Health Anxiety and Mental Health Outcome During COVID-19 Lockdown in Italy: The Mediating and Moderating Roles of Psychological Flexibility

The COVID-19 emergency has severely affected the Italian population. During a pandemic, those with high health anxiety are at risk of adverse mental health outcomes, including peritraumatic distress and mood disturbance. No prior research has explored the role of psychological flexibility in protecting people at high risk of poorer mental health impacts due to health anxiety during a pandemic. Psychological flexibility is the cornerstone of psychological health and resiliency. According to acceptance and commitment therapy (ACT), it involves behaving consistently with one\u2019s chosen values even in the presence of emotional and mental discomfort. This study examined the mediating and moderating roles of psychological flexibility in the link between trait health anxiety and three mental health outcomes: COVID-19 peritraumatic distress, anxiety, and depression. We hypothesized that higher psychological flexibility would decrease the negative impacts of trait health anxiety on mental health outcomes. During the mandatory national lockdown (M = 35.70 days, SD = 8.41), 944 Italian adults (75.5% female, M = 38.86 years, SD = 13.20) completed an online survey consisting of standardized measures of psychological flexibility, trait health anxiety, COVID-19 distress, anxiety, and depression. Results indicated that psychological flexibility did not moderate the link between trait health anxiety and mental health outcomes. Rather, greater psychological flexibility mediated decreases in the adverse effects of trait health anxiety on COVID-19 distress, anxiety, and depression. In particular, two psychological flexibility processes, observing unhelpful thoughts rather than taking them literally (defusion) and values-based action (committed action), mediated decreases in the negative effects of trait health anxiety on all mental health outcomes. In contrast, the psychological flexibility process acceptance, which involves openness to inner discomfort, mediated increases in negative mental health outcomes. Overall, the combination of these processes mitigated the detrimental impacts of trait health anxiety on mental health during the emergency mandatory COVID-19 nationwide lockdown. Consistent with the ACT conceptualization of psychological flexibility, findings suggest embracing (rather than avoiding) inner discomfort and observing associated unhelpful thoughts, while also engaging in values-based action, increases resilience during adversity. Evidenced-based large-scale online public health interventions that target psychological flexibility in those experiencing health anxiety in the context of a pandemic are urgently needed. Many empirically-based ACT interventions are suited for this purpose

The impact of psychological distress on weight regain in post-bariatric patients during the COVID-19 pandemic: A latent profile analysis

Objective: The COVID-19 pandemic has caused a global health crisis disrupting healthcare delivery for people with severe obesity who have undergone bariatric surgery. This study examined the role of psychological distress during the first Italian COVID-19 lockdown in predicting post-operative outcomes in post-bariatric patients reaching the end of the 12-18 months follow-up during the lockdown. By using a person-centered approach, groups of patients with different psychological distress profiles were identified. We hypothesized that compared to post-bariatric patients with low psychological distress, post-bariatric patients with high psychological distress will be more at risk of weight regain. Methods: A total of 67 patients (71.6% female, Mage = 45.9) participated in this observational retrospective cohort study. Patients' anthropometric data were gathered from medical records while the weight at the end of the lockdown through phone interviews. Psychological distress, operationalized with anxiety symptoms, depressive symptoms, and sleep disturbances, was assessed by an online self-report questionnaire. Results: Significant differences were highlighted in the high and low psychological distressed group in weight changes, F(1,58) = 5.2, p < 0.001, η2 = 0.3. Specifically, compared to post-bariatric patients in the low psychological distress group, those in the high psychological distressed group reported weight regained (95% CI = 1.0, 2.6). Conclusion: Results highlight the need to target post-bariatric patients with high psychological distress who are at risk for weight regain during the COVID-19 pandemic. Interventions mitigating psychological distress and obesogenic behaviors during future pandemics or in post-COVID times are needed in vulnerable post-bariatric patients reporting high psychological distress

Psicosomatica e medicina riabilitativa

Lo scopo della ricerca \ue8 di esaminare approfonditamente i risultati a medio-lungo termine del percorso riabilitativo, in differenti ambiti della medicina, identificando le variabili psicosomatiche che ne influenzano il decorso e l\u2019esito. 2. Vengono studiati i disturbi somatoformi nell\u2019infanzia e nell\u2019adolescenza e il loro impatto sul benessere psicologico, sia in ambito medico che scolastico. 3. Vengono condotti studi controllati randomizzati con l\u2019utilizzazione di strategie (basate su tecniche ad indirizzo cognitivo-comportamentale e di promozione del benessere) finalizzate a modificare stili di vita e atteggiamenti disadattivi che sembrano compromettere il benessere psicosociale e gli esiti degli interventi terapeutici, in differenti ambiti clinici. 4. Vengono studiati, attraverso un approccio multidimensionale, fattori clinici e patterns di sintomi psicosomatici correlati alla depressione ansiosa

The Concept of Mental Pain

Mental pain is no less real than other types of pain related to parts of the body, but does not seem to get adequate attention. A major problem is the lack of agreement about its distinctive features, conceptualization and operational definition. I will examine some suggested descriptions of mental pain, its association with psychiatric disorders and grief, its assessment and the implications that research in this field may entail

Depressione ansiosa in medicina generale e in ambito riabilitativo

Molti pazienti con disturbo depressivo maggiore (circa il 40-45%) presentano comorbidit\ue0 con disturbi d'ansia, frequentemente associati ad una mancata risposta al trattamento farmacologico, alla cronicizzazione e ad un aumento di rischio di suicidio. La concomitante presenza di disturbi ansiosi e depressivi ha rilevanti implicazioni sul trattamento con antidepressivi. Inoltre i sintomi residui dell'ansia risultano essere associati ad un maggior rischio di ricaduta nei pazienti con disturbo depressivo maggiore. La depressione ansiosa viene considerata sia un disturbo depressivo maggiore con alti livelli di sintomi ansiosi (approccio dimensionale, basato sul livello di severit\ue0 dei sintomi ansiosi) che un disturbo depressivo maggiore con comorbidit\ue0 di disturbi ansiosi (approccio sindromico, basato sul grado di comorbidit\ue0). Molti studi presenti in letteratura hanno evidenziato che spesso i disturbi ansiosi e depressivi vengono somatizzati dal paziente, dando origine a sintomi fisici di natura non organica, cio\ue8 sintomi somatici non specifici (come dolore, dispepsia, affaticamento, insonnia, ecc.). Obiettivo principale dello studio \ue8 valutare fattori clinici e patterns di sintomi correlati nella depressione ansiosa e descriverne il decorso