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Bai F, Bono V, Borghi L, Bonazza F, Falcinella C, Vitaletti V, Miraglia F, Trunfio M, Calcagno A, Cusato J, Vegni E, Monforte AD, Marchetti G. Association between tight junction proteins and cognitive performance in untreated Persons living with HIV (PLWH). AIDS 2024:00002030-990000000-00485. [PMID: 38704619 DOI: 10.1097/qad.0000000000003923] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/06/2024]
Abstract
BACKGROUND HIV-associated neurocognitive disorders (HAND) still affects persons living with HIV (PLWH) and their pathogenesis isn't completely understood. We aimed to explore the association between plasma and CSF markers of blood-brain barrier (BBB) impairment and HAND in untreated PLWH. DESIGN Cross-sectional study. METHODS We enrolled untreated PLWH, who underwent blood exams and lumbar puncture to measure inflammation (IL-15, TNF-α), BBB damage (zonulin and tight junction proteins, TJs: occludin, claudin-5) and endothelial adhesion molecules (VCAM-1, ICAM-1). A comprehensive neurocognitive battery was used to diagnose HAND (Frascati criteria). RESULTS Twenty-one patients (21/78, 26,9%) patients presented HAND (100% ANI). HAND patients displayed more frequently non-CNS AIDS-defining conditions, lower nadir CD4+ T-cells and increased CD4+ T-cell exhaustion (lower CD4+CD127+ and CD4+CD45RA+ T cells percentages), in comparison to subjects without cognitive impairment. Furthermore, HAND was characterized by higher plasma inflammation (IL-15), but lower CSF levels of biomarkers of BBB impairment (zonulin and occludin). The association between BBB damage with HAND was confirmed by fitting a multivariable logistic regression. CSF/plasma endothelial adhesion molecules weren't associated with HAND, but with a poor performance in different cognitive domains. CONCLUSIONS By showing heightened inflammation and BBB impairment, our study suggests loss of BBB integrity as a possible factor contributing to the development of HAND in untreated PLWH.
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Affiliation(s)
- Francesca Bai
- Clinic of Infectious Diseases, San Paolo Hospital, ASST Santi Paolo e Carlo, Department of Health Sciences, University of Milan, Milan, Italy
| | - Valeria Bono
- Clinic of Infectious Diseases, San Paolo Hospital, ASST Santi Paolo e Carlo, Department of Health Sciences, University of Milan, Milan, Italy
| | - Lidia Borghi
- Unit of Clinical Psychology, San Paolo Hospital, ASST Santi Paolo e Carlo, Department of Health Sciences, University of Milan, Milan, Italy
| | - Federica Bonazza
- Unit of Clinical Psychology, San Paolo Hospital, ASST Santi Paolo e Carlo, Department of Health Sciences, University of Milan, Milan, Italy
| | - Camilla Falcinella
- Clinic of Infectious Diseases, San Paolo Hospital, ASST Santi Paolo e Carlo, Department of Health Sciences, University of Milan, Milan, Italy
| | - Virginia Vitaletti
- Clinic of Infectious Diseases, San Paolo Hospital, ASST Santi Paolo e Carlo, Department of Health Sciences, University of Milan, Milan, Italy
| | - Federica Miraglia
- Clinic of Infectious Diseases, San Paolo Hospital, ASST Santi Paolo e Carlo, Department of Health Sciences, University of Milan, Milan, Italy
| | - Mattia Trunfio
- Clinic of Infectious Diseases, Amedeo di Savoia Hospital, Department of Medical Sciences, University of Turin
| | - Andrea Calcagno
- Clinic of Infectious Diseases, Amedeo di Savoia Hospital, Department of Medical Sciences, University of Turin
| | - Jessica Cusato
- Laboratory of Pharmacology and Pharmacotherapy, Amedeo di Savoia Hospital, Department of Medical Sciences, University of Turin
| | - Elena Vegni
- Unit of Clinical Psychology, San Paolo Hospital, ASST Santi Paolo e Carlo, Department of Health Sciences, University of Milan, Milan, Italy
| | | | - Giulia Marchetti
- Clinic of Infectious Diseases, San Paolo Hospital, ASST Santi Paolo e Carlo, Department of Health Sciences, University of Milan, Milan, Italy
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Bonazza F, Del Negro S, Racagni M, Previtera AM, Vegni E. [Management of patients with chronic pain: emerging perspectives and current practices.]. Recenti Prog Med 2024; 115:30-34. [PMID: 38169358 DOI: 10.1701/4169.41643] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/05/2024]
Abstract
According to the International association for the study of pain (Aisd), chronic pain is «an unpleasant sensory and emotional experience associated with, or resembling, ongoing, or potential tissue damage». The evolution of the definition of chronic pain has recognized the centrality of subjective and multidimensional valence, involving biological, psychological, and social aspects. Hence, there is a need to introduce patient-centered medicine and broaden the chronic pain management modalities. The primary clinical goal purpose does not end with the biological dimension and treatment of pain but should include the patient's individual experience and maintain an interdisciplinary value, including pharmacological therapy, as well as psychological care and integrative interventions. The perspectives illustrated provided the theoretical rationale for the organization of the Pain Clinic at Asst Santi Paolo e Carlo University Hospitals in Milan. The articulation of this care pathway can serve as a model, which can be applied to other clinical settings, where an interdisciplinary and multimodal approach is needed.
