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JournalISSN: 1664-0640

Frontiers in Psychiatry 

Frontiers Media
About: Frontiers in Psychiatry is an academic journal published by Frontiers Media. The journal publishes majorly in the area(s): Medicine & Psychology. It has an ISSN identifier of 1664-0640. It is also open access. Over the lifetime, 11352 publications have been published receiving 150089 citations.


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Journal ArticleDOI
TL;DR: High rates of negative mental health outcomes in the Italian general population 3 weeks into the CO VID-19 lockdown measures and different COVID-19 related risk factors are found.
Abstract: Background The psychological impact of the COronaVIrus Disease 2019 (COVID-19) outbreak and lockdown measures on the Italian population are unknown. The current study assesses rates of mental health outcomes in the Italian general population three to 4 weeks into lockdown measures and explores the impact of COVID-19 related potential risk factors. Methods A web-based survey spread throughout the internet between March 27th and April 6th 2020. Eighteen thousand one hundred forty-seven individuals completed the questionnaire, 79.6% women. Selected outcomes were post-traumatic stress symptoms (PTSS), depression, anxiety, insomnia, perceived stress, and adjustment disorder symptoms (ADS). Seemingly unrelated logistic regression analysis was performed to identify COVID-19 related risk factors. Results Endorsement rates for PTSS were 6,604 (37%), 3,084 (17.3%) for depression, 3,700 (20.8%) for anxiety, 1,301 (7.3%) for insomnia, 3,895 (21.8%) for high perceived stress and 4,092 (22.9%) for adjustment disorder. Being woman and younger age were associated with all of the selected outcomes. Quarantine was associated with PTSS, anxiety and ADS. Any recent COVID-related stressful life event was associated with all the selected outcomes. Discontinued working activity due to the COVID-19 was associated with all the selected outcomes, except for ADS; working more than usual was associated with PTSS, Perceived stress and ADS. Having a loved one deceased by COVID-19 was associated with PTSS, depression, perceived stress, and insomnia. Conclusion We found high rates of negative mental health outcomes in the Italian general population 3 weeks into the COVID-19 lockdown measures and different COVID-19 related risk factors. These findings warrant further monitoring on the Italian population's mental health.

897 citations

Journal ArticleDOI
TL;DR: Anxiety disorders are associated with reduced HRV, findings associated with a small-to-moderate effect size, highlighting a need for comprehensive cardiovascular risk reduction.
Abstract: Background: Anxiety disorders increase risk of future cardiovascular disease (CVD) and mortality, even after controlling for confounds including smoking, lifestyle, and socioeconomic status, and irrespective of a history of medical disorders. While impaired vagal function, indicated by reductions in heart rate variability (HRV), may be one mechanism linking anxiety disorders to CVD, prior studies have reported inconsistent findings highlighting the need for meta-analysis. Method: Studies comparing resting-state HRV recordings in patients with an anxiety disorder as a primary diagnosis and healthy controls were considered for meta-analysis. Results: Meta-analyses were based on 36 articles, including 2086 patients with an anxiety disorder and 2294 controls. Overall, anxiety disorders were characterized by lower HRV [high frequency (HF): Hedges’ gD 0.29. 95% CI: 0.41 to 0.17, p < 0.001; time domain: Hedges’ gD 0.45, 95% CI: 0.57 to 0.33, p < 0.001] than controls. Panic disorder (nD 447), post-traumatic stress disorder (nD 192), generalized anxiety disorder (nD 68), and social anxiety disorder (nD 90), but not obsessive‐compulsive disorder (nD 40), displayed reductions in HF HRV relative to controls (all ps< 0.001). Conclusion: Anxiety disorders are associated with reduced HRV, findings associated with a small-to-moderate effect size. Findings have important implications for future physical health and well-being of patients, highlighting a need for comprehensive cardiovascular risk reduction.

