Insomnia and related factors in patients with pre-existing psychiatric disorders compared to the general population during the COVID-19 lockdown: Findings from the multicentric COMET study

Acute stress symptoms in general population during the first wave of COVID lockdown in Italy: Results from the COMET trial

BACKGROUND

The coronavirus disease of 2019 (COVID-19) pandemic is an unprecedented traumatic event that has severely impacted social, economic, and health well-being worldwide. The COvid Mental hEalth Trial was specifically designed to evaluate the impact of the COVID-19 pandemic and its containment measures on the mental health of the Italian general population in terms of COVID-19-related acute stress disorder (ASD) symptoms.

METHODS

The present cross-sectional study is based on an online survey carried out in the period March-May 2020. Italian general adult population was invited to compile an anonymous survey, which included the severity of acute stress symptoms scale/National Stressful Events Survey Short Scale to investigate the occurrence and severity of ASD symptoms.

RESULTS

The final sample consisted of 20,720 participants. During the lockdown, subjects with pre-existing mental health problems reported a statistically significant higher risk of acute post-traumatic symptoms compared to the general population (B: 2.57; 95% CI:2.04-3.09; p < .0001) and health care professionals (B: .37; 95% CI: .02-0.72; p < .05). According to multivariate regression models, the levels of acute post-traumatic symptoms (p < .0001) were higher in younger and female respondents. Social isolation and sleep disorder/insomnia represented positive predictors of acute stress (B = 3.32, 95% CI = 3.08-3.57).

CONCLUSIONS

Concerns about the risk of infection as well as social isolation caused a higher incidence of acute post-traumatic stress symptoms that may predict the subsequent development of post-traumatic stress disorder symptoms in the long term.

Chronic Insomnia Disorder across Europe: Expert Opinion on Challenges and Opportunities to Improve Care

One in ten adults in Europe have chronic insomnia, which is characterised by frequent and persistent difficulties initiating and/or maintaining sleep and daily functioning impairments. Regional differences in practices and access to healthcare services lead to variable clinical care across Europe. Typically, a patient with chronic insomnia (a) will usually present to a primary care physician; (b) will not be offered cognitive behavioural therapy for insomnia-the recommended first-line treatment; (c) will instead receive sleep hygiene recommendations and eventually pharmacotherapy to manage their long-term condition; and (d) will use medications such as GABA receptor agonists for longer than the approved duration. Available evidence suggests that patients in Europe have multiple unmet needs, and actions for clearer diagnosis of chronic insomnia and effective management of this condition are long overdue. In this article, we provide an update on the clinical management of chronic insomnia in Europe. Old and new treatments are summarised with information on indications, contraindications, precautions, warnings, and side effects. Challenges of treating chronic insomnia in European healthcare systems, considering patients' perspectives and preferences are presented and discussed. Finally, suggestions are provided-with healthcare providers and healthcare policy makers in mind-for strategies to achieve the optimal clinical management.

The Short-Term Consequences of COVID-19 on Mental Health: State of the Art from Available Studies

Since the outbreak of the COVID-19 pandemic, the consequences on mental health have been found to be considerable, with potential effects on the general population and in high-risk groups, with a variety of physiopathological mechanisms [...].

Increasing public concern on insomnia during the COVID-19 outbreak in China: An info-demiology study

Background

Since December 2019, an unexplained pneumonia has broken out in Wuhan, Hubei Province, China. In order to prevent the rapid spread of this disease, quarantine or lockdown measures were taken by the Chinese government. These measures turned out to be effective in containing the contagious disease. In spite of that, social distancing measures, together with disease itself, would potentially cause certain health risks among the affected population, such as sleep disorder. We herein conducted this web search analysis so as to examine the temporal and spatial changes of public search volume of the mental health topic of "insomnia" during COVID-19 pandemic in China.

Methods

The data sources included Baidu Index (BDI) to analyze related search terms and the official website of the National Health Commission of the People's Republic of China to collect the daily number of newly confirmed COVID-19 cases. Following a descriptive analysis of the overall search situation, Spearman's correlation analysis was used to analyze the relationship between the daily insomnia-related search values and the daily newly confirmed cases. The means of search volume for insomnia-related terms during the COVID-19 outbreak period (January 23rd, 2020 to April 8th, 2020) were compared with those during 2016-2019 using Student's t test. Finally, by analyzing the overall daily mean of insomnia in various provinces, we further evaluated whether there existed regional differences in searching for insomnia during the COVID-19 outbreak period.

Results

During the COVID-19 outbreak period, the number of insomnia-related searches increased significantly, especially the average daily the BDI for the term "1 min to fall asleep immediately". Spearman's correlation analysis showed that 6 out of the 10 insomnia-related keywords were significantly positively related to the daily newly confirmed cases. Compared with the same period in the past four years, a significantly increased search volume was found in 60.0% (6/10) insomnia-related terms during the COVID-19 outbreak period. We also found that Guangdong province had the highest number of searches for insomnia-related during the pandemic.

Conclusions

The surge in the number of confirmed cases during the COVID-19 pandemic has led to an increase in concern and online searches on this topic of insomnia. Further studies are needed to determine whether the search behavior truly reflect the real-time prevalence profile of relevant mental disorders, and further to establish a risk prediction model to determine the prevalence risk of psychopathological disorders, including insomnia, using insomnia-related BDI and other well-established risk factors.

The Psychiatric Consequences of Long-COVID: A Scoping Review

The COVID-19 pandemic has represented a new form of traumatic event, affecting the general population worldwide and causing severe disruption of daily routine. A new urgent concern is related to the burden associated with COVID-19 symptoms that persist beyond the onset of infection, the so-called long-COVID syndrome. The present paper aims to: (1) describe the most frequent psychiatric symptoms reported by patients affected by long-COVID syndrome; (2) evaluate methodological discrepancies among the available studies; (3) inform clinicians and policy-makers on the possible strategies to be promoted in order to manage the psychiatric consequences of long-COVID syndrome. Twenty-one papers have been included in the present review, mostly with a cross-sectional or cohort design. Significant heterogeneity of long-COVID syndrome definitions was found. The presence of psychiatric symptoms was evaluated with very different assessment tools. The most common psychiatric symptoms of the long-COVID syndrome included fatigue, cognitive disturbances/impairment, depression, and anxiety symptoms. The rate of fatigue varied from 93.2-82.3% to 11.5%, cognitive impairment/cognitive dysfunction from 61.4% to 23.5% and depressive-anxiety symptoms from 23.5%to 9.5%.