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Gordon M, Jayakumar N, Atzema C, Korczak DJ, Kennedy S, Schaffer A, Goldstein B, Orser BA, Yee D, Fiksenbaum L, Choi LHL, Phillips A, McFarlan A, Kreller M, Freedman C, Tanenbaum B, McDowall D, Ceniti A, Sinyor M. Self-harm presentations to hospital trauma centre emergency departments during the first year of the COVID-19 pandemic. Psychiatry Res 2024; 336:115892. [PMID: 38642422 DOI: 10.1016/j.psychres.2024.115892] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/14/2023] [Revised: 04/01/2024] [Accepted: 04/02/2024] [Indexed: 04/22/2024]
Abstract
The COVID-19 pandemic raised concerns regarding increased suicide-related behaviours. We compared characteristics and counts of Emergency Department (ED) presentations for self-harm, an important suicide-related outcome, during versus prior to the pandemic's first year. We included patients presenting with self-harm to the ED of two trauma centres in Toronto, Canada. Time series models compared intra-pandemic (March 2020-February 2021) presentation counts to predictions from pre-pandemic data. The self-harm proportion of ED presentations was compared between the intra-pandemic period and preceding three years. A retrospective chart review of eligible patients seen from March 2019-February 2021 compared pre- vs. intra-pandemic patient and injury characteristics. While monthly intra-pandemic self-harm counts were largely within expected ranges, the self-harm proportion of total presentations increased. Being widowed (OR=9.46; 95 %CI=1.10-81.08), employment/financial stressors (OR=1.65, 95 %CI=1.06-2.58), job loss (OR=3.83; 95 %CI=1.36-10.76), and chest-stabbing self-harm (OR=2.50; 95 %CI=1.16-5.39) were associated with intra-pandemic presentations. Intra-pandemic self-harm was also associated with Intensive Care Unit (ICU) admission (OR=2.18, 95 %CI=1.41-3.38). In summary, while the number of self-harm presentations to these trauma centres did not increase during the early pandemic, their proportion was increased. The association of intra-pandemic self-harm with variables indicating medically severe injury, economic stressors, and being widowed may inform future suicide and self-harm prevention strategies.
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Affiliation(s)
- Madeleine Gordon
- Sunnybrook Health Sciences Centre. 2075 Bayview Ave, Toronto M4N 3M5, ON, Canada; Temerty Faculty of Medicine, University of Toronto. 1 King's College Circle, Toronto M5S 1A8, ON, Canada; Faculty of Medicine, University of Ottawa. 451 Smyth Rd, Ottawa K1H 8M5, ON, Canada.
| | - Navitha Jayakumar
- Sunnybrook Health Sciences Centre. 2075 Bayview Ave, Toronto M4N 3M5, ON, Canada
| | - Clare Atzema
- Sunnybrook Health Sciences Centre. 2075 Bayview Ave, Toronto M4N 3M5, ON, Canada; Temerty Faculty of Medicine, University of Toronto. 1 King's College Circle, Toronto M5S 1A8, ON, Canada
| | - Daphne J Korczak
- Temerty Faculty of Medicine, University of Toronto. 1 King's College Circle, Toronto M5S 1A8, ON, Canada; The Hospital for Sick Children, 555 University Ave, Toronto M5G 1X8, ON, Canada
| | - Sidney Kennedy
- Temerty Faculty of Medicine, University of Toronto. 1 King's College Circle, Toronto M5S 1A8, ON, Canada; St. Michael's Hospital. 36 Queen St E, Toronto M5B 1W8, ON, Canada
| | - Ayal Schaffer
- Sunnybrook Health Sciences Centre. 2075 Bayview Ave, Toronto M4N 3M5, ON, Canada; Temerty Faculty of Medicine, University of Toronto. 1 King's College Circle, Toronto M5S 1A8, ON, Canada
| | - Benjamin Goldstein
- Temerty Faculty of Medicine, University of Toronto. 1 King's College Circle, Toronto M5S 1A8, ON, Canada; Centre for Addiction and Mental Health. 250 College St, Toronto M5T 1R8, ON, Canada
| | - Beverley A Orser
- Sunnybrook Health Sciences Centre. 2075 Bayview Ave, Toronto M4N 3M5, ON, Canada; Temerty Faculty of Medicine, University of Toronto. 1 King's College Circle, Toronto M5S 1A8, ON, Canada
| | - Doreen Yee
- Sunnybrook Health Sciences Centre. 2075 Bayview Ave, Toronto M4N 3M5, ON, Canada; Temerty Faculty of Medicine, University of Toronto. 1 King's College Circle, Toronto M5S 1A8, ON, Canada
| | - Lisa Fiksenbaum
- Sunnybrook Health Sciences Centre. 2075 Bayview Ave, Toronto M4N 3M5, ON, Canada; Temerty Faculty of Medicine, University of Toronto. 1 King's College Circle, Toronto M5S 1A8, ON, Canada; York University. 4700 Keele St, Toronto M3J 1P3, ON, Canada
| | - Liz Hanbyul Lee Choi
- Sunnybrook Health Sciences Centre. 2075 Bayview Ave, Toronto M4N 3M5, ON, Canada
| | - Andrea Phillips
- Sunnybrook Health Sciences Centre. 2075 Bayview Ave, Toronto M4N 3M5, ON, Canada
| | - Amanda McFarlan
- St. Michael's Hospital. 36 Queen St E, Toronto M5B 1W8, ON, Canada
| | - Margaret Kreller
- The Hospital for Sick Children, 555 University Ave, Toronto M5G 1X8, ON, Canada
| | - Corey Freedman
- Sunnybrook Health Sciences Centre. 2075 Bayview Ave, Toronto M4N 3M5, ON, Canada
| | - Brandy Tanenbaum
- Sunnybrook Health Sciences Centre. 2075 Bayview Ave, Toronto M4N 3M5, ON, Canada
| | - Dorothy McDowall
- The Hospital for Sick Children, 555 University Ave, Toronto M5G 1X8, ON, Canada
| | - Amanda Ceniti
- St. Michael's Hospital. 36 Queen St E, Toronto M5B 1W8, ON, Canada
| | - Mark Sinyor
- Sunnybrook Health Sciences Centre. 2075 Bayview Ave, Toronto M4N 3M5, ON, Canada; Temerty Faculty of Medicine, University of Toronto. 1 King's College Circle, Toronto M5S 1A8, ON, Canada
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Yan B, Liao P, Wang C, Han Z, Cheng F, Lei P. Genetic causal association between varicella-zoster virus infection and psychiatric disorders: A 2-sample Mendelian randomization study. Behav Brain Res 2024; 464:114927. [PMID: 38428645 DOI: 10.1016/j.bbr.2024.114927] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2023] [Revised: 02/17/2024] [Accepted: 02/26/2024] [Indexed: 03/03/2024]
Abstract
BACKGROUND Psychiatric disorders, such as schizophrenia (SCZ), major depressive (MDD), and bipolar disorder (BD) have a profound impact on millions of individuals worldwide. The critical step toward developing effective preventive and treatment strategies lies in comprehending the causal mechanisms behind these diseases and identifying modifiable risk factors associated with them. METHODS In this study, we conducted a 2-sample Mendelian randomization analysis to explore the potential links between chickenpox(varicella-zoster virus infection) and three major psychiatric disorders(SCZ, MDD, BD). RESULTS In our MR study, among the three major psychiatric disorders, chickenpox was shown to be causally related to BD, indicating that infection with chickenpox may increase the risk of developing BD (IVW: OR = 1.064, 95% CI =1.025-1.104, P=0.001; RAPS: OR=1.066, 95% CI=1.024-1.110, P=0.002), while there was no causal relationship between SCZ and MDD. Similar estimated causal effects were observed consistently across the various MR models. The robustness of the identified causal relationship between chickenpox and BD holds true regardless of the statistical methods employed, as confirmed by extensive sensitivity analyses that address violations in model assumptions. The MR-Egger regression test failed to reveal any signs of directional pleiotropy (intercept = -0.042, standard error (SE) = 0.029, p = 0.236). Similarly, the MR-PRESSO analysis revealed no evidence of directional pleiotropy or outliers among the chickenpox-related instrumental variables (global test p = 0.653). Furthermore, a leave-one-out sensitivity analysis yielded consistent results, further underscoring the credibility and stability of the causal relationship. CONCLUSIONS Our findings provide compelling evidence of a causal effect of chickenpox on the risk of BD. To gain a more comprehensive understanding of this association and its underlying mechanisms, additional research is needed. Such investigations are pivotal in identifying effective interventions for promoting BD prevention.
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Affiliation(s)
- Bo Yan
- Department of Geriatrics, Tianjin Medical University General Hospital, Tianjin 300052, China; Tianjin Neurological Institute, Tianjin Key Laboratory of Injuries, Variations and Regeneration of Nervous System, Tianjin, China
| | - Pan Liao
- School of Medicine, Nankai University, Tianjin, 300071, China
| | - Conglin Wang
- Department of Geriatrics, Tianjin Medical University General Hospital, Tianjin 300052, China; Tianjin Neurological Institute, Tianjin Key Laboratory of Injuries, Variations and Regeneration of Nervous System, Tianjin, China
| | - Zhaoli Han
- Department of Geriatrics, Tianjin Medical University General Hospital, Tianjin 300052, China
| | - Fangyuan Cheng
- Department of Geriatrics, Tianjin Medical University General Hospital, Tianjin 300052, China; Tianjin Neurological Institute, Tianjin Key Laboratory of Injuries, Variations and Regeneration of Nervous System, Tianjin, China
| | - Ping Lei
- Department of Geriatrics, Tianjin Medical University General Hospital, Tianjin 300052, China; Tianjin Neurological Institute, Tianjin Key Laboratory of Injuries, Variations and Regeneration of Nervous System, Tianjin, China.
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3
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Bransfield RC, Mao C, Greenberg R. Microbes and Mental Illness: Past, Present, and Future. Healthcare (Basel) 2023; 12:83. [PMID: 38200989 PMCID: PMC10779437 DOI: 10.3390/healthcare12010083] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Revised: 11/30/2023] [Accepted: 12/06/2023] [Indexed: 01/12/2024] Open
Abstract
A review of the association between microbes and mental illness is performed, including the history, relevant definitions, infectious agents associated with mental illnesses, complex interactive infections, total load theory, pathophysiology, psychoimmunology, psychoneuroimmunology, clinical presentations, early-life infections, clinical assessment, and treatment. Perspectives on the etiology of mental illness have evolved from demonic possession toward multisystem biologically based models that include gene expression, environmental triggers, immune mediators, and infectious diseases. Microbes are associated with a number of mental disorders, including autism, schizophrenia, bipolar disorder, depressive disorders, and anxiety disorders, as well as suicidality and aggressive or violent behaviors. Specific microbes that have been associated or potentially associated with at least one of these conditions include Aspergillus, Babesia, Bartonella, Borna disease virus, Borrelia burgdorferi (Lyme disease), Candida, Chlamydia, coronaviruses (e.g., SARS-CoV-2), Cryptococcus neoformans, cytomegalovirus, enteroviruses, Epstein-Barr virus, hepatitis C, herpes simplex virus, human endogenous retroviruses, human immunodeficiency virus, human herpesvirus-6 (HHV-6), human T-cell lymphotropic virus type 1, influenza viruses, measles virus, Mycoplasma, Plasmodium, rubella virus, Group A Streptococcus (PANDAS), Taenia solium, Toxoplasma gondii, Treponema pallidum (syphilis), Trypanosoma, and West Nile virus. Recognition of the microbe and mental illness association with the development of greater interdisciplinary research, education, and treatment options may prevent and reduce mental illness morbidity, disability, and mortality.
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Affiliation(s)
- Robert C. Bransfield
- Rutgers-Robert Wood Johnson Medical School, Piscataway, NJ 08854, USA
- Hackensack Meridian School of Medicine, Nutey, NJ 07110, USA
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4
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Volk P, Rahmani Manesh M, Warren ME, Besko K, Gonçalves de Andrade E, Wicki-Stordeur LE, Swayne LA. Long-term neurological dysfunction associated with COVID-19: Lessons from influenza and inflammatory diseases? J Neurochem 2023. [PMID: 38014645 DOI: 10.1111/jnc.16016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2023] [Revised: 11/01/2023] [Accepted: 11/05/2023] [Indexed: 11/29/2023]
Abstract
As the COVID-19 pandemic persists, SARS-CoV-2 infection is increasingly associated with long-term neurological side effects including cognitive impairment, fatigue, depression, and anxiety, colloquially known as "long-COVID." While the full extent of long-COVID neuropathology across years or even decades is not yet known, we can perhaps take direction from long-standing research into other respiratory diseases, such as influenza, that can present with similar long-term neurological consequences. In this review, we highlight commonalities in the neurological impacts of influenza and COVID-19. We first focus on the common potential mechanisms underlying neurological sequelae of long-COVID and influenza, namely (1) viral neurotropism and (2) dysregulated peripheral inflammation. The latter, namely heightened peripheral inflammation leading to central nervous system dysfunction, is emerging as a shared mechanism in various peripheral inflammatory or inflammation-associated diseases and conditions. We then discuss historical and modern examples of influenza- and COVID-19-associated cognitive impairment, depression, anxiety, and fatigue, revealing key similarities in their neurological sequelae. Although we are learning that the effects of influenza and COVID differ somewhat in terms of their influence on the brain, as the impacts of long-COVID grow, such comparisons will likely prove valuable in guiding ongoing research into long-COVID, and perhaps foreshadow what could be in store for individuals with COVID-19 and their brain health.
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Affiliation(s)
- Parker Volk
- Division of Medical Sciences, University of Victoria, Victoria, British Columbia, Canada
| | | | - Mary E Warren
- Division of Medical Sciences, University of Victoria, Victoria, British Columbia, Canada
| | - Katie Besko
- Division of Medical Sciences, University of Victoria, Victoria, British Columbia, Canada
| | | | - Leigh E Wicki-Stordeur
- Division of Medical Sciences, University of Victoria, Victoria, British Columbia, Canada
| | - Leigh Anne Swayne
- Division of Medical Sciences, University of Victoria, Victoria, British Columbia, Canada
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5
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Rajkumar RP. Examining the Relationships between the Incidence of Infectious Diseases and Mood Disorders: An Analysis of Data from the Global Burden of Disease Studies, 1990-2019. Diseases 2023; 11:116. [PMID: 37754312 PMCID: PMC10528187 DOI: 10.3390/diseases11030116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2023] [Revised: 08/27/2023] [Accepted: 09/04/2023] [Indexed: 09/28/2023] Open
Abstract
Mood disorders are among the commonest mental disorders worldwide. Epidemiological and clinical evidence suggests that there are close links between infectious diseases and mood disorders, but the strength and direction of these association remain largely unknown. Theoretical models have attempted to explain this link based on evolutionary or immune-related factors, but these have not been empirically verified. The current study examined cross-sectional and longitudinal associations between the incidence of infectious diseases and mood disorders, while correcting for climate and economic factors, based on data from the Global Burden of Disease Studies, 1990-2019. It was found that major depressive disorder was positively associated with lower respiratory infections, while bipolar disorder was positively associated with upper respiratory infections and negatively associated with enteric and tropical infections, both cross-sectionally and over a period of 30 years. These results suggest that a complex, bidirectional relationship exists between these disorders. This relationship may be mediated through the immune system as well as through the gut-brain and lung-brain axes. Understanding the mechanisms that link these groups of disorders could lead to advances in the prevention and treatment of both.
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Affiliation(s)
- Ravi Philip Rajkumar
- Department of Psychiatry, Jawaharlal Institute of Postgraduate Medical Education and Research, Pondicherry 605006, India
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6
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Ramalho S, Martins-Mendes D, Macedo JM, Barros C, Luis C, Sá S, Gestoso Á, Pereira AC, Baylina P, Fernandes R. Unveiling the Path to Resilience: Prioritizing Mental Health, Sleep, and Nutrition in the Post-COVID Era. Healthcare (Basel) 2023; 11:2463. [PMID: 37685496 PMCID: PMC10487180 DOI: 10.3390/healthcare11172463] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2023] [Revised: 08/28/2023] [Accepted: 08/31/2023] [Indexed: 09/10/2023] Open
Abstract
The COVID-19 pandemic has disrupted daily life, impacting relationships, work, and education. This has led to increased stress, anxiety, and depression, along with altered sleep patterns and eating behaviors. Quarantine and isolation have worsened mental health, especially in children and the elderly, due to the loss of activities and physical contact. Sleep disorders and negative dreams perpetuate poor sleep quality, increasing the risk of health issues. Sedentary lifestyles and emotional effects contribute to unhealthy eating patterns and obesity, exacerbated by disrupted routines and limited outdoor activities. Addressing these challenges requires prioritizing mental health, promoting healthy sleep habits, and addressing obesity factors. The pandemic has profoundly affected human well-being, but resilience, mental health, sleep, and nutrition can enhance overall well-being and adaptability in the post-COVID era. This comprehensive opinion aims to raise awareness of the wide-ranging impacts of this pandemic on various aspects of human well-being and to emphasize the importance of implementing strategies that prioritize mental health, improve sleep habits, address eating behaviors, and foster resilience to navigate and thrive in the face of future challenges.
