COVID-19 represents an overwhelming stressor to mental health. Elderly individuals are particularly at risk, but it is still unclear whether the risk is equally distributed among men and women. The aim of this study was to define gender differences in persistent psychiatric symptoms after COVID-19 illness and to test their association with resilience factors. Methods: We assessed 348 individuals aged >65 years at a multidisciplinary post-COVID-19 service. Mood and anxiety symptoms were investigated, as well as psychological distress and resilience, as assessed with the Kessler-10 (K10) Scale and the Connor-Davidson Resilience Scale (CD-RISC), respectively. Multivariate and linear regression analyses were used to test the distribution patterns of psychiatric symptoms and resilience factors. Results: In the total sample, 214 (61.5%) were men (a mean age of 73.25 years ±6.04) and 134 (38.5%) were women (a mean age of 72.69 years ±6.43; p = 0.407). Men and women significantly differed in marital status (χ² = 25.17; p < 0.001, more men were married), living alone (χ² = 11.62; p < 0.01, fewer men were living alone), hospitalization during COVID-19 illness (χ² = 12.35; p < 0.001, more men were hospitalized during COVID-19), and subjective health status before COVID-19 infection (χ² = 4.32; p < 0.001, men reporting better subjective health than women). Women reported more psychiatric symptoms and fewer resilience factors than men. Low resilience levels significantly predicted psychological distress in both men and women. Conclusions: The female elderly population affected by COVID-19 showed a greater vulnerability to psychiatric symptoms. Our data point to the need to strengthen resilience resources, especially in women.

Depression, anxiety, and perceived stress are common comorbidities in patients with inflammatory bowel disease (IBD) and may negatively influence the disease course. Likewise, severe IBD may contribute to the development or worsening of psychiatric symptoms. Despite the established relevance of the gut–brain axis and frequent use of psychotropic medications in IBD patients, limited evidence exists regarding the effects of psychiatric treatments on gastrointestinal disease activity. Therefore, the aim of this systematic review is to evaluate the effectiveness of psychiatric therapies on gastrointestinal symptoms and disease activity in patients with IBD. The work was conducted in accordance with PRISMA guidelines. Searches were performed across PubMed, Web of Science, and Scopus up to July 2024. Eligible studies evaluated the effectiveness of psychiatric medications—including antidepressants, antipsychotics, anxiolytics, sedative-hypnotics, mood stabilizers, anticonvulsants, and others—on at least one gastrointestinal outcome in patients with IBD. Outcomes included changes in commonly used clinical and endoscopic scores for Crohn’s disease (CD) and ulcerative colitis (UC), number of bowel movements, stool consistency, presence of blood in stool, severity of abdominal pain, as well as in surrogate markers of disease activity following treatment. Out of 8513 initially identified articles, 22 studies involving 45,572 IBD patients met the inclusion criteria. Antidepressants, particularly bupropion, tricyclic antidepressants, selective serotonin reuptake inhibitors (SSRIs), venlafaxine, and duloxetine, were associated with improvements in IBD activity scores, including Crohn’s Disease Activity Index (CDAI) and Simple Endoscopic Score for Crohn’s Disease (SES-CD) for CD, Mayo score and Ulcerative Colitis Endoscopic Index of Severity (UCEIS) for UC. Case reports highlighted potential benefits of pregabalin and lithium carbonate, respectively, showed by the reduction in clinical and endoscopic score of disease activity for pregabalin and improvement of UC symptoms for lithium carbonate, while topiramate showed limited efficacy. Clonidine and naltrexone determined the reductions in clinical and endoscopic score of disease activity, including CDAI and Crohn’s disease endoscopy index severity score (CDEIS) for CD and Disease Activity Index (DAI) for UC. Despite the limited data and study heterogeneity, antidepressants, naltrexone, and clonidine were associated with improvements in IBD activity. Larger, prospective studies are needed to confirm the therapeutic potential of psychiatric medications in modulating IBD activity and to guide integrated clinical management.

Psychological distress and gut dysbiosis play key roles in IBD. This study investigated whether specific psychopathological and gut microbiota features predict adverse outcomes in UC patients. This retrospective cohort study included 35 UC patients recruited in 2019. Baseline assessments involved clinical interviews, psychiatric evaluations, and stool sampling. In 2024, follow-up interviews and medical record reviews assessed disease progression, including biologic therapy failure, hospitalization, surgery, and diagnosis changes. Disease activity was measured via the Mayo score. Psychological testing included MMPI-2, STAI-Y2, GSES, CD-RISC, and TAS-20. Patients with biological therapy failure showed increased levels of Proteobacteria, Fusobacteria, Enterobacteriaceae, and Trabulsiella, while Firmicutes were less abundant. UC-related hospitalized patients had lower levels of Rikenellaceae, Ruminococcaceae, Faecalibacterium, Lachnospira, Methanobrevibacter, and Phascolarctobacterium compared to non-hospitalized patients. Hospitalized patients scored higher on the Sc clinical scale and the OBS and HEA content scales. Acidaminococcus and Bilophila were more abundant in patients who underwent surgery. PCA revealed differences between patients with and without biological failure. Logistic regression found that Fusobacteria were negatively correlated with the failure of three or more biologics, while Hy and Pd were positively correlated. Pa and Pt were negatively correlated with multifailure. Obsessiveness, health concerns, somatization, and reduced SCFA-producing bacteria may predict UC-related adverse outcomes.

