scholarly journals Impact of COVID-19 Pandemic on the Psychological Outcomes: Multiple Indicators and Multiple Causes (MIMIC) Modeling

2021 ◽  
Author(s):  
Musheer A. Aljaberi ◽  
Naser A. Alareqe ◽  
Mousa A. Qasem ◽  
Abdulsamad Alsalahi ◽  
Sarah Noman ◽  
...  
Keyword(s):  
Structural Equation ◽  
Online Survey ◽  
Psychological Impact ◽  
Psychological Outcomes ◽  
Post Traumatic Stress ◽  
Latent Factors ◽  
Event Scale ◽  
Multiple Indicators ◽  
The Impact ◽  
Multiple Causes

Abstract Background: Due to the limited research examining the psychological impact of coronavirus disease 2019 (COVID-19), our study aims to investigate the effect of the COVID-19 pandemic on psychological outcomes and assess the differences between participants with and without post-traumatic stress disorder (PTSD) on the psychological outcomes as latent factors and items. Methods: An online survey was conducted on 999 participants. The Impact of Event Scale-Revised (IES-R) assessed the psychological impact, while outcomes were measured by Patient Health Questionnaire-9 (PHQ-9), Generalized Anxiety Disorder (GAD-7), and Insomnia Severity Index (ISI). A series of Confirmatory Factor Analysis (CFA), structural equation model (SEM), Multiple Indicators and Multiple Causes (MIMIC), and Differential Item Functioning (DIF) were conducted. Results: The IES-R has significant effects on the psychological outcomes. Participants with PTSD have a higher impact on latent factors (depression, anxiety, and insomnia) than those without PTSD. Among participants, 36.5% experienced moderate to severe symptoms of depression, and 32.6% had mild depressive symptoms. For anxiety, 23.7% of respondents experienced moderate to severe anxiety symptoms, and 33.1% had mild symptoms of anxiety. For the ISI, 51.5% of participants experienced symptoms of insomnia. Conclusion: the IES-R for COVID-19 has a significant impact on depression, anxiety, and insomnia at the level of latent constructs and observed variables.

scholarly journals Psychological Impact of the COVID-19 Pandemic on Adults and Their Children in Italy

2021 ◽  
Vol 12 ◽  
Author(s):  
Chiara Davico ◽  
Ada Ghiggia ◽  
Daniele Marcotulli ◽  
Federica Ricci ◽  
Federico Amianto ◽  
...  
Keyword(s):  
High Risk ◽  
Sex Education ◽  
Traumatic Stress ◽  
Online Survey ◽  
Psychological Impact ◽  
Post Traumatic Stress ◽  
Impact Of Event Scale ◽  
Event Scale ◽  
Post Traumatic ◽  
The Impact

Aim: The coronavirus disease 2019 (COVID-19) pandemic has abruptly changed the life of millions as travel and social contacts have been severely restricted. We assessed the psychological impact of COVID-19 on adults and children, with special attention to health care workers (HCWs).Methods: A self-rated online survey, including the Impact of Event Scale-Revised (IES-R) for adults and the Children Revised Impact of Event Scale-Revised-13 items (CRIES-13) for their 8–18-year-old offspring, was conducted in Italy on March 20–26, 2020. Linear mixed-effects models were applied to the data, accounting for age, sex, education, and other demographic characteristics.Results: Data were available from 2,419 adults (78.4% females, mean age 38.1 ± SD 13.1 years; 15.7% HCW) and 786 children (50.1% male, mean age 12.3 ± 3.2 years). Median (IQR) IES-R score was 30.0 (21.0–40.0), corresponding to mild psychological impact, with 33.2% reporting severe psychological impact. IES-R was lower in HCWs (29.0) than non-HCWs (31.0), but HCWs directly involved in COVID-19 care had higher scores [33.0 (26.0–43.2)] than uninvolved HCWs [28.0 (19.0–36.0)]. Median CRIES-13 score was [21.0 (11.0–32.0)], with 30.9% of the children at high risk for post-traumatic stress disorder. Parent and child scores were correlated.Conclusions: Up to 30% of adult and children in the pandemic area are at high risk for post-traumatic stress disturbances. The risk is greater for HCWs directly involved in COVID-19 care and for their children.

scholarly journals Brainstem Quadruple Aberrant Hyperphosphorylated Tau, Beta-Amyloid, Alpha-Synuclein and TDP-43 Pathology, Stress and Sleep Behavior Disorders

