Trauma-Related Distress During the COVID-19 Pandemic In 59 Countries

First published online March 11, 2022The COVID-19 pandemic has upended life like few other events in modern history, with differential impacts on varying population groups. This study examined trauma-related distress among 6,882 adults ages 18 to 94 years old in 59 countries during April to May 2020. More than two-thirds of participants reported clinically significant trauma-related distress. Increased distress was associated with unemployment; identifying as transgender, nonbinary, or a cisgender woman; being from a higher income country; current symptoms and positive diagnosis of COVID-19; death of a loved one; restrictive government-imposed isolation; financial difficulties; and food insecurity. Other factors associated with distress included working with potentially infected individuals, care needs at home, a difficult transition to working from home, conflict in the home, separation from loved ones, and event restrictions. Latin American and Caribbean participants reported more trauma-related distress than participants from Europe and Central Asia. Findings inform treatment efforts and highlight the need to address trauma-related distress to avoid long-term mental health consequences.The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: This work was supported by the European Commission (H2020-MSCA-IF-2018-837228-ENGRAVING). Daniela Ramos-Usuga was supported by a predoctoral fellowship from the Basque Government (PRE_2019_1_0164)

Moderate, little, or no improvements in neurobehavioral symptoms among individuals with long COVID: A 34-country retrospective study

(1) Background: Some people with COVID-19 develop a series of symptoms that last for several months after infection, known as Long COVID. Although these symptoms interfere with people’s daily functioning and quality of life, few studies have focused on neurobehavioral symptoms and the risk factors associated with their development; (2) Methods: 1001 adults from 34 countries who had previously tested positive for COVID-19 completed the Neurobehavioral Symptom Inventory reporting the symptoms before their COVID-19 diagnosis, during the COVID-19 infection, and currently; (3) Results: Participants reported large-sized increases before vs. during COVID-19 in all domains. Participants reported a medium-sized improvement (during COVID-19 vs. now) in somatic symptoms, a small-sized improvement in affective symptoms, and very minor/no improvement in cognitive symptoms. The risk factors for increased neurobehavioral symptoms were: being female/trans, unemployed, younger age, low education, having another chronic health condition, greater COVID-19 severity, greater number of days since the COVID-19 diagnosis, not having received oxygen therapy, and having been hospitalized. Additionally, participants from North America, Europe, and Central Asia reported higher levels of symptoms across all domains relative to Latin America and Sub-Saharan Africa; (4) Conclusions: The results highlight the importance of evaluating and treating neurobehavioral symptoms after COVID-19, especially targeting the higher-risk groups identified. General rehabilitation strategies and evidence-based cognitive rehabilitation are needed in both the acute and Long COVID phases.Daniela Ramos Usuga was supported by a predoctoral fellowship from the Basque Government (PRE_2019_1_0164)

Longitudinal Growth Curve Trajectories of Family Dynamics after Pediatric Traumatic Brain Injury in Mexico

Pediatric traumatic brain injury (TBI) represents a serious public health concern. Family members are often caregivers for children with TBI, which can result in a significant strain on familial relationships. Research is needed to examine aspects of family functioning in the context of recovery post-TBI, especially in Latin America, where cultural norms may reinforce caregiving by family members, but where resources for these caregivers may be scarce. This study examined caregiver-reported family satisfaction, communication, cohesion, and flexibility at three time points in the year post-injury for 46 families of a child with TBI in comparison to healthy control families. Families experiencing pediatric TBI were recruited from a large hospital in Guadalajara, Mexico, while healthy controls were recruited from a local educational center. Results from multilevel growth curve models demonstrated that caregivers of children with a TBI reported significantly worse family functioning than controls at each assessment. Families experiencing pediatric TBI were unable to attain the level of functioning of controls during the time span studied, suggesting that these families are likely to experience long-term disruptions in family functioning. The current study highlights the need for family-level intervention programs to target functioning for families affected by pediatric TBI who are at risk for difficulties within a rehabilitation context.This study was supported by the Department of Veterans Affairs Office of Academic Affiliations Advanced Fellowship Program in Mental Illness Research and Treatment, the Medical Research Service of the Veterans Affairs Central Virginia Health Care System, and the Department of Veterans Affairs Mid-Atlantic Mental Illness Research, Education, and Clinical Center (MIRECC). Ramos-Usuga, D. was supported by a predoctoral fellowship from the Basque Government (PRE_2019_1_0164)

Brain connectivity and cognitive functioning in individuals six months after multiorgan failure

