Brain functional connectivity differences between responders and non-responders to sleeve gastrectomy.

PURPOSE: To compare resting-state functional connectivity (RSFC) of obese patients responders or non-responders to sleeve gastrectomy (SG) with a group of obese patients with no past medical history of metabolic or bariatric surgery. METHODS: MR images were acquired at 1.5 Tesla. Resting-state fMRI data were analyzed with statistical significance threshold set at p < 0.05, family-wise error (FWE) corrected. RESULTS: Sixty-two subjects were enrolled: 20 controls (age range 25-64; 14 females), 24 responders (excess weight loss > 50%; age range 23-68; 17 females), and 18 non-responders to sleeve gastrectomy (SG) (excess weight loss < 50%; age range 23-67; 13 females). About within-network RSFC, responders showed significantly lower RSFC with respect to both controls and non-responders in the default mode and frontoparietal networks, positively correlating with psychological scores. Non-responders showed significantly higher (p < 0.05, family-wise error (few) corrected) RSFC in regions of the lateral visual network as compared to controls. Regarding between-network RSFC, responders showed significantly higher anti-correlation between executive control and salience networks (p < 0.05, FWE corrected) with respect to both controls and non-responders. Significant positive correlation (Spearman rho = 0.48, p = 0.0012) was found between % of excess weight loss and executive control-salience network RSFC. CONCLUSION: There are differences in brain functional connectivity in either responders or non-responders patients to SG. The present results offer new insights into the neural correlates of outcome in patients who undergo SG and expand knowledge about neural mechanisms which may be related to surgical response.

The psychological impact of the covid-19 pandemic on radiotherapy cancer patients.

In March 2020, the World Health Organization (WHO) characterized the outbreak of the coronavirus disease 2019 (COVID-19) as a pandemic. The aim of this study was to evaluate the psychological impact of the COVID-19 pandemic on cancer patients undergoing radiotherapy. Were enrolled 210 patients in treatment and in follow-up who had access to the Radiation Oncology Department of the Campus Bio-Medico University Hospital Foundation between April and May 2020. The sample was subjected to structured interview and validated questionnaires. 37% of patients showed significant levels of distress; depressive symptoms were reported by 22.4% of patients and 99% of sample had clinically significant anxiety symptoms. All patients anxiety worsened during the COVID-19 pandemic (p=< 0.001). Patients on active treatment had higher levels of distress (3.5 vs 2.6; p = 0.04) and anxiety (3.5 vs 2.6; p = 0.04). Lung cancer patients appeared to be more afraid of COVID-19 than other patients (24.2 vs 22.2). This study highlights the presence of clinically significant anxiety in 99% of sample. This conclusion reflects the condition of emotional distress present during the pandemic which makes it necessary to treat patients in a multidisciplinary perspective that includes psychological support in the care plan.

Resilience and psychological impact on Italian university students during COVID-19 pandemic. Distance learning and health.

COVID-19 epidemic has been spreading in the world causing strong psychological pressure for the global population. Quarantine has huge impact and can cause considerable psychological stress. The study aims to identify psychological stress, emotional changes, approach to studies, resilience skills related to the experience of the COVID-19 pandemic in a sample of university students. A sample of university students from the Campus Bio Medico University of Rome was studied. The participants responded to an online questionnaire packet that included socio-demographic information, COVID-19 impact on emotions and on university life, perceived stress (PSS-10) and resilience skills (RS-14). We received 955 responses. The respondents experienced an increase in perceived stress in 89.4% of cases (66% stress moderate and 23.4% high). Moreover, 54.4% of students reported decrease in attention span and difficulty in studying with consequent concern about the exam outcomes (55%). Resilience skills positively affect stressful events and in particular the COVID-19 impact on study and interpersonal relationships. The study shows a psychological impact of the Covid-19 emergency on college students. Stress significantly decreases learning and negatively affects psychological well-being of students. Resilience skills were a protective factor to overcome difficulties learning.