2021 ◽  
Vol 18 (13) ◽  
pp. 6689
Author(s):  
Lilian Calderón-Garcidueñas ◽  
Ravi Philip Rajkumar ◽  
Elijah W. Stommel ◽  
Randy Kulesza ◽  
Yusra Mansour ◽  
...  
Keyword(s):  
Online Survey ◽  
Amyloid Β ◽  
Alpha Synuclein ◽  
Amyloid Β Peptide ◽  
Hyperphosphorylated Tau ◽  
Post Traumatic Stress ◽  
Impact Of Event Scale ◽  
Sleep Behavior ◽  
Event Scale ◽  
The Impact

Quadruple aberrant hyperphosphorylated tau (p-τ), amyloid-β peptide, alpha-synuclein and TDP-43 brainstem and supratentorial pathology are documented in forensic ≤40y autopsies in Metropolitan Mexico City (MMC), and p-τ is the major aberrant protein. Post-traumatic stress disorder (PTSD) is associated with an elevated risk of subsequent dementia, and rapid eye movement sleep behavior disorder (RBD) is documented in PD, AD, Lewy body dementia and ALS. This study aimed to identify an association between PTSD and potential pRBD in Mexico. An anonymous online survey of 4502 urban college-educated adults, 29.3 ± 10.3 years; MMC, n = 1865; non-MMC, n = 2637, measured PTSD symptoms using the Impact of Event Scale–Revised (IES-R) and pRBD symptoms using the RBD Single-Question. Over 50% of the participants had IES-R scores ≥33 indicating probable PTSD. pRBD was identified in 22.6% of the participants across Mexico and 32.7% in MMC residents with PTSD. MMC subjects with PTSD had an OR 2.6218 [2.5348, 2.7117] of answering yes to the pRBD. PTSD and pRBD were more common in women. This study showed an association between PTSD and pRBD, strengthening the possibility of a connection with misfolded proteinopathies in young urbanites. We need to confirm the RBD diagnosis using an overnight polysomnogram. Mexican women are at high risk for stress and sleep disorders.

scholarly journals Maternal Distress/Coping and Children's Adaptive Behaviors During the COVID-19 Lockdown: Mediation Through Children's Emotional Experience

2020 ◽  
Vol 8 ◽  
Author(s):  
Serena Petrocchi ◽  
Annalisa Levante ◽  
Federica Bianco ◽  
Ilaria Castelli ◽  
Flavia Lecciso
Keyword(s):  
Structural Equation ◽  
Positive Emotions ◽  
Online Survey ◽  
Emotional Experience ◽  
Psychological Impact ◽  
Mediation Effect ◽  
Distance Measures ◽  
Maternal Distress ◽  
Equation Modeling ◽  
The Impact

The present study focused on the psychological impact that the lockdown due to coronavirus disease-19 (COVID-19) had on families in Italy. During the COVID-19 pandemic, the Italian government imposed a strict lockdown for all citizens. People were forced to stay at home, and the length of the lockdown was uncertain. Previous studies analyzed the impact of social distance measures on individuals' mental health, whereas few studies have examined the interplay between the adults' functioning, as parents, during this period and the association with the child's adjustment. The present study tested if maternal distress/coping predicts children's behaviors during the COVID-19 lockdown, hypothesizing a mediation effect via children's emotional experience. Participants were 144 mothers (Mage = 39.3, 25–52, SD = 5.6) with children aged 5–10 years (Mage = 7.54, SD = 1.6, 82 boys); mothers answered to an online survey. Results indicated that mothers with higher exposure to COVID-19 showed higher levels of distress and higher display of coping attitudes, even if in the structural equation modeling model, the COVID-19 exposure was not a predictor of mothers' distress. Compared with mothers with good coping skills, mothers with higher stress levels were more likely to attribute negative emotions to their children at the expense of their positive emotions. Moreover, children's emotions acted as mediators between maternal distress/coping and children's adaptive/maladaptive behaviors. In conclusion, it is important to support parents during pandemic emergence, by providing them with adequate information to manage the relationship with their children, to reduce their level of distress and to enhance their coping abilities.

scholarly journals Coping Strategies and Psychopathological Responses Among Medical and Non-medical Professionals – a Cross-Sectional Online Survey

