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Monti L, Marconi E, Bocci MG, Kotzalidis GD, Mazza M, Galliani C, Tranquilli S, Vento G, Conti G, Sani G, Antonelli M, Chieffo DPR. COVID-19 pandemic in the intensive care unit: Psychological implications and interventions, a systematic review. World J Psychiatry 2023; 13:191-217. [PMID: 37123099 PMCID: PMC10130962 DOI: 10.5498/wjp.v13.i4.191] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/10/2022] [Revised: 02/06/2023] [Accepted: 03/27/2023] [Indexed: 04/18/2023] Open
Abstract
BACKGROUND The coronavirus disease 2019 (COVID-19) pandemic produced changes in intensive care units (ICUs) in patient care and health organizations. The pandemic event increased patients’ risk of developing psychological symptoms during and after hospitalisation. These consequences also affected those family members who could not access the hospital. In addition, the initial lack of knowledge about the virus and its management, the climate of fear and uncertainty, the increased workload and the risk of becoming infected and being contagious, had a strong impact on healthcare staff and organizations. This highlighted the importance of interventions aimed at providing psychological support to ICUs, involving patients, their relatives, and the staff; this might involve the reorganisation of the daily routine and rearrangement of ICU staff duties.
AIM To conduct a systematic review of psychological issues in ICUs during the COVID-19 pandemic involving patients, their relatives, and ICU staff.
METHODS We investigated the PubMed and the ClinicalTrials.gov databases and found 65 eligible articles, upon which we commented.
RESULTS Our results point to increased perceived stress and psychological distress in staff, patients and their relatives and increased worry for being infected with severe acute respiratory syndrome coronavirus-2 in patients and relatives. Furthermore, promising results were obtained for some psychological programmes aiming at improving psychological measures in all ICU categories.
CONCLUSION As the pandemic limited direct inter-individual interactions, the role of interventions using digital tools and virtual reality is becoming increasingly important. All considered, our results indicate an essential role for psychologists in ICUs.
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Affiliation(s)
- Laura Monti
- UOS Psicologia Clinica, Governo Clinico, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome 00168, Italy
| | - Elisa Marconi
- UOS Psicologia Clinica, Governo Clinico, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome 00168, Italy
| | - Maria Grazia Bocci
- UOC Anestesia, Rianimazione, Terapia Intensiva e Tossicologia Clinica, Dipartimento di Scienze Dell’Emergenza, Anestesiologiche e Della Rianimazione, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome 00168, Italy
| | - Georgios Demetrios Kotzalidis
- UOC Psichiatria Clinica e d’Urgenza, Dipartimento di Scienze Dell’Invecchiamento, Neurologiche, Ortopediche e Della Testa-collo, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome 00168, Italy
- NESMOS Department, Facoltà di Medicina e Psicologia, Sant’Andrea University Hospital, Rome 00189, Italy
| | - Marianna Mazza
- UOC Psichiatria Clinica e d’Urgenza, Dipartimento di Scienze Dell’Invecchiamento, Neurologiche, Ortopediche e Della Testa-collo, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome 00168, Italy
- Department of Psychiatry, Università Cattolica del Sacro Cuore, Rome 00168, Italy
| | - Carolina Galliani
- Department of Psychology, Università Cattolica del Sacro Cuore, Rome 00168, Italy
| | - Sara Tranquilli
- Department of Psychology, Università Cattolica del Sacro Cuore, Rome 00168, Italy
| | - Giovanni Vento
- UOC Neonatologia, Dipartimento di Scienze Della Salute Della Donna, Del Bambino e di Sanità Pubblica, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome 00168, Italy
- UOC Neonatologia, Università Cattolica del Sacro Cuore, Rome 00168, Italy
| | - Giorgio Conti
- UOC Terapia Intensiva Pediatrica e Trauma Center Pediatrico, Dipartimento di Scienze Dell’Emergenza, Anestesiologiche e Della Rianimazione, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome 00168, Italy
- UOC Terapia Intensiva Pediatrica e Trauma Center Pediatrico, Università Cattolica del Sacro Cuore, Rome 00168, Italy
| | - Gabriele Sani
- UOC Psichiatria Clinica e d’Urgenza, Dipartimento di Scienze Dell’Invecchiamento, Neurologiche, Ortopediche e Della Testa-collo, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome 00168, Italy
- Department of Psychiatry, Università Cattolica del Sacro Cuore, Rome 00168, Italy
| | - Massimo Antonelli
- UOC Anestesia, Rianimazione, Terapia Intensiva e Tossicologia Clinica, Dipartimento di Scienze Dell’Emergenza, Anestesiologiche e Della Rianimazione, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome 00168, Italy
- Department of Anesthesiology and Intensive Care Medicine, Università Cattolica del Sacro Cuore, Rome 00168, Italy
| | - Daniela Pia Rosaria Chieffo
- UOS Psicologia Clinica, Governo Clinico, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome 00168, Italy
- Department of Psychology, Università Cattolica del Sacro Cuore, Rome 00168, Italy
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Scarpina F, Turroni S, Mambrini S, Barone M, Cattaldo S, Mai S, Prina E, Bastoni I, Cappelli S, Castelnuovo G, Brigidi P, Scacchi M, Mauro A. Gut Microbiota and Fear Processing in Women Affected by Obesity: An Exploratory Pilot Study. Nutrients 2022; 14:nu14183788. [PMID: 36145169 PMCID: PMC9505791 DOI: 10.3390/nu14183788] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2022] [Revised: 08/31/2022] [Accepted: 09/06/2022] [Indexed: 11/20/2022] Open
Abstract
The microbiota–gut–brain axis extends beyond visceral perception, influencing higher-order brain structures, and ultimately psychological functions, such as fear processing. In this exploratory pilot study, we attempted to provide novel experimental evidence of a relationship between gut microbiota composition and diversity, and fear-processing in obesity, through a behavioral approach. Women affected by obesity were enrolled and profiled for gut microbiota, through 16S rRNA amplicon sequencing. Moreover, we tested their ability to recognize facial fearful expressions through an implicit-facial-emotion-recognition task. Finally, a traditional self-report questionnaire was used to assess their temperamental traits. The participants exhibited an unbalanced gut microbiota profile, along with impaired recognition of fearful expressions. Interestingly, dysbiosis was more severe in those participants with altered behavioral performance, with a decrease in typically health-associated microbes, and an increase in the potential pathobiont, Collinsella. Moreover, Collinsella was related to a lower expression of the persistence temperamental trait, while a higher expression of the harm-avoidance temperament, related to fear-driven anxiety symptoms, was linked to Lactobacillus. Once confirmed, our findings could pave the way for the design of innovative microbiome-based strategies for the treatment of psychological and emotional difficulties by mitigating obesity-related consequences and behaviors.