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Affiliation(s)
- Federica Bonazza
- Dipartimento di Scienze della salute, Università di Milano - Dipartimento di Psicologia, Università Cattolica del Sacro Cuore, Milano
| | - Silvia Del Negro
- Dipartimento di Scienze della salute, Università di Milano - Unità operativa complessa di Psicologia clinica, Asst Santi Paolo e Carlo, Milano
| | - Milena Racagni
- Anestesia e terapia intensiva neurochirurgica, Asst Santi Paolo e Carlo, Milano
| | - Antonino M Previtera
- Dipartimento di Scienze della salute, Università di Milano - Unità operativa di Riabilitazione specialistica, Asst Santi Paolo e Carlo, Milano
| | - Elena Vegni
- Dipartimento di Scienze della salute, Università di Milano - Unità operativa complessa di Psicologia clinica, Asst Santi Paolo e Carlo, Milano
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Sansone F, Pellegrino GM, Caronni A, Bonazza F, Vegni E, Lué A, Bocci T, Pipolo C, Giusti G, Di Filippo P, Di Pillo S, Chiarelli F, Sferrazza Papa GF, Attanasi M. Long COVID in Children: A Multidisciplinary Review. Diagnostics (Basel) 2023; 13:1990. [PMID: 37370884 DOI: 10.3390/diagnostics13121990] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2023] [Revised: 06/01/2023] [Accepted: 06/01/2023] [Indexed: 06/29/2023] Open
Abstract
Long COVID syndrome has emerged as a long-lasting consequence of acute SARS-CoV-2 infection in adults. In addition, children may be affected by Long COVID, with potential clinical issues in different fields, including problems in school performance and daily activities. Yet, the pathophysiologic bases of Long COVID in children are largely unknown, and it is difficult to predict who will develop the syndrome. In this multidisciplinary clinical review, we summarise the latest scientific data regarding Long COVID and its impact on children. Special attention is given to diagnostic tests, in order to help the physicians to find potential disease markers and quantify impairment. Specifically, we assess the respiratory, upper airways, cardiac, neurologic and motor and psychological aspects. Finally, we also propose a multidisciplinary clinical approach.