2021 ◽  
Vol 12 ◽  
Author(s):  
Marta Ciułkowicz ◽  
Julian Maciaszek ◽  
Błażej Misiak ◽  
Anna Pałȩga ◽  
Joanna Rymaszewska ◽  
...  
Keyword(s):  
Coping Strategies ◽  
Online Survey ◽  
General Health Questionnaire ◽  
Well Being ◽  
Medical Professionals ◽  
Post Traumatic Stress ◽  
Cross Sectional ◽  
Event Scale ◽  
Medical Career ◽  
The Impact

Background: The SARS-CoV-2 pandemic was announced on March 11th, 2020, due to a surge of newly confirmed cases that significantly impacted populations worldwide, both directly and indirectly. Based on past epidemics research, the mental health implications of introduced restrictions should be expected and adequately addressed irrespective of the practiced profession.Objective: The study aimed to explore psychopathological responses, including post-traumatic stress disorder (PTSD), concerning coping strategy clusters during the COVID-19 pandemic among medical and non-medical workers.Methods: A cross-sectional web survey of the general population of internet users was performed from March 16th to April 26th, 2020, in Poland during the first peak of COVID-19 cases. A sample of 1,831 professionally active respondents, 64.0% of which pursuing a medical career, filled out General Health Questionnaire-28 (GHQ-28), The Impact of Event Scale-Revised (IES-R), and MiniCOPE, along with the socio-demographic questionnaire exploring personal as well as the work-related possibility of direct exposure to contagion and availability of proper protection, contact with the infected without accurate protective measures as well as the adequacy of workers when compared settings.Results: Individuals labeled with specific clusters had significantly different psychopathological manifestations. Irrespective of performed job maladaptive cluster was associated with significantly higher GHQ-28 and IES-R scores on total subscales and all subscales compared to those representing the non-specific and adaptive cluster. Similar findings were observed concerning the frequency of the GHQ-28 positive score. Moreover, the non-specific cluster was associated with significantly higher GHQ-28 total scores among medical professionals. However, GHQ-28 positive scores were significantly more frequent in medical workers using adaptive clusters when compared to non-specific. Such relations were not observed in the non-medical group.IES-R total and subscales' scores did not significantly vary within medical and non-medical groups when adaptive and non-specific clusters were compared. Pursuing a non-medical career was found to be a determinant of lower scores, while female sex was observed to be determinant of higher scores in both GHQ-28 and IES-R scales.Conclusions: Positive screening for psychopathological and PTSD symptoms was expected regardless of the analyzed groups' coping strategies. Given the dramatically developing situation of the COVID-19 pandemic, support initiatives grounded in research evidence may be essential for maintaining the mental well-being and resilience of both the medical and non-medical workforce.

scholarly journals Early Psychological Impact of the COVID-19 Pandemic in Brazil: A National Survey

2020 ◽  
Vol 9 (9) ◽  
pp. 2976 ◽  
Author(s):  
Juliana Alvares Duarte Bonini Campos ◽  
Bianca Gonzalez Martins ◽  
Lucas Arrais Campos ◽  
João Marôco ◽  
Rayya Ahmed Saadiq ◽  
...  
Keyword(s):  
Mental Health ◽  
Online Survey ◽  
Psychological Symptoms ◽  
Psychological Impact ◽  
Validity And Reliability ◽  
Related Factors ◽  
Event Scale ◽  
Increased Risk ◽  
Population Demographic ◽  
The Impact

Background: Isolation measures used to contain epidemics generate social interaction restrictions and impose changes in routines of the public that increase negative psychological outcomes. Anxiety and depression are the most common symptoms. Objective: To evaluate the mental health of the Brazilian population during the SARs-CoV-2 pandemic and its relationship with demographic and health characteristics. Methods: Adults from all Brazilian States participated (n = 12,196; women: 69.8%, mean age = 35.2 years). The Depression, Anxiety and Stress Scale, and the Impact of Event Scale–revised were used (online survey). Data validity and reliability were verified by confirmatory factor analysis and ordinal alpha coefficient. The probability of presenting psychological symptoms was calculated by multiple logistic regression and odds ratio (OR) (0 = without symptoms, 1 = with mild, moderate, and severe levels of symptoms). Results: High prevalence of depression (61.3%), anxiety (44.2%), stress (50.8%), and psychological impact (54.9%) due to the isolation experienced from the pandemic was found. Younger individuals (OR = 1.58–3.58), those that felt unsafe (OR = 1.75–2.92), with a previous diagnosis of mental health (OR = 1.72–2.64) and/or had general health problems before the pandemic (OR = 1.17–1.51), who noticed changes in their mental state due to the pandemic context (OR = 2.53–9.07), and excessively exposed to the news (OR = 1.19–2.18) were at increased risk of developing symptoms. Women (OR = 1.35–1.65) and those with lower economic status (OR = 1.38–2.69) were more likely to develop psychological symptoms. Lower educational levels increased the likelihood of depressive (OR = 1.03–1.34) and intrusive symptoms (OR = 1.09–1.51). Conclusions: The pandemic and related factors can have a high impact on the mental health of the population. Demographic characteristics can influence the occurrence of psychological symptoms.

