The relationship between social media use, stress symptoms and burden caused by coronavirus (Covid-19) in Germany and Italy: A cross-sectional and longitudinal investigation

Introduction

The need for “social distancing” to reduce the spread of Covid-19 is accompanied by an increase of social media use (SMU). Many people engage in intensive online activity to find information about the current Covid-19 situation and to interact about it with other users. The present study investigated the extent of SMU as Covid-19 information source and its relationship with stress symptoms and burden caused by the pandemic in Germany and Italy.

Methods

Cross-national longitudinal (Germany, N = 501; 3-months period) and cross-sectional (Italy, N = 951) data on Covid-19 information sources, stress symptoms and burden caused by Covid-19 were collected via online surveys.

Results

About 50% of the German sample and about 60% of the Italian sample frequently used SM as Covid-19 information source. Cross-sectional analyses in both countries revealed that SMU is positively associated with stress symptoms and experienced burden. Moreover, stress symptoms mediated the link between SMU and burden. This was also confirmed by longitudinal analyses in Germany (burden assessed three months after SMU and stress symptoms).

Limitations

The mostly female and relatively young sample composition limits the generalizability of present findings. Only two European countries were investigated.

Conclusions

The present findings reveal a potential negative impact of enhanced SMU on individual mental health state and behavior. Additionally, they emphasize the significance of a conscious and cautious use of SM as information source specifically during the pandemic.

The influence of ethanol infusion on the effects of 35% CO2challenge. A study in panic disorder patients and healthy volunteers

Alcohol and panic disorders co-occur at a rate that exceeds chance significantly. Early experimental work suggests that alcoholic subjects, compared to non-alcoholics, are less sensitive to sodium lactate and that alcohol intake reduces the response to a 35% CO2challenge in Panic Disorder patients. The present study documents the direct pharmacological effect of ethanol infusion on CO2induced panic.

Methods

According to a placebo-controlled, double-blind, randomized, cross-over design 10 drug free panic disorder patients and 16 healthy volunteers underwent a 35% CO2challenge after intravenous infusion of a moderate dose of ethanol on one test day and of placebo on another test day.

Results

Compared to the placebo condition, the effect of the CO2challenge was significantly smaller after ethanol infusion (P= 0.041).

Discussion

A moderate dose of ethanol decreased the response to a 35% CO2without inducing pre challenge sedation.

Conclusion

The results comfort earlier findings of a direct pharmacological effect of ethanol on panic.

Socio-demographic and clinical characteristics of benzodiazepine long-term users: Results from a tertiary care center

OBJECTIVE

The use of benzodiazepines (BDZs) represents a critical issue since a long-term treatment may lead to dependence. This study aimed at evaluating socio-demographic and clinical characteristics of BZD long-term users who followed a detoxification program at a tertiary care center.

METHOD

Two hundred-five inpatients were evaluated. Socio-demographic (e.g., gender, age, education) and clinical information (e.g., BZD used, dose, reason of prescription) was collected. BZDs dose was standardized as diazepam dose equivalents and was compared via the Defined Daily Dose (DDD). Chi-square, Fisher test, ANOVA and Bonferroni analyses were performed.

RESULTS

Females were more frequently BDZ long-term users than males. Hypnotic BZDs were frequently prescribed for problems different from sleep disturbances. Lorazepam, alprazolam, and lormetazepam were the most prescribed drugs. Lorazepam was more frequently used by males, consumed for a long period, in pills, and prescribed for anxiety. Lormetazepam was more frequently consumed by females with a high school education, having a psychiatric disorder, taken in drops and prescribed for insomnia. Lormetazepam had the highest DDD.

CONCLUSION

A specific profile of BZD long-term user seems to exist and presents different socio-demographic and clinical characteristics according to the benzodiazepine taken into account.

The effect of alexithymia on anxiety, depression, coping, and difficulties in daily living in oncologic patients

Introduction

Alexithymia is a personality trait that may influence the resilience in oncologic patients.

Objectives

Data on the effect of alexithymia on anxiety, depression, coping, and difficulties in daily living in oncologic patients are lacking.

Aims

To test how alexithymia may influence the development of anxiety, depression, difficulties in daily living, and coping in oncologic patients if compared to healthy volunteers.

Methods

Healthy subjects with high level of alexithymia, healthy subjects with low level of alexithymia, oncologic patients with high level of alexithymia, and oncologic patients with low level of alexithymia were compared. The Toronto Alexithymia Scale (TAS-20) was used to assess alexithymia, the Hospital Anxiety and Depression Scale (HADS) allowed to assess anxiety and depression, the Brief COPE was used to assess the coping, and the dimension of daily living of the Behaviour And Symptom Identification Scale (BASIS-32) was used to assess the difficulties in daily living. The differences among the groups were analysed by means of the analyses of covariance controlling for age, education, marital status, and working activity.