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Affiliation(s)
- Susana Ramalho
- FP-I3ID, Instituto de Investigação, Inovação e Desenvolvimento, FP-BHS, Biomedical and Health Sciences, Universidade Fernando Pessoa, 4249-004 Porto, Portugal; (S.R.); (D.M.-M.); (J.M.M.); (C.B.); (C.L.); (S.S.); (Á.G.); (A.C.P.)
- CECLIN, Centro de Estudos Clínicos, Hospital Fernando Pessoa, 4420-096 Gondomar, Portugal
- Faculdade de Ciências da Saúde, Universidade Fernando Pessoa, 4200-150 Porto, Portugal
- I3S, Instituto de Investigação e Inovação em Saúde, Universidade do Porto, 4200-135 Porto, Portugal;
- Faculdade de Biologia, Universidade de Vigo, 36310 Vigo, Spain
| | - Daniela Martins-Mendes
- FP-I3ID, Instituto de Investigação, Inovação e Desenvolvimento, FP-BHS, Biomedical and Health Sciences, Universidade Fernando Pessoa, 4249-004 Porto, Portugal; (S.R.); (D.M.-M.); (J.M.M.); (C.B.); (C.L.); (S.S.); (Á.G.); (A.C.P.)
- CECLIN, Centro de Estudos Clínicos, Hospital Fernando Pessoa, 4420-096 Gondomar, Portugal
- Faculdade de Ciências da Saúde, Universidade Fernando Pessoa, 4200-150 Porto, Portugal
- I3S, Instituto de Investigação e Inovação em Saúde, Universidade do Porto, 4200-135 Porto, Portugal;
- Faculdade de Medicina, Universidade do Porto, 4200-319 Porto, Portugal
| | - José Mário Macedo
- FP-I3ID, Instituto de Investigação, Inovação e Desenvolvimento, FP-BHS, Biomedical and Health Sciences, Universidade Fernando Pessoa, 4249-004 Porto, Portugal; (S.R.); (D.M.-M.); (J.M.M.); (C.B.); (C.L.); (S.S.); (Á.G.); (A.C.P.)
- CECLIN, Centro de Estudos Clínicos, Hospital Fernando Pessoa, 4420-096 Gondomar, Portugal
- Faculdade de Ciências da Saúde, Universidade Fernando Pessoa, 4200-150 Porto, Portugal
- I3S, Instituto de Investigação e Inovação em Saúde, Universidade do Porto, 4200-135 Porto, Portugal;
- Faculdade de Biologia, Universidade de Vigo, 36310 Vigo, Spain
| | - Carla Barros
- FP-I3ID, Instituto de Investigação, Inovação e Desenvolvimento, FP-BHS, Biomedical and Health Sciences, Universidade Fernando Pessoa, 4249-004 Porto, Portugal; (S.R.); (D.M.-M.); (J.M.M.); (C.B.); (C.L.); (S.S.); (Á.G.); (A.C.P.)
- Faculdade de Ciências Humanas e Sociais, Universidade Fernando Pessoa, 4249-004 Porto, Portugal
| | - Carla Luis
- FP-I3ID, Instituto de Investigação, Inovação e Desenvolvimento, FP-BHS, Biomedical and Health Sciences, Universidade Fernando Pessoa, 4249-004 Porto, Portugal; (S.R.); (D.M.-M.); (J.M.M.); (C.B.); (C.L.); (S.S.); (Á.G.); (A.C.P.)
- CECLIN, Centro de Estudos Clínicos, Hospital Fernando Pessoa, 4420-096 Gondomar, Portugal
- Faculdade de Ciências da Saúde, Universidade Fernando Pessoa, 4200-150 Porto, Portugal
- I3S, Instituto de Investigação e Inovação em Saúde, Universidade do Porto, 4200-135 Porto, Portugal;
- Faculdade de Medicina, Universidade do Porto, 4200-319 Porto, Portugal
| | - Sara Sá
- FP-I3ID, Instituto de Investigação, Inovação e Desenvolvimento, FP-BHS, Biomedical and Health Sciences, Universidade Fernando Pessoa, 4249-004 Porto, Portugal; (S.R.); (D.M.-M.); (J.M.M.); (C.B.); (C.L.); (S.S.); (Á.G.); (A.C.P.)
- CECLIN, Centro de Estudos Clínicos, Hospital Fernando Pessoa, 4420-096 Gondomar, Portugal
- Faculdade de Ciências da Saúde, Universidade Fernando Pessoa, 4200-150 Porto, Portugal
- I3S, Instituto de Investigação e Inovação em Saúde, Universidade do Porto, 4200-135 Porto, Portugal;
- Faculdade de Medicina, Universidade do Porto, 4200-319 Porto, Portugal
| | - Álvaro Gestoso
- FP-I3ID, Instituto de Investigação, Inovação e Desenvolvimento, FP-BHS, Biomedical and Health Sciences, Universidade Fernando Pessoa, 4249-004 Porto, Portugal; (S.R.); (D.M.-M.); (J.M.M.); (C.B.); (C.L.); (S.S.); (Á.G.); (A.C.P.)
- CECLIN, Centro de Estudos Clínicos, Hospital Fernando Pessoa, 4420-096 Gondomar, Portugal
- Faculdade de Ciências da Saúde, Universidade Fernando Pessoa, 4200-150 Porto, Portugal
- I3S, Instituto de Investigação e Inovação em Saúde, Universidade do Porto, 4200-135 Porto, Portugal;
| | - Ana Cláudia Pereira
- FP-I3ID, Instituto de Investigação, Inovação e Desenvolvimento, FP-BHS, Biomedical and Health Sciences, Universidade Fernando Pessoa, 4249-004 Porto, Portugal; (S.R.); (D.M.-M.); (J.M.M.); (C.B.); (C.L.); (S.S.); (Á.G.); (A.C.P.)
- CECLIN, Centro de Estudos Clínicos, Hospital Fernando Pessoa, 4420-096 Gondomar, Portugal
- Faculdade de Ciências da Saúde, Universidade Fernando Pessoa, 4200-150 Porto, Portugal
- I3S, Instituto de Investigação e Inovação em Saúde, Universidade do Porto, 4200-135 Porto, Portugal;
| | - Pilar Baylina
- I3S, Instituto de Investigação e Inovação em Saúde, Universidade do Porto, 4200-135 Porto, Portugal;
- Escola S. Saúde, Instituto Politécnico do Porto, 4200-465 Porto, Portugal
| | - Rúben Fernandes
- FP-I3ID, Instituto de Investigação, Inovação e Desenvolvimento, FP-BHS, Biomedical and Health Sciences, Universidade Fernando Pessoa, 4249-004 Porto, Portugal; (S.R.); (D.M.-M.); (J.M.M.); (C.B.); (C.L.); (S.S.); (Á.G.); (A.C.P.)
- CECLIN, Centro de Estudos Clínicos, Hospital Fernando Pessoa, 4420-096 Gondomar, Portugal
- Faculdade de Ciências da Saúde, Universidade Fernando Pessoa, 4200-150 Porto, Portugal
- I3S, Instituto de Investigação e Inovação em Saúde, Universidade do Porto, 4200-135 Porto, Portugal;
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7
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Hickie IB, Merikangas KR, Carpenter JS, Iorfino F, Scott EM, Scott J, Crouse JJ. Does circadian dysrhythmia drive the switch into high- or low-activation states in bipolar I disorder? Bipolar Disord 2023; 25:191-199. [PMID: 36661342 PMCID: PMC10947388 DOI: 10.1111/bdi.13304] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
OBJECTIVES Emerging evidence suggests a role of circadian dysrhythmia in the switch between "activation" states (i.e., objective motor activity and subjective energy) in bipolar I disorder. METHODS We examined the evidence with respect to four relevant questions: (1) Are natural or environmental exposures that can disrupt circadian rhythms also related to the switch into high-/low-activation states? (2) Are circadian dysrhythmias (e.g., altered rest/activity rhythms) associated with the switch into activation states in bipolar disorder? (3) Do interventions that affect the circadian system also affect activation states? (4) Are associations between circadian dysrhythmias and activation states influenced by other "third" factors? RESULTS Factors that naturally or experimentally alter circadian rhythms (e.g., light exposure) have been shown to relate to activation states; however future studies need to measure circadian rhythms contemporaneously with these natural/experimental factors. Actigraphic measures of circadian dysrhythmias are associated prospectively with the switch into high- or low-activation states, and more studies are needed to establish the most relevant prognostic actigraphy metrics in bipolar disorder. Interventions that can affect the circadian system (e.g., light therapy, lithium) can also reduce the switch into high-/low-activation states. Whether circadian rhythms mediate these clinical effects is an unknown but valuable question. The influence of age, sex, and other confounders on these associations needs to be better characterised. CONCLUSION Based on the reviewed evidence, our view is that circadian dysrhythmia is a plausible driver of transitions into high- and low-activation states and deserves prioritisation in research in bipolar disorders.
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Affiliation(s)
- Ian B. Hickie
- Youth Mental Health and Technology Team, Brain and Mind Centre, Faculty of Medicine and HealthUniversity of SydneyNew South WalesSydneyAustralia
| | - Kathleen R. Merikangas
- Genetic Epidemiology Research Branch, Division of Intramural Research ProgramNational Institute of Mental HealthBethesdaMarylandUSA
| | - Joanne S. Carpenter
- Youth Mental Health and Technology Team, Brain and Mind Centre, Faculty of Medicine and HealthUniversity of SydneyNew South WalesSydneyAustralia
| | - Frank Iorfino
- Youth Mental Health and Technology Team, Brain and Mind Centre, Faculty of Medicine and HealthUniversity of SydneyNew South WalesSydneyAustralia
| | - Elizabeth M. Scott
- Youth Mental Health and Technology Team, Brain and Mind Centre, Faculty of Medicine and HealthUniversity of SydneyNew South WalesSydneyAustralia
| | - Jan Scott
- Institute of NeuroscienceNewcastle UniversityNewcastle upon TyneUK
- Norwegian University of Science and TechnologyTrondheimNorway
- Université de ParisParisFrance
| | - Jacob J. Crouse
- Youth Mental Health and Technology Team, Brain and Mind Centre, Faculty of Medicine and HealthUniversity of SydneyNew South WalesSydneyAustralia
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8
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Won GH, Lee HJ, Lee JH, Choi TY, Hong HL, Jung CY. Impact of a Psychiatric Consultation Program on COVID-19 Patients: An Experimental Study. Psychiatry Investig 2023; 20:471-480. [PMID: 37253473 DOI: 10.30773/pi.2022.0295] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/11/2022] [Accepted: 03/17/2023] [Indexed: 06/01/2023] Open
Abstract
OBJECTIVE Following the coronavirus disease-2019 (COVID-19) outbreak, the importance of addressing acute stress induced by psychological burdens of diseases became apparent. This study attempted to evaluate the effectiveness of a new mode of psychiatric intervention designed to target similar psychological crises. METHODS Participants included 32 out of 114 COVID inpatients at a hospital in Daegu, Korea, who were assessed between March 30 and April 7, 2020. Multiple scales for screening psychological difficulties such as depressed mood, anxiety, insomnia, acute stress, and suicidality were done. Psychological problem evaluations and interventions were conducted in the form of consultations to alleviate participants' psychological challenges via telepsychiatry. The interventions' effects, as well as clinical improvements before and after the intervention, were analyzed. RESULTS As a result of screening, 21 patients were experiencing psychological difficulties beyond clinical thresholds after COVID-19 infection (screening positive group). The remaining 11 were screening negative groups. The two groups differed significantly in past psychiatric histories (p=0.034), with the former having a higher number of diagnoses. The effect of the intervention was analyzed, and clinical improvement before and after the intervention was observed. Our intervention was found to be effective in reducing the overall emotional difficulties. CONCLUSION This study highlighted the usefulness of new interventions required in the context of healthcare following the COVID-19 pandemic.
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Affiliation(s)
- Geun Hui Won
- Department of Psychiatry, Daegu Catholic University School of Medicine, Daegu, Republic of Korea
| | - Hye Jeong Lee
- Department of Psychiatry, Daegu Catholic University School of Medicine, Daegu, Republic of Korea
| | - Jong Hun Lee
- Department of Psychiatry, Daegu Catholic University School of Medicine, Daegu, Republic of Korea
| | - Tae Young Choi
- Department of Psychiatry, Daegu Catholic University School of Medicine, Daegu, Republic of Korea
| | - Hyo-Lim Hong
- Department of Internal Medicine, Daegu Catholic University School of Medicine, Daegu, Republic of Korea
| | - Chi Young Jung
- Department of Internal Medicine, Daegu Catholic University School of Medicine, Daegu, Republic of Korea
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Serafini G, Costanza A, Aguglia A, Amerio A, Trabucco A, Escelsior A, Sher L, Amore M. The Role of Inflammation in the Pathophysiology of Depression and Suicidal Behavior: Implications for Treatment. Med Clin North Am 2023; 107:1-29. [PMID: 36402492 DOI: 10.1016/j.mcna.2022.09.001] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Depression and suicidal behavior are 2 complex psychiatric conditions of significant public health concerns due to their debilitating nature. The need to enhance contemporary treatments and preventative approaches for these illnesses not only calls for distillation of current views on their pathogenesis but also provides an impetus for further elucidation of their novel etiological determinants. In this regard, inflammation has recently been recognized as a potentially important contributor to the development of depression and suicidal behavior. This review highlights key evidence that supports the presence of dysregulated neurometabolic and immunologic signaling and abnormal interaction with microbial species as putative etiological hallmarks of inflammation in depression as well as their contribution to the development of suicidal behavior. Furthermore, therapeutic insights addressing candidate mechanisms of pathological inflammation in these disorders are proposed.
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Affiliation(s)
- Gianluca Serafini
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health DINOGMI, Section of Psychiatry, University of Genoa, Genoa, Italy; IRCCS Ospedale Policlinico San Martino, Largo Rosanna Benzi 10, Genoa 16132, Italy.
| | - Alessandra Costanza
- Department of Psychiatry, Faculty of Medicine, University of Geneva (UNIGE), Geneva, Switzerland, Faculty of Biomedical Sciences, Università della Svizzera Italiana (USI), Lugano, Switzerland; Department of Psychiatry, Faculty of Biomedical Sciences, University of Italian Switzerland (USI), Lugano, Switzerland
| | - Andrea Aguglia
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health DINOGMI, Section of Psychiatry, University of Genoa, Genoa, Italy; IRCCS Ospedale Policlinico San Martino, Largo Rosanna Benzi 10, Genoa 16132, Italy
| | - Andrea Amerio
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health DINOGMI, Section of Psychiatry, University of Genoa, Genoa, Italy; IRCCS Ospedale Policlinico San Martino, Largo Rosanna Benzi 10, Genoa 16132, Italy
| | - Alice Trabucco
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health DINOGMI, Section of Psychiatry, University of Genoa, Genoa, Italy
| | - Andrea Escelsior
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health DINOGMI, Section of Psychiatry, University of Genoa, Genoa, Italy; IRCCS Ospedale Policlinico San Martino, Largo Rosanna Benzi 10, Genoa 16132, Italy
| | - Leo Sher
- James J. Peters VA Medical Center, Bronx, NY, USA; Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA; Department of Psychiatry, New York, NY, USA
| | - Mario Amore
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health DINOGMI, Section of Psychiatry, University of Genoa, Genoa, Italy; IRCCS Ospedale Policlinico San Martino, Largo Rosanna Benzi 10, Genoa 16132, Italy
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10
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Sinyor M, Zaheer R, Webb RT, Knipe D, Eyles E, Higgins JP, McGuinness L, Schmidt L, Macleod-Hall C, Dekel D, Gunnell D, John A. SARS-CoV-2 Infection and the Risk of Suicidal and Self-Harm Thoughts and Behaviour: A Systematic Review. CANADIAN JOURNAL OF PSYCHIATRY. REVUE CANADIENNE DE PSYCHIATRIE 2022; 67:812-827. [PMID: 35532916 PMCID: PMC9096003 DOI: 10.1177/07067437221094552] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
OBJECTIVE The COVID-19 pandemic has had a complex impact on risks of suicide and non-fatal self-harm worldwide with some evidence of increased risk in specific populations including women, young people, and people from ethnic minority backgrounds. This review aims to systematically address whether SARS-CoV-2 infection and/or COVID-19 disease confer elevated risk directly. METHOD As part of a larger Living Systematic Review examining self-harm and suicide during the pandemic, automated daily searches using a broad list of keywords were performed on a comprehensive set of databases with data from relevant articles published between January 1, 2020 and July 18, 2021. Eligibility criteria for our present review included studies investigating suicide and/or self-harm in people infected with SARS-CoV-2 with or without manifestations of COVID-19 disease with a comparator group who did not have infection or disease. Suicidal and self-harm thoughts and behaviour (STBs) were outcomes of interest. Studies were excluded if they reported data for people who only had potential infection/disease without a confirmed exposure, clinical/molecular diagnosis or self-report of a positive SARS-CoV-2 test result. Studies of news reports, treatment studies, and ecological studies examining rates of both SARS-CoV-2 infections and suicide/self-harm rates across a region were also excluded. RESULTS We identified 12 studies examining STBs in nine distinct samples of people with SARS-CoV-2. These studies, which investigated STBs in the general population and in subpopulations, including healthcare workers, generally found positive associations between SARS-CoV-2 infection and/or COVID-19 disease and subsequent suicidal/self-harm thoughts and suicidal/self-harm behaviour. CONCLUSIONS This review identified some evidence that infection with SARS-CoV-2 and/or COVID-19 disease may be associated with increased risks for suicidal and self-harm thoughts and behaviours but a causal link cannot be inferred. Further research with longer follow-up periods is required to confirm these findings and to establish whether these associations are causal.
