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Jessica Balikji,1 Marlou Mackus,1 Johan Garssen,1,2 Maarten M Hoogbergen,3 Joris C Verster1,4 1Division of Pharmacology, Utrecht Institute for Pharmaceutical Sciences, Utrecht University, Utrecht, 3584 CG, the Netherlands; 2Division of Plastic Surgery, Catharina Ziekenhuis, Eindhoven, 5623 EJ, the Netherlands; 3Global Centre of Excellence Immunology, Nutricia Danone Research, Utrecht, 3584 CT, the Netherlands; 4Centre for Human Psychopharmacology, Swinburne University, Melbourne, VIC, 3122, AustraliaCorrespondence: Joris C Verster, Tel +31 30 253 6909, Email j.c.verster@uu.nlBackground: Having chronic wounds and impaired wound healing are associated with psychological distress. The current study aims to evaluate migraine and headache complaints in young adults with self-reported impaired wound healing.Methods: A survey was conducted among N=1935 young adults (83.6% women), 18– 30 years old, living in the Netherlands. Wound healing status was verified, immune fitness was assessed using a single-item rating scale, and ID Migraine was completed. In addition, several questions were answered on past year’s headache experiences (including frequency, quantity, type, location, and severity).Results: In both the control group (p < 0.001) and the IWH group (p = 0.002) immune fitness was significantly lower among those that reported headaches compared to those that reported no headaches. Individuals with self-reported impaired wound healing (IWH) scored significantly higher on the ID Migraine scale, and individuals of the IWH group scored significantly more often positive for migraine (ie, an ID Migraine score ≥ 2). They reported a younger age of onset of experiencing headaches, and significantly more often reported having a beating or pounding headache than the control group. Compared to the control group, the IWH group reported being significantly more limited in their daily activities compared to the control group.Conclusion: Headaches and migraines are more frequently reported by individuals with self-reported impaired wound healing, and their reported immune fitness is significantly poorer compared to healthy controls. These headache and migraine complaints significantly limit them in their daily activities.Keywords: headache, migraine, impaired wound healing, wound infection, slow healing wounds, chronic wounds, immune fitness

Pauline A Hendriksen,1 Pantea Kiani,1 Johan Garssen,1,2 Gillian Bruce,3 Joris C Verster1,4 1Division of Pharmacology, Utrecht Institute for Pharmaceutical Sciences, Utrecht University, Utrecht, 3584CG, the Netherlands; 2Global Centre of Excellence Immunology, Nutricia Danone Research, Utrecht, 3584CT, the Netherlands; 3Division of Psychology and Social Work, School of Education and Social Sciences, University of the West of Scotland, Paisley, PA1 2BE, UK; 4Centre for Human Psychopharmacology, Swinburne University, Melbourne, VIC3122, AustraliaCorrespondence: Joris C VersterDivision of Pharmacology, Utrecht Institute for Pharmaceutical Sciences, Utrecht University, Universiteitsweg 99, Utrecht, 3584CG, the NetherlandsTel +3130 253 6909Email J.c.verster@uu.nlPurpose: The aim of this study was to evaluate whether or not living alone or together throughout the lockdown had an impact on mood, perceived immune fitness, as well as the presence and severity of COVID-19 symptoms.Methods: N = 505 participants completed an online survey, which included questions on living situations, as well as mood, perceived immune fitness and COVID-19 symptom presence and severity. These factors were assessed retrospectively for the time periods before and during the COVID-19 pandemic.Results: An overall decrease in mood was observed for both those living alone and together during the lockdown period. However, significantly larger increases in feelings of loneliness were observed for the group living alone. Furthermore, both groups reported decreases in perceived immune fitness, whereas only the group living alone reported a significant increase in COVID-19 symptom presence and severity. Moreover, significant correlations were found between perceived immune fitness, anxiety, and loneliness. These correlations were strongest in the group living alone. Lastly, positive correlations were found between perceived immune fitness and mood outcomes with being active, optimistic and the ability to cope with stress. Increased optimism, being more active and the adequate ability to cope with stress were associated with a reduced negative impact on perceived immune fitness.Conclusion: The first COVID-19 lockdown period in the Netherlands was a challenging period for both people who lived alone and those living together, resulting in decreases in mood and poorer perceived immune fitness. Those living alone were, however, more heavily impacted by the lockdown restrictions. This was further reflected by the increased presence and severity of COVID-19 symptoms in people who lived alone during the first COVID-19 lockdown in The Netherlands.Keywords: corona virus, living situation, health, stress, quality of life

