key: cord-0981638-xmhhad1f
authors: Hendriksen, P.; Kiani, P.; Garssen, J.; Bruce, G.; Verster, J.C.
title: P.0117 Living alone or together during lockdown: differences in mood, perceived immune fitness and experiencing covid-19 symptoms
date: 2021-12-30
journal: Eur Neuropsychopharmacol
DOI: 10.1016/j.euroneuro.2021.10.117
sha: 1ecb1ad127d2a325c3329282cb8082f27e50c62e
doc_id: 981638
cord_uid: xmhhad1f

Background: The 2019 coronavirus (COVID-19) lockdowns have been associated with significant increases in negative mood and stress, reduced (perceived) health and poorer quality of life [1]. These effects were particularly seen among people who live alone and lack daily social support of family or housemates. Objective: To compare mood and stress of those that lived alone or together with others during the COVID-19 lockdown, and to investigate the impact on perceived immune fitness and presence and severity of COVID-19 related symptoms. Methods: An online survey among Dutch adults compared the period before the lockdown (15 January–14 March 2020) with the lockdown period (15 March–11 May 2020) [2]. Participants indicated whether they ‘lived alone’ or ‘together with others’ during the lockdown. Mood (“anxiety”, “depression”, “fatigue”, “hostility”, “loneliness” and “happiness) and “stress” was assessed via 1-item scales [3]. Perceived immune fitness and quality of life was measured using a scale ranging from 0 (very poor) to 10 (excellent) [3,4]. The severity of COVID-19 symptoms was assessed using the COVID-19 Symptoms Scale [2]. Items could be rated as none (0), mild (1), moderate (2), or severe (3). The sum score served as severity score, and the number of items with a score > 0 as COVID-19 symptom presence score. Differences between outcomes of the groups that lived alone or lived together during lockdown were compared with Independent-Samples Mann-Whitney U tests. For each variable, difference scores (Δ, lockdown – before lockdown) were calculated and compared between the groups with analysis of variance. Pearson's correlations were calculated between difference scores. Results: Data of N=505 participants were analyzed. The mean (SD) age was 38.2 (15.8), and 65.5% of the sample were female. During the lockdown period, 115 (22.8%) lived alone and 390 (77.2%) lived together with others. The mean (SD) number of household members was 2.8 (1.6), with a range of 1 to 12. During the lockdown, individuals that lived alone reported significantly higher ratings (p<0.05) of loneliness, anxiety, depression, and significantly lower scores on happiness and quality of life compared to the group that lived together with others. Comparing difference scores (during lockdown – before lockdown) of both groups revealed that the group that lived alone reported a significant greater increase in loneliness (p=0.002), which was accompanied by a significant increase in reported COVID-19 symptoms (presence: p=0.019, severity: p=0.041), whereas a small decrease in symptom presence and severity was seen among the ‘lived together’ group. The Δ loneliness scores correlated significantly with Δ perceived immune fitness (r = -0.239, p<0.0001) and Δ presence (r = 0.144, p=0.001) and Δ severity (r = 0.160, p<0.0001) of COVID-19 symptoms. Conclusions: Living alone and associated feelings of loneliness have a negative impact on mood, perceived immune fitness, and the presence and severity of COVID-19 symptoms. Loneliness is an important determinant of mental health, though often underestimated. Future research should investigate how the impact of increased social support, for example with the aid of mobile technology, can counteract loneliness and thereby improve health and quality of life. No conflict of interest

European Neuropsychopharmacology 53 (2021) S73-S145 characteristics of anxiety periods showed a higher effect in SMDD and no MDD groups. Neuroticism had indirect effects on FWS through specific depressive symptoms, particularly concentration difficulties and tiredness during the worst depression (percentage mediated 40-49% and 38-63%, respectively). Physical diseases and lifestyle explained only 4-5% of variance in FWS, slightly higher in the groups with lifetime MDD. The PRS of MDD showed the largest effect on FWS compared to the PRS of other psychiatric disorders, but the variance explained was very small ( < 1%). Conclusions This was the first study to comprehensively evaluate the predictors of wellbeing in relation to the history of MDD. The identified variables are important to identify individuals at risk and promote wellbeing. Limitations of the study included the potential risk of bias derived from the analysis of self-reported variables, the use of crosssectional data that does not allow inference of causal relationships and the fact that UKB is not representative of the general population (older, more often female, healthier, of a higher socioeconomic background [4] ). [1] . These effects were particularly seen among people who live alone and lack daily social support of family or housemates. Objective: To compare mood and stress of those that lived alone or together with others during the COVID-19 lockdown, and to investigate the impact on perceived immune fitness and presence and severity of COVID-19 related symptoms.