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Affiliation(s)
| | | | - Antonio Caronni
- Department of Neurorehabilitation Sciences, IRCCS Istituto Auxologico Italiano, Ospedale San Luca, 20122 Milan, Italy
- Department of Biomedical Sciences for Health, Università degli Studi di Milano, 20133 Milan, Italy
| | - Federica Bonazza
- Department of Health Sciences, Clinical Psychology, University of Milan, Via di Rudinì 8, 20142 Milan, Italy
| | - Elena Vegni
- Department of Health Sciences, Clinical Psychology, University of Milan, Via di Rudinì 8, 20142 Milan, Italy
- Unit of Clinical Psychology, San Paolo Hospital, ASST Santi Paolo e Carlo, Via di Rudinì 8, 20142 Milan, Italy
| | - Alberto Lué
- Service of Digestive Diseases, University Clinic Hospital Lozano Blesa, IIS Aragón, 50009 Zaragoza, Spain
| | - Tommaso Bocci
- Department of Health Sciences, University of Milan, 20146 Milan, Italy
- Clinical Neurology Unit, Department of Health Sciences, "Azienda Socio-Sanitaria Territoriale Santi Paolo e Carlo", University of Milan, 20146 Milan, Italy
| | - Carlotta Pipolo
- Department of Health Sciences, Otorhinolaryngology Department, ASST Santi Paolo e Carlo, University of Milan, 20142 Milan, Italy
| | - Giuliano Giusti
- Paediatric Cardiology Unit, Niguarda Hospital, 20162 Milan, Italy
| | - Paola Di Filippo
- Paediatric Allergy and Pulmonology Unit, Department of Paediatrics, University of Chieti-Pescara, 66100 Chieti, Italy
| | - Sabrina Di Pillo
- Paediatric Allergy and Pulmonology Unit, Department of Paediatrics, University of Chieti-Pescara, 66100 Chieti, Italy
| | - Francesco Chiarelli
- Paediatric Allergy and Pulmonology Unit, Department of Paediatrics, University of Chieti-Pescara, 66100 Chieti, Italy
| | | | - Marina Attanasi
- Paediatric Allergy and Pulmonology Unit, Department of Paediatrics, University of Chieti-Pescara, 66100 Chieti, Italy
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Bonazza F, Politi G, Leone D, Vegni E, Borghi L. Psychological factors in functional hypothalamic amenorrhea: A systematic review and meta-analysis. Front Endocrinol (Lausanne) 2023; 14:981491. [PMID: 36777338 PMCID: PMC9911452 DOI: 10.3389/fendo.2023.981491] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2022] [Accepted: 01/16/2023] [Indexed: 01/28/2023] Open
Abstract
BACKGROUND Psychological factors have been found to be associated with functional hypothalamic amenorrhea (FHA); however, their role in the onset or persistence of FHA is still understudied. The study aims to assess the associations of psychological factors with the presence vs the absence of FHA. METHODS A systematic literature search has been conducted across the major databases (PubMed, PsycINFO, Scopus, and Embase) to explore the psychological factors associated with FHA. The search was limited to English-written articles published from 2000 onwards. Articles were selected based on stringent inclusion/exclusion criteria. After data extraction, meta-analysis and meta-synthesis were conducted. RESULTS Of 349 retrieved articles, eight studies were included. Findings indicate that the main psychological factors associated to FHA seem to be depression and eating attitudes, especially drive for thinness. FHA women present higher levels of anxiety, sleep disorders, dysfunctional attitudes, and alexithymia. The meta-analysis on drive for thinness revealed that the pooled MD across the studies was statistically significant both in the fixed 0.63 (95% CI: 0.31-0.95) and random model 0.70 (95% CI: 0.13-1.26). Likewise, as for depression, the pooled MD across the studies was statistically significant both in the fixed 0.60 (95% CI: 0.36-0.84) and random model 0.61 (95% CI: 0.20-1.01). DISCUSSION Findings showed the association of psychological factors and FHA and recognized their involvement in the persistence of the disorder. A multidisciplinary approach should involve a collaborative process between gynecologists, clinical psychologists, and psychiatrists, from diagnosis to treatment. Longitudinal studies should be implemented with a comparison/control group or by including clinical psychologists in the psychological assessment and study design.
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Affiliation(s)
- Federica Bonazza
- Department of Health Sciences, University of Milan, Milan, Italy
- *Correspondence: Federica Bonazza,
| | - Giuliana Politi
- Azienda Socio-Sanitaria Territoriale (ASST) Santi Paolo e Carlo, San Paolo University Hospital, Milan, Italy
| | - Daniela Leone
- Department of Health Sciences, University of Milan, Milan, Italy
- Azienda Socio-Sanitaria Territoriale (ASST) Santi Paolo e Carlo, San Paolo University Hospital, Milan, Italy
| | - Elena Vegni
- Department of Health Sciences, University of Milan, Milan, Italy
- Azienda Socio-Sanitaria Territoriale (ASST) Santi Paolo e Carlo, San Paolo University Hospital, Milan, Italy
| | - Lidia Borghi
- Department of Health Sciences, University of Milan, Milan, Italy
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Ballesio A, Zagaria A, Musetti A, Lenzo V, Palagini L, Quattropani MC, Vegni E, Bonazza F, Filosa M, Manari T, Freda MF, Saita E, Castelnuovo G, Plazzi G, Lombardo C, Franceschini C. Longitudinal associations between stress and sleep disturbances during COVID‐19. Stress Health 2022; 38:919-926. [PMID: 35332673 PMCID: PMC9111163 DOI: 10.1002/smi.3144] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/30/2021] [Revised: 12/13/2021] [Accepted: 03/16/2022] [Indexed: 12/16/2022]
Abstract
The psychological consequences of COVID-19 pandemic may include the activation of stress systems, that involve the hypothalamic-pituitary-adrenal axis which influences many physiological functions, including sleep. Despite epidemiological studies evidenced greater prevalence of stress symptoms and sleep disturbances during COVID-19, longitudinal evidence investigating the effects of stress on sleep disturbances during the pandemic is lacking. We collected measures of perceived stress and sleep disturbances during the first wave of COVID-19 (March 2020) and at 8-10 months follow up in a sample of 648 adults (M = 33.52, SD = 12.98 years). Results showed that 39.4% of participants reported moderate to extremely severe stress in March 2020. Prevalence of sleep disturbances was 54.8% in March 2020 and 57.4% at follow-up. Structural equation modelling highlighted that perceived stress in March 2020 significantly predicted sleep disturbances at follow up (β = 0.203; p < 0.001), even after controlling for baseline sleep disturbances. Results remained significant even after controlling for the effects of covariates including age, sex, depression and anxiety symptoms, and referring to psychological services (β = 0.179; p < 0.05). Findings confirm the high prevalence of stress symptoms during the COVID-19 pandemic and provide first longitudinal evidence for the effects of perceived stress on sleep disturbances during the pandemic.
