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      Dietary Habits and Psychological States during COVID-19 Home Isolation in Italian College Students: The Role of Physical Exercise

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          Abstract

          Social isolation has adverse effects on mental health, physical exercise, and dietary habits. This longitudinal observational study aimed to investigate the effects of mood states and exercise on nutritional choices, on 176 college students (92 males, 84 females; 23 ± 4 years old) during the COVID-19 lockdown. During 21 days, nutrition and exercise were daily monitored, and the mood states assessed. A factor analysis was used to reduce the number of nutritional variables collected. The relationships between exercise, mood and nutrition were investigated using a multivariate general linear model and a mediation model. Seven factors were found, reflecting different nutritional choices. Exercise was positively associated with fruit, vegetables and fish consumption ( p = 0.004). Depression and quality of life were, directly and inversely, associated with cereals, legumes ( p = 0.005; p = 0.004) and low-fat meat intake ( p = 0.040; p = 0.004). Exercise mediated the effect of mood states on fruit, vegetables and fish consumption, respectively, accounting for 4.2% and 1.8% of the total variance. Poorer mood states possibly led to unhealthy dietary habits, which can themselves be linked to negative mood levels. Exercise led to healthier nutritional choices, and mediating the effects of mood states, it might represent a key measure in uncommon situations, such as home-confinement.

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          The PHQ-9: validity of a brief depression severity measure.

          While considerable attention has focused on improving the detection of depression, assessment of severity is also important in guiding treatment decisions. Therefore, we examined the validity of a brief, new measure of depression severity. The Patient Health Questionnaire (PHQ) is a self-administered version of the PRIME-MD diagnostic instrument for common mental disorders. The PHQ-9 is the depression module, which scores each of the 9 DSM-IV criteria as "0" (not at all) to "3" (nearly every day). The PHQ-9 was completed by 6,000 patients in 8 primary care clinics and 7 obstetrics-gynecology clinics. Construct validity was assessed using the 20-item Short-Form General Health Survey, self-reported sick days and clinic visits, and symptom-related difficulty. Criterion validity was assessed against an independent structured mental health professional (MHP) interview in a sample of 580 patients. As PHQ-9 depression severity increased, there was a substantial decrease in functional status on all 6 SF-20 subscales. Also, symptom-related difficulty, sick days, and health care utilization increased. Using the MHP reinterview as the criterion standard, a PHQ-9 score > or =10 had a sensitivity of 88% and a specificity of 88% for major depression. PHQ-9 scores of 5, 10, 15, and 20 represented mild, moderate, moderately severe, and severe depression, respectively. Results were similar in the primary care and obstetrics-gynecology samples. In addition to making criteria-based diagnoses of depressive disorders, the PHQ-9 is also a reliable and valid measure of depression severity. These characteristics plus its brevity make the PHQ-9 a useful clinical and research tool.
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            The psychological impact of quarantine and how to reduce it: rapid review of the evidence

            Summary The December, 2019 coronavirus disease outbreak has seen many countries ask people who have potentially come into contact with the infection to isolate themselves at home or in a dedicated quarantine facility. Decisions on how to apply quarantine should be based on the best available evidence. We did a Review of the psychological impact of quarantine using three electronic databases. Of 3166 papers found, 24 are included in this Review. Most reviewed studies reported negative psychological effects including post-traumatic stress symptoms, confusion, and anger. Stressors included longer quarantine duration, infection fears, frustration, boredom, inadequate supplies, inadequate information, financial loss, and stigma. Some researchers have suggested long-lasting effects. In situations where quarantine is deemed necessary, officials should quarantine individuals for no longer than required, provide clear rationale for quarantine and information about protocols, and ensure sufficient supplies are provided. Appeals to altruism by reminding the public about the benefits of quarantine to wider society can be favourable.
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              Development and validation of brief measures of positive and negative affect: The PANAS scales.

              In recent studies of the structure of affect, positive and negative affect have consistently emerged as two dominant and relatively independent dimensions. A number of mood scales have been created to measure these factors; however, many existing measures are inadequate, showing low reliability or poor convergent or discriminant validity. To fill the need for reliable and valid Positive Affect and Negative Affect scales that are also brief and easy to administer, we developed two 10-item mood scales that comprise the Positive and Negative Affect Schedule (PANAS). The scales are shown to be highly internally consistent, largely uncorrelated, and stable at appropriate levels over a 2-month time period. Normative data and factorial and external evidence of convergent and discriminant validity for the scales are also presented.
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                Author and article information

                Journal
                Nutrients
                Nutrients
                nutrients
                Nutrients
                MDPI
                2072-6643
                28 November 2020
                December 2020
                : 12
                : 12
                : 3660
                Affiliations
                [1 ]Department of Biomolecular Sciences, University of Urbino Carlo Bo, 61029 Urbino, Italy; s.amatori1@ 123456campus.uniurb.it (S.A.); sabrina.zeppa@ 123456uniurb.it (S.D.Z.); marco.gervasi@ 123456uniurb.it (M.G.); erica.gobbi@ 123456uniurb.it (E.G.); f.ferrini2@ 123456campus.uniurb.it (F.F.); marco.rocchi@ 123456uniurb.it (M.B.L.R.); fabrizio.perroni@ 123456uniurb.it (F.P.); giovanni.piccoli@ 123456uniurb.it (G.P.); vilberto.stocchi@ 123456uniurb.it (V.S.); davide.sisti@ 123456uniurb.it (D.S.)
                [2 ]Department of Neurosciences, University of Turin, 10124 Turin, Italy; antonio.preti@ 123456unito.it
                [3 ]Faculty of Psychology, eCampus University, 22060 Novedrate, Italy; carlo.baldari@ 123456uniecampus.it
                Author notes
                [* ]Correspondence: piero.sestili@ 123456uniurb.it
                [†]

                These authors contributed equally to this work.

                Author information
                https://orcid.org/0000-0001-7497-755X
                https://orcid.org/0000-0001-5879-0752
                https://orcid.org/0000-0001-9003-9838
                https://orcid.org/0000-0001-7112-1780
                https://orcid.org/0000-0002-4885-4932
                https://orcid.org/0000-0002-0056-5795
                https://orcid.org/0000-0001-6227-3571
                https://orcid.org/0000-0003-2094-4351
                https://orcid.org/0000-0001-9412-1660
                https://orcid.org/0000-0002-7925-7495
                Article
                nutrients-12-03660
                10.3390/nu12123660
                7759990
                33260711
                ea8d5f63-bc4c-468c-a672-c788454c9d94
                © 2020 by the authors.

                Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license ( http://creativecommons.org/licenses/by/4.0/).

                History
                : 10 November 2020
                : 26 November 2020
                Categories
                Article

                Nutrition & Dietetics
                diet,exercise,lifestyle,mood,quarantine,young adults
                Nutrition & Dietetics
                diet, exercise, lifestyle, mood, quarantine, young adults

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