Publications by authors named "W Michael Vanderlind"

10 Publications

A systematic review of neuropsychological and psychiatric sequalae of COVID-19: implications for treatment.

Curr Opin Psychiatry 2021 07;34(4):420-433

Department of Psychiatry, Weill Cornell Medicine.

Purpose Of Review: COVID-19 impacts multiple organ systems and is associated with high rates of morbidity and mortality. Pathogenesis of viral infection, co-morbidities, medical treatments, and psychosocial factors may contribute to COVID-19 related neuropsychological and psychiatric sequelae. This systematic review aims to synthesize available literature on psychiatric and cognitive characteristics of community-dwelling survivors of COVID-19 infection.

Recent Findings: Thirty-three studies met inclusion/exclusion criteria for review. Emerging findings link COVID-19 to cognitive deficits, particularly attention, executive function, and memory. Psychiatric symptoms occur at high rates in COVID-19 survivors, including anxiety, depression, fatigue, sleep disruption, and to a lesser extent posttraumatic stress. Symptoms appear to endure, and severity of acute illness is not directly predictive of severity of cognitive or mental health issues. The course of cognitive and psychiatric sequelae is limited by lack of longitudinal data at this time. Although heterogeneity of study design and sociocultural differences limit definitive conclusions, emerging risk factors for psychiatric symptoms include female sex, perceived stigma related to COVID-19, infection of a family member, social isolation, and prior psychiatry history.

Summary: The extant literature elucidates treatment targets for cognitive and psychosocial interventions. Research using longitudinal, prospective study designs is needed to characterize cognitive and psychiatric functioning of COVID-19 survivors over the course of illness and across illness severity. Emphasis on delineating the unique contributions of premorbid functioning, viral infection, co-morbidities, treatments, and psychosocial factors to cognitive and psychiatric sequelae of COVID-19 is warranted.
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http://dx.doi.org/10.1097/YCO.0000000000000713DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8183238PMC
July 2021

Use of virtual reality in the inpatient rehabilitation of COVID-19 patients.

Gen Hosp Psychiatry 2021 Apr 29;71:76-81. Epub 2021 Apr 29.

Department of Medicine, Weill Cornell Medicine, New York, NY; Division of Hospital Medicine, Ascension Saint Thomas Hospital West, Nashville, TN.

Introduction: Use of virtual reality (VR) in healthcare has expanded in recent years. The challenges faced by patients with prolonged COVID-19-related hospitalizations - social isolation, disability, neurologic sequelae, adjustment-related anxiety, depression, and stress - may be mitigated by the novel use of VR as one modality of a comprehensive rehabilitation plan. This descriptive study aimed to understand patient satisfaction and perceived benefit of virtual reality on a COVID-19 recovery unit, as well as the logistical and operational feasibility of providing VR content for patients and staff.

Materials And Methods: During the COVID-19 surge in New York City in 2020, the COVID-19 Recovery Unit (CRU) of a large academic hospital invited patients and staff to participate in VR sessions with three categories of experience: (1) Guided meditation, (2) Exploration of natural environments, (3) Cognitive stimulation games. Patients and staff were surveyed about satisfaction and perceived benefit.

Results: 13 patients and 11 staff were surveyed, with median patient satisfaction scores of 9 out of 10, with ten representing "extremely satisfied," and median staff satisfaction scores of 10. 13/13 patients answered "yes" to recommending the therapy to others, and 12/13 answered "yes" to perceived enhancement of their treatment. 11/11 staff answered "yes" to recommending the therapy to others, and 11/11 answered "yes" to perceived enhancement of their wellbeing.

Discussion: A VR program implemented on a COVID-19 rehabilitation unit for patients and healthcare providers was rated as highly satisfactory with perceived benefit by survey respondents. Participants commented that the use of VR was useful in coping with isolation and loneliness, and could be implemented within the context of clinical care for COVID-19 patients as part of a comprehensive rehabilitation model. The use of VR was also logistically and operationally feasible on the CRU. Future work to compare benefits of VR to standard neuropsychological rehabilitation is needed.
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http://dx.doi.org/10.1016/j.genhosppsych.2021.04.008DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8081572PMC
April 2021

Positive emotion in daily life: Emotion regulation and depression.