Multiorgan failure (MOF) is a life-threating condition that affects two or more systems of organs not involved in the disorder that motivates admission to an Intensive Care Unit (ICU). Patients who survive MOF frequently present long-term functional, neurological, cognitive, and psychiatric sequelae. However, the changes to the brain that explain such symptoms remain unclear. Objective: To determine brain connectivity and cognitive functioning differences between a group of MOF patients six months after ICU discharge and healthy controls (HC). Methods: 22 MOF patients and 22 HC matched by age, sex, and years of education were recruited. Both groups were administered a 3T magnetic resonance imaging (MRI), including structural T1 and functional BOLD, as well as a comprehensive neuropsychological evaluation that included tests of learning and memory, speed of information processing and attention, executive function, visual constructional abilities, and language. Voxel-based morphometry was used to analyses T1 images. For the functional data at rest, functional connectivity (FC) analyses were performed. Results: There were no significant differences in structural imaging and neuropsychological performance between groups, even though patients with MOF performed worse in all the cognitive tests. Functional neuroimaging in the default mode network (DMN) showed hyper-connectivity towards sensory-motor, cerebellum, and visual networks. DMN connectivity had a significant association with the severity of MOF during ICU stay and with the neuropsychological scores in tests of attention and visual constructional abilities. Conclusions: In MOF patients without structural brain injury, DMN connectivity six months after ICU discharge is associated with MOF severity and neuropsychological impairment, which supports the use of resting-state functional MRI as a potential tool to predict the onset of long-term cognitive deficits in these patients. Similar to what occurs at the onset of other pathologies, the observed hyper-connectivity might suggest network re-adaptation following MOF.This research was founded by Ministerio Economia, Industria y Competitividad, Spain and FEDER (grant no. DPI2016-79874-R) to JC and JCAL. ID's time was founded by the Department of Education of the Basque Country, postdoctoral program. JR's time was founded by the Ministry of Education, Language Policy and Culture (Basque Government). JMC's time was founded by Ikerbasque and the Department of Economic Development and Infrastructure of the Basque Country, Elkartek Program (grant no. KK-2018/00032). JCAL's time was founded by Ikerbasque and Fundacion Mutua Madrileña (grant no. AP169812018). IG's time was founded by the Instituto de Salud Carlos III for a Juan Rodes (grant no. JR15/00008 ) co-funded by the European Regional Development Fund/European Social Fund ‘Investing in Your Future’. AJM's time was partly founded by Euskampus Fundazioa

Brain connectivity and cognitive functioning in individuals six months after multiorgan failure

Abstract Multiorgan failure (MOF) is a life-threating condition that affects two or more systems of organs not involved in the disorder that motivates admission to an Intensive Care Unit (ICU). Patients who survive MOF frequently present long-term functional, neurological, cognitive, and psychiatric sequelae. However, the changes to the brain that explain such symptoms remain unclear. OBJECTIVE: To determine brain connectivity and cognitive functioning differences between a group of MOF patients six months after ICU discharge and healthy controls (HC). METHODS: 22 MOF patients and 22 HC matched by age, sex, and years of education were recruited. Both groups were administered a 3T magnetic resonance imaging (MRI), including structural T1 and functional BOLD, as well as a comprehensive neuropsychological evaluation that included tests of learning and memory, speed of information processing and attention, executive function, visual constructional abilities, and language. Voxel-based morphometry was used to analyses T1 images. For the functional data at rest, functional connectivity (FC) analyses were performed. RESULTS: There were no significant differences in structural imaging and neuropsychological performance between groups, even though patients with MOF performed worse in all the cognitive tests. Functional neuroimaging in the default mode network (DMN) showed hyper-connectivity towards sensory-motor, cerebellum, and visual networks. DMN connectivity had a significant association with the severity of MOF during ICU stay and with the neuropsychological scores in tests of attention and visual constructional abilities. CONCLUSIONS: In MOF patients without structural brain injury, DMN connectivity six months after ICU discharge is associated with MOF severity and neuropsychological impairment, which supports the use of resting-state functional MRI as a potential tool to predict the onset of long-term cognitive deficits in these patients.Similar to what occurs at the onset of other pathologies, the observed hyper-connectivity might suggest network re-adaptation following MOF.This research was founded by Ministerio Economia, Industria y Competitividad, Spain and FEDER (grant no. DPI2016-79874-R) to JC and JCAL. ID's time was founded by the Department of Education of the Basque Country, postdoctoral program. JR's time was founded by the Ministry of Education, Language Policy and Culture (Basque Government). JMC's time was founded by Ikerbasque and the Department of Economic Development and Infrastructure of the Basque Country, Elkartek Program (grant no. KK-2018/00032). JCAL's time was founded by Ikerbasque and Fundacion Mutua Madrilena (grant no. AP169812018). IG's time was founded by the Instituto de Salud Carlos III for a Juan Rodes (grant no. JR15/00008) co-funded by the European Regional Development Fund/European Social Fund 'Investing in Your Future'. AJM's time was partly founded by Euskampus Fundazioa

Estudio del funcionamiento neuroconductual, neuropsicológico y de la conectividad cerebral a largo plazo en personas infectadas por SARS-CoV-2

160 p.Se estudian síntomas neuroconductuales, así como el funcionamiento neuropsicológico y la conectividad funcional en pacientes infectados por el SARS CoV-2. Para ello se realizaron tres estudios. En el primero se comparó la presencia de los síntomas neuroconductuales antes de la infección, durante y después (al momento de realizar la encuesta), a través de una escala estandarizada, en una gran muestra internacional. Además, se examinaron los factores de riesgo para el desarrollo de dichos síntomas. En el segundo, se estudiaron las interrelaciones entre dichos síntomas como un sistema dinámico, a través de un análisis de redes psicométricas. En el último, se comparó longitudinalmente el funcionamiento cognitivo y la conectividad funcional de un grupo de pacientes ingresados en la Unidad de Cuidados Intensivos (UCI) por un fallo multiorgánico (FMO) debido a la COVID-19 con el de otro grupo de pacientes con FMO debido a otra causa y un grupo de controles sanos. Los resultados indican que la COVID-19 cursa con un amplio abanico de síntomas persistentes, que se relacionan entre sí. Esto parece estar influido por factores demográficos y clínicos. Predominan los problemas cognitivos, particularmente las dificultades atencionales y un procesamiento lento de la información, que parecen estar relacionadas con un patrón de hipoconectividad funcional entre la RND y la red de saliencia