For survivors of severe COVID-19 disease, having defeated the virus is just the beginning of an uncharted recovery path. What follows after the acute phase of SARS-CoV-2 infection depends on the extension and severity of viral attacks in different cell types and organs. Despite the ridiculously large number of papers that have flooded scientific journals and preprinthosting websites, a clear clinical picture of COVID-19 aftermath is vague at best. Without larger prospective observational studies that are only now being started, clinicians can retrieve information just from case reports and or small studies. This is the time to understand how COVID-19 goes forward and what consequences survivors may expect to experience. To this aim, a multidisciplinary post-acute care service involving several specialists has been established at the Fondazione Policlinico Universitario A. Gemelli IRCSS (Rome, Italy). Although COVID-19 is an infectious disease primarily affecting the lung, its multi-organ involvement requires an interdisciplinary approach encompassing virtually all branches of internal medicine and geriatrics. In particular, during the post-acute phase, the geriatrician may serve as the case manager of a multidisciplinary team. The aim of this article is to describe the importance of the interdisciplinary approach-coordinated by geriatrician-to cope the potential post-acute care needs of recovered COVID-19 patients.

To study the long-term psychological effects of Covid-19 disease, we recruited 61 patients older than 60 years of age and administered the Kessler questionnaire K10 to assess psychological distress and classify them according to mental health risk groups. Patients' affective temperaments were assessed with the 39-item form of the Temperament Evaluation of Memphis, Pisa, Paris, and San Diego (TEMPS-A-39) and emotional dysregulation with the Difficulties in Emotion Regulation Scale (DERS). Patients were divided in two samples according to their scores on the K10, i.e., a high likelihood of psychological distress group ( N = 18) and a low likelihood of psychological distress group ( N = 43). The two groups differed on their gender composition, in that more women ( N = 11) were in the former and more men in the latter ( N = 29) (χ 2 = 4.28; p = 0.039). The high likelihood of psychological distress group scored higher on the Cyclothymic (3.39 ± 3.45 vs. 0.93 ± 1.08, p < 0.001) and the Depressive (2.28 ± 2.82 vs. 0.65 ± 1.09, p = 0.01) affective temperaments of the TEMPS and on the lack of Impulse control (12.67 ± 4.04 vs. 9.63 ± 3.14, p = 0.003) and lack of Clarity (15.00 ± 5.56 vs. 9.85 ± 4.67, p = 0.004) scales of the DERS. Our results show that having had Covid-19 may be related with high likelihood for psychological distress in advanced-age people and this may in turn be associated with impaired emotional regulation and higher scores on depressive and cyclothymic temperaments.

The results suggest that childhood trauma may have a different effect in health and disease on volumes of gray matter in the amygdala and hippocampus, which are brain areas specifically involved in response to stress and emotion processing.

The COVID-19 pandemic has spiked stress-related symptoms worldwide. This study aims to assess depressive symptoms related to the early phase of the COVID-19 outbreak among the Italian general population and to analyze anhedonia and emotion dysregulation as potential predictors of depression severity. Through an online questionnaire, we collected sociodemographic and lockdown-related information; depressive symptoms, hedonic tone, and emotion dysregulation were assessed through the Beck Depression Inventory II, the Snaith–Hamilton Pleasure Scale, and the Difficulties in Emotion Regulation Scale, respectively. In our sample (n = 500), 122 individuals (24.4%) reported depressive symptoms during the COVID-19 outbreak. Individuals with and without depression differed in gender (X2 = 4.77, df = 1, p = 0.02) and age (X2 = 15.7, df = 4, p = 0.003). Among individuals presenting with depressive symptoms, those reporting close contact with confirmed cases of COVID-19 were at higher risk for severe depression (p = 0.026). Reduced hedonic tone (p = 0.014) and emotion dysregulation (p < 0.001) also predicted depression severity. To the best of our knowledge, these are among the earliest data that focus on the risk for depression among a sizeable sample of the Italian general population during the COVID-19 outbreak. Our results indicate emotion dysregulation and reduced hedonic tone as potential factors predicting COVID-19-related depression severity and provide insight into developing targeted intervention policies.

BACKGROUND AND OBJECTIVES. Gambling Disorder (GD) is a major public health problem, leading to impaired socio-economical functioning and increased social costs. Although the research on this field has been rising over the years, approved treatment guidelines for GD are currently not available. The aim of this study was to systematically review the literature on the pharmacological and non-pharmacological treatment of adults with GD, to identify possible agreed-upon standards of care. METHODS. MEDLINE, PubMed, and Cochrane electronic databases were searched up to September 2018 for systematic reviews on pharmacological and nonpharmacological treatment of adults with GD. Twenty-three studies were eventually included in this meta-review. RESULTS. Studies reported promising results of opioid antagonists and mood stabilizers in reducing GD-related symptomatology. Lithium was particularly effective in gamblers with comorbid bipolar disorders. Cognitive Behavioural Therapy (CBT) was the most commonly used psychological intervention and reduced global severity, gambling frequency, and financial loss. Motivational Interviewing (MI) seemed to improve several GD domains, alone or in combination with CBT. Self Help Interventions (SHIs) showed some efficacy in promoting treatment-seeking, and in combination with other treatments. CONCLUSIONS. We found moderate evidence of effect for CBT, but lower evidence for pharmacotherapy and SHIs. Results suggested some efficacy for MI in the shortbut not in the long-term. It is likely that certain interventions might be more effective than others on specific features of GD. Further studies are needed to compare the efficacy and acceptability of individual and combined psychosocial and pharmacological interventions, in order to deliver patient-tailored treatments.