scholarly journals Mental Health of the General Population during the 2019 Coronavirus Disease (COVID-19) Pandemic: A Tale of Two Developing Countries

2021 ◽  
Vol 2 (1) ◽  
pp. 71-84
Author(s):  
Cuiyan Wang ◽  
Mohammad A. Fardin ◽  
Mahmoud Shirazi ◽  
Riyu Pan ◽  
Xiaoyang Wan ◽  
...  
Keyword(s):  
Mental Health ◽  
Developing Countries ◽  
Health Information ◽  
Psychological Impact ◽  
Healthcare Services ◽  
Anxiety And Depression ◽  
Post Traumatic Stress ◽  
Impact Of Event Scale ◽  
Event Scale ◽  
The Impact

Background: This study aimed to compare the severity of psychological impact, anxiety and depression between people from two developing countries, Iran and China, and to correlate mental health parameters with variables relating to the COVID-19 pandemic. Although China and Iran are developing countries based on the World Bank’s criteria, these two countries are different in access to resources and health care systems. We hypothesized that Iranians would show higher levels of depression, anxiety and stress as compared to Chinese. Methods: This study collected information related to the COVID-19 pandemic including physical health, precautionary measures and knowledge about the pandemic. We also used validated questionnaires such as the Impact of Event Scale-Revised (IES-R) and the Depression, Anxiety and Stress Scale (DASS-21) to assess the mental health status. Results: There were a total of 1411 respondents (550 from Iran; 861 from China). The mean IES-R scores of respondents from both countries were above the cut-off for post-traumatic stress disorder (PTSD) symptoms. Iranians had significantly higher levels of anxiety and depression (p < 0.01). Significantly more Iranians believed COVID-19 was transmitted via contact, practised hand hygiene, were unsatisfied with health information and expressed less confidence in their doctors, but were less likely to wear a facemask (p < 0.001). Significantly more Iranians received health information related to COVID-19 via television while Chinese preferred the Internet (p < 0.001). Conclusions: This cross-country study found that Iranians had significantly higher levels of anxiety and depression as compared to Chinese. The difference in reported measures between respondents from Iran and China were due to differences in access to healthcare services and governments’ responses to the pandemic.

scholarly journals Psychological impact of managing COVID-19 patients among doctors: A pre- and post-survey study

2021 ◽  
Vol 19 (9) ◽  
pp. 91-97
Author(s):  
Amber Tahir, MBBS, FCPS-I (Psychiatry) ◽  
Anaam Bugti, MBBS, FCPS-I (Psychiatry) ◽  
Ayesha Sarwat, MBBS, MCPS (Psychiatry), FCPS (Psychiatry) ◽  
Azizullah Khan Dhiloo, MBBS, FCPS (Medicine), FCPS (Infectious Diseases) ◽  
Mahnoor Yousif Shaikh, MBBS
Keyword(s):  
Mental Health ◽  
Psychological Health ◽  
Negative Impact ◽  
Psychological Impact ◽  
Survey Study ◽  
Care Providers ◽  
Post Traumatic Stress ◽  
Event Scale ◽  
The Mean ◽  
The Impact

