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      Multidisciplinary research priorities for the COVID-19 pandemic: a call for action for mental health science

      , Prof, PhD a , b , * , , Prof, PhD c , * , , Prof, PhD d , , Prof, PhD g , , Prof, MD i , , Prof, PhD i , , Prof, PhD k , , Prof, PhD l , , Prof, PhD m , , Prof, PhD i , , Prof, PhD n , , Prof, PhD p , , PhD q , , BSc r , , Prof, MD s , , Prof, PhD e , , Prof, PhD h , , Prof, PhD f , , PhD t , , Prof, PhD u , , Prof, PhD v , , MA w , , PhD x , * , , Prof, PhD i , j , , , Prof, PhD n , o ,

      The Lancet. Psychiatry

      Elsevier Ltd.

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          There is no author summary for this article yet. Authors can add summaries to their articles on ScienceOpen to make them more accessible to a non-specialist audience.

          Summary

          The coronavirus disease 2019 (COVID-19) pandemic is having a profound effect on all aspects of society, including mental health and physical health. We explore the psychological, social, and neuroscientific effects of COVID-19 and set out the immediate priorities and longer-term strategies for mental health science research. These priorities were informed by surveys of the public and an expert panel convened by the UK Academy of Medical Sciences and the mental health research charity, MQ: Transforming Mental Health, in the first weeks of the pandemic in the UK in March, 2020. We urge UK research funding agencies to work with researchers, people with lived experience, and others to establish a high level coordination group to ensure that these research priorities are addressed, and to allow new ones to be identified over time. The need to maintain high-quality research standards is imperative. International collaboration and a global perspective will be beneficial. An immediate priority is collecting high-quality data on the mental health effects of the COVID-19 pandemic across the whole population and vulnerable groups, and on brain function, cognition, and mental health of patients with COVID-19. There is an urgent need for research to address how mental health consequences for vulnerable groups can be mitigated under pandemic conditions, and on the impact of repeated media consumption and health messaging around COVID-19. Discovery, evaluation, and refinement of mechanistically driven interventions to address the psychological, social, and neuroscientific aspects of the pandemic are required. Rising to this challenge will require integration across disciplines and sectors, and should be done together with people with lived experience. New funding will be required to meet these priorities, and it can be efficiently leveraged by the UK's world-leading infrastructure. This Position Paper provides a strategy that may be both adapted for, and integrated with, research efforts in other countries.

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          Most cited references 56

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          Severe Acute Respiratory Syndrome Coronavirus Infection Causes Neuronal Death in the Absence of Encephalitis in Mice Transgenic for Human ACE2

          Journal of Virology, 82(15), 7264-7275
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            Axonal Transport Enables Neuron-to-Neuron Propagation of Human Coronavirus OC43

            Human coronaviruses (HCoVs) are recognized respiratory pathogens for which accumulating evidence indicates that in vulnerable patients the infection can cause more severe pathologies. HCoVs are not always confined to the upper respiratory tract and can invade the central nervous system (CNS) under still unclear circumstances. HCoV-induced neuropathologies in humans are difficult to diagnose early enough to allow therapeutic interventions. Making use of our already described animal model of HCoV neuropathogenesis, we describe the route of neuropropagation from the nasal cavity to the olfactory bulb and piriform cortex and then the brain stem. We identified neuron-to-neuron propagation as one underlying mode of virus spreading in cell culture. Our data demonstrate that both passive diffusion of released viral particles and axonal transport are valid propagation strategies used by the virus. We describe for the first time the presence along axons of viral platforms whose static dynamism is reminiscent of viral assembly sites. We further reveal that HCoV OC43 modes of propagation can be modulated by selected HCoV OC43 proteins and axonal transport. Our work, therefore, identifies processes that may govern the severity and nature of HCoV OC43 neuropathogenesis and will make possible the development of therapeutic strategies to prevent occurrences. IMPORTANCE Coronaviruses may invade the CNS, disseminate, and participate in the induction of neurological diseases. Their neuropathogenicity is being increasingly recognized in humans, and the presence and persistence of human coronaviruses (HCoV) in human brains have been proposed to cause long-term sequelae. Using our mouse model relying on natural susceptibility to HCoV OC43 and neuronal cell cultures, we have defined the most relevant path taken by HCoV OC43 to access and spread to and within the CNS toward the brain stem and spinal cord and studied in cell culture the underlying modes of intercellular propagation to better understand its neuropathogenesis. Our data suggest that axonal transport governs HCoV OC43 egress in the CNS, leading to the exacerbation of neuropathogenesis. Exploiting knowledge on neuroinvasion and dissemination will enhance our ability to control viral infection within the CNS, as it will shed light on underlying mechanisms of neuropathogenesis and uncover potential druggable molecular virus-host interfaces.
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              Threatening communication: a critical re-analysis and a revised meta-analytic test of fear appeal theory