652 citations

Journal ArticleDOI
TL;DR: It is suggested that both pervasive trait abnormalities and florid failures of inference in the psychotic state can be linked to factors controlling post-synaptic gain – such as NMDA receptor function and (dopaminergic) neuromodulation.
Abstract: This paper considers psychotic symptoms in terms of false inferences or beliefs. It is based on the notion that the brain is an inference machine that actively constructs hypotheses to explain or predict its sensations. This perspective provides a normative (Bayes optimal) account of action and perception that emphasises probabilistic representations; in particular, the confidence or precision of beliefs about the world. We will consider hallucinosis, abnormal eye movements, sensory attenuation deficits, catatonia and delusions as various expressions of the same core pathology: namely, an aberrant encoding of precision. From a cognitive perspective, this represents a pernicious failure of metacognition (beliefs about beliefs) that can confound perceptual inference. In the embodied setting of active (Bayesian) inference, it can lead to behaviours that are paradoxically more accurate than Bayes optimal behaviour. Crucially, this normative account is accompanied by a neuronally plausible process theory based upon hierarchical predictive coding. In predictive coding, precision is thought to be encoded by the postsynaptic gain of neurons reporting prediction error. This suggests that both pervasive trait abnormalities and florid failures of inference in the psychotic state can be linked to factors controlling postsynaptic gain – such as NMDA receptor function and (dopaminergic) neuromodulation. We illustrate these points using biologically plausible simulations of perceptual synthesis, smooth pursuit eye movements and attribution of agency – that all use the same predictive coding scheme and pathology: namely, a reduction in the precision of prior beliefs, relative to sensory evidence.

631 citations

Journal ArticleDOI
TL;DR: The study found that more than one-third of the medical staff suffered insomnia symptoms during the COVID-19 outbreak, and interventions for insomnia among medical staff are needed considering the various sociopsychological factors at play in this situation.
Abstract: Objective: The outbreak of the 2019 novel coronavirus disease (COVID-19) caused not only extraordinary public health concerns but also tremendous psychological distress, particularly among medical staff. We aimed to investigate the prevalence rate of insomnia and confirm the related social psychological factors among medical staff in hospitals during the COVID-19 outbreak. Method: Medical staff members in China were recruited, including frontline medical workers. The questionnaire, administered through the WeChat program, obtained demographic data and asked self-design questions related to the COVID-19 outbreak, insomnia/depressive/anxiety symptoms, and stress-related symptoms. We used logistic regression analysis to examine the associations between sociodemographic factors and insomnia symptoms. Result: There were 1,563 participants in our study. Five hundred and sixty-four (36.1%) participants had insomnia symptoms according to the Insomnia Severity Index (ISI) (total score ≥ 8). A multiple binary logistic regression model revealed that insomnia symptoms were associated with the education level of high school or below (OR = 2.69, p = 0.042, 95% CI = 1.0–7.0), occupation of doctor (OR = 0.44, p = 0.007, 95% CI = 0.2–0.8), currently working in an isolation unit (OR = 1.71, p = 0.038, 95% CI = 1.0–2.8), worry about being infected (OR = 2.30, p < 0.001, 95% CI = 1.6–3.4), perceived lack of helpfulness in terms of psychological support from news or social media with regard to COVID-19 (OR = 2.10, p = 0.001, 95% CI = 1.3–3.3), and having very strong uncertainty regarding effective disease control (OR = 3.30, p = 0.013, 95% CI = 1.3–8.5). Conclusion: Our study found that more than one-third of the medical staff suffered from insomnia symptoms during the COVID-19 outbreak. The related factors included education level, an isolation environment, psychological worries about the COVID-19 outbreak, and occupation of doctor. Interventions for insomnia among medical staff are needed considering the different sociopsychological factors.

518 citations

Journal ArticleDOI
TL;DR: Various functions of the vagus nerve are discussed, which make it an attractive target in treating psychiatric and gastrointestinal disorders and preliminary evidence for gut bacteria to have beneficial effect on mood and anxiety, partly by affecting the activity of thevagus nerve.
Abstract: The vagus nerve represents the main component of the parasympathetic nervous system, which oversees a vast array of crucial bodily functions, including control of mood, immune response, digestion, and heart rate. It establishes one of the connections between the brain and the gastrointestinal tract and sends information about the state of the inner organs to the brain via afferent fibers. In this review article, we discuss various functions of the vagus nerve which make it an attractive target in treating psychiatric and gastrointestinal disorders. There is preliminary evidence that vagus nerve stimulation is a promising add-on treatment for treatment-refractory depression, posttraumatic stress disorder, and inflammatory bowel disease. Treatments that target the vagus nerve increase the vagal tone and inhibit cytokine production. Both are important mechanism of resiliency. The stimulation of vagal afferent fibers in the gut influences monoaminergic brain systems in the brain stem that play crucial roles in major psychiatric conditions, such as mood and anxiety disorders. In line, there is preliminary evidence for gut bacteria to have beneficial effect on mood and anxiety, partly by affecting the activity of the vagus nerve. Since, the vagal tone is correlated with capacity to regulate stress responses and can be influenced by breathing, its increase through meditation and yoga likely contribute to resilience and the mitigation of mood and anxiety symptoms.

487 citations

Performance
Metrics
No. of papers from the Journal in previous years
YearPapers
20231,504
20223,173
20212,215
20201,574
2019964
2018733