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Affiliation(s)
- Federica Scarpina
- “Rita Levi Montalcini” Department of Neurosciences, University of Turin, Via Cherasco 15, 10126 Turin, Italy
- I.R.C.C.S. Istituto Auxologico Italiano, U.O. di Neurologia e Neuroriabilitazione, Ospedale San Giuseppe, Str. L Cadorna 90, 28824 Piancavallo, Italy
- Correspondence: (F.S.); (S.T.)
| | - Silvia Turroni
- Unit of Microbiome Science and Biotechnology, Department of Pharmacy and Biotechnology, University of Bologna, Via Belmeloro 6, 40126 Bologna, Italy
- Correspondence: (F.S.); (S.T.)
| | - Sara Mambrini
- I.R.C.C.S. Istituto Auxologico Italiano, Laboratorio di Ricerca Metabolica, Ospedale San Giuseppe, Str. L Cadorna 90, 28824 Piancavallo, Italy
- International Center for the Assessment of Nutritional Status (ICANS), Department of Food, Environmental and Nutritional Sciences (DeFENS), University of Milan, Via G. Celoria 2, 20133 Milan, Italy
| | - Monica Barone
- Unit of Microbiome Science and Biotechnology, Department of Pharmacy and Biotechnology, University of Bologna, Via Belmeloro 6, 40126 Bologna, Italy
- Department of Medical and Surgical Sciences, Unit of Microbiomics, University of Bologna, Via Massarenti 11, 40126 Bologna, Italy
| | - Stefania Cattaldo
- I.R.C.C.S. Istituto Auxologico Italiano, Laboratorio di Neurobiologia Clinica, Ospedale San Giuseppe, Str. L Cadorna 90, 28824 Piancavallo, Italy
| | - Stefania Mai
- I.R.C.C.S. Istituto Auxologico Italiano, Laboratorio di Ricerca Metabolica, Ospedale San Giuseppe, Str. L Cadorna 90, 28824 Piancavallo, Italy
| | - Elisa Prina
- I.R.C.C.S. Istituto Auxologico Italiano, Laboratorio di Ricerca Metabolica, Ospedale San Giuseppe, Str. L Cadorna 90, 28824 Piancavallo, Italy
| | - Ilaria Bastoni
- I.R.C.C.S. Istituto Auxologico Italiano, Laboratorio di Psicologia, Ospedale San Giuseppe, Str. L Cadorna 90, 28824 Piancavallo, Italy
| | - Simone Cappelli
- I.R.C.C.S. Istituto Auxologico Italiano, Laboratorio di Psicologia, Ospedale San Giuseppe, Str. L Cadorna 90, 28824 Piancavallo, Italy
| | - Gianluca Castelnuovo
- I.R.C.C.S. Istituto Auxologico Italiano, Laboratorio di Psicologia, Ospedale San Giuseppe, Str. L Cadorna 90, 28824 Piancavallo, Italy
- Department of Psychology, Catholic University of Milan, Largo Agostino Gemelli 1, 20123 Milan, Italy
| | - Patrizia Brigidi
- Department of Medical and Surgical Sciences, Unit of Microbiomics, University of Bologna, Via Massarenti 11, 40126 Bologna, Italy
| | - Massimo Scacchi
- I.R.C.C.S. Istituto Auxologico Italiano, Divisione di Medicina Generale ad indirizzo Endocrino-Metabolico, Ospedale San Giuseppe, Str. L Cadorna 90, 28824 Piancavallo, Italy
- Department of Clinical Sciences and Community Health, University of Milan, Via Festa del Perdono 7, 20122 Milan, Italy
| | - Alessandro Mauro
- “Rita Levi Montalcini” Department of Neurosciences, University of Turin, Via Cherasco 15, 10126 Turin, Italy
- I.R.C.C.S. Istituto Auxologico Italiano, U.O. di Neurologia e Neuroriabilitazione, Ospedale San Giuseppe, Str. L Cadorna 90, 28824 Piancavallo, Italy
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