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Affiliation(s)
- Mark Sinyor
- Department of Psychiatry, Sunnybrook Health Sciences Centre,
Toronto, Canada
- Department of Psychiatry, University of Toronto, Toronto, Canada
| | - Rabia Zaheer
- Department of Psychiatry, Sunnybrook Health Sciences Centre,
Toronto, Canada
- Department of Education Services, Centre for Addiction and Mental
Health, Toronto, Canada
| | - Roger T. Webb
- Division of Psychology and Mental Health, University of Manchester,
Manchester, UK
- National Institute for Health Research Greater Manchester Patient
Safety Translational Research Centre, Manchester, UK
| | - Duleeka Knipe
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Emily Eyles
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
- The National Institute of Health and Care Research Applied Research
Collaboration West (NIHR ARC West), University Hospitals Bristol NHS Foundation
Trust, Bristol, UK
| | - Julian P.T. Higgins
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
- The National Institute of Health and Care Research Applied Research
Collaboration West (NIHR ARC West), University Hospitals Bristol NHS Foundation
Trust, Bristol, UK
- The National Institute of Health and Care Research Biomedical
Research Centre, University Hospitals Bristol NHS Foundation Trust and the
University of Bristol, Bristol, UK
| | - Luke McGuinness
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Lena Schmidt
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
- Sciome LLC, Research Triangle Park, NC, USA
| | | | - Dana Dekel
- Population Data Science, Swansea University, Swansea, UK
| | - David Gunnell
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
- The National Institute of Health and Care Research Biomedical
Research Centre, University Hospitals Bristol NHS Foundation Trust and the
University of Bristol, Bristol, UK
| | - Ann John
- Population Data Science, Swansea University, Swansea, UK
- Public Health Wales NHS Trust, Wales, UK
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11
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Kazmi SMA, Lewis CA, Hasan SS, Iftikhar R, Fayyaz MU, Anjum FA. Mental and physical health correlates of the psychological impact of the first wave of COVID-19 among general population of Pakistan. Front Psychol 2022; 13:942108. [PMID: 36337509 PMCID: PMC9629987 DOI: 10.3389/fpsyg.2022.942108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2022] [Accepted: 07/20/2022] [Indexed: 12/03/2022] Open
Abstract
The primary aim was to assess the role of mental and physical health of COVID-19 and its psychological impact in the general population of Pakistan during the first wave of COVID-19. It was hypothesized that there would be a significant predictive association among socio-demographic variables, psychological impact and mental health status resulting from COVID-19, and poor self-reported physical health would be significantly associated with adverse psychological impact and poor mental health status because of COVID-19. A cross-sectional survey research design was used in which 1,361 respondents were sampled online during lockdown imposed in the country. The Impact of Events Scale-Revised (IES-R) was used to assess the psychological impact of COVID-19, and the Depression Anxiety Stress Scales (DASS-21) was used to assess participants’ mental health status. 18% of the respondents reported moderate to severe event-specific distress, 22.6% reported moderate to severely extreme depression, 29% reported moderate to extreme anxiety, and 12.1% reported moderate to extreme stress. Female gender, having graduate-level education, currently studying, and self-reported physical symptoms (persistent fever, chills, headache, cough, breathing difficulty, dizziness, and sore throat) were significantly associated with higher levels of psychological impact exhibited through higher scores on the IES-R and poorer mental health status exhibited through higher scores on the DASS-21 (Depression, Anxiety, and Stress Subscales).
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Affiliation(s)
| | - Christopher Alan Lewis
- School of Psychology and Therapeutic Studies, Faculty of Social and Health Sciences, Leeds Trinity University, Leeds, United Kingdom
| | - Syeda Salma Hasan
- Department of Psychology, Government College University, Lahore, Pakistan
| | - Rabia Iftikhar
- Department of Clinical Psychology, Government College University, Lahore, Pakistan
| | - Muhammad Umar Fayyaz
- Department of Psychology, National University of Medical Sciences, Rawalpindi, Pakistan
- *Correspondence: Muhammad Umar Fayyaz,
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12
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Akçay E, Çöp E, Dinç GS, Göker Z, Parlakay AÖ, Demirel BD, Mutlu M, Kırmızı B. Loneliness, internalizing symptoms, and inflammatory markers in adolescent COVID-19 survivors. Child Care Health Dev 2022; 48:1112-1121. [PMID: 35946414 PMCID: PMC9537962 DOI: 10.1111/cch.13043] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/13/2021] [Revised: 04/18/2022] [Accepted: 08/07/2022] [Indexed: 11/30/2022]
Abstract
BACKGROUND Concerns about the psychiatric sequelae after COVID-19 infection have increased as the pandemic spreads worldwide. The increase in self-isolation during this pandemic period has also revealed the importance of feelings of loneliness. This study aimed to examine the relationship between baseline inflammation levels, internalizing symptoms, and feelings of loneliness in adolescent COVID-19 survivors in the long term. METHODS A total of 74 adolescents (41 girls, 55.4%, mean age 14.88) and their parents were included in the study. This cross-sectional study assessed internalizing symptoms via Revised Children's Anxiety and Depression Scale (RCADS) and feelings of loneliness using the UCLA-loneliness scale. Baseline inflammatory markers at COVID-19 diagnosis were collected. Logistic regression analysis was used to determine predictors for depression in adolescents. RESULTS The most common disorder was Major Depressive Disorder (MDD) (25.7%), and 33.8% of the adolescents were in the clinical range in at least one internalizing domain. Baseline C-Reactive Protein (CRP) levels correlated weakly with MDD scores. Loneliness scores correlated with all internalizing symptoms, strong association with MDD scores. Loneliness, anxiety, and parental anxiety were associated with an increased likelihood of MDD. Baseline CRP positivity did not predict MDD in adolescent COVID-19 survivors. CONCLUSIONS This study indicates that anxiety, loneliness, and parental anxiety play an important role in adolescents' experience of depressive symptoms after COVID-19 infection. Thus, screening parental psychopathology and loneliness in COVID-19 survivors seems to be preventive for adolescent mental health problems.
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Affiliation(s)
- Elif Akçay
- Department of Child and Adolescent PsychiatryAnkara City HospitalAnkaraTurkey
| | - Esra Çöp
- Department of Child and Adolescent PsychiatryAnkara City HospitalAnkaraTurkey
| | - Gülser Senses Dinç
- Department of Child and Adolescent PsychiatryAnkara City HospitalAnkaraTurkey
| | - Zeynep Göker
- Department of Child and Adolescent PsychiatryAnkara City HospitalAnkaraTurkey
| | | | - Betül Damla Demirel
- Department of Child and Adolescent PsychiatryAnkara City HospitalAnkaraTurkey
| | - Müge Mutlu
- Department of Child and Adolescent PsychiatryAnkara City HospitalAnkaraTurkey
| | - Begüm Kırmızı
- Department of Child and Adolescent PsychiatryAnkara City HospitalAnkaraTurkey
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13
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Non-SARS Coronaviruses in Individuals with Psychiatric Disorders. Curr Top Behav Neurosci 2022; 61:265-278. [PMID: 35947355 DOI: 10.1007/7854_2022_386] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/15/2022]
Abstract
BACKGROUND The pandemic caused by severe acute respiratory syndrome-Coronavirus-2 (SARS-CoV-2) has highlighted the importance of coronaviruses in human health. Several seasonal, non-SARS Coronaviruses are endemic in most areas of the world. In a previous study, we found that the level of antibodies to these seasonal Coronaviruses was elevated in persons with a recent onset of psychosis. In the current study, the level of antibodies to seasonal Coronaviruses was compared between individuals with psychiatric disorders and a non-psychiatric comparison group. METHODS Participants (N = 195) were persons with a diagnosis of schizophrenia, bipolar disorder, major depressive disorder, or without a psychiatric disorder. Each participant had a blood sample drawn from which were measured IgG antibodies to the spike proteins in four non-SARS Coronaviruses, 229E, HKU1, NL63, and OC43, using a multiplex electrochemiluminescence assay. Linear regression models were employed to compare the levels of antibodies between each psychiatric group and the comparison group adjusting for demographic variables. Logistic regression models were employed to calculate the odds ratios associated with increased levels of antibodies to each seasonal Coronavirus based on the 50th percentile level of the comparison group. RESULTS The schizophrenia group had significantly increased levels of antibodies to the seasonal Coronaviruses OC43 and NL63. This group also had increased odds of having elevated antibody levels to OC43. The major depression group showed a significantly lower level of antibodies to Coronavirus 229E. There were no significant differences between any of the psychiatric groups and the comparison group in the levels of antibodies to seasonal Coronaviruses 229E or HKU1. CONCLUSIONS The elevated level of antibodies to OC43 and NL63 in the schizophrenia group indicates increased exposure to these agents and raises the possibility that Coronaviruses may contribute to the etiopathology of this disorder. The cause-and-effect relationship between seasonal Coronaviruses and psychiatric disorders should be the subject of additional investigations focusing on longitudinal cohort studies.
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14
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Smith CJ, Renshaw P, Yurgelun-Todd D, Sheth C. Acute and chronic neuropsychiatric symptoms in novel coronavirus disease 2019 (COVID-19) patients: A qualitative review. Front Public Health 2022; 10:772335. [PMID: 36033820 PMCID: PMC9404694 DOI: 10.3389/fpubh.2022.772335] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2021] [Accepted: 07/11/2022] [Indexed: 01/21/2023] Open
Abstract
The coronavirus disease 2019 (COVID-19), caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) was declared a global pandemic by the World Health Organization (WHO) on March 11th, 2020. It has had unprecedented adverse effects on healthcare systems, economies, and societies globally. SARS-CoV-2 is not only a threat to physical health but has also been shown to have a severe impact on neuropsychiatric health. Many studies and case reports across countries have demonstrated insomnia, depressed mood, anxiety, post-traumatic stress disorder (PTSD), and cognitive change in COVID-19 patients during the acute phase of the infection, as well as in apparently recovered COVID-19 patients. The goal of this narrative review is to synthesize and summarize the emerging literature detailing the neuropsychiatric manifestations of COVID-19 with special emphasis on the long-term implications of COVID-19.
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Affiliation(s)
- Calen J. Smith
- Department of Psychiatry, University of Utah School of Medicine, Salt Lake City, UT, United States
- Diagnostic Neuroimaging, University of Utah, Salt Lake City, UT, United States
| | - Perry Renshaw
- Department of Psychiatry, University of Utah School of Medicine, Salt Lake City, UT, United States
- Diagnostic Neuroimaging, University of Utah, Salt Lake City, UT, United States
- George E. Wahlen Department of Veterans Affairs Medical Center, VA VISN 19 Mental Illness Research, Education and Clinical Center (MIRECC), Salt Lake City, UT, United States
| | - Deborah Yurgelun-Todd
- Department of Psychiatry, University of Utah School of Medicine, Salt Lake City, UT, United States
- Diagnostic Neuroimaging, University of Utah, Salt Lake City, UT, United States
- George E. Wahlen Department of Veterans Affairs Medical Center, VA VISN 19 Mental Illness Research, Education and Clinical Center (MIRECC), Salt Lake City, UT, United States
| | - Chandni Sheth
- Department of Psychiatry, University of Utah School of Medicine, Salt Lake City, UT, United States
- Diagnostic Neuroimaging, University of Utah, Salt Lake City, UT, United States
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15
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Xiao X, Zhang H, Ning W, Yang Z, Wang Y, Zhang T. Knockdown of FSTL1 inhibits microglia activation and alleviates depressive-like symptoms through modulating TLR4/MyD88/NF-κB pathway in CUMS mice. Exp Neurol 2022; 353:114060. [DOI: 10.1016/j.expneurol.2022.114060] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2021] [Revised: 03/24/2022] [Accepted: 03/27/2022] [Indexed: 12/28/2022]
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16
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Singh D, Singh E. An overview of the neurological aspects in COVID-19 infection. J Chem Neuroanat 2022; 122:102101. [PMID: 35430271 PMCID: PMC9008979 DOI: 10.1016/j.jchemneu.2022.102101] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2021] [Revised: 04/07/2022] [Accepted: 04/07/2022] [Indexed: 01/07/2023]
Abstract
The Crown-shaped, severe acute respiratory syndrome-Coronavirus-2 (SARS-CoV-2) triggered the globally fatal illness of Coronavirus disease-2019 (COVID-19). This infection is known to be initially reported in bats and has been causing major respiratory challenges. The primary symptoms of COVID-19 include fever, fatigue and dry cough. As progressed the complications may lead to acute respiratory distress syndrome (ADRS), arrhythmia and shock. This review illustrates the neurological and neuropsychiatric impairments due to COVID-19 infection. The SARS-CoV-2 virus enters via the hematogenous or neural route, spreads to the Central Nervous System (CNS), causing a blood-brain barrier (BBB) dysfunction. Recent scientific articles have reported that SARS-CoV-2 causes several neurological issues such as encephalitis, seizures, acute stroke, delirium, meningoencephalitis and Guillain-Barré Syndrome (GBS). As a long-term effect of this disease certain neuropsychiatric conditions are witnessed such as depression and anxiety. Invasion into followed by degeneration takes place causing an uncontrolled immune response. Transcription factors like NF-κB (nuclear factor kappa light chain enhancer of activated B cells), which modulate genes responsible for inflammatory response gets over expressed. Nrf2 (nuclear factor erythroid 2- related factor 2) counterpoises the inflammation by antioxidant response towards COVID-19 infection. Like every other infection, the severity of this infection leads to deterioration of major organ systems and even leads to death. By the columns of this review, we elaborate on the neurological aspects of this life-threatening infection.
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Affiliation(s)
- Divyanshi Singh
- KIIT School of Biotechnology, Bhubaneswar, Odisha 751024, India.
| | - Ekta Singh
- Acharya & BM Reddy College of Pharmacy, Soladevanahalli, Bengaluru 560107, India
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17
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De Berardis D, Di Carlo F, Di Giannantonio M, Pettorruso M. Legacy of neuropsychiatric symptoms associated with past COVID-19 infection: A cause of concern. World J Psychiatry 2022; 12:773-778. [PMID: 35978974 PMCID: PMC9258273 DOI: 10.5498/wjp.v12.i6.773] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/06/2021] [Revised: 09/13/2021] [Accepted: 05/17/2022] [Indexed: 02/06/2023] Open
Abstract
Although primarily affecting the respiratory system, growing attention is being paid to the neuropsychiatric consequences of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infections. Acute and sub-acute neuropsychiatric manifestations of coronavirus disease 2019 (COVID-19) disease and their mechanisms are better studied and understood currently than they had been when the pandemic began; however, many months or years will be necessary to fully comprehend how significant the consequences of such complications will be. In this editorial, we discuss the possible long-term sequelae of the COVID-19 pandemic, deriving our considerations on experiences drawn from past coronaviruses’ outbreaks, such as the SARS and the middle east respiratory syndrome, and from the knowledge of the mechanisms of neurotropism and invasiveness of SARS-CoV-2. Acknowledging the global spread of COVID-19 and the vast number of people affected, to date amounting to many millions, the matter of this pandemic’s neuropsychiatric legacy appears concerning. Public health monitoring strategies and early interventions seem to be necessary to manage the possible emergence of a severe wave of neuropsychiatric distress among the survivors.