Results

A total of 124 subjects participated to the study (57 oncologic patients and 67 healthy subjects). Results showed a between-subjects effect of alexithymia. Subjects with higher level of alexithymia had higher scores in anxiety and depression, higher difficulties in daily living, and lower problem-focused and dysfunctional coping strategies, regardless of having cancer or not.

Conclusions

Alexithymia seems to influence the development of anxiety/depression, the functional daily living, and some strategies of coping more than having cancer.

Expressed emotion and parental attitudes toward children of alcoholics

Introduction

Individuals who grow up in alcoholic families seem to have a family environment and climate different from those who grow up in non alcoholic families.

Objectives

Data on expressed emotion and parental attitudes in alcoholic family are lacking.

Aims

Study the level of expressed emotion and the parental attitudes in children of alcoholics (COAs) compared with children of non alcoholics (non COAs).

Methods

The Level of Expressed Emotion Scale (LEES) and the Parental Attitudes Scale (PAD) were used to measure respectively the expressed emotion and the family climate. The LEES was filled by the COAs or by the non COAs; the PAD was filled by their significant parent. COAs and non COAs were matched for age and gender.

Results

COAs perceived a statistically lower level of intrusiveness from their parents and a significantly higher emotional response and attitudes toward illness from their parents than non COAs. According to the PAD, there was no difference in the family climate between the two groups. When correlations between LEES and PAD were evaluated, among COAs high level of expressed tolerance (LEES tolerance/expectation subscale) was significantly correlated with a low dominance in the children (PAD Dominance/Submissiveness); among controls, high level of expressed emotion (LEES total score) was significantly correlated with lower pleasure in the children (PAD Pleasure/Displeasure subscale).

Conclusions

COAs and non COAs seem to perceive the emotion expressed in their family environment differently and correlate it with their parental attitudes according to a different pattern.

Clinical epidemiology of eating disorders: results from the Sesto Fiorentino study

BACKGROUND

It is speculated that clinical samples do not fully reflect the characteristics of eating disorders (EDs) as they are in the general population, especially in their lowest range of severity. The present article reports the prevalence of EDs in a community sample aged >14 years, their clinical and psychopathological features, and their course and outcome on naturalistic grounds.

METHODS

The Sesto Fiorentino Study is a three-phase community-based survey where 2,355 out of 2,500 people representative of the population aged >14 years living in Sesto Fiorentino were evaluated by their own general practitioner using the Mini International Neuropsychiatric Interview plus six additional questions. All those who had positive results plus a probability sample of the non-cases were re-interviewed by psychiatrists using the Florence Psychiatric Interview. The subjects who reported ED symptoms were subsequently administered the Eating Disorder Examination (12th edition).

RESULTS

Overall, the lifetime prevalence of EDs was 1.21%. More precisely, 0.42% had anorexia nervosa, 0.32% bulimia nervosa, 0.32% binge eating disorder and 0.32% eating disorder not otherwise specified. All the subjects suffering from an ED fulfilled diagnostic criteria for at least another DSM-IV axis I psychiatric disorder. At the moment of the interview, conducted a few years (average 7 years) after the onset of the disorder, 50% had fully recovered from EDs, 26.9% were currently affected by an ED, 23.1% showed a persistent body image disturbance and/or the presence of compensatory behaviours.

CONCLUSIONS

Community surveys conducted by clinicians may provide useful additional information on the psychopathological features, natural course and outcome of these disorders on naturalistic grounds.

The epidemiology of panic disorder and agoraphobia in Europe

A literature search, in addition to expert survey, was performed to estimate the size and burden of panic disorder in the European Union (EU). Epidemiologic data from EU countries were critically reviewed to determine the consistency of prevalence estimates across studies and to identify the most pressing questions for future research. A comprehensive literature search focusing on epidemiological studies in community and clinical settings in European countries since 1980 was conducted (Medline, Web of Science, Psychinfo). Only studies using established diagnostic instruments on the basis of DSM-III-R or DSM-IV, or ICD-10 were considered. Thirteen studies from a total of 14 countries were identified. Epidemiological findings are relatively consistent across the EU. The 12-month prevalence of panic disorder and agoraphobia without history of panic were estimated to be 1.8% (0.7-2.2) and 1.3% (0.7-2.0) respectively across studies. Rates are twice as high in females and age of first onset for both disorders is in adolescence or early adulthood. In addition to comorbidity with agoraphobia, panic disorder is strongly associated with other anxiety disorders, and a wide range of somatoform, affective and substance use disorders. Even subclinical forms of panic disorder (i.e., panic attacks) are associated with substantial distress, psychiatric comorbidity and functional impairment. In general health primary care settings, there appears to be substantial underdiagnosis and undertreatment of panic disorder. Moreover, panic disorder and agoraphobia are poorly recognized and rarely treated in mental health settings, despite high health care utilization rates and substantial long-term disability.