Marith Van Schrojenstein Lantman,1 Marlou Mackus,1 Leila S Otten,1 Deborah de Kruijff,1 Aurora JAE van de Loo,1,2 Aletta D Kraneveld,1,2 Johan Garssen,1,3 Joris C Verster1,2,4 1Division of Pharmacology, Utrecht University, Utrecht, the Netherlands; 2Institute for Risk Assessment Sciences, Utrecht University, Utrecht, the Netherlands; 3Nutricia Research, Utrecht, the Netherlands; 4Centre for Human Psychopharmacology, Swinburne University, Melbourne, Australia Background: Mental resilience can be seen as a trait that enables an individual to recover from stress and to face the next stressor with optimism. People with resilient traits are considered to have a better mental and physical health. However, there are limited data available assessing the relationship between resilient individuals and their perspective of their health and immune status. Therefore, this study was conducted to examine the relationship between mental resilience, perceived health, and perceived immune status. Methods: A total of 779 participants recruited at Utrecht University completed a questionnaire consisting of demographic characteristics, the brief resilience scale for the assessment of mental resilience, the immune function questionnaire (IFQ), and questions regarding their perceived health and immune status. Results: When correcting for gender, age, height, weight, smoker status, amount of cigarettes smoked per week, alcohol consumption status, amount of drinks consumed per week, drug use, and frequency of past year drug use, mental resilience was significantly correlated with perceived health (r=0.233, p=0.0001), perceived immune functioning (r=0.124, p=0.002), and IFQ score (r=−0.185, p=0.0001). Conclusion: A significant, albeit modest, relationship was found between mental resilience and perceived immune functioning and health. Keywords: mental resilience, immune functioning, health, vitality, quality of life

A Hogewoning,1,* AJAE Van de Loo,1,* M Mackus,1 SJ Raasveld,1 R De Zeeuw,1 ER Bosma,1 NH Bouwmeester,1 KA Brookhuis,2 J Garssen,1,3 JC Verster1,4 1Division of Pharmacology, Utrecht University, Utrecht, 2Faculty of Behavioral and Social Sciences, Groningen University, Groningen, 3Nutricia Research, Utrecht, the Netherlands; 4Centre for Human Psychopharmacology, Swinburne University, Melbourne, VIC, Australia *These authors contributed equally to this work Background: A number of social drinkers claim that they do not experience next-day hangovers despite consuming large quantities of alcohol. The aim of this study was to investigate the characteristics of drinkers who claim to be hangover immune and compare them with drinkers who do report having hangovers. Methods: A total of 36 social drinkers participated in a naturalistic study consisting of a hangover day (alcohol consumed) and a control day (no alcohol consumed). Data were collected on alcohol consumption, demographics, sleep, next-day adverse effects, and mood. Data from drinkers with a hangover (N=18) were compared with data from drinkers who claim to be hangover immune (N=18). Results: Drinkers with a hangover reported drowsiness-related symptoms, symptoms related to reduced cognitive functioning, and classic hangover symptoms such as headache, nausea, dizziness, weakness, and stomach pain. Corresponding mood changes comprised increased feelings of depression, anger–hostility, fatigue, and reduced vigor–activity. In contrast, hangover-immune drinkers reported relatively few hangover symptoms, with only mild corresponding severity scores. The reported symptoms were limited to drowsiness-related symptoms such as sleepiness and being tired. The classic hangover symptoms were usually not reported by these drinkers. Conclusion: In contrast to drinkers with a hangover, for those who claim to be hangover immune, next-day adverse effects of alcohol consumption are limited to a mild increase in drowsiness-related symptoms. Keywords: alcohol, hangover, symptoms, mood, immunity

Marilou DP Tromp,1 Anouk AMT Donners,1 Johan Garssen,1,2 Joris C Verster1,31Division of Pharmacology, Utrecht Institute for Pharmaceutical Sciences, Utrecht University, Utrecht, the Netherlands; 2Nutricia Research, Utrecht, the Netherlands; 3Center for Human Psychopharmacology, Swinburne University, Melbourne, VIC, AustraliaObjective: To investigate the relationship between eating disorders, body mass index (BMI), sleep disorders, and daytime functioning.Design: Survey.Setting: The Netherlands.Participants: N=574 Dutch young adults (18–35 years old).Measurements: Participants completed a survey on eating and sleep habits including the Eating Disorder Screen for Primary care (ESP) and SLEEP-50 questionnaire subscales for sleep apnea, insomnia, circadian rhythm disorder (CRD), and daytime functioning. SLEEP-50 outcomes of participants who screened negative (≤2) and positive (>2) on the ESP were compared. In addition, SLEEP-50 scores of groups of participants with different ESP scores (0–4) and different BMI groups (ie, underweight, healthy weight, overweight, and obese) were compared using nonparametric statistics.Results: Almost 12% (n=67) of participants screened positive for having an eating disorder. Relative to participants without eating disorders, participants who screened positive for eating disorders reported significantly higher scores on sleep apnea (3.7 versus 2.9, P=0.012), insomnia (7.7 versus 5.5, P