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Affiliation(s)
| | - Francesco Di Carlo
- Neurosciences and Imaging and Clinical Sciences, University "G. D'Annunzio", Chieti 66100, Italy
| | - Massimo Di Giannantonio
- Neurosciences and Imaging and Clinical Sciences, University "G. D'Annunzio", Chieti 66100, Italy
| | - Mauro Pettorruso
- Neurosciences and Imaging and Clinical Sciences, University "G. D'Annunzio", Chieti 66100, Italy
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Karimi Z, Chenari M, Rezaie F, Karimi S, Parhizgari N, Mokhtari-Azad T. Proposed Pathway Linking Respiratory Infections with Depression. CLINICAL PSYCHOPHARMACOLOGY AND NEUROSCIENCE : THE OFFICIAL SCIENTIFIC JOURNAL OF THE KOREAN COLLEGE OF NEUROPSYCHOPHARMACOLOGY 2022; 20:199-210. [PMID: 35466092 PMCID: PMC9048006 DOI: 10.9758/cpn.2022.20.2.199] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/12/2021] [Revised: 06/30/2021] [Accepted: 07/15/2021] [Indexed: 12/28/2022]
Abstract
Depression is one of the most important causes of disability and loss of useful life of people around the world. Acute respiratory infection caused a large number of severe illnesses and deaths of the world and most of these due to viral infections, which is estimated more than 80% of respiratory infections. Detection of viruses by immune pathogen recognition receptors activates the intracellular signaling cascade and eventually cause produces interferons. Inflammatory process begins with secretion of interferons and the expression of interferon-stimulated genes. One of the most important of these genes is indoleamine-pyrrole 2,3-dioxygenase (IDO), which plays a major role in tryptophan catabolism. IDO is an intracellular monomeric enzyme that is also responsible for breaking down and consuming tryptophan in the Kynurenine pathway. Increased inflammation has been linked to decrease tryptophan concentrations and increase kynurenine levels. We tried to explain the role of inflammation by viral respiratory infections in causing depression.
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Affiliation(s)
- Zeinab Karimi
- Department of Virology, School of Public Health, Tehran University of Medical Science, Tehran, Iran
| | - Maryam Chenari
- Department of Virology, School of Public Health, Tehran University of Medical Science, Tehran, Iran
| | - Farhad Rezaie
- Department of Virology, School of Public Health, Tehran University of Medical Science, Tehran, Iran
| | - Shima Karimi
- Faculty of Health, Ilam University of Medical Sciences, Ilam, Iran
| | - Najmeh Parhizgari
- Department of Virology, School of Public Health, Tehran University of Medical Science, Tehran, Iran
| | - Talat Mokhtari-Azad
- Department of Virology, School of Public Health, Tehran University of Medical Science, Tehran, Iran
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19
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Hanson BA, Visvabharathy L, Ali ST, Kang AK, Patel TR, Clark JR, Lim PH, Orban ZS, Hwang SS, Mattoon D, Batra A, Liotta EM, Koralnik IJ. Plasma Biomarkers of Neuropathogenesis in Hospitalized Patients With COVID-19 and Those With Postacute Sequelae of SARS-CoV-2 Infection. NEUROLOGY(R) NEUROIMMUNOLOGY & NEUROINFLAMMATION 2022; 9:9/3/e1151. [PMID: 35256481 PMCID: PMC8901169 DOI: 10.1212/nxi.0000000000001151] [Citation(s) in RCA: 26] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/04/2021] [Accepted: 01/24/2022] [Indexed: 12/19/2022]
Abstract
BACKGROUND AND OBJECTIVES Although patients hospitalized with COVID-19 frequently present with encephalopathy, those with mild initial COVID-19 disease who never required hospitalization also often develop neurologic symptoms as part of postacute sequelae of severe acute respiratory coronavirus type 2 (SARS-CoV-2) infection (neuro-PASC). The pathogenic mechanisms of COVID-19 encephalopathy and neuro-PASC are unknown. We sought to establish biochemical evidence of CNS injury in those patients and their association with neuropsychiatric manifestations and SARS-CoV-2 antigenemia. METHODS We recruited hospitalized, posthospitalized, and nonhospitalized patients with confirmed diagnosis of COVID-19 with neurologic symptoms in addition to healthy control (HC) subjects. Plasma neurofilament light chain (pNfL), plasma glial fibrillary acidic protein (pGFAP), and plasma SARS-CoV-2 Nucleocapsid antigen (pN Ag) were measured by HD-X Simoa analyzer (Quanterix) and compared with neuropsychiatric symptoms, patient-reported quality-of-life measures, and standardized cognitive assessments. Neuroglial scores (pGFAP/pNfL) were calculated to estimate the relative contribution of astroglial and neuronal involvement. RESULTS We enrolled a total of 64 study participants, including 9 hospitalized patients with COVID-19 encephalopathy (CE), 9 posthospitalization neuro-PASC (PNP) patients, 38 nonhospitalized neuro-PASC (NNP) patients, and 8 HC subjects. Patients with CE were older, had higher pNfL and pGFAP concentrations, and more frequent pN Ag detection than all neuro-PASC groups. PNP and NNP patients exhibited similar PASC symptoms, decreased quality-of-life measures, and cognitive dysfunction, and 1 of the 38 (2.6%) NNP patients had pN Ag detectable 3 weeks postsymptoms onset. Patients with neuro-PASC presenting with anxiety/depression had higher neuroglial scores, which were correlated with increased anxiety on quality-of-life measures. DISCUSSION pNfL, pGFAP, and pN Ag measurements indicate neuronal dysfunction and systemic involvement in hospitalized COVID-19 patients with encephalopathy. Detection of SARS-CoV-2 N Ag in blood 3 weeks after symptoms onset in a nonhospitalized patient suggests that prolonged antigenic stimulation, or possibly latent infection, may occur. Anxiety was associated with evidence of astroglial activation in patients with neuro-PASC. These data shed new light on SARS-Cov-2 neuropathogenesis and demonstrate the value of plasma biomarkers across the COVID-19 disease spectrum.
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Affiliation(s)
- Barbara A Hanson
- From the Ken and Ruth Davee Department of Neurology (B.A.H., L.V., S.T.A., A.K.K., T.R.P., J.R.C., P.H.L., Z.S.O., A.B., E.M.L., I.J.K.), Feinberg School of Medicine, Northwestern University; Rush Medical College (B.A.H.), Chicago IL; and Quanterix Corporation (S.S.H., D.M.), Billerica, MA
| | - Lavanya Visvabharathy
- From the Ken and Ruth Davee Department of Neurology (B.A.H., L.V., S.T.A., A.K.K., T.R.P., J.R.C., P.H.L., Z.S.O., A.B., E.M.L., I.J.K.), Feinberg School of Medicine, Northwestern University; Rush Medical College (B.A.H.), Chicago IL; and Quanterix Corporation (S.S.H., D.M.), Billerica, MA
| | - Sareen T Ali
- From the Ken and Ruth Davee Department of Neurology (B.A.H., L.V., S.T.A., A.K.K., T.R.P., J.R.C., P.H.L., Z.S.O., A.B., E.M.L., I.J.K.), Feinberg School of Medicine, Northwestern University; Rush Medical College (B.A.H.), Chicago IL; and Quanterix Corporation (S.S.H., D.M.), Billerica, MA
| | - Anthony K Kang
- From the Ken and Ruth Davee Department of Neurology (B.A.H., L.V., S.T.A., A.K.K., T.R.P., J.R.C., P.H.L., Z.S.O., A.B., E.M.L., I.J.K.), Feinberg School of Medicine, Northwestern University; Rush Medical College (B.A.H.), Chicago IL; and Quanterix Corporation (S.S.H., D.M.), Billerica, MA
| | - Tulsi R Patel
- From the Ken and Ruth Davee Department of Neurology (B.A.H., L.V., S.T.A., A.K.K., T.R.P., J.R.C., P.H.L., Z.S.O., A.B., E.M.L., I.J.K.), Feinberg School of Medicine, Northwestern University; Rush Medical College (B.A.H.), Chicago IL; and Quanterix Corporation (S.S.H., D.M.), Billerica, MA
| | - Jeffrey R Clark
- From the Ken and Ruth Davee Department of Neurology (B.A.H., L.V., S.T.A., A.K.K., T.R.P., J.R.C., P.H.L., Z.S.O., A.B., E.M.L., I.J.K.), Feinberg School of Medicine, Northwestern University; Rush Medical College (B.A.H.), Chicago IL; and Quanterix Corporation (S.S.H., D.M.), Billerica, MA
| | - Patrick H Lim
- From the Ken and Ruth Davee Department of Neurology (B.A.H., L.V., S.T.A., A.K.K., T.R.P., J.R.C., P.H.L., Z.S.O., A.B., E.M.L., I.J.K.), Feinberg School of Medicine, Northwestern University; Rush Medical College (B.A.H.), Chicago IL; and Quanterix Corporation (S.S.H., D.M.), Billerica, MA
| | - Zachary S Orban
- From the Ken and Ruth Davee Department of Neurology (B.A.H., L.V., S.T.A., A.K.K., T.R.P., J.R.C., P.H.L., Z.S.O., A.B., E.M.L., I.J.K.), Feinberg School of Medicine, Northwestern University; Rush Medical College (B.A.H.), Chicago IL; and Quanterix Corporation (S.S.H., D.M.), Billerica, MA
| | - Soyoon S Hwang
- From the Ken and Ruth Davee Department of Neurology (B.A.H., L.V., S.T.A., A.K.K., T.R.P., J.R.C., P.H.L., Z.S.O., A.B., E.M.L., I.J.K.), Feinberg School of Medicine, Northwestern University; Rush Medical College (B.A.H.), Chicago IL; and Quanterix Corporation (S.S.H., D.M.), Billerica, MA
| | - Dawn Mattoon
- From the Ken and Ruth Davee Department of Neurology (B.A.H., L.V., S.T.A., A.K.K., T.R.P., J.R.C., P.H.L., Z.S.O., A.B., E.M.L., I.J.K.), Feinberg School of Medicine, Northwestern University; Rush Medical College (B.A.H.), Chicago IL; and Quanterix Corporation (S.S.H., D.M.), Billerica, MA
| | - Ayush Batra
- From the Ken and Ruth Davee Department of Neurology (B.A.H., L.V., S.T.A., A.K.K., T.R.P., J.R.C., P.H.L., Z.S.O., A.B., E.M.L., I.J.K.), Feinberg School of Medicine, Northwestern University; Rush Medical College (B.A.H.), Chicago IL; and Quanterix Corporation (S.S.H., D.M.), Billerica, MA
| | - Eric M Liotta
- From the Ken and Ruth Davee Department of Neurology (B.A.H., L.V., S.T.A., A.K.K., T.R.P., J.R.C., P.H.L., Z.S.O., A.B., E.M.L., I.J.K.), Feinberg School of Medicine, Northwestern University; Rush Medical College (B.A.H.), Chicago IL; and Quanterix Corporation (S.S.H., D.M.), Billerica, MA
| | - Igor J Koralnik
- From the Ken and Ruth Davee Department of Neurology (B.A.H., L.V., S.T.A., A.K.K., T.R.P., J.R.C., P.H.L., Z.S.O., A.B., E.M.L., I.J.K.), Feinberg School of Medicine, Northwestern University; Rush Medical College (B.A.H.), Chicago IL; and Quanterix Corporation (S.S.H., D.M.), Billerica, MA.
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20
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Depressive symptoms, but not anxiety, predict subsequent diagnosis of Coronavirus disease 19: a national cohort study. Epidemiol Psychiatr Sci 2022; 31:e16. [PMID: 35331365 PMCID: PMC8967696 DOI: 10.1017/s2045796021000676] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
AIMS Several diseases are linked to increased risk of Coronavirus disease 19 (COVID-19). Our aim was to investigate whether depressive and anxiety symptoms predict subsequent risk of COVID-19, as has been shown for other respiratory infections. METHODS We based our analysis on UK Biobank participants providing prospective data to estimate temporal association between depressive and anxiety symptoms and COVID-19. We estimated whether the magnitude of these symptoms predicts subsequent diagnosis of COVID-19 in this sample. Further, we evaluated whether depressive and anxiety symptoms predicted (i) being tested for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and (ii) COVID-19 in those tested. RESULTS Based on data from N = 135 102 participants, depressive symptoms (odds ratio (OR) = 1.052; 95% confidence interval (CI) 1.017-1.086; absolute case risk: (moderately) severe depression: 493 per 100 000 v. minimal depression: 231 per 100 000) but not anxiety (OR = 1.009; 95% CI 0.97-1.047) predicted COVID-19. While depressive symptoms but not anxiety predicted (i) being tested for SARS-CoV-2 (OR = 1.039; 95% CI 1.029-1.05 and OR = 0.99; 95% CI 0.978-1.002), (ii) neither predicted COVID-19 in those tested (OR = 1.015; 95% CI 0.981-1.05 and OR = 1.021; 95% CI 0.981-1.061). Results remained stable after adjusting for sociodemographic characteristics, multimorbidity and behavioural factors. CONCLUSIONS Depressive symptoms were associated with a higher risk of COVID-19 diagnosis, irrespective of multimorbidities. Potential underlying mechanisms to be elucidated include risk behaviour, symptom perception, healthcare use, testing likelihood, viral exposure, immune function and disease progress. Our findings highlight the relevance of mental processes in the context of COVID-19.
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21
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Wu CY, Lee MB, Huong PTT, Chan CT, Chen CY, Liao SC. The impact of COVID-19 stressors on psychological distress and suicidality in a nationwide community survey in Taiwan. Sci Rep 2022; 12:2696. [PMID: 35177670 PMCID: PMC8854558 DOI: 10.1038/s41598-022-06511-1] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2021] [Accepted: 01/28/2022] [Indexed: 12/18/2022] Open
Abstract
COVID-19 stressors and psychological stress response are important correlates of suicide risks under the COVID-19 pandemic. This study aimed to investigate the prevalence of COVID-19 stress, its impact on mental health and associated risk factors among the general population during the outbreak of COVID-19 in July 2020 throughout Taiwan. A nationwide population-based survey was conducted using a computer-assisted telephone interview system with a stratified, proportional randomization method for the survey. The questionnaire comprised demographic variables, psychological distress assessed by the five-item Brief Symptom Rating Scale and independent psychosocial variables including COVID-19 stressors, loneliness, suicidality, and health-related self-efficacy. In total, 2094 respondents completed the survey (female 51%). The COVID-19 stress was experienced among 45.4% of the participants, with the most prevalent stressors related to daily life and job/financial concerns. Higher levels of suicidality, loneliness, and a lower level of self-efficacy had significantly higher odds of having COVID-19 stress. The structural equation model revealed that COVID-19 stress was moderately associated with psychological distress and mediated by other psychosocial risk factors. The findings call for more attention on strategies of stress management and mental health promotion for the public to prevent larger scales of psychological consequences in future waves of the COVID-19 pandemic.
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Affiliation(s)
- Chia-Yi Wu
- School of Nursing, National Taiwan University College of Medicine, Taipei, Taiwan.
- Department of Nursing, National Taiwan University Hospital, Taipei, Taiwan.
- Taiwanese Society of Suicidology & Taiwan Suicide Prevention Center, Taipei, Taiwan.