Background/Objectives: Ulcerative colitis (UC) and Crohn’s disease (CD) are two forms of inflammatory bowel disease (IBD), which, despite their shared inflammatory nature, differ markedly in clinical presentation and disease course. In this study, we aimed to explore whether these clinical differences are also reflected at the psychological level. Specifically, we sought to delineate the personality characteristics of a sample of patients with IBD and to investigate psychological and psychopathological differences between individuals with UC and CD. Methods: We enrolled 29 (44.61%) UC patients and 36 (55.39%) CD patients, all aged 18 years or older. Each participant completed the Minnesota Multiphasic Personality Inventory-2 (MMPI-2), which was subsequently scored and interpreted by trained psychologists. The MMPI-2 is a 567-item inventory with dichotomous answers (true/false), providing measures of a wide range of symptoms, beliefs, attitudes, and personality traits. Results: The total sample showed clinically significant elevations on hypochondriasis (Hs), health concerns (HEA), general health concerns (HEA₃), and physical malfunctioning (D₃) scales. UC patients had statistically significant higher scores on hypomania (p = 0.043), lack of ego mastery—defective inhibition (p = 0.006), and fears (p = 0.038) scales than CD patients. On the other hand, CD patients showed statistically significant higher scores on the Overcontrolled Hostility scale (p = 0.043). Conclusions: Both groups of patients experience emotional difficulties related to their clinical conditions, leading to an increased preoccupation with bodily symptoms and illness. These aspects appear to be accompanied by shifts in mood towards a more depressive state. Notably, the UC group demonstrates a greater degree of impairment compared to the CD group, with experiences of anxiety, stress, difficulties in emotional control, and emerging relational challenges.

Background: Late-onset depression (LOD) represents a distinct clinical and biological phenotype emerging in the context of global population ageing. This study aims to synthesize current evidence on the epidemiology, risk factors, mechanistic pathways, and therapeutic approaches of LOD, integrating biological, psychological, and social dimensions. Methods: This narrative review synthesizes recent evidence across epidemiology, clinical symptomatology, neurobiology, and treatment. Where conceptually appropriate or empirically overlapping, we incorporate findings from the broader late-life depression (LLD) literature. Results: LOD emerges (as a distinct clinical and biological entity in later life) as a clinically and biologically meaningful presentation of depression in later life, representing a minority of depressive cases. It is defined by prominent apathy, psychomotor slowing, and cognitive impairment, and is closely linked to frailty, medical comorbidity, and heightened dementia risk. Pathophysiological mechanisms converge on vascular, inflammatory, oxidative, and neuroplasticity pathways, while psychosocial adversity further shapes onset and course. Treatment prioritizes efficacy and tolerability amid multiple morbidity; SSRIs and SNRIs are first-line, with pro-dopaminergic or dual-action agents addressing anhedonia and apathy, and neuromodulation or augmentation strategies reserved for resistance. Integrative approaches combining pharmacotherapy, psychotherapy, and lifestyle interventions are essential to optimize outcomes in aging populations. Conclusions: Late-onset depression (is a distinct, biologically and psychosocially driven disorder) represents a biologically and psychosocially enriched subtype in its own within the spectrum of late-life depression, requiring integrated, personalized care. Addressing neurovascular mechanisms, psychosocial adversity, and prevention through coordinated geriatric and psychiatric strategies may improve outcomes in aging populations.

Background and Objectives: Psychological resilience is increasingly recognized as a determinant of how patients respond to surgical stress, yet its role in perioperative medicine remains poorly defined. This narrative review aims to synthesize current evidence on resilience in surgical populations from a psychobiological perspective, spanning conceptual models, measurement approaches, clinical correlates, biological mechanisms, and intervention strategies. Materials and Methods: This narrative review was conducted to examine psychological resilience in adult surgical populations from an integrated psychobiological and perioperative perspective. A structured literature search was performed in December 2026 using PubMed, Scopus, and PsycInfo, combining resilience-related constructs with surgical, perioperative, biological, and clinical outcome keywords. Eligible publications included observational, longitudinal, interventional, translational, and conceptually relevant studies addressing resilience in adult surgical settings. Evidence was synthesized qualitatively across predefined domains, including conceptualization and measurement of resilience, associations with perioperative outcomes, neuroendocrine and inflammatory mechanisms, and resilience-modulating interventions within perioperative and Enhanced Recovery After Surgery (ERAS) frameworks. Results: Contemporary models conceptualize resilience as a dynamic, context-dependent process supported by interacting psychological, biological, and social factors. In surgical cohorts, higher resilience is consistently associated with better patient-reported outcomes, including quality of life, pain control, and emotional adjustment, and in some studies with survival and functional recovery. Preoperative depression, anxiety, maladaptive coping, and low social support converge as components of a broader “resilience profile” linked to poorer postoperative trajectories. Biologically, resilient phenotypes are characterized by more regulated hypothalamic–pituitary–adrenal and autonomic responses and reduced inflammatory activation. Psychological therapies, prehabilitation programs, and selected pharmacological strategies show convergent, though heterogeneous, signals of benefit and can be interpreted as indirect resilience-enhancing interventions. Conclusions: Resilience appears to be a clinically meaningful, potentially modifiable construct that links psychosocial functioning, biological vulnerability, and postoperative outcomes. Incorporating resilience assessment into preoperative risk stratification and systematically embedding resilience-building strategies within perioperative and ERAS pathways may support more personalized, psychologically informed surgical care. Prospective, multidomain studies are needed to validate measurement tools, clarify mechanisms, and test resilience-targeted interventions in surgical populations.