Methods: An online survey among Dutch adults compared the period before the lockdown (15 January-14 March 2020) with the lockdown period (15 March-11 May 2020) [2] . Participants indicated whether they 'lived alone' or 'together with others' during the lockdown. Mood ("anxiety", "depression", "fatigue", "hostility", "loneliness" and "happiness) and "stress" was assessed via 1-item scales [3] . Perceived immune fitness and quality of life was measured using a scale ranging from 0 (very poor) to 10 (excellent) [ 3 , 4 ] . The severity of COVID-19 symptoms was assessed using the COVID-19 Symptoms Scale [2] . Items could be rated as none (0), mild (1), moderate (2), or severe (3). The sum score served as severity score, and the number of items with a score > 0 as COVID-19 symptom presence score. Differences between outcomes of the groups that lived alone or lived together during lockdown were compared with Independent-Samples Mann-Whitney U tests. For each variable, difference scores ( , lockdown -before lockdown) were calculated and compared between the groups with analysis of variance. Pearson's correlations were calculated between difference scores. Results: Data of N = 505 participants were analyzed. The mean (SD) age was 38.2 (15.8), and 65.5% of the sample were female. During the lockdown period, 115 (22.8%) lived alone and 390 (77.2%) lived together with others. The mean (SD) number of household members was 2.8 (1.6), with a range of 1 to 12. During the lockdown, individuals that lived alone reported significantly higher ratings (p < 0.05) of loneliness, anxiety, depression, and significantly lower scores on happiness and quality of life compared to the group that lived together with others. Comparing difference scores (during lockdown -before lockdown) of both groups revealed that the group that lived alone reported a significant greater increase in loneliness (p = 0.002), which was accompanied by a significant increase in reported COVID-19 symptoms (presence: p = 0.019, severity: p = 0.041), whereas a small decrease in symptom presence and severity was seen among the 'lived together' group. The loneliness scores correlated significantly with perceived immune fitness (r = -0.239, p < 0.0001) and presence (r = 0.144, p = 0.001) and severity (r = 0.160, p < 0.0001) of COVID-19 symptoms. Conclusions: Living alone and associated feelings of loneliness have a negative impact on mood, perceived immune fitness, and the presence and severity of COVID-19 symptoms. Loneliness is an important determinant of mental health, though often underestimated. Future research should investigate how the impact of increased social support, for example with the aid of mobile technology, can counteract loneliness and thereby improve health and quality of life.

No link between inflammatory cytokines, "bac-teroides2" enterotype and anti-suicidal response to ketamine C. Schiweck 1 , M. Valles-Colomer 2 , A. Reif 3 , J. Raes 4 , E. Vrieze 5 , S. Claes 5

Understanding psychological distress and protective factors amongst older adults during the COVID-19 Pandemic

Immune fitness, and the psychosocial and health consequences of the COVID-19 pandemic lockdown in The Netherlands: methodology and design of the CLOFIT study

The use of single-item ratings versus traditional multiple-item questionnaires to assess mood and health

Development and validation of the Immune Status Questionnaire (ISQ)

Alterations of multiple peripheral inflammatory cytokine levels after repeated ketamine infusions in major depressive disorder

The past 30 years have made it clear that there is a link between depression and inflammation. However, rather than being a universal characteristic, inflammation likely describes a subgroup of patients, which could be used for precision medicine. To use targeted therapy, further phenotypical characterization is necessary. Two interesting candidates for this characterization are suicidal ideation and the gut microbiome enterotype "Bac-teroides2", which is more prevalent in depression and other inflammatory disorders (e.g., irritable bowel disease). Yet, it is still unclear if inflammation is linked to the gut microbiome in depression, and if both relate to suicidality and treatment response. The rapid acting antidepressant ketamine has potent anti-suicidal effects and was shown to decrease inflammatory cytokines [1] . Ketamine thus provides a unique opportunity to test whether the anti-suicidal response to ketamine may be influenced by gut microbiome composition (Bacteroides2 enterotype) and/or inflammatory cytokines within a short time frame. Aim: To investigate whether a) participants with suicidal ideation had higher levels of peripheral inflammatory cytokines, b) whether this is linked to the Bacteroides2 enterotype and c) whether the anti-suicidal effect of ketamine was influenced by levels of inflammatory serum proteins and/or enterotype. Methods: Twenty-nine patients with treatment resistant major depressive disorder and 25 controls were included. Twenty-eight patients were randomized to either ketamine (n = 21) or placebo (n = 7). Suicidal ideation was assessed with the Columbia Suicide Rating Scale (CSSRS). Assessment timepoints for questionnaires and gut microbiome were at baseline, 4 hours (h) (except for gut microbiome), 24h and 1 week after ketamine infusion. Interleukin (IL)-6, tumor necrosis factor α and IL-1 β were analysed using MSD V-plex proinflammatory panel (Meso Scale Diagnostics, U.S.A.), as per manufacturer's instructions. 16S sequencing was performed for gut microbiome analyses, and enterotypes were determined by DMM community typing. Statistical models were analysed with linear mixed models including a random intercept. Results: For ketamine, anti-suicidal effects emerged 4h post treatment (t = -2.15, p = 0.036), 24h post infusion (t = -4.68, p < 0.001), and 7 days post treatment (t = -2.38, p = 0.020). Patients treated with placebo also experienced improvements at 24h (t = -2.51, p = 0.003) and 7 days (t = -3.41, p = 0.021), but not at 4h (t = -1.12, p = 0.274) post treatment. In the overall group, none of the inflammatory markers was elevated at baseline compared to controls, nor did they change significantly after treatment (all p > 0.133). Patients with low and high (median split) suicidal ideation did not differ in levels of inflammatory cytokines (all W > 43, p > 0.527). Logistic regression revealed no effect of CSSRS (z = 1.23, p = 0.220) or cytokines (all z < -1.43, all p > 0.152) on Bacteroides2 compared to the other enterotypes (Bacteroides1, Prevotella, and Ruminococcaceae), although mean CSSRS levels were slightly elevated in the Bacteroides2 group (15.38 vs. 11.95).Conclusion: In this small sample of patients, suicidal ideation was not linked to inflammatory cytokines or the Bacteroides2 enterotype. While suicidality decreased after ketamine treatment, no link could be established with cytokine changes and/or enterotype. This study is limited by the small sample size and the fact that no inflammatory cytokines were elevated in patients with depression at baseline, demonstrating the need for careful stratification of patients.