- School of Nursing, National Taiwan University College of Medicine, 1, Jen-Ai Road Section 1, Taipei, 10051, Taiwan.
| | - Ming-Been Lee
- Taiwanese Society of Suicidology & Taiwan Suicide Prevention Center, Taipei, Taiwan
- Department of Psychiatry, Shin Kong Wu Ho-Su Memorial Hospital, Taipei, Taiwan
- Department of Psychiatry, National Taiwan University College of Medicine, Taipei, Taiwan
| | - Pham Thi Thu Huong
- School of Nursing, National Taiwan University College of Medicine, Taipei, Taiwan
- Faculty of Nursing and Midwifery, Hanoi Medical University, Hanoi, Vietnam
- National Institute of Mental Health, Bach Mai Hospital, Hanoi, Vietnam
| | - Chia-Ta Chan
- Taiwanese Society of Suicidology & Taiwan Suicide Prevention Center, Taipei, Taiwan
- Department of Psychiatry, Shin Kong Wu Ho-Su Memorial Hospital, Taipei, Taiwan
| | - Chun-Yin Chen
- Taiwanese Society of Suicidology & Taiwan Suicide Prevention Center, Taipei, Taiwan
| | - Shih-Cheng Liao
- Taiwanese Society of Suicidology & Taiwan Suicide Prevention Center, Taipei, Taiwan
- Department of Psychiatry, National Taiwan University College of Medicine, Taipei, Taiwan
- Department of Psychiatry, National Taiwan University Hospital, Taipei, Taiwan
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22
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Hornick MG, Olson ME, Jadhav AL. SARS-CoV-2 Psychiatric Sequelae: A Review of Neuroendocrine Mechanisms and Therapeutic Strategies. Int J Neuropsychopharmacol 2022; 25:1-12. [PMID: 34648616 PMCID: PMC8524640 DOI: 10.1093/ijnp/pyab069] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2021] [Revised: 09/07/2021] [Accepted: 10/12/2021] [Indexed: 12/15/2022] Open
Abstract
From the earliest days of the coronavirus disease 2019 (COVID-19) pandemic, there have been reports of significant neurological and psychological symptoms following Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) infection. This narrative review is designed to examine the potential psychoneuroendocrine pathogenic mechanisms by which SARS-CoV-2 elicits psychiatric sequelae as well as to posit potential pharmacologic strategies to address and reverse these pathologies. Following a brief overview of neurological and psychological sequelae from previous viral pandemics, we address mechanisms by which SARS-CoV-2 could enter or otherwise elicit changes in the CNS. We then examine the hypothesis that COVID-19-induced psychiatric disorders result from challenges to the neuroendocrine system, in particular the hypothalamic-pituitary-adrenal stress axis and monoamine synthesis, physiological mechanisms that are only further enhanced by the pandemic-induced social environment of fear, isolation, and socioeconomic pressure. Finally, we evaluate several FDA-approved therapeutics in the context of COVID-19-induced psychoneuroendocrine disorders.
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Affiliation(s)
- Mary G Hornick
- Roosevelt University, College of Science, Health and Pharmacy, Schaumburg, Illinois, USA
| | - Margaret E Olson
- Roosevelt University, College of Science, Health and Pharmacy, Schaumburg, Illinois, USA
| | - Arun L Jadhav
- Roosevelt University, College of Science, Health and Pharmacy, Schaumburg, Illinois, USA
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23
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Del Casale A, Modesti MN, Rapisarda L, Girardi P, Tambelli R. Clinical Aspects of Manic Episodes After SARS-CoV-2 Contagion or COVID-19. Front Psychiatry 2022; 13:926084. [PMID: 35782430 PMCID: PMC9240303 DOI: 10.3389/fpsyt.2022.926084] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/22/2022] [Accepted: 05/24/2022] [Indexed: 12/02/2022] Open
Abstract
As COVID-19 pandemic spread all over the world, it brought serious health consequences in every medical field, including mental health. Not only healthcare professionals were more prone to develop anxiety, depression, and stress, but the general population suffered as well. Some of those who had no prior history of a psychiatric disease developed peculiar symptoms following infection with SARS-CoV-2, mostly because of psychological and social issues triggered by the pandemic. People developed traumatic memories, and hypochondria, probably triggered by social isolation and stress. Infection with SARS-CoV-2 has influenced the mental health of psychiatric patients as well, exacerbating prior psychiatric conditions. In this review, we focus on analyzing those cases of mania in the context of bipolar disorder (BD) reported after COVID-19 disease, both in people with no prior psychiatric history and in psychiatric patients who suffered an exacerbation of the disease. Results have shown that COVID-19 may trigger a pre-existing BD or unmask an unknown BD, due to social and psychological influences (decreased social interaction, change in sleep patterns) and through biological pathways both (neuroinflammation and neuroinvasion through ACE-2 receptors expressed in the peripheral and central nervous systems (PNS and CNS respectively). No direct correlation was found between the severity of COVID-19 disease and manic symptoms. All cases presenting severe symptoms of both diseases needed specific medical treatment, meaning that they concur but are separate in the treatment strategy needed. This review highlights the importance of a now widespread viral disease as a potential agent unmasking and exacerbating bipolar mood disorder, and it can hopefully help physicians in establishing a rapid diagnosis and treatment, and pave the road for future research on neuroinflammation triggered by SARS-CoV-2.
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Affiliation(s)
- Antonio Del Casale
- Department of Dynamic and Clinical Psychology, and Health Studies, Faculty of Medicine and Psychology, Sapienza University, Rome, Italy.,Unit of Psychiatry, 'Sant'Andrea' University Hospital, Rome, Italy
| | | | | | - Paolo Girardi
- Department of Dynamic and Clinical Psychology, and Health Studies, Faculty of Medicine and Psychology, Sapienza University, Rome, Italy
| | - Renata Tambelli
- Department of Dynamic and Clinical Psychology, and Health Studies, Faculty of Medicine and Psychology, Sapienza University, Rome, Italy
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24
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Leone M, Kuja-Halkola R, Leval A, D'Onofrio BM, Larsson H, Lichtenstein P, Bergen SE. Association of severe childhood infections with depression and intentional self-harm in adolescents and young adults. Brain Behav Immun 2022; 99:247-255. [PMID: 34655731 DOI: 10.1016/j.bbi.2021.10.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2021] [Revised: 09/16/2021] [Accepted: 10/11/2021] [Indexed: 02/08/2023] Open
Abstract
Early-life infections have been linked with subsequent depression and self-harm. Examination of specific groups of infections and the role of familial factors may elucidate this observed relationship. We addressed these considerations in our investigations of the association of severe childhood infections with the risks of depression and self-harm in adolescence and early-adulthood. This population-based cohort study included all individuals born in Sweden between 1982 and 1996, with follow-up through 2013 (N = 1,506,070). Severe childhood infections were identified using inpatient and outpatient diagnoses from birth through age 12. Any infection as well as specific groups of infections were investigated. We examined diagnoses of depression and self-harm within inpatient and outpatient care and death by self-harm between ages 13 and 31. Cox proportional hazards regression models were used to estimate absolute risks, hazard ratios (HRs), and 95% CIs. When adjusting for sex and birth year, individuals exposed to any childhood infection demonstrated increased absolute risk differences for both outcomes (2.42% [95% CI, 0.41-4.43%] of being diagnosed with depression up until age 31, and 0.73% [-2.05% to 3.51%] of self-harm up until age 31) and increased relative risks (HR, 1.22 [1.20-1.24] for depression and HR, 1.29 [1.25-1.32] for self-harm). When controlling for unmeasured factors shared between family members by comparing discordant siblings, no strong association persisted. Our findings show that childhood infections may not be involved in the etiology of later depression and self-harm, and highlight the importance of identifying these genetic and environmental familial risk factors, which may serve as targets for interventions.
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Affiliation(s)
- Marica Leone
- Janssen Pharmaceutical Companies of Johnson and Johnson, Solna, Sweden; Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Solna, Sweden
| | - Ralf Kuja-Halkola
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Solna, Sweden
| | - Amy Leval
- Janssen Pharmaceutical Companies of Johnson and Johnson, Solna, Sweden; Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Solna, Sweden
| | - Brian M D'Onofrio
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Solna, Sweden; Department of Psychological and Brain Sciences, Indiana University, Bloomington, United States
| | - Henrik Larsson
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Solna, Sweden; School of Medical Sciences, Örebro University, Örebro, Sweden
| | - Paul Lichtenstein
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Solna, Sweden
| | - Sarah E Bergen
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Solna, Sweden.
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25
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Austgen G, Meyers MS, Gordon M, Livingston R. The Use of Electroconvulsive Therapy in Neuropsychiatric Complications of Coronavirus Disease 2019: A Systematic Literature Review and Case Report. J Acad Consult Liaison Psychiatry 2022; 63:86-93. [PMID: 34358726 PMCID: PMC8332922 DOI: 10.1016/j.jaclp.2021.07.010] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2021] [Accepted: 07/20/2021] [Indexed: 12/22/2022]
Abstract
BACKGROUND There is a significant prevalence of new onset neuropsychiatric symptoms (NPS), some severe and persistent, in patients with coronavirus disease 2019 (COVID-19). OBJECTIVE This study reports on the use of electroconvulsive therapy (ECT) to treat NPS associated with COVID-19. METHODS A review of the literature pertaining to the use of ECT in patients with COVID-19 and NPS was performed through PubMed, PsycINFO, and MEDLINE. Search terms included "Electroconvulsive Therapy" and "ECT," combined with "COVID-19" and "Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-COV-2)." In addition, we present a case in which ECT was used to achieve complete remission in a patient who developed new onset, treatment-resistant depression, psychosis, and catatonia, associated with COVID-19. RESULTS A total of 67 articles were reviewed with 3 selected for inclusion. These articles detailed 3 case reports of patients with new onset NPS (mania, psychosis and suicidality, and catatonia) that developed in the context of active COVID-19 and were treated successfully with ECT. CONCLUSIONS ECT, a broad-spectrum treatment that has been found to be effective in various NPS (independent of etiology), is shown in our case report and others, to be safe and effective for NPS associated with COVID-19. Although we identified only 3 other cases in the literature, we believe that the probable antiinflammatory mechanism of ECT, its safety and tolerability, and the faster time to symptom remission support the need for more research and increased clinician awareness about this life-saving procedure.
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Affiliation(s)
- Gabriela Austgen
- The Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX.
| | - Matthew S Meyers
- The Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX
| | - Mollie Gordon
- The Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX
| | - Robin Livingston
- The Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX
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26
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Russo M, Consoli S, De Rosa M, Calisi D, Dono F, Carrarini C, Onofrj M, De Angelis M, Sensi S. A case of Sars-Cov-2-related mania with prominent psychosis>. Psychiatry Res 2021; 306:114266. [PMID: 34781110 PMCID: PMC8562037 DOI: 10.1016/j.psychres.2021.114266] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2021] [Revised: 10/19/2021] [Accepted: 10/31/2021] [Indexed: 01/15/2023]
Affiliation(s)
- M. Russo
- Department of Neuroscience, Imaging and Clinical Sciences, “G. d'Annunzio” University of Chieti-Pescara, Chieti, Italy
| | - S. Consoli
- Department of Neuroscience, Imaging and Clinical Sciences, “G. d'Annunzio” University of Chieti-Pescara, Chieti, Italy
| | - M.A. De Rosa
- Department of Neuroscience, Imaging and Clinical Sciences, “G. d'Annunzio” University of Chieti-Pescara, Chieti, Italy
| | - D. Calisi
- Department of Neuroscience, Imaging and Clinical Sciences, “G. d'Annunzio” University of Chieti-Pescara, Chieti, Italy
| | - F. Dono
- Department of Neuroscience, Imaging and Clinical Sciences, “G. d'Annunzio” University of Chieti-Pescara, Chieti, Italy
| | - C. Carrarini
- Department of Neuroscience, Imaging and Clinical Sciences, “G. d'Annunzio” University of Chieti-Pescara, Chieti, Italy
| | - M. Onofrj
- Department of Neuroscience, Imaging and Clinical Sciences, “G. d'Annunzio” University of Chieti-Pescara, Chieti, Italy
| | - M.V. De Angelis
- Department of Neuroscience, Imaging and Clinical Sciences, “G. d'Annunzio” University of Chieti-Pescara, Chieti, Italy
| | - S.L. Sensi
- Department of Neuroscience, Imaging and Clinical Sciences, “G. d'Annunzio” University of Chieti-Pescara, Chieti, Italy,Center of Advanced Studies and Technology, “G. d'Annunzio” University of Chieti-Pescara, Chieti, Italy,Institute for Mind Impairments and Neurological Disorders (IMIND), University of California – Irvine, Irvine, USA,Corresponding author at: Department of Neuroscience, Imaging, and Clinical Sciences, “G. d'Annunzio”, University of Chieti-Pescara, Chieti, Italy
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27
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Javelot H, Straczek C, Meyer G, Gitahy Falcao Faria C, Weiner L, Drapier D, Fakra E, Fossati P, Weibel S, Dizet S, Langrée B, Masson M, Gaillard R, Leboyer M, Llorca PM, Hingray C, Haffen E, Yrondi A. Psychotropics and COVID-19: An analysis of safety and prophylaxis. L'ENCEPHALE 2021; 47:564-588. [PMID: 34548153 PMCID: PMC8410507 DOI: 10.1016/j.encep.2021.08.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/23/2021] [Accepted: 08/19/2021] [Indexed: 12/15/2022]
Abstract
The use of psychotropics during the COVID-19 pandemic has raised two questions, in order of importance: first, what changes should be made to pharmacological treatments prescribed to mental health patients? Secondly, are there any positive side effects of these substances against SARS-CoV-2? Our aim was to analyze usage safety of psychotropics during COVID-19; therefore, herein, we have studied: (i) the risk of symptomatic complications of COVID-19 associated with the use of these drugs, notably central nervous system activity depression, QTc interval enlargement and infectious and thromboembolic complications; (ii) the risk of mistaking the iatrogenic impact of psychotropics with COVID-19 symptoms, causing diagnostic error. Moreover, we provided a summary of the different information available today for these risks, categorized by mental health disorder, for the following: schizophrenia, bipolar disorder, anxiety disorder, ADHD, sleep disorders and suicidal risk. The matter of psychoactive substance use during the pandemic is also analyzed in this paper, and guideline websites and publications for psychotropic treatments in the context of COVID-19 are referenced during the text, so that changes on those guidelines and eventual interaction between psychotropics and COVID-19 treatment medication can be reported and studied. Finally, we also provide a literature review of the latest known antiviral properties of psychotropics against SARS-CoV-2 as complementary information.