Objective: In any struggling healthcare system, it is always the frontline workers—doctors, nurses, and paramedical staff – that are affected first. This study aimed to assess the psychological impact—anxiety, stress, depression, and post-traumatic stress disorder (PTSD) —among doctors working in COVID-19 wards and the underlying triggers in a public hospital in Karachi. Methods: Pre- and post-survey methodologies were adopted. Post-graduate trainees working in COVID-19 isolation facilities from April till September 2020 were interviewed before starting their one-month rotation and after completing it. The psychological impact was assessed using two standard instruments—Depression Anxiety and Stress 21 (DASS-21) and the Impact of Event Scale-Revised (IES-R). Data were entered and analyzed through SPSS version 22.0. Results: For 100 doctors, the mean score for stress, anxiety, stress, and depression on DASS-21 and PTSD on IES-R significantly increased after the rotation (p 0.01). The mean score of depression and IES-R was higher in younger (28 years) doctors (p ≤ 0.05). Married doctors scored higher on anxiety and IES-R (p ≤ 0.05). Doctors who were not willfully performing their duties scored worse on all measures of DASS-21 and IES-R (p 0.01). Doctors facing family resist­ance scored significantly higher on stress, anxiety, and IES-R (p 0.01). Conclusion: Working in COVID-19 facilities is imparting a negative impact on the psychological health of doctors. Healthcare administration should be aware of this psychological distress and should introduce mental health aid at administrative levels to prevent a mental health epidemic among care providers.

scholarly journals Psychological effects of the COVID-19 outbreak and lockdown among students and workers of a Spanish university

2020 ◽  
Author(s):  
Paula Odriozola-González ◽  
Álvaro Planchuelo-Gómez ◽  
María Jesús Irurtia-Muñiz ◽  
Rodrigo de Luis-García
Keyword(s):  
Online Survey ◽  
Psychological Impact ◽  
Emotional Impact ◽  
Depression Anxiety Stress Scale ◽  
Cross Sectional ◽  
Impact Of Event Scale ◽  
Event Scale ◽  
The University ◽  
Anxiety Depression ◽  
The Impact

The aim of this study was to analyze the psychological impact of COVID-19 in the university community during the first weeks of confinement. A cross-sectional study was conducted. The Depression Anxiety Stress Scale (DASS-21) was employed to assess symptoms of depression, anxiety and stress. The emotional impact of the situation was analyzed using the Impact of Event Scale. An online survey was fulfilled by 2530 members of the University of Valladolid, in Spain. Moderate to extremely severe scores of anxiety, depression, and stress were reported by 21.34%, 34.19% and 28.14% of the respondents, respectively. A total of 50.43% of respondents presented moderate to severe impact of the outbreak. Students from Arts &amp; Humanities and Social Sciences &amp; Law showed higher scores related to anxiety, depression, stress and impact of event with respect to students from Engineering &amp; Architecture. University staff presented lower scores in all measures compared to students, who seem to have suffered an important psychological impact during the first weeks of the COVID-19 lockdown. In order to provide timely crisis-oriented psychological services and to take preventive measures in future pandemic situations, mental health in university students should be carefully monitored.

Assessing Subgroup Differences in Posttraumatic Stress Disorder Among Rescue Workers in Japan With the Impact of Event Scale–Revised

2018 ◽  
Vol 13 (02) ◽  
pp. 309-318 ◽  
Author(s):  
Yoshikazu Noda ◽  
Kenichi Asano ◽  
Eiji Shimizu ◽  
Yoshiyuki Hirano
Keyword(s):  
Higher Education ◽  
Path Model ◽  
Model Fit ◽  
Impact Of Event Scale ◽  
Event Scale ◽  
Rescue Workers ◽  
Multiple Indicators ◽  
Early Arrival ◽  
The Impact ◽  
Multiple Causes

ABSTRACTObjectiveWe examined the impact of demographic confounding factors on responses to the Impact of Event Scale–Revised.MethodsParticipants were rescue workers aged 20 to 65 years who had responded during the Great East Japan Earthquake in 2011. A multiple indicators, multiple causes model was used to examine associations between covariates and latent factors or items in the Impact of Event Scale–Revised.ResultsParticipants were recruited from April to August 2015. The model fit indices in the confirmatory factor analysis and the multiple indicators, multiple causes model suggested an acceptable model fit. Higher education and the Connor-Davidson Resilience Scale score were significantly associated with a decrease in intrusion, avoidance, and hyperarousal. Counseling was significantly associated with increased avoidance. In the direct path model using modification indices, counseling and early arrival were identified as significant covariates.ConclusionsThis study found that higher education and resilience reduced all 3 factors in the Impact of Event Scale–Revised and improved the symptoms of intrusion, avoidance, and hyperarousal. Counseling and early arrival were also associated with improvement in certain items. However, counseling was also linked to increased avoidance and worsening psychophysiological reactions. Further research is recommended to clarify these relationships. (Disaster Med Public Health Preparedness. 2019;13:309–318)

scholarly journals POS1176 THE IMPACT OF COVID-19 QUARANTINE ON MENTAL HEALTH OF PATIENTS WITH FIBROMYALGIA

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 869.2-869
Author(s):  
F. Ingegnoli ◽  
M. Buoli ◽  
C. Posio ◽  
R. DI Taranto ◽  
R. Caporali
Keyword(s):  
Perceived Stress ◽  
Rheumatic Diseases ◽  
Online Survey ◽  
Causal Effect ◽  
Well Being ◽  
Total Sample ◽  
National Association ◽  
Post Traumatic Stress ◽  
Event Scale ◽  
The Impact

