NEUROPSYCHIATRIC EFFECTS OF LOCKDOWN
In the midst of the SARS-COVID2 infection pandemic phase, there is increased attention to the neurological and psychiatric effects on the population during this sensitive period.
Effects related to the spread of the virus in the central nervous system
In this regard, two kinds of effects should be recorded:
- Direct effects, related to the spread of the virus in the central nervous system.
- Indirect effects, related to conditions such as quarantine, social isolation, and concern for the immediate future.
Effects related to the spread of the virus in the central nervous system
After an initial phase in which the focus was on respiratory manifestations of the infection, ranging in severity to severe and sometimes fatal “interstitial pneumonia,” a clinical picture of widespread involvement of various organs and systems has emerged in recent weeks. These include the nervous system. In this case, the disorders described varied widely, from “simple” anosmia and ageusia (disturbances of smell and taste), to a severe picture of cerebral stroke and infections of the central nervous system (encephalitis) and peripheral nervous system. SARS-COVID2 infection is indeed capable of triggering a severe inflammatory reaction that can also affect the nervous system. Beware, therefore, of the appearance of symptoms of a neurological nature, even a seemingly trivial and sudden loss of taste, since association with viral infection cannot be ruled out at this time.
Indirect neuropsychiatric effects of the pandemic
The level of attention is finally being raised on these, so much so that psychologists have been included in the ministerial task force.
A number of papers have documented increased levels of mood anxiety and depression in the population. One interesting study looked at posts on Weibo, a Chinese microblogging site (somewhere between Facebook and Twitter), analyzing parameters such as the frequency of keywords used and emotional and cognitive indicators. The results showed an increase in posts associated with negative emotions (anxiety, depression, uncertainty about the future). From the results of this study, a number of intervention initiatives have started to address a risk of even more serious psychiatric events in the general population.
[ Download the study on Weibo Users | PDF ]
A study conducted by our research group (Tagliavia et al., in preparation; University of Palermo in collaboration with NeuroTeam), showed the presence of severe anxiety and depressive disorders, in 18% of the population quarantined in recent weeks. An interesting finding that emerged is the inverse correlation between these disorders and the practice of physical activities associated with meditation and relaxation, such as Mindfulness and Yoga, which would thus seem to play a “protective” role from the emergence of these disorders.
Another study by our group (Oliveri et al., in preparation) compared presence of disturbances in the control of negative emotions with the ability to activate specific parts of the brain, the prefrontal regions. The goal is to show that people with better ability to activate those regions of the brain, involved in planning, problem solving, ability to inhibit inappropriate responses, are also more efficient in controlling the presence of psychological distress and neuropsychiatric disorders in this pandemic period.
A general suggestion emerges from these observations to control and/or prevent the onset of severe anxiety or depression disorders: practice “problem solving” activities, such as crossword puzzles, rebuses, strategy video games…A number of studies have in this regard pointed to the game Tetris as an effective tool for controlling negative emotions.
A separate commentary deserves sleep disorders, which affect a fair percentage of the population during this period. In addition to the obvious association between anxiety disorders and sleep disorders, the latter are present even in individuals without obvious manifestations of anxiety and depression. Sleep is in some ways a reworking process of everyday experiences. Media bombardment about contagions, deceased persons, uncertainties about “stage 2” keeps the wakefulness and activation state switches active, instead hindering the physiological activation of sleep stage switches, especially deep sleep. The advice in this case is to take maximum care of sleep hygiene (as well as hand hygiene!), not spending too many hours in front of video terminals, especially in the evening hours, going to sleep at regular times, and reserving “news supply” about the epidemic at other times of the day, not in the evening hours.
Author