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Affiliation(s)
- Andrea Ballesio
- Department of PsychologySapienza University of RomeRomeItaly
| | - Andrea Zagaria
- Department of PsychologySapienza University of RomeRomeItaly
| | - Alessandro Musetti
- Department of Humanities, Social Sciences and Cultural IndustriesUniversity of ParmaParmaItaly
| | - Vittorio Lenzo
- Department of Social and Educational Sciences of the Mediterranean AreaUniversity for Foreigners “Dante Alighieri”Reggio CalabriaItaly
| | - Laura Palagini
- Department of Clinical and Experimental Medicine, Psychiatric SectionUniversity of PisaAzienda Ospedaliera Universitaria Pisana (AOUP)PisaItaly
| | | | - Elena Vegni
- Department of Health SciencesUniversity of MilanMilanItaly
| | | | - Maria Filosa
- Department of Medicine and SurgeryUniversity of ParmaParmaItaly
| | - Tommaso Manari
- Department of Humanities, Social Sciences and Cultural IndustriesUniversity of ParmaParmaItaly
| | | | - Emanuela Saita
- Department of PsychologyCatholic University of MilanMilanItaly
| | - Gianluca Castelnuovo
- Department of PsychologyCatholic University of MilanMilanItaly,Istituto Auxologico Italiano IRCCSPsychology Research LaboratoryVerbaniaItaly
| | - Giuseppe Plazzi
- Department of Biomedical, Metabolic and Neural SciencesUniversity of Modena and Reggio EmiliaModenaItaly,IRCCS Istituto delle Scienze Neurologiche di BolognaBolognaItaly
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Wiedenmann F, Bergamelli E, Fior G, Del Giudice R, Bonazza F, Luridiana Battistini C, Sferrazza Papa G, Lamiani G, D'Agostino A. Psychiatric outcomes in patients hospitalized during the first wave of COVID-19 in Milan: A cohort study. Psychiatry Res 2022; 317:114931. [PMID: 37732869 PMCID: PMC9633257 DOI: 10.1016/j.psychres.2022.114931] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/04/2022] [Revised: 10/15/2022] [Accepted: 10/25/2022] [Indexed: 11/06/2022]
Affiliation(s)
- Federico Wiedenmann
- Department of Mental Health and Addiction, ASST Santi Paolo e Carlo, Milan, Italy; Department of Health Sciences, Università degli Studi di Milano, Italy
| | - Emilio Bergamelli
- Department of Mental Health and Addiction, ASST Santi Paolo e Carlo, Milan, Italy
| | - Giulia Fior
- Department of Mental Health and Addiction, ASST Santi Paolo e Carlo, Milan, Italy; Department of Health Sciences, Università degli Studi di Milano, Italy
| | - Renata Del Giudice
- Department of Mental Health and Addiction, ASST Santi Paolo e Carlo, Milan, Italy
| | - Federica Bonazza
- Department of Health Sciences, Università degli Studi di Milano, Italy
| | | | | | - Giulia Lamiani
- Department of Mental Health and Addiction, ASST Santi Paolo e Carlo, Milan, Italy
| | - Armando D'Agostino
- Department of Mental Health and Addiction, ASST Santi Paolo e Carlo, Milan, Italy; Department of Health Sciences, Università degli Studi di Milano, Italy.
