key: cord-0072534-70ro13ga
authors: Turco, M.; Caldiroli, A.; Capuzzi, E.; Tagliabue, I.; Montana, C.; Tringali, A.; Fortunato, A.; Sibilla, M.; Pellicioli, C.; Maggioni, L.; Colmegna, F.; Buoli, M.; Clerici, M.
title: P.0638 Comparing the psychological impact of COVID-19 pandemic between psychiatric patients and healthy subjects: an observational retrospective study from northern Italy
date: 2021-12-30
journal: Eur Neuropsychopharmacol
DOI: 10.1016/j.euroneuro.2021.10.603
sha: 345bd62ed6b932b11bff29c1b2c8af29a58469a9
doc_id: 72534
cord_uid: 70ro13ga

nan

M. Turco, A. Caldiroli, E. Capuzzi et al.

released from the gut and intestinal bacteria. Many factors such as diet, antibiotic therapy, stress, metabolism and genetics are known to play a critical role in regulating the colonization pattern of the microbiota. Recent studies have shown the role of the low carbohydrate, adequate protein, and high fat "ketogenic diet" in remodeling the composition of the gut microbiome and thereby facilitating protective effects in various central nervous system (CNS) disorders. The authors elaborate a narrative literature review to understand the role of ketogenic diet in anxiety disorders. Methods : PubMed database searched using the terms "anxiety disorders", "gut microbiota" and "ketogenic diet". Results : Ketogenic diet, a high fat and low carbohydrate diet, has been effective therapeutic for a wide range of neurological disorders such as epilpesy, Parkinson's disease and autism and seem promising for weight mass optimization among mentaly ill patients with possible anxiolytic effect. A diet is characterised as being low-carb high-fat when fat comprises > 70% of the daily calorie consumption, with sugars being 5-15%, and the rest of the calories being supported by proteins. A very low-carb Ketogenic diet and starvation have something in common, and the process is called ketosis. The direct and indirect influence on the central nervous system of Ketogentic Diet can be observerd in the increasing of the cerebral blood flow, and the decreasing the mammalian target of rapamycin by the increase of the level of endotelial nitric oxide synthase protein expression, but also passively (indirectly). This indirect effects on the central nervous system are supposed to be mediated by microbiota through an increase of short-chain fatty acids and a decrease of GABA. Furthermore, GABA can be synthesized by the gut microbiota residents: Lactobacilli and Bifidobacteria. As a ketogenic diet modifies the gut microbiome, the preservation of proper gut health through the implementation of fermented food or pre/probiotics consumption seem important. It is possible that taking probiotics could help prevent composition disorders of the gut microbiota as a consequence of chronic stress, and the depletion of inflammation and the increasing of serotonin biosynthesis probiotics could be an elemento of anxiety disorder relapse prevention. Introduction : From the very beginning, COVID-19 pandemic had a great impact not only on physical, but also on mental health, both in general population and psychiatric patients. Self-isolation, fear of virus exposure and of death, unemployment and poor social network have increased psychological distress and Post-Traumatic Stress Disorder (PTSD) symptoms [1] . Nevertheless, little is known about the difference between subjects affected by mental disorders and healthy individuals in perceiving the pandemic as a traumatic event [2] . Aim : Comparing psychiatric patients and healthy controls (HC) in terms of change over time of post-traumatic symptoms.

Methods : Data about demographic and clinical variables were retrospectively collected. Impact of Event Scale Revised (IES-R) scores were registered referring at two time points: T1, during the so-called 'Phase I' in March-April 2020 (lockdown period) and T2, during the so-called 'Phase II' in May-June 2020 (restarting). Descriptive analyses and linear regression models were performed. In particular, IES-R scores at T1 were overall higher than T2 scores (p < 0.001), except for OCD patients. Moreover, patients presented lower IES-R scores than HC (p = 0.02), independently from diagnosis. When HC have been compared with the different diagnostic groups, SKZ patients resulted to have significantly lower IES-R scores than HC (p = 0.004). Differently, only PD patients showed higher IES-R scores than HC, but the result did not reach the statistical significance (p = 0.44). Conclusions : In general, both patients and HC presented a significant decrease of IES-R scores between T1 and T2, when the pandemic showed a decline and preventive restrictions have been removed; only OCD patients have shown a different trend, which can be explained by a global worsening of obsession and compulsion, associated with the urge of control against risks of contamination [3] . Comparing patients and HC, higher scores on IES-R scale have been observed in HC: this trend is particularly meaningful in SKZ subgroup, and it may be explained considering the limited awareness about the risk of infection, associated with less fear or striking emotion related to pandemic [4] . PD patients, in contrast, were found to be more affected by social restrictions than HC, probably because of a greater vulnerability to PTSD symptomatology and poorer coping skills [5] , pointing out the need to implement telematic interventions, such as psychotherapy and group therapy. This is, to our knowledge, one of the few studies evaluating and comparing the psychological distress perceived by psychiatric patients (including all major diagnoses) and HC during the first wave of COVID-19 pandemic.

Introduction Besides neuropsychiatric effects of the SARS-CoV-2 virus, the pandemic has a severe negative psychological impact, with a high risk of development or worsening of mental disorders due to stress associated with public health measures, lockdown, and isolation, which significantly contribute to anxiety. Thus, identification of risk and protective factors is of key importance to prevent development of disorders, decrease suffering and burden on the healthcare system. Our aim was to analyze factors contributing to selfreported changes in anxiety during the COVID-lockdown.

As part of a 42-country international collaboration effort to assess changes in subjective mental well-being during the pandemic-related lockdown, our present analysis included data from 763 Hungarian adults recruited using a snowball method, who provided demographic and healthrelated data including psychiatric and medical history and presence of chronic somatic problems, and completed self-report questionnaires evaluating depression (CES-D), anxiety (STAI), suicidal behavior, subjective changes in psychological symptoms, maintenance of daily routine, lifestyle changes including physical activity, sleep, eating and nutrition, degree of lock-up, changes in the frequency and quality of family relationships, being a caretaker of someone from a vulnerable group, fear of contracting the virus or of family member contracting the virus, belief in the effectiveness of precautions, beliefs in conspiracy theories related to the pandemic, financial state, and several work and profession-related variables. Analyses included binary logistic regression models and χ 2 -square tests. Conclusions: Besides the acute and post-infection neuropsychiatric effects of SARS-CoV-2, the pandemic-related lockdown may also cause severe psychological distress and symptoms. Our study identified multiple factors influencing lockdown-related subjective changes in anxiety acting either as risk or protective factors, the majority of which are modifiable and can be targeted with information, psychoeducation or low-threshold intervention or preventive efforts. Identifying and modifying such factors and their impact, besides decreasing subjective suffering and the risk of development of worsening of psychiatric disorders, also decreases burden on the healthcare system. 

Impact of COVID-19 pandemic on mental health in the general population: A systematic review

Perceived Impact of Covid-19 Across Different Mental Disorders: A Study on Disorder-Specific Symptoms, Psychosocial Stress and Behavior

The impact of the COVID-19 pandemic on patients with OCD: Effects of contamination symptoms and remission state before the quarantine in a preliminary naturalistic study

Social networks and symptomatic and functional outcomes in schizophrenia: a systematic review and meta-analysis

Relationship between PTSD and pathological personality traits in context of

Disclosure statement: The study has been registered on ClinicalTrials.gov with the following ID number: NCT04694482