              Despite decades of research, consensus regarding the dynamics of fear appeals remains elusive. A meta-analysis was conducted that was designed to resolve this controversy. Publications that were included in previous meta-analyses were re-analysed, and a number of additional publications were located. The inclusion criteria were full factorial orthogonal manipulations of threat and efficacy, and measurement of behaviour as an outcome. Fixed and random effects models were used to compute mean effect size estimates. Meta-analysis of the six studies that satisfied the inclusion criteria clearly showed a significant interaction between threat and efficacy, such that threat only had an effect under high efficacy (d = 0.31), and efficacy only had an effect under high threat (d = 0.71). Inconsistency in results regarding the effectiveness of threatening communication can likely be attributed to flawed methodology. Proper tests of fear appeal theory yielded the theoretically hypothesised interaction effect. Threatening communication should exclusively be used when pilot studies indicate that an intervention successfully enhances efficacy.
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                Author and article information

                Contributors
                Journal
                Lancet Psychiatry
                Lancet Psychiatry
                The Lancet. Psychiatry
                Elsevier Ltd.
                2215-0366
                2215-0374
                15 April 2020
                15 April 2020
                Affiliations
                [a ]Department of Psychology, Uppsala University, Uppsala, Sweden
                [b ]Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
                [c ]Suicidal Behaviour Research Laboratory, Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK
                [d ]UK Dementia Research Institute, University College London, London, UK
                [e ]UCL Centre for Behaviour Change, University College London, London, UK
                [f ]UCL Great Ormond Street Institute of Child Health, University College London, London, UK
                [g ]Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK
                [h ]Oxford Internet Institute, University of Oxford, Oxford, UK
                [i ]Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
                [j ]NIHR Biomedical Research Centre at the Maudsley, Maudsley Hospital, London, UK
                [k ]University of Exeter Medical School, University of Exeter, Exeter, UK
                [l ]Black Dog Institute, Sydney, Australia
                [m ]Department of Psychological Science, Department of Medicine, and Program in Public Health, University of California, Irvine, USA
                [n ]Department of Psychiatry, University of Cambridge, Cambridge, UK
                [o ]Department of Research and Development, Cambridgeshire & Peterborough NHS Foundation Trust, Cambridge, UK
                [p ]Swansea University Medical School, Swansea University, Swansea, UK
                [q ]The McPin Foundation, London, UK
                [r ]Independent, Cambridge, UK
                [s ]Department of Occupational Health, Guy's and St Thomas' NHS Foundation Trust, London, UK
                [t ]Population Health Research Institute, St George's University of London, London, UK
                [u ]Anthropology Faculty, Emory University, Atlanta, USA
                [v ]School of Psychological Science, University of Bristol, Bristol, UK
                [w ]Katherine Cowan Consulting Ltd, St Leonards-on-Sea, UK
                [x ]Academy of Medical Sciences, London, UK
                Author notes
                [* ]Correspondence to: Dr Claire Cope, Academy of Medical Sciences, London W1B 1QH, UK claire.cope@ 123456acmedsci.ac.uk
                [*]

                Joint first authors

                [†]

                Joint last authors

                Article
                S2215-0366(20)30168-1
                10.1016/S2215-0366(20)30168-1
                7159850
                32304649
                © 2020 Elsevier Ltd. All rights reserved.

                Since January 2020 Elsevier has created a COVID-19 resource centre with free information in English and Mandarin on the novel coronavirus COVID-19. The COVID-19 resource centre is hosted on Elsevier Connect, the company's public news and information website. Elsevier hereby grants permission to make all its COVID-19-related research that is available on the COVID-19 resource centre - including this research content - immediately available in PubMed Central and other publicly funded repositories, such as the WHO COVID database with rights for unrestricted research re-use and analyses in any form or by any means with acknowledgement of the original source. These permissions are granted for free by Elsevier for as long as the COVID-19 resource centre remains active.

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