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Affiliation(s)
- H Javelot
- Établissement public de santé Alsace Nord, 141, avenue Strasbourg, 67170 Brumath, France; Laboratoire de toxicologie et pharmacologie neuro cardiovasculaire, centre de recherche en biomédecine de Strasbourg, université de Strasbourg, 1, rue Eugène-Boeckel, 67000 Strasbourg, France.
| | - C Straczek
- Département de pharmacie, CHU d'Henri-Mondor, université Paris Est Créteil (UPEC), AP-HP, 1, rue Gustave-Eiffel, 94000 Créteil, France; Inserm U955, institut Mondor de recherche biomédical, neuropsychiatrie translationnelle, 8, rue du Général-Sarrail, 94000 Créteil, France
| | - G Meyer
- Service pharmacie, établissement public de santé Alsace Nord, 141, avenue Strasbourg, 67170 Brumath, France; Service pharmacie, CHU de Strasbourg, 1, porte de L'Hôpital, 67000 Strasbourg, France
| | - C Gitahy Falcao Faria
- Institute of Psychiatry, Federal University of Rio de Janeiro (UFRJ), avenue Pedro-Calmon, 550 - Cidade Universitária da Universidade Federal do Rio de Janeiro, 21941-901 Rio de Janeiro, Brazil
| | - L Weiner
- Clinique de psychiatrie, hôpitaux universitaire de Strasbourg, 1, porte de L'Hôpital, 67000 Strasbourg, France
| | - D Drapier
- Pôle hospitalo-universitaire de psychiatrie adulte, centre hospitalier Guillaume-Régnier, rue du Moulin-de-Joué, 35700 Rennes, France; EA 4712, comportements et noyaux gris centraux, université de Rennes 1, 2, avenue du Professeur Léon-Bernard, CS 34317, campus santé de Villejean, 35043 Rennes cedex, France
| | - E Fakra
- Pôle universitaire de psychiatrie, CHU de Saint-Étienne, 37, rue Michelet, 42000 Saint-Étienne, France
| | - P Fossati
- Inserm U1127, ICM, service de psychiatrie adultes, groupe hospitalier pitié Salpêtrière, Sorbonne université, AP-HP, 47-83, boulevard de l'Hôpital, 75013 Paris, France
| | - S Weibel
- Clinique de psychiatrie, hôpitaux universitaire de Strasbourg, 1, porte de L'Hôpital, 67000 Strasbourg, France
| | - S Dizet
- Centre de ressources et d'expertise en psychopharmacologie (CREPP) Bourgogne Franche-Comté, Chalon-sur-Saône, France; Service Pharmacie, CHS de Sevrey, 55, rue Auguste-Champio, 71100 Sevrey, France
| | - B Langrée
- Service pharmacie, centre hospitalier Guillaume-Régnier, rue du Moulin-de-Joué, 35700 Rennes, France; Clinique du Château de Garches, Nightingale Hospitals-Paris, 11, bis rue de la Porte-Jaune, 92380 Garches, France
| | - M Masson
- SHU, GHU psychiatrie et neurosciences, 1, rue Cabanis, 75014 Paris, France; GHU psychiatrie et neurosciences, université de Paris, Paris, France
| | - R Gaillard
- Conseil national des universités (CNU), 1, rue Cabanis, 75014 Paris, France
| | - M Leboyer
- Inserm, DMU IMPACT, IMRB, translational neuropsychiatry, fondation FondaMental, hôpitaux universitaires « H. Mondor », université Paris Est Créteil (UPEC), AP-HP, 40, rue de Mesly, 94000 Créteil, France; CHU de Clermont-Ferrand, 58, rue Montalembert, 63000 Clermont-Ferrand, France
| | - P M Llorca
- Université Clermont-Auvergne, 1, rue Lucie- et Raymond-Aubrac, 63100 Clermont-Ferrand, France; Pôle hospitalo-universitaire de psychiatrie d'adultes du Grand Nancy, centre psychothérapique de Nancy, 1, rue Docteur Archambault, 54520 Laxou, France
| | - C Hingray
- Département de neurologie, CHU de Nancy, 25, rue Lionnois, 54000 Nancy, France; CIC-1431 Inserm, service de psychiatrie, CHU de Besançon, 3, boulevard Alexandre-Fleming, 25000 Besançon, France
| | - E Haffen
- Laboratoire de neurosciences, université de Franche-Comté, 19, rue Ambroise-Paré, 25030 Besançon cedex, France
| | - A Yrondi
- Unité ToNIC, UMR 1214 CHU Purpan-Pavillon Baudot, place du Dr Joseph Baylac, 31024 Toulouse cedex 3, France
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Barthorpe A, Rogers JP. Coronavirus infections from 2002-2021: Neuropsychiatric Manifestations. Sleep Med 2021; 91:282-288. [PMID: 35221210 PMCID: PMC8651478 DOI: 10.1016/j.sleep.2021.11.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/12/2021] [Revised: 11/25/2021] [Accepted: 11/25/2021] [Indexed: 11/01/2022]
Abstract
Coronaviruses have been known to infect humans for several decades and there are four endemic subtypes: HCoV (human coronavirus) −229E, -NL63, -OC43 and -HKU1. These mainly cause a mild upper respiratory illness, but occasionally in vulnerable individuals they can result in more severe respiratory disease and, rarely, CNS involvement. Prior exposure to these viruses has also been associated with an increased odds of having a major psychiatric illness. The severe acute respiratory syndrome (SARS), caused by SARS-CoV, started in 2002 and, as well as causing a more severe respiratory phenotype, was also associated with delirium and affective symptoms acutely. Psychosis occurred in about 1% of individuals and was generally thought to be due to corticosteroid administration. The Middle East respiratory syndrome (MERS), caused by MERS-CoV, revealed similar findings. Survivors of both SARS and MERS reported persistent physical and psychological symptoms at least several months after the acute illness. The reported neuropsychiatric symptoms of COVID-19 range from the common symptoms of systemic and upper respiratory infections to severe and disabling conditions. Delirium has been described using varying terminology; as well as being a possible presenting feature of COVID-19, it has also been shown to be a marker of severe disease. Stroke, both ischaemic and haemorrhagic, have been reported to be more common in COVID-19 than in other medical illnesses. Mood and anxiety disorders are likely to be common at follow-up, while psychosis remains rare and controversial. ‘Long Covid’ is likely to represent a highly clinically and aetiologically heterogeneous group.
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Benedetti F, Palladini M, Paolini M, Melloni E, Vai B, De Lorenzo R, Furlan R, Rovere-Querini P, Falini A, Mazza MG. Brain correlates of depression, post-traumatic distress, and inflammatory biomarkers in COVID-19 survivors: A multimodal magnetic resonance imaging study. Brain Behav Immun Health 2021; 18:100387. [PMID: 34746876 PMCID: PMC8562046 DOI: 10.1016/j.bbih.2021.100387] [Citation(s) in RCA: 52] [Impact Index Per Article: 17.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2021] [Accepted: 10/31/2021] [Indexed: 01/08/2023] Open
Abstract
Psychiatric sequelae substantially contribute to the post-acute burden of disease associated with COVID-19, persisting months after clearance of the virus. Brain imaging shows white matter (WM) hypodensities/hyperintensities, and the involvement of grey matter (GM) in prefrontal, anterior cingulate (ACC) and insular cortex after COVID, but little is known about brain correlates of persistent psychopathology. With a multimodal approach, we studied whole brain voxel-based morphometry, diffusion-tensor imaging, and resting-state connectivity, to correlate MRI measures with depression and post-traumatic distress (PTSD) in 42 COVID-19 survivors without brain lesions, at 90.59 ± 54.66 days after COVID. Systemic immune-inflammation index (SII) measured in the emergency department, which reflects the immune response and systemic inflammation based on peripheral lymphocyte, neutrophil, and platelet counts, predicted worse self-rated depression and PTSD, widespread lower diffusivity along the main axis of WM tracts, and abnormal functional connectivity (FC) among resting state networks. Self-rated depression and PTSD inversely correlated with GM volumes in ACC and insula, axial diffusivity, and associated with FC. We observed overlapping associations between severity of inflammation during acute COVID-19, brain structure and function, and severity of depression and post-traumatic distress in survivors, thus warranting interest for further study of brain correlates of the post-acute COVID-19 syndrome. Beyond COVID-19, these findings support the hypothesis that regional GM, WM microstructure, and FC could mediate the relationship between a medical illness and its psychopathological sequelae, and are in agreement with current perspectives on the brain structural and functional underpinnings of depressive psychopathology.
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Affiliation(s)
- Francesco Benedetti
- Vita-Salute San Raffaele University, Milano, Italy
- Psychiatry & Clinical Psychobiology, Division of Neuroscience, IRCCS Scientific Institute Ospedale San Raffaele, Milano, Italy
| | - Mariagrazia Palladini
- Psychiatry & Clinical Psychobiology, Division of Neuroscience, IRCCS Scientific Institute Ospedale San Raffaele, Milano, Italy
| | - Marco Paolini
- Vita-Salute San Raffaele University, Milano, Italy
- Psychiatry & Clinical Psychobiology, Division of Neuroscience, IRCCS Scientific Institute Ospedale San Raffaele, Milano, Italy
- PhD Program in Molecular Medicine, University Vita-Salute San Raffaele, Milan, Italy
| | - Elisa Melloni
- Vita-Salute San Raffaele University, Milano, Italy
- Psychiatry & Clinical Psychobiology, Division of Neuroscience, IRCCS Scientific Institute Ospedale San Raffaele, Milano, Italy
| | - Benedetta Vai
- Vita-Salute San Raffaele University, Milano, Italy
- Psychiatry & Clinical Psychobiology, Division of Neuroscience, IRCCS Scientific Institute Ospedale San Raffaele, Milano, Italy
| | - Rebecca De Lorenzo
- Vita-Salute San Raffaele University, Milano, Italy
- Division of Immunology, Transplantation and Infectious Diseases, IRCCS Scientific Institute Ospedale San Raffaele, Milan, Italy
| | - Roberto Furlan
- Clinical Neuroimmunology, Division of Neuroscience, IRCCS Scientific Institute Ospedale San Raffaele, Milano, Italy
| | - Patrizia Rovere-Querini
- Vita-Salute San Raffaele University, Milano, Italy
- Division of Immunology, Transplantation and Infectious Diseases, IRCCS Scientific Institute Ospedale San Raffaele, Milan, Italy
| | - Andrea Falini
- Vita-Salute San Raffaele University, Milano, Italy
- Department of Neuroradiology, IRCCS Scientific Institute Ospedale San Raffaele, Milan, Italy
| | - Mario Gennaro Mazza
- Vita-Salute San Raffaele University, Milano, Italy
- Psychiatry & Clinical Psychobiology, Division of Neuroscience, IRCCS Scientific Institute Ospedale San Raffaele, Milano, Italy
- PhD Program in Cognitive Neuroscience, University Vita-Salute San Raffaele, Milan, Italy
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30
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Affiliation(s)
- S. Bentolhoda Mousavi
- Psychosis Research Center, University of
Social Welfare and Rehabilitation Sciences, Tehran, Iran
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31
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Putri C, Arisa J, Hananto JE, Hariyanto TI, Kurniawan A. Psychiatric sequelae in COVID-19 survivors: A narrative review. World J Psychiatry 2021; 11:821-829. [PMID: 34733644 PMCID: PMC8546765 DOI: 10.5498/wjp.v11.i10.821] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/26/2021] [Revised: 05/13/2021] [Accepted: 08/18/2021] [Indexed: 02/06/2023] Open
Abstract
In December 2019, a novel coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) was initially reported in Wuhan, China. Previous epidemics including SARS and middle east respiratory syndrome raises concern that COVID-19 infection may pose a significant threat to the mental health of affected individuals. Studies and reviews have shown the acute psychiatric manifestations in COVID-19 patients, although long term psychiatric sequelae are predicted, there are only few review studies about the long term psychiatry outcome in COVID-19 survivors. Clinically significant post-traumatic stress disorder, anxiety, and/or depression among COVID-19 survivors during 14-90 d were observed following the diagnosis. Risk of anxiety or depression were higher in patients with more severe illness at 6 mo follow-up, early convalescence, and at 1 mo follow-up. Diagnosis of COVID-19 Led to more first diagnoses and relapses of psychiatric illness during the first 14-90 d after COVID-19 diagnosis. The possible underlying mechanisms of psychiatric sequelae in COVID-19 infection are neurotropism, immune response to SARS-CoV-2, hypothalamo-pituitary-adrenal axis hyperactivity, disrupted neuronal circuits in several brain regions, increased stress levels, neuroinflammation, and neuronal death. This study will review the psychiatric sequelae in previous coronavirus pandemics, current studies, risk factors, and thorough explanation on pathophysiology of the psychiatric sequalae in COVID-19 survivors.
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Affiliation(s)
- Cynthia Putri
- Faculty of Medicine, Pelita Harapan University, Tangerang 15811, Indonesia
| | - Jessie Arisa
- Faculty of Medicine, Pelita Harapan University, Tangerang 15811, Indonesia
| | | | | | - Andree Kurniawan
- Department of Internal Medicine, Faculty of Medicine, Pelita Harapan University, Tangerang 15811, Indonesia
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COVID-19 dimensions are related to depression and anxiety among US college students: Findings from the Healthy Minds Survey 2020. J Affect Disord 2021; 292:270-275. [PMID: 34134025 PMCID: PMC8595066 DOI: 10.1016/j.jad.2021.05.121] [Citation(s) in RCA: 34] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/20/2021] [Revised: 04/30/2021] [Accepted: 05/31/2021] [Indexed: 11/27/2022]
Abstract
BACKGROUND The COVID-19 pandemic has brought about tremendous social and economic turmoil, which has been associated with increased levels of depression and anxiety. METHODS We analyzed data from the Healthy Minds Study (Fall Semester Cohort 2020), a non-probability sample of students across multiple colleges who completed an online survey between September - December 2020. Using multivariable logistic regression, we examined the associations between COVID-19 dimensions (concern, racial/ethnic discrimination, financial distress, infection, illness of loved one, death of loved one, caregiving) and mental health outcomes (depression, anxiety), adjusting for age, gender, race/ethnicity, and international student status. RESULTS Nearly a fifth of the sample reported moderately severe or severe depression, and nearly a third reported moderately severe or severe anxiety over the past two weeks. When accounting for all COVID-19 dimensions in the same model, COVID-19 concern, racial/ethnic discrimination, financial distress, and infection were significantly associated with moderately severe or severe depression; COVID-19 concern, financial distress, and infection were significantly associated with moderately severe or severe anxiety. CONCLUSIONS This study showed that the COVID-19 pandemic may have shaped mental health through a range of potential social and environmental dimensions. Interventions are required that consider multiple dimensions of COVID-19 to improve mental health during and after the pandemic.
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Rittmannsberger H, Barth M, Malik P, Yazdi K. [Neuropsychiatric Aspects of COVID-19 - A Narrative Overview]. FORTSCHRITTE DER NEUROLOGIE-PSYCHIATRIE 2021; 90:108-120. [PMID: 34341978 DOI: 10.1055/a-1523-3850] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
The SARS-CoV-2 virus (Severe Acute Respiratory Syndrome Coronavirus Type 2) and COVID-19 (Coronavirus Disease 2019) can affect numerous organ systems. In the present paper we offer an overview of the current state of knowledge about the psychiatric aspects of SARS-CoV-2 infection.Medline, Embase und LIVIVO were searched for relevant literature, the last query dating from March 2nd, 2021. Different stress factors in the context of the pandemic can lead to manifest mental illnesses. In addition, there is a risk of neuropsychological changes due to the biological effects of the virus itself.Our work describes the psychological symptoms of COVID-19 sufferers themselves and the psychological effects of the epidemic and the associated socio-economic and psychosocial stress factors on those who are not sick.The most common psychiatric complication among people with COVID-19 is delirium, while hospitalized patients seem to have an increased incidence of symptoms of anxiety, depression and PTSD. There are many case reports on psychotic disorders. In general, an existing psychiatric illness (especially dementia and psychotic disorders) also increases the risk of infection and of a more severe course of the disease. After recovery from COVID-19 infection, there is also a higher incidence of mental illnesses, in particular "Chronic Post-SARS Syndrome" with its manifestations such as fatigue, anxiety, depression and PTSD. In addition, the course of dementia seems to be negatively influenced by an infection with SARS-CoV-2.The second part deals with the effects of the epidemic as a stressor and the established socio-political measures on the mental health of people with and without previous mental illnesses. The literature currently available shows high symptom values for anxiety and depressive disorders as well as post-traumatic stress disorders, stress, suicidality, sleep disorders etc. Risk factors seem to include female gender, younger age and fewer resources, as well as previous psychiatric or physical illnesses. Extrinsic factors such as high infection rates, large numbers of deaths, long curfews/lockdowns, low trust in the government and ineffective measures against economic and social consequences increase the burden.
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Affiliation(s)
- Hans Rittmannsberger
- Abteilung Psychiatrie und psychotherapeutische Medizin, Pyhrn-Eisenwurzen Klinikum Steyr, Steyr, Austria
| | - Martin Barth
- Abteilung Psychiatrie und psychotherapeutische Medizin, Pyhrn-Eisenwurzen Klinikum Steyr, Steyr, Austria
| | - Peter Malik
- Abteilung Psychiatrie und psychotherapeutische Medizin, Pyhrn-Eisenwurzen Klinikum Steyr, Steyr, Austria
| | - Kurosch Yazdi
- Klinik für Psychiatrie mit Schwerpunkt Suchtmedizin, Kepler Universitatsklinikum GmbH, Linz, Austria.,Medizinische Fakultät, Johannes Kepler Universität Linz, Linz, Austria
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Association between chronic fatigue syndrome and suicidality among survivors of Middle East respiratory syndrome over a 2-year follow-up period. J Psychiatr Res 2021; 137:1-6. [PMID: 33631632 PMCID: PMC7888998 DOI: 10.1016/j.jpsychires.2021.02.029] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/11/2020] [Revised: 02/08/2021] [Accepted: 02/12/2021] [Indexed: 12/16/2022]
Abstract
Suicide is an important public health issue during the current pandemic of emerging infectious diseases (EIDs). In EIDs, various symptoms persist even after recovery, and chronic fatigue is among those that are commonly reported. The aim of this study was to examine the effects of chronic fatigue syndrome on suicidality during the recovery phase among survivors of Middle East respiratory syndrome (MERS). MERS survivors were recruited from five centers and prospectively followed up for 2 years. In total, 63 participants were registered at 12 months (T1), of whom 53 and 50 completed the assessments at 18 months (T2) and 24 months (T3), respectively. Suicidality and chronic fatigue were evaluated using the suicidality module of the Mini-International Neuropsychiatric Interview (MINI) and the Fatigue Severity Scale (FSS), respectively. We analyzed the relationship between chronic fatigue and suicidality during the follow-up period using the generalized estimating equation (GEE). The suicidality rates were 22.2% (n = 14), 15.1% (n = 8), and 10.0% (n = 5) at T1-T3, respectively. Of the 63 participants, 29 had chronic fatigue syndrome at T1. The group that reported chronic fatigue syndrome at T1 was more likely to experience suicidality during the 2-year follow-up than the group that reported otherwise (RR: 7.5, 95% CI: 2.4-23.1). This association was present even after adjusting for potential confounders (RR: 7.6, 95% CI: 2.2-26.0). Chronic fatigue syndrome and suicide risk among emerging infectious disease (EID) survivors should be acknowledged, and effective interventions must be developed.
