Human social isolation and stress: a systematic review of different contexts and recommendations for future studies

Abstract Objectives The emergence of the coronavirus disease 2019 (COVID-19) pandemic and subsequent lockdowns and social distancing measures adopted worldwide raised questions about the possible health effects of human social isolation. Methods We conducted a systematic review on PubMed, Scopus, and Embase electronic databases using terms related to human social isolation - defined as the isolation of an individual from regular routines and usual social contact - and psychological stress, searching for simulated or naturalistic isolation environments. We present the main results, as well as the validity and limitations of each model. PROSPERO registry number: CRD42021241880. Results Despite the diversity of contexts reviewed, some outcomes almost ubiquitously relate to psychological stress, i.e., longer periods, expectation of a longer period, confinement, lack of social interaction, and support. Based on the results, and considering that most studies were not designed for the purpose of understanding isolation itself, we propose a group of recommendations for future experimental or naturalistic research on the topic. Conclusion Evidence on the impact of different situations in which individuals are subjected to social isolation can assist in development of directed preventive strategies to support people under similar circumstances. Such strategies might increase the general public's compliance with social distancing as a non-pharmacological intervention for emerging infectious diseases.

Risk of pre-term birth as a function of sleep quality and obesity: prospective analysis in a large Prematurity Research Cohort.

Study Objective: To investigate whether poor sleep quality is associated with pre-term birth (PTB) risk, overall and independent of sleep apnea and habitual snoring. Methods: We used longitudinal data from the Washington University Prematurity Research Cohort to investigate the association between poor sleep quality (defined as a Pittsburgh Sleep Quality Index > 5) and PTB, overall and independent of sleep apnea and snoring (defined by the Berlin questionnaire and prior sleep clinic attendance). Associations were investigated for sleep quality early and throughout pregnancy. Stratified analyses were performed by factors previously shown to modify associations between sleep and PTB (race, pre-pregnancy obesity). Results: Of the 976 eligible participants, 50.1% experienced poor sleep quality early in pregnancy (<20 completed weeks) and 14.2% delivered pre-term (n = 50 without and 89 with poor sleep quality). In multivariable-adjusted analyses, poor sleep quality early in pregnancy was associated with increased PTB risk (hazard ratio [HR] = 1.48, 95% confidence interval [CI] = 1.02-2.14). This association persisted after further adjustment for sleep apnea and snoring (HR = 1.50, 95% CI = 1.02-2.20) and in analyses stratified by race. It varied, however, by pre-pregnancy obesity. Among individuals without obesity, no association was observed between poor sleep and PTB (HR = 1.08, 95% CI = 0.65-1.79), whereas among those with obesity, a positive association was observed (HR = 2.94, 95% CI = 1.52-5.69, p-interaction = .05). This association was limited to individuals with obesity who experienced poor sleep both earlier and later in pregnancy (HR = 3.94, 95% CI = 1.56-9.99). Conclusion: Our findings suggest that improving sleep quality early in pregnancy may be important for PTB prevention, particularly among individuals with obesity.

Human Social Isolation and Stress: A Systematic Review of Different Contexts and Recommendations for Future Studies.

OBJECTIVES: The emergence of COVID-19 pandemic and subsequent lockdowns and social distancing measures adopted worldwide raised questions about the possible health effects of human social isolation. METHODS: We conducted a systematic review on PubMed, Scopus and Embase electronic databases using terms related to human social isolation - defined as the isolation of an individual from regular routines and usual social contact - and psychological stress, searching for simulated or naturalistic isolation environments. We present the main results, as well as the validity and limitations of each model. PROSPERO registry number: CRD42021241880. RESULTS: Despite the diversity of contexts reviewed, some outcomes almost ubiquitously relate to psychological stress, i.e. longer periods, expectation of a longer period, confinement, lack of social interaction and support. Based on the results, considering that most studies were not designed for the purpose of understanding isolation itself, we propose a group of recommendations for future experimental or naturalistic research on the topic. CONCLUSION: Evidence on the impact of different situations in which individuals are subjected to social isolation can assist in the development of directed preventive strategies to support people under similar circumstances. Such strategies might increase the compliance of the general public to social distancing as a non-pharmacological intervention for emerging infectious diseases.