Emotion 2021 Mar 4. Epub 2021 Mar 4.

Department of Psychology, Yale University.

Depression is associated with the infrequent use of emotion regulation strategies that increase positive emotion and the frequent use of strategies that decrease positive emotion. However, prior research mostly relies on global, retrospective assessments that fail to capture dynamic relations between positive emotion and emotion regulation in ecologically valid settings. This study used an ecological momentary assessment (EMA) design to test whether depression is related to positive emotion regulation in daily life. We recruited 108 individuals to complete a 14-day EMA study, tracking strategy use and positive emotion over time. Higher momentary positive emotion was associated with greater subsequent use of positive rumination and less use of dampening. Elevated depressive symptoms, however, were associated with lower average use of positive rumination and higher average use of dampening. Depressive symptom levels did not modulate relations between positive emotion and emotion regulation strategy use. Less use of positive rumination and more use of dampening were related to lower levels of momentary positive emotion. Taken together, depression was associated with a pattern of strategy use that is associated with low positive emotion. Emotion regulation may help to explain positive emotion deficits in depression. (PsycInfo Database Record (c) 2021 APA, all rights reserved).
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http://dx.doi.org/10.1037/emo0000944DOI Listing
March 2021

Frequency and profile of objective cognitive deficits in hospitalized patients recovering from COVID-19.

Neuropsychopharmacology 2021 Feb 15. Epub 2021 Feb 15.

Department of Psychiatry, Weill Cornell Medicine, New York, NY, US.

Early reports and case series suggest cognitive deficits occurs in some patients with COVID-19. We evaluated the frequency, severity, and profile of cognitive dysfunction in patients recovering from prolonged COVID-19 hospitalization who required acute inpatient rehabilitation prior to discharge. We analyzed cross-sectional scores from the Brief Memory and Executive Test (BMET) in a cohort of N = 57 COVID-19 patients undergoing inpatient rehabilitation, calculating the frequency of impairment based on neuropsychologist diagnosis and by age-normed BMET subtests. In total, 43 patients (75%) were male, 35 (61%) were non-white, and mean age was 64.5 (SD = 13.9) years. In total, 48 (84%) were previously living at home independently. Two patients had documented preexisting cognitive dysfunction; none had known dementia. Patients were evaluated at a mean of 43.2 (SD = 19.2) days after initial admission. In total, 50 patients (88%) had documented hypoxemic respiratory failure and 44 (77%) required intubation.  Forty-six patients (81%) had cognitive impairment, ranging from mild to severe. Deficits were common in working memory (26/47 [55%] of patients), set-shifting (21/44 [47%]), divided attention (18/39 [46%]), and processing speed (14/35 [40%]). Executive dysfunction was not significantly associated with intubation length or the time from extubation to assessment, psychiatric diagnosis, or preexisting cardiovascular/metabolic disease. Attention and executive functions are frequently impaired in COVID-19 patients who require acute rehabilitation prior to discharge. Though interpretation is limited by lack of a comparator group, these results provide an early benchmark for identifying and characterizing cognitive difficulties after COVID-19. Given the frequency and pattern of impairment, easy-to-disseminate interventions that target attention and executive dysfunctions may be beneficial to this population.
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http://dx.doi.org/10.1038/s41386-021-00978-8DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7884062PMC
February 2021

Behavioral interventions in acute COVID-19 recovery: A new opportunity for integrated care.

Gen Hosp Psychiatry 2021 Mar-Apr;69:113-114. Epub 2020 Jul 7.

Department of Psychiatry, Weill Cornell Medicine, 525 E. 68th Street, New York, NY 10065, United States of America; NewYork-Presbyterian Hospital/Weill Cornell Medical Center, 525 E. 68th Street, New York, NY 10065, United States of America.

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http://dx.doi.org/10.1016/j.genhosppsych.2020.07.001DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7340026PMC
March 2021