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Vegni E, Bonazza F, Borghi L, Lamiani G. Communication and relationship at time of COVID-19: a possible heritage. Intern Emerg Med 2022; 17:943-944. [PMID: 35066858 PMCID: PMC8783787 DOI: 10.1007/s11739-021-02900-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/09/2021] [Accepted: 11/17/2021] [Indexed: 11/10/2022]
Affiliation(s)
- Elena Vegni
- Department of Health Sciences, University of Milan, Via A. di Rudinì 8, 20142, Milan, Italy.
- ASST Santi Paolo e Carlo, San Carlo Hospital, Via Di Rudinì 8, 20142, Milan, Italy.
| | - Federica Bonazza
- Department of Health Sciences, University of Milan, Via A. di Rudinì 8, 20142, Milan, Italy
| | - Lidia Borghi
- Department of Health Sciences, University of Milan, Via A. di Rudinì 8, 20142, Milan, Italy
| | - Giulia Lamiani
- Department of Health Sciences, University of Milan, Via A. di Rudinì 8, 20142, Milan, Italy
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Lamiani G, Borghi L, Bonazza F, Rebecchi D, Lazzari D, Vegni E. Adjustment Processes After the First Wave of the COVID-19 Pandemic: A Grounded Theory Study Based on Clinical Psychologists' Experience. Front Psychol 2022; 13:854745. [PMID: 35310254 PMCID: PMC8931717 DOI: 10.3389/fpsyg.2022.854745] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2022] [Accepted: 02/16/2022] [Indexed: 12/22/2022] Open
Abstract
Background Anxiety, depression, and post-traumatic stress have been reported among the general population during the first wave of the COVID-19 pandemic. However, the adjustment after the emergency phase remains under-investigated. This study aims to understand the adjustment processes of the population after the emergency phase of the pandemic. Methods We conducted a grounded theory based on the experience of 24 clinical psychologists who provided extensive support to the population during the pandemic in different Italian regions. Three online focus groups were conducted. The transcripts of the focus groups were analyzed through a process of open, axial, and selective coding. Data collection terminated once thematic saturation was reached. Results Repositioning emerged as the evolutionary task people were confronted with in the face of a New Reality. Repositioning meant dealing with and integrating unpleasant Emotional Experiences deriving from the lockdown and reopening (i.e., unsafety, emotional exhaustion, loneliness, uncertainty, loss, and disconnection) through different Coping Strategies. Repositioning was facilitated or hindered by contextual and individual Intervening Conditions and led to two Adjustment Outcomes: growth or block. Conclusion Results suggest that repositioning was the core task people had to face after the emergency phase of COVID-19. Proactive psychological interventions may support the population in repositioning in order to prevent maladjustment and encourage post-traumatic growth.
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Affiliation(s)
- Giulia Lamiani
- Department of Health Sciences, University of Milan, Milan, Italy
| | - Lidia Borghi
- Department of Health Sciences, University of Milan, Milan, Italy
| | - Federica Bonazza
- Department of Health Sciences, University of Milan, Milan, Italy
| | | | - David Lazzari
- Unit of Clinical Psychology, Hospital of Terni, Terni, Italy
| | - Elena Vegni
- Department of Health Sciences, University of Milan, Milan, Italy.,Unit of Clinical Psychology, ASST Santi Paolo e Carlo Hospital, Milan, Italy
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Bonazza F, Luridiana Battistini C, Fior G, Bergamelli E, Wiedenmann F, D'Agostino A, Sferrazza Papa GF, Borghi L, Piscopo K, Vegni E, Lamiani G. Recovering from COVID-19: psychological sequelae and post-traumatic growth six months after discharge. Eur J Psychotraumatol 2022; 13:2095133. [PMID: 35903268 PMCID: PMC9318207 DOI: 10.1080/20008198.2022.2095133] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