Background:Detrimental psychological effects, including symptoms of post-traumatic stress disorder (PTSD), stress, anxiety, and depression have been related to COVID-19 quarantine measures (1). These aspects may be particularly relevant in stress-related disorders such as fibromyalgia (FM) in which previous evidence demonstrated a causal effect of psychological stressors on chronic non-inflammatory pain of FM (2). Recent studies highlighted a significant worsening of FM symptoms after COVID-19 related lockdown period (3-4), but the levels of perceived stress and distress have not been evaluated yet.Objectives:The aim of this study is to establish the COVID-19 related perceived stress and distress among patients with FM who experienced the COVID-19 quarantine in Italy. Data were retrieved from a larger nationwide online survey involving patients affected by different rheumatic diseases (RD).Methods:We collected data from May to September 2020 from RD patients living in Italy during the COVID-19 quarantine by an ad-hoc online survey. Eleven associations of RD patients sent a call by using their mailing list, webpages and social network. They asked to complete an anonymous online survey which included the Perceived Stress Scale (PSS), and the Impact Event Scale-Revised (IES-R). Descriptive statistics were used to summarize results.Results:79 of 507 (15.6%) of RD patients who completed the survey declared to have been diagnosed FM. 77 (97.5%) were females, with a mean (± SD) age of 51.0 ± 12.4 yrs. In FM patients, the mean (SD) PSS score was 23.8 ± 8.1. In particular, 8 (10.1%) reported low, 38 (48.1%) moderate and 33 (41.8%) high PSS scores. Moreover, IES-R mean (SD) score was 38.5 ± 17.2. Among FM patients, 51 (64.6%) reported scores greater than 33, indicating the probable presence of a PTSD. With regard to the IES-R subscale scores, the total sample did not show a prominence of one of the three main domains: intrusion (13.9 ± 7.3), avoidance (11.9 ± 6.1) and hyperarousal (12.6 ± 5.9). In these FM patients, self-reported major sources of anxiety were related to personal and relatives’ health (59.5%), followed by social withdrawal (21.5%) and employment loss/financial difficulties (11.4%). There was a slight increase of self-reported use of antidepressants (15 [18.9%] vs 16 [20.2%]) and anxiolytics drugs (4 [5.1%] vs 5 [6.3%]) after lockdown period.Conclusion:These results confirm that psychosocial stress and distress were highly pervasive in FM after COVID-19 national lockdown. It is known that stressed status may exacerbate and/or precipitate later development of FM symptoms. These data support the substantial worsening of somatic burden of FM after lockdown period reported in previous studies (3-4). Coping strategies should be implemented to ameliorate psychological well-being of these patients in this stressful era.References:[1]Brooks SK, et al. Lancet. 2020;395:912-20.[2]Hung CH, et al. Ann Rheum Dis 2020;79:1644-1656.[3]Batres-Marroquín AB, et al. J Clin Rheumatol. 2020 Epub ahead of print.[4]Cavalli G, et al. Rheumatology 2021;60:465-467.Acknowledgements:We wish to thank the Lombard Association of Rheumatic Diseases (ALOMAR) for its invaluable contribution to the planning and dissemination the survey, all the Italian associations among which the National Association of People with Rheumatic and Rare Diseases (APMARR) and National Association of People with Rheumatic Diseases (ANMAR) that disseminated the survey through social media. The authors are grateful to all patients for contributing to this project.Disclosure of Interests:Francesca Ingegnoli: None declared, Massimiliano Buoli: None declared, Cristina Posio: None declared, Raffaele Di Taranto: None declared, Roberto Caporali Speakers bureau: Abbvie, Amgen, BMS, Celltrion, Galapagos, Gilead, Lilly, Pfizer, Roche, UCB, Sanofi, Fresenius Kabi, Samsung bioepis, MSD, Consultant of: Galapagos, Gilead, Lilly,Janssen, MSD.

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