The psychological impact of COVID-19 pandemic on patients included in a bariatric surgery program.

PURPOSE: The COVID-19 pandemic has radically impacted the world lifestyle. Epidemics are well-known to cause mental distress, and patients with a current or past history of obesity are at increased risk for the common presence of psychological comorbidities. This study investigates the psychological impact of the current pandemic in patients participating in a bariatric surgery program. METHODS: Patients were consecutively enrolled during the Italian lockdown among those waiting for bariatric surgery or attending a post-bariatric follow-up, and were asked to complete through an online platform the Depression Anxiety Stress Scales-21 and a self-assessment questionnaire of 22 items evaluating the resilience, change in eating behavior and emotional responses referring to the ongoing pandemic. RESULTS: 59% of the 434 enrolled subjects reported of being worried about the pandemic, and 63% specifically reported of being worried about their or their relatives' health. 37% and 56% felt lonelier and more bored, respectively. 66% was hungrier with increased frequency of snacking (55%) and 39% reported more impulse to eat. Noteworthy, 49% felt unable to follow a recommended diet. No difference in terms of psychological profile was recorded among pre and post-bariatric subjects. Logistic regression analysis on post-bariatric patients showed a relationship between snacking, hunger, eating impulsivity, and anxiety, stress, and/or depression symptoms. CONCLUSION: The pandemic led to increased psychological distress in patients with a current or past history of obesity, reducing quality of life and affecting dietary compliance. Targeted psychological support is warranted in times of increased stress for fragile subjects such as pre- and post-bariatric patients. LEVEL OF EVIDENCE: Level V: cross-sectional descriptive study.

Towards a Transversal Definition of Psychological Resilience: A Literature Review.

Background and objectives: This paper addresses psychological resilience, a multidisciplinary theoretical construct with important practical implications for health sciences. Although many definitions have been proposed in several contexts, an essential understanding of the concept is still lacking up to now. This negatively affects comparisons among research results and makes objective measurement difficult. The aim of this review is to identify shared elements in defining the construct of resilience across the literature examined in order to move toward a conceptual unification of the term. Materials and methods: A literature review was performed using the electronic databases 'PubMed' and 'PsycINFO'. Scientific studies written in English between 2002 and May 2019 were included according to the following key terms: 'Psychological', 'resilience', and 'definition'. Results: The review identifies five macro-categories that summarize what has been reported in the recent literature concerning the resilience phenomenon. They serve as a preliminary and necessary step toward a conceptual clarification of the construct. Conclusions: We propose a definition of psychological resilience as the ability to maintain the persistence of one's orientation towards existential purposes. It constitutes a transversal attitude that can be understood as the ability to overcome the difficulties experienced in the different areas of one's life with perseverance, as well as good awareness of oneself and one's own internal coherence by activating a personal growth project. The conceptual clarification proposed will contribute to improving the accuracy of research on this topic by suggesting future paths of investigation aimed at deeply exploring the issues surrounding the promotion of resilience resources.

Progressively promoting metacognition in a case of obsessive-compulsive personality disorder treated with metacognitive interpersonal therapy.

BACKGROUND: Many persons with personality disorders (PD) have problems contemplating mental states and using psychological knowledge to cope with their suffering and solve social problems, the skill termed metacognition in this article. Therapists can focus on metacognitive dysfunctions in order to tailor PD treatment to clients' metacognitive skills. AIMS: To briefly summarize procedures for promoting clients' abilities to define problems in mentalistic terms and use this knowledge to develop new paths towards living an adapted social life, within the context of a continuous regulation of the therapy relationship. METHOD: Qualitative analysis of session transcript excerpts from a good-outcome case treated with metacognitive interpersonal therapy. CONCLUSION: A therapeutic focus on metacognitive dysfunctions and a regulation of the therapy relationship can lead to improvements in symptoms and interpersonal functioning. The possibility of generalizing the procedure and testing it empirically is discussed.