UNLABELLED Background: Clinical and scientific evidence has shown that a range of long-lasting symptoms can persist in the post-virological period. However, little is known about the psychological sequelae of patients hospitalized for coronavirus disease 2019 (COVID-19). Objective: This study aims to assess the prevalence of anxiety-depressive symptoms, post-traumatic stress disorder (PTSD), and post-traumatic growth among patients hospitalized for COVID-19 during the first wave of the pandemic 6 months after discharge, and to identify sociodemographic and clinical factors associated with psychological outcomes. Method: This cross-sectional cohort study enrolled recovered COVID-19 patients during a multidisciplinary follow-up screening. At 6 months post-discharge, participants underwent a remote assessment with the Mini-International Neuropsychiatric Interview Plus and completed the Hospital Anxiety and Depression Scale, PTSD Checklist for DSM-5, and Post-Traumatic Growth Inventory. Descriptive and regression analyses were conducted. Results: The sample was composed of 100 patients, mainly males (72%), with a mean ± SD age of 58.7 ± 11.8 years. Regarding psychological symptoms, 34% and 24% of patients, respectively, reported anxiety and depression over the clinical threshold, and 20% met the criteria for a possible PTSD diagnosis. Psychological symptoms were associated with the presence of a mood disorder in the patient's clinical history and having received a psychological consultation after discharge. Post-traumatic growth was associated with younger age and having received a psychological consultation after discharge. Conclusions: A high prevalence of anxiety and depressive symptoms, potentially indicative for a mood or anxiety disorder, and PTSD was confirmed among COVID-19 survivors after 6 months. Anxiety and depressive symptoms and PTSD were associated with a previous diagnosis of a mood disorder and having received psychological consultation. Post-traumatic growth was associated with younger age and having received psychological consultation. Tailored psychological interventions could help to elaborate the psychological suffering and foster post-traumatic growth after a traumatic experience such as COVID-19 hospitalization. HIGHLIGHTS A high prevalence of psychological symptoms has been observed among COVID-19 survivors 6 months after hospitalization.Tailored psychological interventions could help to contain the psychological sequelae and facilitate post-traumatic growth.
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Affiliation(s)
- Federica Bonazza
- Psychology, Department of Health Sciences, University of Milan, Milan, Italy
| | | | - Giulia Fior
- Psychiatry, Department of Health Sciences, University of Milan, Milan, Italy
| | - Emilio Bergamelli
- Psychiatry, Department of Health Sciences, University of Milan, Milan, Italy
| | - Federico Wiedenmann
- Psychiatry, Department of Health Sciences, University of Milan, Milan, Italy
| | - Armando D'Agostino
- Psychiatry, Department of Health Sciences, University of Milan, Milan, Italy
| | | | - Lidia Borghi
- Psychology, Department of Health Sciences, University of Milan, Milan, Italy
| | - Kyrie Piscopo
- Unit of Clinical Psychology, San Paolo Hospital, Milan, Italy
| | - Elena Vegni
- Psychology, Department of Health Sciences, University of Milan, Milan, Italy.,Unit of Clinical Psychology, San Paolo Hospital, Milan, Italy
| | - Giulia Lamiani
- Psychology, Department of Health Sciences, University of Milan, Milan, Italy
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Borghi L, Bonazza F, Lamiani G, Musetti A, Manari T, Filosa M, Quattropani MC, Lenzo V, Freda MF, Lemmo D, Saita E, Cattivelli R, Castelnuovo G, Vegni E, Franceschini C. Dreaming during lockdown: a quali-quantitative analysis of the Italian population dreams during the first COVID-19 pandemic wave. Res Psychother 2021; 24:547. [PMID: 34568113 PMCID: PMC8451213 DOI: 10.4081/ripppo.2021.547] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/03/2021] [Accepted: 07/29/2021] [Indexed: 12/02/2022]
Abstract
This study aims to explore the emotional experiences related to the lockdown during the first pandemic wave, analysing the dreams of the Italian population. Through an online survey spread throughout the country, participants completed the Depression Anxiety Stress Scale-21 (DASS-21), the Resilience Scale (RS) and were asked to narrate a dream they had during the lockdown. The dreams were qualitatively analysed through the thematic content analysis. Logistic regression analyses were then conducted to verify the relationship among the categories that emerged and between these categories and the DASS-21 and RS scores. In the dreams 8 categories were identified (Places, Characters, Relationships, Actions, Danger, Death, Processes, and Emotions) composed of specific sub-categories, which seem to compose a sort of narrative structure of the dream. Some sub-categories were found to be predictor of depression and resilience or with exposure to COVID-19. Dreams can be a valid tool both to understand the experiences of the population during the pandemic and to evaluate those at risk of developing distress in clinical practice.