Mudança de fotoperíodo: proposta de modelo experimental / Change of photoperiod: proposal for an experimental model

Introduction: There are some physiological and behavioral variations related to seasonality, and light is the major synchronizer of these variations according to the seasonal functions in temperate latitudes. Thus, the objective of this study was to validate a methodology for photoperiod modification in Wistar rats byevaluating its interference in the biological rhythm. Methods: Three male adult Wistar rats (60 days) were exposed to 3 photoperiods of 17 days each, with different light/dark cycles (LD): LDPP/SDPP Animal, exposed to initial LD 16:30/07:30 (LDPP, long-day photoperiod) and final LD 07:30/16:30 (SDPP, short-day photoperiod); SDPP/LDPP Animal, exposed to initial LD 07:30/16:30 and final LD 16:30/07:30; and final LD 16:30/07:30; and CT Animal, under constant LD 12:00/12:00. LDPP/SDPP and SDPP/LDPP animals underwent an intermediate photoperiod between initial and final LD, in which light exposure was increased or reduced by 30 min each day until the photoperiods were inverted. All animals remained isolated during the study and had their core temperatures continuously measured by sensors implanted in the peritoneal cavity and their locomotive activity assessed by sensors attached to their cages. The data obtained were used to construct histograms. Results: LDPP/SDPP and SDPP/LDPP animals had a longer period of activity in the SDPP than in the LDPP. The temperature of the CT animal followed a rhythmic pattern. The rat strain used was sensitive to changes in photoperiod. Conclusions: The model proposed and validated in this study can be used in experiments that aim to assess the consequences of changes in light exposure.

Introdução: Existem variações fisiológicas e comportamentais relacionadas à sazonalidade, e a luz é o principal sincronizador destas variações de acordo com as funções sazonais em latitudes de climas temperados. Sendo assim, o objetivo deste estudo foi validar uma metodologia de modificação de fotoperíodo com ratos Wistar avaliando sua interferência no ritmo biológico. Métodos: Três ratos Wistar machos adultos (60 dias) foram expostos a 3 fotoperíodos de 17 dias cada, com diferentes ciclos claro/escuro (light/dark, LD): Animal CL/CC, exposto a LD inicial 16:30/07:30 (CL, claro longo) e LD final 07:30/16:30 (CC, claro curto); Animal CC/CL, exposto a LD inicial 07:30/16:30 e LD final 16:30/07:30; e Animal CT, sob LD constante 12:00/12:00. Os animais CL/CC e CC/CL passaram por um fotoperíodo intermediário entre o LD inicial e final, no qual a exposição à luz foi aumentada ou diminuída em 30 min a cada dia até que os fotoperíodos se invertessem. Todos os animais permaneceram isolados durante o estudo e tiveram suas temperaturas corporais continuamente aferidas por sensores implantados na cavidade peritoneal e suas atividades locomotoras medidas por sensores acoplados às suas caixas. Os dados obtidos foram utilizados para construção de histogramas. Resultados: Os animais CL/CC e CC/CL apresentaram maior período de atividade em CC do que em CL. A temperatura do animal CT seguiu um padrão rítmico. A linhagem utilizada apresentou sensibilidade à mudança de fotoperíodo. Conclusão: O modelo proposto e validado neste estudo pode ser usado em experimentos que tenham como objetivo avaliar as consequências das mudanças de exposição à luz.

Effects of the putative antipsychotic alstonine on glutamate uptake in acute hippocampal slices.

A dysfunctional glutamatergic system is thought to be central to the negative symptoms and cognitive deficits recognized as determinant to the poor quality of life of people with schizophrenia. Modulating glutamate uptake has, thus, been suggested as a novel target for antipsychotics. Alstonine is an indole alkaloid sharing with atypical antipsychotics the profile in animal models relevant to schizophrenia, though divergent in its mechanism of action. The aim of this study was to evaluate the effects of alstonine on glutamate uptake. Additionally, the effects on glutathione content and extracellular S100B levels were assessed. Acute hippocampal slices were incubated with haloperidol (10µM), clozapine (10 and 100µM) or alstonine (1-100µM), alone or in combination with apomorphine (100µM), and 5-HT(2) receptor antagonists (0.01µM altanserin and 0.1µM SB 242084). A reduction in glutamate uptake was observed with alstonine and clozapine, but not haloperidol. Apomorphine abolished the effect of clozapine, whereas 5-HT(2A) and 5-HT(2C) antagonists abolished the effects of alstonine. Increased levels of glutathione were observed only with alstonine, also the only compound that failed to decrease the release of S100B. This study shows that alstonine decreases glutamate uptake, which may be beneficial to the glutamatergic deficit observed in schizophrenia. Noteworthily, the decrease in glutamate uptake is compatible with the reversal of MK-801-induced social interaction and working memory deficits. An additional potential benefit of alstonine as an antipsychotic is its ability to increase glutathione, a key cellular antioxidant reported to be decreased in the brain of patients with schizophrenia. Adding to the characterization of the novel mechanism of action of alstonine, the lack of effect of apomorphine in alstonine-induced changes in glutamate uptake reinforces that D(2) receptors are not primarily implicated. Though clearly mediated by 5-HT(2A) and 5-HT(2C) serotonin receptors, the precise mechanisms that result in the effects of alstonine on glutamate uptake warrant elucidation.