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35
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Abstract
ABSTRACT COVID-19 hit the world amidst an unprecedented suicide epidemic in this century. As the world focuses on limiting the spread of the virus and prioritizing acutely medically ill patients, containment measures are not without mental health consequences. With rising anxiety and depression, risk of suicide-acutely and in the aftermath of the pandemic-also rises. This article aims to shed light on this major public health problem and better understand what factors may create or exacerbate psychiatric symptoms and suicide. We review suicide data predating the pandemic and examine impact of previous epidemics on suicide rates. We then focus on the current pandemic's impacts and the world's response to COVID-19. We examine how these may lead to increased suicide rates, focusing on the US population. Finally, we offer suggestions on mitigating interventions to curb the impending rise in suicide and the resultant increased burden on an already stretched health care system.
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Affiliation(s)
| | - Gaelle Rached
- Faculty of Medicine, University of Saint Joseph of Beirut, Beirut, Lebanon
| | - Jeffrey Geller
- Department of Psychiatry, University of Massachusetts Medical School
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36
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Contribution of Pro-Inflammatory Molecules Induced by Respiratory Virus Infections to Neurological Disorders. Pharmaceuticals (Basel) 2021; 14:ph14040340. [PMID: 33917837 PMCID: PMC8068239 DOI: 10.3390/ph14040340] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2021] [Revised: 03/30/2021] [Accepted: 04/02/2021] [Indexed: 12/19/2022] Open
Abstract
Neurobehavioral alterations and cognitive impairment are common phenomena that represent neuropsychiatric disorders and can be triggered by an exacerbated immune response against pathogens, brain injury, or autoimmune diseases. Pro-inflammatory molecules, such as cytokines and chemokines, are produced in the brain by resident cells, mainly by microglia and astrocytes. Brain infiltrating immune cells constitutes another source of these molecules, contributing to an impaired neurological synapse function, affecting typical neurobehavioral and cognitive performance. Currently, there is increasing evidence supporting the notion that behavioral alterations and cognitive impairment can be associated with respiratory viral infections, such as human respiratory syncytial virus, influenza, and SARS-COV-2, which are responsible for endemic, epidemic, or pandemic outbreak mainly in the winter season. This article will review the brain′s pro-inflammatory response due to infection by three highly contagious respiratory viruses that are the leading cause of acute respiratory illness, morbidity, and mobility in infants, immunocompromised and elderly population. How these respiratory viral pathogens induce increased secretion of pro-inflammatory molecules and their relationship with the alterations at a behavioral and cognitive level will be discussed.
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37
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Wierenga KL, Moore SE, Pressler SJ, Hacker ED, Perkins SM. Associations between COVID-19 perceptions, anxiety, and depressive symptoms among adults living in the United States. Nurs Outlook 2021; 69:755-766. [PMID: 33894985 PMCID: PMC8530452 DOI: 10.1016/j.outlook.2021.03.020] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2020] [Revised: 03/26/2021] [Accepted: 03/29/2021] [Indexed: 11/19/2022]
Abstract
BACKGROUND Associations among illness perceptions of viruses, anxiety and depression symptoms, and self-management decisions, such as mask-wearing, are critical to informing public health practices to mitigate the short- and long-term consequences of the SARS-CoV-2 viral pandemic. PURPOSE Guided by the common-sense model of self-regulation, this observational study examined associations among illness perceptions of COVID-19, anxiety, and depression symptoms among community-dwelling adults. METHOD Data were collected from 1380 adults living in the United States early in the pandemic (03-23-2020 to 06-02-2020). Participants completed online surveys. Analyses were conducted using descriptive statistics and correlations. FINDINGS While increased anxiety symptoms were associated with less perceived personal control, greater concern, and higher emotional responsiveness, increased depression symptoms were related to lower concern as well as greater emotional responsiveness and perceived consequences of the pandemic. DISCUSSION Associations among illness perceptions, anxiety, and depression symptoms may impact viral spread mitigation behavior adoption.
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Affiliation(s)
| | - Scott Emory Moore
- Frances Payne Bolton School of Nursing, Case Western Reserve University, Cleveland, OH
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38
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Nobile B, Durand M, Olié E, Guillaume S, Molès JP, Haffen E, Courtet P. The Anti-inflammatory Effect of the Tricyclic Antidepressant Clomipramine and Its High Penetration in the Brain Might Be Useful to Prevent the Psychiatric Consequences of SARS-CoV-2 Infection. Front Pharmacol 2021; 12:615695. [PMID: 33767623 PMCID: PMC7985338 DOI: 10.3389/fphar.2021.615695] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2020] [Accepted: 02/04/2021] [Indexed: 12/12/2022] Open
Abstract
At the time of writing (December 2020), coronavirus disease 2019 (COVID-19) has already caused more than one million deaths worldwide, and therefore, it is imperative to find effective treatments. The “cytokine storm” induced by Severe Acute Respiratory Syndrome-Coronavirus type 2 (SARS-CoV-2) is a good target to prevent disease worsening, as indicated by the results obtained with tocilizumab and dexamethasone. SARS-CoV-2 can also invade the brain and cause neuro-inflammation with dramatic neurological manifestations, such as viral encephalitis. This could lead to potentially incapacitating long-term consequences, such as the development of psychiatric disorders, as previously observed with SARS-CoV. Several pathways/mechanisms could explain the link between viral infection and development of psychiatric diseases, especially neuro-inflammation induced by SARS-CoV-2. Therefore, it is important to find molecules with anti-inflammatory properties that penetrate easily into the brain. For instance, some antidepressants have anti-inflammatory action and pass easily through the blood brain barrier. Among them, clomipramine has shown very strong anti-inflammatory properties in vitro, in vivo (animal models) and human studies, especially in the brain. The aim of this review is to discuss the potential application of clomipramine to prevent post-infectious mental complications. Repositioning and testing antidepressants for COVID-19 management could help to reduce peripheral and especially central inflammation and to prevent the acute and particularly the long-term consequences of SARS-CoV-2 infection.
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Affiliation(s)
- B Nobile
- Department of Emergency Psychiatry and Acute Care, CHU Montpellier, Montpellier, France.,IGF, Univ. Montpellier, CNRS, INSERM, Montpellier, France
| | - M Durand
- Pathogenesis and Control of Chronic Infection, University of Montpellier, INSERM, EFS; CHU Montpellier, Montpellier, France
| | - E Olié
- Department of Emergency Psychiatry and Acute Care, CHU Montpellier, Montpellier, France.,IGF, Univ. Montpellier, CNRS, INSERM, Montpellier, France.,FondaMental Foundation, Créteil, France
| | - S Guillaume
- Department of Emergency Psychiatry and Acute Care, CHU Montpellier, Montpellier, France.,IGF, Univ. Montpellier, CNRS, INSERM, Montpellier, France.,FondaMental Foundation, Créteil, France
| | - J P Molès
- Pathogenesis and Control of Chronic Infection, University of Montpellier, INSERM, EFS; CHU Montpellier, Montpellier, France
| | - E Haffen
- FondaMental Foundation, Créteil, France.,Service de Psychiatrie de l'Adulte, CIC-1431 INSERM, CHU de Besançon, Laboratoire de Neurosciences, Université de Franche-Comté, Besancon, France
| | - P Courtet
- Department of Emergency Psychiatry and Acute Care, CHU Montpellier, Montpellier, France.,IGF, Univ. Montpellier, CNRS, INSERM, Montpellier, France.,FondaMental Foundation, Créteil, France
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Collins ML, Cheney GA, Yehl JL, Sullivan GA, Stewart JT, Catalano G. Postviral Depression. J Psychiatr Pract 2021; 27:126-130. [PMID: 33656819 DOI: 10.1097/pra.0000000000000508] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
A previously healthy 68-year-old man rapidly developed a severe melancholic depression following influenza infection. There is an evolving understanding of the complex and possibly bidirectional relationship between depression and inflammation. We review the literature concerning this relationship in the context of viral infection and discuss possible implications for treatment.
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40
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Jung SJ, Lim SS, Yoon JH. Fluctuations in influenza-like illness epidemics and suicide mortality: A time-series regression of 13-year mortality data in South Korea. PLoS One 2021; 16:e0244596. [PMID: 33577567 PMCID: PMC7880447 DOI: 10.1371/journal.pone.0244596] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2020] [Accepted: 12/11/2020] [Indexed: 11/18/2022] Open
Abstract
Aims We explored the association between influenza epidemic and suicide mortality rates in a large population using a time-series regression of 13-year mortality data in South Korea. Methods Weekly suicide mortalities and influenza-like illness (ILI) were analyzed using time series regression. Regression coefficient for suicide mortality based on percentage change of ILI was calculated using a quasi-Poisson regression. Non-linear distributed lag models with quadratic function up to 24 weeks were constructed. Results The association between ILI and suicide mortality increased significantly up to 8 weeks post-influenza diagnosis. A significant positive association between ILI and suicide mortality was observed from 2009, when a novel influenza A(H1N1)pdm09 virus provoked a worldwide pandemic. No meaningful association between these factors was observed before 2009. Conclusion There was a significant positive relationship between ILI and suicide mortality after 2009, when a novel influenza A(H1N1)pdm09 virus provoked a worldwide pandemic.
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Affiliation(s)
- Sun Jae Jung
- Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea.,Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, Massachusetts, United States of America
| | - Sung-Shil Lim
- The Institute for Occupational Health, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Jin-Ha Yoon
- Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea.,The Institute for Occupational Health, Yonsei University College of Medicine, Seoul, Republic of Korea
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41
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Jung SJ, Lim SS, Yoon JH. Fluctuations in influenza-like illness epidemics and suicide mortality: A time-series regression of 13-year mortality data in South Korea. PLoS One 2021; 16:e0244596. [PMID: 33577567 DOI: 10.2139/ssrn.3441827] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2020] [Accepted: 12/11/2020] [Indexed: 05/23/2023] Open
Abstract
AIMS We explored the association between influenza epidemic and suicide mortality rates in a large population using a time-series regression of 13-year mortality data in South Korea. METHODS Weekly suicide mortalities and influenza-like illness (ILI) were analyzed using time series regression. Regression coefficient for suicide mortality based on percentage change of ILI was calculated using a quasi-Poisson regression. Non-linear distributed lag models with quadratic function up to 24 weeks were constructed. RESULTS The association between ILI and suicide mortality increased significantly up to 8 weeks post-influenza diagnosis. A significant positive association between ILI and suicide mortality was observed from 2009, when a novel influenza A(H1N1)pdm09 virus provoked a worldwide pandemic. No meaningful association between these factors was observed before 2009. CONCLUSION There was a significant positive relationship between ILI and suicide mortality after 2009, when a novel influenza A(H1N1)pdm09 virus provoked a worldwide pandemic.
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Affiliation(s)
- Sun Jae Jung
- Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
- Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, Massachusetts, United States of America
| | - Sung-Shil Lim
- The Institute for Occupational Health, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Jin-Ha Yoon
- Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
- The Institute for Occupational Health, Yonsei University College of Medicine, Seoul, Republic of Korea
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Kahil K, Cheaito MA, El Hayek R, Nofal M, El Halabi S, Kudva KG, Pereira-Sanchez V, El Hayek S. Suicide during COVID-19 and other major international respiratory outbreaks: A systematic review. Asian J Psychiatr 2021; 56:102509. [PMID: 33418284 PMCID: PMC7764387 DOI: 10.1016/j.ajp.2020.102509] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2020] [Revised: 10/22/2020] [Accepted: 12/08/2020] [Indexed: 12/01/2022]
Abstract
Coronavirus disease 2019 (COVID-19) was recently declared a pandemic by the WHO. This outbreak threatens not only physical health but also has significant repercussions on mental health. In recent world history, major infectious outbreaks were associated with severe mental health sequelae, including suicide. In this study, we systematically review the literature on suicidal outcomes during major international respiratory outbreaks, including COVID-19. We reviewed descriptive and analytic articles addressing suicide during major international respiratory outbreaks. We searched PubMed, Medline, Embase, Scopus, and PsycInfo databases and then utilized an independent method for study selection by a pair of reviewers. Two reviewers completed data abstraction and conducted a narrative summary of the findings. Our search generated 2,153 articles. Nine studies (three descriptive, five analytical, and one with mixed methodology) were eligible. The included studies were heterogeneous, divergent in methods, and with a low degree of evidence. Deducing an association between pandemics, suicide, and suicide-related outcomes remains thus poorly supported. Future research with better methodological characteristics, the use of longitudinal studies, and a focus on suicide as the primary outcome would allow for an in-depth understanding and formulation of the scope of this problem.
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Affiliation(s)
- Karine Kahil
- Department of Psychiatry, American University of Beirut, Riad El Solh, Beirut, 1107 2020, Lebanon
| | - Mohamad Ali Cheaito
- Department of Emergency Medicine, American University of Beirut, Riad El Solh, Beirut, 1107 2020, Lebanon
| | - Rawad El Hayek
- Faculty of Medicine, American University of Beirut, Riad El Solh, Beirut, 1107 2020, Lebanon
| | - Marwa Nofal
- Helwan Mental Health Hospital, Extension of Mansour St., Behind Kbretaj Helwan Club, Helwan, 25562198, Cairo, Egypt
| | - Sarah El Halabi
- Columbia University Program in Narrative Medicine, Columbia University, New York, NY, 10033, USA
| | - Kundadak Ganesh Kudva
- Early Psychosis Intervention Programme and East Region, Institute of Mental Health, 10 Buangkok View, Buangkok Green, Medical Park, 539747, Singapore
| | - Victor Pereira-Sanchez
- Department of Child and Adolescent Psychiatry, NYU Grossman School of Medicine, One Park Avenue, New York, NY, 10016, USA
| | - Samer El Hayek
- Department of Psychiatry, American University of Beirut, Riad El Solh, Beirut, 1107 2020, Lebanon.
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Szcześniak D, Gładka A, Misiak B, Cyran A, Rymaszewska J. The SARS-CoV-2 and mental health: From biological mechanisms to social consequences. Prog Neuropsychopharmacol Biol Psychiatry 2021; 104:110046. [PMID: 32730915 PMCID: PMC7384993 DOI: 10.1016/j.pnpbp.2020.110046] [Citation(s) in RCA: 71] [Impact Index Per Article: 23.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/13/2020] [Revised: 07/20/2020] [Accepted: 07/20/2020] [Indexed: 12/20/2022]
Abstract
In December 2019, the first case of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2, COVID-19) infection was reported. In only few weeks it has caused a global pandemic, with mortality reaching 3.4%, mostly due to a severe pneumonia. However, the impact of SARS-CoV-2 virus on the central nervous system (CNS) and mental health outcomes remains unclear. Previous studies have demonstrated the presence of other types of coronaviruses in the brain, especially in the brainstem. There is evidence that the novel coronavirus can penetrate CNS through the olfactory or circulatory route as well as it can have an indirect impact on the brain by causing cytokine storm. There are also first reports of neurological signs in patients infected by the SARS-Cov-2. They show that COVID-19 patients have neurologic manifestations like acute cerebrovascular disease, conscious disturbance, taste and olfactory disturbances. In addition, there are studies showing that certain psychopathological symptoms might appear in infected patients, including those related to mood and psychotic disorders as well as post-traumatic stress disorder. Accumulating evidence also indicates that the pandemic might have a great impact on mental health from the global perspective, with medical workers being particularly vulnerable. In this article, we provide a review of studies investigating the impact of the SARS-CoV-2 on the CNS and mental health outcomes. We describe neurobiology of the virus, highlighting the relevance to mental disorders. Furthermore, this article summarizes the impact of the SARS-CoV-2 from the public health perspective. Finally, we present a critical appraisal of evidence and indicate future directions for studies in this field.