A self-controlled, naturalistic study of selective serotonin reuptake inhibitors versus tricyclic antidepressants

OBJECTIVE

To compare the effectiveness of serotonin reuptake inhibitors (SSRIs) and tricyclic antidepressants (TCAs) for anxiety and mood disorders in a naturalistic setting.

METHODS

114 of 2,000 outpatients drawn from a private facility with a diagnosis of mood or anxiety disorder had two separate episodes during which they were treated once with a SSRI and once with a TCA. The drugs had to be in monotherapy and appropriate according to the recent guidelines. Key outcome measures included several rating scales, the results of which were combined into three measures of outcome: full response (no symptom), partial response (residual symptoms), poor response.

RESULTS

TCAs produced a better response in 63 cases and SSRIs in 18 cases (p < 0.00001). When the outcome was dichotomized, TCAs were still superior (stricter criterion of full response: p = 0.0002; lower threshold: p < 0.0001). Considering depressive and anxiety disorders separately, TCAs remained superior in terms of efficacy (for depression: p < 0.0001; for anxiety: p = 0.026). Moreover, the second episode of illness showed a better outcome than the first (p = 0.0008).

CONCLUSIONS

In those cases where two different antidepressants were prescribed over two different episodes of illness, TCAs were significantly more effective than SSRIs, regardless of the type of disorder and order of prescription.

A new sinus lift technique in conjunction with placement of 265 implants: a 6-year retrospective study

A new surgical crestal approach for implant placement in deficient alveolar ridges is presented. Drills of different and increasing lengths allow the surgeon to approach the membrane without risk of tearing it. The study is supported by 265 cases and a 6-year follow-up period (1994-1999). Implants that were 13 and 15 mm in length were inserted, respectively, in 205 and 60 cases. The alveolar ridge height varied between 4 and 10 mm. All implants were HA-coated and had a 3.25-mm diameter. The results of this investigation suggest that this is a reliable and predictable technique for the prosthetic rehabilitation of the maxillary posterior regions in the presence of anatomical restrictions for implant placement.

A 7-year retrospective study of 423 immediate implants

This article reports the results of a study conducted from 1989 to 1995 of 423 hydroxyapatite-coated implants used for immediate tooth replacement after extraction in 353 patients with an age range from 15 to 68 years. The implants replaced teeth that were extracted because of periodontal disease, root fractures, and endodontic problems. Bone defects relative to the implant were treated with bone regeneration procedures using polytetrafluoroethylene (PTFE) membranes and resorbable collagen membranes with and without augmentation material (hydroxyapatite--188 cases, demineralized freeze-dried bone allograft--208 cases, and 27 cases without augmentation material). Histologic evaluation confirmed viability of the regenerated bone. The length of implants ranged from 8 mm to 18 mm, and a total of 284 PTFE and 139 collagen membranes were used. During the 1-year follow-up, 1 implant was lost and an additional implant failed during the 7-year follow-up, with a final success rate of 99.53%.

Localized chronic suppurative bone infection as a sequel of peri-implantitis in a hydroxyapatite-coated dental implant

Plaque-induced lesions can produce peri-implant bone loss with ultimate implant loss. Although the peri-implant tissues seem to be more resistant than the periodontal ones to plaque and calculus, they can produce a more extensive spread of the infection to the deeper tissues around implants. The case of a 45-year-old female patient is presented in which, over a three year period, there was a progressive loss of peri-implant bone and the formation of a periapical radiolucency with an external fistula. The implant was removed and examined with the cutting-grinding system. Microscopy examination showed that most of the hydroxyapatite (HA) was still adherent to the metal. There was a detachment in the area of the HA-titanium interface. The implant surface was almost completely covered by bacteria. Bacteria were also present in the bone medullary spaces surrounding the implant. The infection of the periodontal tissues had progressed into the alveolar bone, thus producing a localized bone infection. The cause of the implant failure is probably related to a defective connection of the abutment or to overloading of the implant due to the presence of interlocks in the prosthetic restoration.

Guided bone regeneration for implant placement using absorbable collagen membranes: case presentations

The current research on the application of guided tissue regeneration principles is focused on the use of absorbable matrix barriers in bone augmentation procedures in extraction sites and around implants. This paper presents two cases in which a new absorbable collagen membrane is used for guided bone regeneration. In the first case, freeze-dried demineralized bone was used with the membrane to place an implant in a fresh extraction site with a grave osseous defect. In the second case, the collagen membrane provided the augmentation of a narrow ridge where three implants were placed, without the use of allograft. In both cases, the barrier membrane demonstrated its applicability for bone regeneration with only one surgical procedure, without complications. The learning objective of this article is to update the knowledge of absorbable barrier membranes from the clinical experience of the authors.