND: Social media are a vital link for people with health concerns who find in Web communities a valid and comforting source for information exchange, debate, and knowledge enrichment. This aspect is important for people affected by chronic diseases like multiple sclerosis (MS), who are very well informed about the disease but are vulnerable to hopes of being cured or saved by therapies whose efficacy is not always scientifically proven. To improve health-related coping and social interaction for people with MS, we created an MS social network (SMsocialnetwork.com) with a medical team constantly online to intervene promptly when false or inappropriate medical information are shared. OBJECTIVE: The goal of this study was to assess the impact of SMsocialnetwork.com on the health-related coping and social interaction of people with MS by analyzing areas of interest through a Web-based survey. METHODS: Referring to previous marketing studies analyzing the online platform's role in targeted health care, we conducted a 39-item Web-based survey. We then performed a construct validation procedure using a factorial analysis, gathering together like items of the survey related to different areas of interest such as utility, proximity, sharing, interaction, solving uncertainty, suggestion attitude, and exploration. RESULTS: We collected 130 Web-based surveys. The areas of interest analysis demonstrated that the users positively evaluated SMsocialnetwork.com to obtain information, approach and solve problems, and to make decisions (utility: median 4.2); improve feeling of closeness (proximity: median 5); catalyze relationships and text general personal opinions (sharing: median 5.6); get in touch with other users to receive innovative, effective, and practical solutions (interaction, solving uncertainty, and suggestion attitude medians were respectively: 4.1, 3, and 3); and share information about innovative therapeutic approaches and treatment options (suggestion attitude: median: 3.3). CONCLUSIONS: SMsocialnetwork.com was perceived by users to be a useful tool to support health-related coping and social interaction, and may suggest a new kind of therapeutic alliance between physicians and people with MS.