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Affiliation(s)
- Lidia Borghi
- Psicologia Clinica, Dipartimento di Scienze della Salute, Università degli Studi di Milano, Milano
| | - Federica Bonazza
- Psicologia Clinica, Dipartimento di Scienze della Salute, Università degli Studi di Milano, Milano
| | - Giulia Lamiani
- Psicologia Clinica, Dipartimento di Scienze della Salute, Università degli Studi di Milano, Milano
| | - Alessandro Musetti
- Dipartimento di Discipline Umanistiche, Sociali e delle Imprese culturali, Università di Parma, Parma
| | - Tommaso Manari
- Dipartimento di Discipline Umanistiche, Sociali e delle Imprese culturali, Università di Parma, Parma
| | - Maria Filosa
- Dipartimento di Medicina e Chirurgia, Università di Parma, Parma
| | | | - Vittorio Lenzo
- Dipartimento di Scienze della Società e della Formazione d’Area Mediterranea, Università per Stranieri ‘Dante Alighieri’ di Reggio Calabria
| | | | - Daniela Lemmo
- Dipartimento di Scienze Umanistiche, Università Federico II, Napoli
| | - Emanuela Saita
- Dipartimento di Psicologia, Università Cattolica di Milano, Milano
| | - Roberto Cattivelli
- Dipartimento di Psicologia, Università Cattolica di Milano, Milano
- Istituto Auxologico Italiano IRCCS, Laboratorio di Ricerca Psicologica, Milano, Italy
| | - Gianluca Castelnuovo
- Dipartimento di Psicologia, Università Cattolica di Milano, Milano
- Istituto Auxologico Italiano IRCCS, Laboratorio di Ricerca Psicologica, Milano, Italy
| | - Elena Vegni
- Psicologia Clinica, Dipartimento di Scienze della Salute, Università degli Studi di Milano, Milano
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Lamiani G, Bonazza F, Del Negro S, Meyer EC. The impact of visiting the Intensive Care Unit on children's and adolescents' psychological well-being: A systematic review. Intensive Crit Care Nurs 2021; 65:103036. [PMID: 33775551 DOI: 10.1016/j.iccn.2021.103036] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2020] [Revised: 02/12/2021] [Accepted: 02/21/2021] [Indexed: 10/21/2022]
Abstract
OBJECTIVES The visits of children/adolescents in adult intensive care units are increasingly more common. However, few studies examine the psychological impact of visiting. This systematic review aims to summarise the psychological effects that visiting family members has on children/adolescents. RESEARCH METHODOLOGY A systematic review of research articles published from 1990 to January 2021 was conducted using PsycInfo, PubMed, and CINAHL. Inclusion/exclusion criteria were applied. Those studies included were evaluated using the Joanna Briggs Institute Critical Appraisal tools. A narrative synthesis of the results was conducted. SETTING Adult intensive care unit. RESULTS The review identified five studies (three of which qualitative), involving 141 children/adolescents. Although the experience of visiting was potentially traumatic, it enabled children/adolescents to better understand the reality and to preserve their relationships with family members. The impact of visiting was influenced by individual characteristics (e.g., age, past traumatic experiences) and by organisational characteristics (e.g., facilitated visit or not). Regardless of visitation, most children/adolescents presented anxiety and depression symptoms that need to be addressed. CONCLUSIONS Child/adolescent visitation seems to have positive effects, provided there is preparation and facilitation. Clinicians should pay attention to individual characteristics and optimise organisational factors (e.g., environment) in order to minimise potentially trauma-inducing aspects.
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Affiliation(s)
- Giulia Lamiani
- Department of Health Sciences, University of Milan, Via Di Rudinì 8, 20142 Milan, Italy.