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Affiliation(s)
- Dorota Szcześniak
- Department of Psychiatry, Wroclaw Medical University, Wybrzeże Ludwika Pasteura 10, 50-367 Wrocław, Poland
| | - Anna Gładka
- Department of Psychiatry, Wroclaw Medical University, Wybrzeże Ludwika Pasteura 10, 50-367 Wrocław, Poland.
| | - Błażej Misiak
- Department of Psychiatry, Wroclaw Medical University, Wybrzeże Ludwika Pasteura 10, 50-367 Wrocław, Poland.
| | - Agnieszka Cyran
- Department of Psychiatry, Wroclaw Medical University, Wybrzeże Ludwika Pasteura 10, 50-367 Wrocław, Poland.
| | - Joanna Rymaszewska
- Department of Psychiatry, Wroclaw Medical University, Wybrzeże Ludwika Pasteura 10, 50-367 Wrocław, Poland.
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The role of neurotropism in psychiatric patients with COVID-19. Eur Arch Psychiatry Clin Neurosci 2021; 271:385-386. [PMID: 32980914 PMCID: PMC7519972 DOI: 10.1007/s00406-020-01197-w] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2020] [Accepted: 09/17/2020] [Indexed: 01/08/2023]
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Hyperactivation of P2X7 receptors as a culprit of COVID-19 neuropathology. Mol Psychiatry 2021; 26:1044-1059. [PMID: 33328588 PMCID: PMC7738776 DOI: 10.1038/s41380-020-00965-3] [Citation(s) in RCA: 88] [Impact Index Per Article: 29.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/22/2020] [Revised: 11/04/2020] [Accepted: 11/17/2020] [Indexed: 12/14/2022]
Abstract
Scientists and health professionals are exhaustively trying to contain the coronavirus disease 2019 (COVID-19) pandemic by elucidating viral invasion mechanisms, possible drugs to prevent viral infection/replication, and health cares to minimize individual exposure. Although neurological symptoms are being reported worldwide, neural acute and long-term consequences of SARS-CoV-2 are still unknown. COVID-19 complications are associated with exacerbated immunoinflammatory responses to SARS-CoV-2 invasion. In this scenario, pro-inflammatory factors are intensely released into the bloodstream, causing the so-called "cytokine storm". Both pro-inflammatory factors and viruses may cross the blood-brain barrier and enter the central nervous system, activating neuroinflammatory responses accompanied by hemorrhagic lesions and neuronal impairment, which are largely described processes in psychiatric disorders and neurodegenerative diseases. Therefore, SARS-CoV-2 infection could trigger and/or worse brain diseases. Moreover, patients with central nervous system disorders associated to neuroimmune activation (e.g. depression, Parkinson's and Alzheimer's disease) may present increased susceptibility to SARS-CoV-2 infection and/or achieve severe conditions. Elevated levels of extracellular ATP induced by SARS-CoV-2 infection may trigger hyperactivation of P2X7 receptors leading to NLRP3 inflammasome stimulation as a key mediator of neuroinvasion and consequent neuroinflammatory processes, as observed in psychiatric disorders and neurodegenerative diseases. In this context, P2X7 receptor antagonism could be a promising strategy to prevent or treat neurological complications in COVID-19 patients.
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Abstract
PURPOSE OF REVIEW The aim of this review was to analyze COVID-19 effect on the biological features of suicidal vulnerability and its interaction with suicide-related biological pathways. We carried out a narrative review of international publications on the interactions of COVID-19 with the biological bases of suicide. RECENT FINDINGS We hypothesize that SARS-CoV-2 interacts with multiple biological processes that underlie suicidal behavior, such as the renin-angiotensin system, nicotinic receptors, and central and systemic inflammation. Social distancing measures may also worsen subjective or objective social disconnection, thus increasing the risk of suicide. Interestingly, the drugs used to prevent suicide could be promising options to counteract brain damage caused by this coronavirus. SARS-CoV-2 interacts with multiple biological pathways involved in suicide and opens a new window for understanding the suicidal process. The development of suicide prevention treatments in the context of a pandemic may benefit from knowledge on these interactions.
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Affiliation(s)
- I Conejero
- Department of Emergency Psychiatry and Acute Care, Lapeyronie Hospital, CHU Montpellier, Montpellier, France.
- PSNREC, Univ Montpellier, INSERM, CHU de Montpellier, Montpellier, France.
| | - B Nobile
- Department of Emergency Psychiatry and Acute Care, Lapeyronie Hospital, CHU Montpellier, Montpellier, France
- PSNREC, Univ Montpellier, INSERM, CHU de Montpellier, Montpellier, France
| | - E Olié
- Department of Emergency Psychiatry and Acute Care, Lapeyronie Hospital, CHU Montpellier, Montpellier, France
- PSNREC, Univ Montpellier, INSERM, CHU de Montpellier, Montpellier, France
- FondaMental Foundation, Créteil, France
| | - Ph Courtet
- Department of Emergency Psychiatry and Acute Care, Lapeyronie Hospital, CHU Montpellier, Montpellier, France
- PSNREC, Univ Montpellier, INSERM, CHU de Montpellier, Montpellier, France
- FondaMental Foundation, Créteil, France
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Postolache TT, Wadhawan A, Rujescu D, Hoisington AJ, Dagdag A, Baca-Garcia E, Lowry CA, Okusaga OO, Brenner LA. Toxoplasma gondii, Suicidal Behavior, and Intermediate Phenotypes for Suicidal Behavior. Front Psychiatry 2021; 12:665682. [PMID: 34177652 PMCID: PMC8226025 DOI: 10.3389/fpsyt.2021.665682] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2021] [Accepted: 04/30/2021] [Indexed: 12/27/2022] Open
Abstract
Within the general literature on infections and suicidal behavior, studies on Toxoplasma gondii (T. gondii) occupy a central position. This is related to the parasite's neurotropism, high prevalence of chronic infection, as well as specific and non-specific behavioral alterations in rodents that lead to increased risk taking, which are recapitulated in humans by T. gondii's associations with suicidal behavior, as well as trait impulsivity and aggression, mental illness and traffic accidents. This paper is a detailed review of the associations between T. gondii serology and suicidal behavior, a field of study that started 15 years ago with our publication of associations between T. gondii IgG serology and suicidal behavior in persons with mood disorders. This "legacy" article presents, chronologically, our primary studies in individuals with mood disorders and schizophrenia in Germany, recent attempters in Sweden, and in a large cohort of mothers in Denmark. Then, it reviews findings from all three meta-analyses published to date, confirming our reported associations and overall consistent in effect size [ranging between 39 and 57% elevation of odds of suicide attempt in T. gondii immunoglobulin (IgG) positives]. Finally, the article introduces certain links between T. gondii and biomarkers previously associated with suicidal behavior (kynurenines, phenylalanine/tyrosine), intermediate phenotypes of suicidal behavior (impulsivity, aggression) and state-dependent suicide risk factors (hopelessness/dysphoria, sleep impairment). In sum, an abundance of evidence supports a positive link between suicide attempts (but not suicidal ideation) and T. gondii IgG (but not IgM) seropositivity and serointensity. Trait impulsivity and aggression, endophenotypes of suicidal behavior have also been positively associated with T. gondii seropositivity in both the psychiatrically healthy as well as in patients with Intermittent Explosive Disorder. Yet, causality has not been demonstrated. Thus, randomized interventional studies are necessary to advance causal inferences and, if causality is confirmed, to provide hope that an etiological treatment for a distinct subgroup of individuals at an increased risk for suicide could emerge.
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Affiliation(s)
- Teodor T Postolache
- Department of Psychiatry, Mood and Anxiety Program, University of Maryland School of Medicine, Baltimore, MD, United States.,Veterans Health Administration, Rocky Mountain Mental Illness Research Education and Clinical Center (MIRECC), Military and Veteran Microbiome: Consortium for Research and Education (MVM-CoRE), Aurora, CO, United States.,Mental Illness Research, Education and Clinical Center (MIRECC), Veterans Integrated Service Network (VISN) 5, VA Capitol Health Care Network, Baltimore, MD, United States
| | - Abhishek Wadhawan
- Department of Psychiatry, Mood and Anxiety Program, University of Maryland School of Medicine, Baltimore, MD, United States.,Department of Psychiatry, Saint Elizabeth's Hospital, Washington, DC, United States
| | - Dan Rujescu
- Department of Psychiatry, Psychotherapy and Psychosomatics, University of Halle, Halle, Germany
| | - Andrew J Hoisington
- Veterans Health Administration, Rocky Mountain Mental Illness Research Education and Clinical Center (MIRECC), Military and Veteran Microbiome: Consortium for Research and Education (MVM-CoRE), Aurora, CO, United States.,Department of Systems Engineering and Management, Air Force Institute of Technology, Dayton, OH, United States.,Department of Physical Medicine & Rehabilitation, University of Colorado, Anschutz Medical Campus, Aurora, CO, United States
| | - Aline Dagdag
- Department of Psychiatry, Mood and Anxiety Program, University of Maryland School of Medicine, Baltimore, MD, United States
| | - Enrique Baca-Garcia
- Department of Psychiatry, Jimenez Diaz Foundation Hospital, Madrid, Spain.,Department of Psychiatry, Madrid Autonomous University, Madrid, Spain.,Department of Psychiatry, Rey Juan Carlos University Hospital, Móstoles, Spain.,Department of Psychiatry, General Hospital of Villalba, Madrid, Spain.,Department of Psychiatry, Infanta Elena University Hospital, Valdemoro, Spain.,Universidad Catolica del Maule, Talca, Chile.,Department of Psychiatry, Centre Hospitalier Universitaire de Nîmes, Nîmes, France
| | - Christopher A Lowry
- Veterans Health Administration, Rocky Mountain Mental Illness Research Education and Clinical Center (MIRECC), Military and Veteran Microbiome: Consortium for Research and Education (MVM-CoRE), Aurora, CO, United States.,Department of Physical Medicine & Rehabilitation, University of Colorado, Anschutz Medical Campus, Aurora, CO, United States.,Department of Integrative Physiology, Center for Neuroscience, Center for Microbial Exploration, University of Colorado Boulder, Boulder, CO, United States
| | - Olaoluwa O Okusaga
- Department of Psychiatry, Mood and Anxiety Program, University of Maryland School of Medicine, Baltimore, MD, United States.,Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, United States.,Michael E DeBakey VA Medical Center, Houston, TX, United States
| | - Lisa A Brenner
- Veterans Health Administration, Rocky Mountain Mental Illness Research Education and Clinical Center (MIRECC), Military and Veteran Microbiome: Consortium for Research and Education (MVM-CoRE), Aurora, CO, United States.,Department of Physical Medicine & Rehabilitation, University of Colorado, Anschutz Medical Campus, Aurora, CO, United States.,Department of Psychiatry & Neurology, University of Colorado, Anschutz Medical Campus, Aurora, CO, United States
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Abstract
PURPOSE OF REVIEW We present biological and psychological factors implicated in psychiatric manifestations of SARS-CoV-2, as well as its neuroinvasive capability and immune pathophysiology. RECENT FINDINGS Preexisting mental illness leads to worse clinical outcomes in COVID-19. The presence of the virus was reported in the cerebrospinal fluid (CSF) and brain tissue post-mortem. Most common psychiatric manifestations include delirium, mood disorders, anxiety disorders, and posttraumatic stress disorder. "Long-COVID" non-syndromal presentations include "brain-fogginess," autonomic instability, fatigue, and insomnia. SARS-CoV-2 infection can trigger prior vulnerabilities based on the priming of microglia and other cells, induced or perpetuated by aging and mental and physical illnesses. COVID-19 could further induce priming of neuroimmunological substrates leading to exacerbated immune response and autoimmunity targeting structures in the central nervous system (CNS), in response to minor immune activating environmental exposures, including stress, minor infections, allergens, pollutants, and traumatic brain injury.
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Dhrisya C, Prasathkumar M, Becky R, Anisha S, Sadhasivam S, Essa MM, Chidambaram SB, Al-Balushi B, Guillemin GJ, Qoronfleh MW. Social and Biological Parameters Involved in Suicide Ideation During the COVID-19 Pandemic: A Narrative Review. Int J Tryptophan Res 2020; 13:1178646920978243. [PMID: 35185341 PMCID: PMC8851148 DOI: 10.1177/1178646920978243] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2020] [Accepted: 11/08/2020] [Indexed: 12/24/2022] Open
Abstract
Fear is an indispensable characteristic of any infectious disease, and the alarm will be further amplified when the infection spreads uncontrollable, unpredictable, and global. The novel corona virus (SARS CoV-2) lead Covid-19, has been declared as a global emergency by WHO as it has affected millions of people with a high mortality rate. The non-availability of medicine for Covid-19 and the various control measures such as social distancing, self-isolation, house quarantine, and the new normal implementation by different nations across the world to control the spread of Covid-19 made people vulnerable to fear and anxiety. As a result, considerable number of Covid-19-related suicidal deaths has been reported across the world during this pandemic. There have been several studies which describe the psychosocial aspects of suicidal ideation. However, the research on the biological aspects of suicidal ideation/suicidal risk factors that are related to pandemic are unreported. Hence this review article is intended to provide a comprehensive analysis of suicidal deaths during Covid-19 and also aimed to addresses the possible link between suicidal ideation and different factors, including psycho-social, behavioral, neurobiological factors (proximal, distal, and inflammatory) and immunity. The alterations in glutamatergic and GABAergic neurotransmitters had upregulated the GABARB3, GABARA4, GABARA3, GABARR1, GABARG2, and GAD2 gene expressions in suicidal victims. The changes in the Kynurenine (KYN) pathway, Hypothalamus-Pituitary-Adrenal axis (HPA axis) hyperactivation, and dysregulation of serotonin biosynthesis would significantly alter the brain chemistry in people with suicide ideation.
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Affiliation(s)
- Chenthamara Dhrisya
- Bioprocess and Biomaterials Laboratory, Department of Microbial Biotechnology, Bharathiar University, Coimbatore, India
| | - Murugan Prasathkumar
- Bioprocess and Biomaterials Laboratory, Department of Microbial Biotechnology, Bharathiar University, Coimbatore, India
| | - Robert Becky
- Bioprocess and Biomaterials Laboratory, Department of Microbial Biotechnology, Bharathiar University, Coimbatore, India
| | - Salim Anisha
- Bioprocess and Biomaterials Laboratory, Department of Microbial Biotechnology, Bharathiar University, Coimbatore, India
| | - Subramaniam Sadhasivam
- Bioprocess and Biomaterials Laboratory, Department of Microbial Biotechnology, Bharathiar University, Coimbatore, India
- Department of Extension and Career Guidance, Bharathiar University, Coimbatore, India
| | - Musthafa Mohamed Essa
- Department of Food Science and Nutrition, CAMS, Sultan Qaboos University, Muscat, Oman
- Ageing and Dementia Research Group, Sultan Qaboos University, Muscat, Oman
| | - Saravana Babu Chidambaram
- Centre for Experimental Pharmacology & Toxicology (CPT), JSS Academy of Higher Education & Research, Mysuru, India
| | - Buthainah Al-Balushi
- Department of Food Science and Nutrition, CAMS, Sultan Qaboos University, Muscat, Oman
| | - Gilles J Guillemin
- Neuroinflammation Group, Faculty of Medicine and Health Sciences, Macquarie University, NSW, Australia
| | - M Walid Qoronfleh
- Research & Policy Department, World Innovation Summit for Health (WISH), Qatar Foundation, Doha, Qatar
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50
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Abstract
Pandemics have ravished the globe periodically, often associated with war, at times commencing as fever and rash, beginning in recorded history in the crowded walled city of Athens during the Peloponnesian War as described in great detail by the Athenian historian and military general Thucydides in 430 BCE. As the world now faces the first major pandemic of the 21st century, we focus on the "plague" commencing in Athens in 430 BCE and the 2 pandemics of the more recent century, which killed more than one million, the Spanish flu of 1918 and the Asian flu of 1957. The latter linked with successful vaccine development thanks to the heroic efforts of microbiologist Maurice Hilleman. We now look back and then forward to the viral infection coronavirus disease 2019 now devastating the world.
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Affiliation(s)
- Robert A Schwartz
- Departments of Dermatology, Pathology, and Pediatrics, Rutgers New Jersey Medical School, Infectious Diseases, Newark, New Jersey, USA
| | - Rajendra Kapila
- Departments of Dermatology, Pathology, and Pediatrics, Rutgers New Jersey Medical School, Infectious Diseases, Newark, New Jersey, USA.
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