| | - Federica Bonazza
- Department of Health Sciences, University of Milan, Via Di Rudinì 8, 20142 Milan, Italy
| | - Silvia Del Negro
- ASST Santi Paolo e Carlo, San Carlo Hospital, Via Pio II 3, 20153 Milan, Italy
| | - Elaine C Meyer
- Department of Psychiatry, Boston Children's Hospital, 300 Longwood Ave, Boston, MA 02115, USA; Center for Bioethics, Harvard Medical School, 641 Huntington Avenue, Boston, MA 02115, USA
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Bonazza F, Borghi L, di San Marco EC, Piscopo K, Bai F, Monforte AD, Vegni E. Psychological outcomes after hospitalization for COVID-19: data from a multidisciplinary follow-up screening program for recovered patients. Res Psychother 2020; 23:491. [PMID: 33585298 PMCID: PMC7875065 DOI: 10.4081/ripppo.2020.491] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/02/2020] [Accepted: 11/04/2020] [Indexed: 12/16/2022]
Abstract
Patients who are hospitalized for coronavirus disease 2019 (COVID-19) face an extremely stressful experience that might challenge their mental health. The study aims to describe the psychological condition of recovered patients, focusing on anxiety and depression symptoms, as well as post-traumatic stress. All the recovered COVID-19 patients who accessed to a multidisciplinary follow-up screening program scheduled within two months after their hospital discharge were included. As far as the psychological assessment, patients completed the Hospital Anxiety and Depression Scale and the Impact of Event Scale- Revised for post-traumatic stress. Socio-demographic and clinical data (days of hospitalization, intensity of received care, and number of supportive sessions with the hospital psychologist after the hospitalization) were collected. Descriptive, correlation and regression analyses were conducted. The sample includes 261 patients (68.2% men), aged between 23 and 90 (mean=58.9 st. dev=13.3). High numbers of patients reported anxiety (28%) and depression symptoms (17%), as well as post-traumatic stress (36.4%). Impaired outcomes were associated with female gender, while patient's age was found to be negatively correlated with anxiety symptoms. 13.8% of patients underwent a psychological visit and 6.1% of them were taken in charge for psychological support. Few months after hospital discharge, individuals recovered by COVID-19 reported negative consequences on their mental health. Understanding the impact that COVID-19 and hospitalization have on recovered patients may provide insights about how to develop an effective psychological intervention to help them deal with such psychological distress and prevent further psychopathological effects.
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Affiliation(s)
| | - Lidia Borghi
- Department of Health Science, University of Milan
| | | | - Kyrie Piscopo
- Unit of Clinical Psychology, Santi Paolo and Carlo Hospital, Milan
| | - Francesca Bai
- Clinic of Infectious Diseases and Tropical Medicine, Department of Health Sciences, University of Milan, ASST Santi Paolo e Carlo, Milan, Italy
| | - Antonella d’Arminio Monforte
- Clinic of Infectious Diseases and Tropical Medicine, Department of Health Sciences, University of Milan, ASST Santi Paolo e Carlo, Milan, Italy
| | - Elena Vegni
- Department of Health Science, University of Milan
- Unit of Clinical Psychology, Santi Paolo and Carlo Hospital, Milan
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Leone D, Borghi L, Bonazza F, Abrami MA, Barcellini G, Benlodi A, Bianchi F, Cacciatori I, Corsini V, Gamba A, Gualeni L, Lo Iacono NB, Longeri A, Mazza U, Ortega A, Pratelli A, Rigamonti V, Sacchelli C, Serafini A, Spada S, Strepparava MG, Vergani L, Zanotti P, Vegni E. [Psychological interventions in hospital during the first-wave of CoViD-19: an overview of the experiences of the Units of Clinical Psychology in Lombardy, Italy.]. Recenti Prog Med 2020; 111:593-601. [PMID: 33078009 DOI: 10.1701/3453.34419] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
The current CoViD-19 pandemic threatens both physical and psychological well-being. According to the bio-psycho-social model, Units of Clinical Psychology of the Hospitals in Lombardy (Italy) reacted to this risk, offering diversified interventions, described in the present contribution. The medical staff operated on the front line during the emergency: psychologists addressed their needs through individual clinical work, sessions of decompression and debriefing. At the same time, Units of Clinical Psychology supported the hospitalized positive patients by conducting psychological consultations, either on the ward or through devices. Moreover, some hospitals activated helplines to address the needs of the population and family members, who were particularly vulnerable during the relative's illness and after the mourning.
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Affiliation(s)
- Daniela Leone
- UOC Psicologia Clinica, ASST Santi Paolo Carlo, Milano
| | - Lidia Borghi
- Psicologia Clinica, Dipartimento di Scienze della Salute, Università di Milano
| | - Federica Bonazza
- Psicologia Clinica, Dipartimento di Scienze della Salute, Università di Milano
| | - Maria Angela Abrami
- UOS Psicologia Clinica e del Benessere Psicologico, ASST Spedali Civili, Brescia
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Maria Grazia Strepparava
- UOSD Psicologia Clinica, ASST Monza - Dipartimento di Medicina e Chirurgia, Università Milano-Bicocca
| | | | | | - Elena Vegni
- UOC Psicologia Clinica, ASST Santi Paolo Carlo, Milano - Psicologia Clinica, Dipartimento di Scienze della Salute, Università di Milano
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