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Sickness not only includes symptoms that classically define an infection (e.g. fever, nausea, headache), but also comes along with profound behavioral consequences for the infected individual (e.g. anhedonia, loss of appetite, lethargy, limpness, fatigue, sleepiness, withdrawal) and for unaffected partners, ...

Sickness not only includes symptoms that classically define an infection (e.g. fever, nausea, headache), but also comes along with profound behavioral consequences for the infected individual (e.g. anhedonia, loss of appetite, lethargy, limpness, fatigue, sleepiness, withdrawal) and for unaffected partners, peers or relatives (e.g. fear of infection, withdrawal, helping behavior). Sickness behavior in the infected individual, triggered by mediators of the activated immune system that signal to the brain, thus has an immunological (inflammatory) and a psychological (behavioral) side. Furthermore, sickness has consequences for the social environment. The COVID-19 pandemic exemplifies the relevance of these issues, as worldwide efforts monitoring sickness and controlling social interactions ultimately led to governmental actions nearly eliminating the social environment that individuals had previously taken for granted.

Thus, immune-driven sickness behavior has communicative significance both internally and externally. On the internal side, behavioral changes during sickness are assumed to support the immune system to fight the infection and re-establish well-being (e.g. by saving energy that is re-allocated to the immune system). On the external side, sickness leads to observable changes in behavior (e.g. social withdrawal, slowing of movements) and appearance (e.g. sweating, reddening of the skin) that make others aware of the infection and that can be accompanied by compassionate (e.g. help and support by peers, relatives or professionals, solidarity) as well as distancing behaviors (e.g. protection against transmission of the disease, fear, ostracism). Both aspects are central to ongoing debates on how to best navigate between the two extremes of social distancing/isolation and the need for solidarity/helping behavior during the COVID-19 crisis. Since December 2019, people globally have been experiencing profound changes of their internal world (e.g. enhanced introspection, fear and uncertainty) and of their external world (e.g. people wearing face masks, contact bans, closing borders) that presumably have had a major impact on their sickness behavior. To delineate whether unspecific symptoms such as discomfort, irritability or sleep disturbances are driven by sickness or by stress (also as a potential corollary of the states of exception enacted by most governments) could help to identify rather asymptomatic COVID-19 infected patients and to prevent disease spreading. On the other hand, strengthening resilience could help support the immune defense against the virus and thus infection outcomes, thereby preventing a surge in psychiatric diseases in this exceptional situation.

The current Research Topic will focus on immune-driven sickness behavior and its social and communicative side. We anticipate assembling a collection of articles that either highlight these specific aspects or expand on these or related questions related to the COVID-19 pandemic. As it is assumed that interactions between the immune system, the brain and the mentioned psychological processes play an important role in the development and maintenance of neuropsychiatric conditions such as depression, anxiety, substance abuse or fatigue, we are also interested in contributions with such a clinical focus.

The goal of this Research Topic is to shed light onto the interplay between the immune system, sickness behavior, social consequences and psychiatric conditions.

The Research Topic welcomes submissions of original articles, reviews, opinion articles or commentaries that include neurobiological, immunological, social, cognitive, and/or behavioral data from clinical or non-clinical samples. We are especially interested in contributions addressing the following:

• new interdisciplinary therapeutic targets (e.g. stress interventions in infected patients or patients at risk, immunomodulatory drugs in psychiatric patients)
• immunological alterations in psychiatric patients (e.g. depression, schizophrenia) and relation to changes of brain function, behavior and infection outcome
• behavioral or neurobiological changes caused by an experimentally induced inflammatory response (e.g. following vaccination), by an inflammatory condition (e.g. cancer, rheumatic diseases) or an infection (e.g., influenza or COVID-19)
• the effect of stress and fear on inflammatory and immunological markers and its potential impact on infectious or psychiatric conditions
• social aspects of sickness behavior (e.g. anhedonia, feelings of disgust) and the impact of governmental measures such as social distancing on intrinsic sickness behavior during the COVID-19 pandemic
• the effect of social support and resilience on infection outcome and solutions for non-physical contacts and treatments during the COVID-19 pandemic (e.g. social media, video consultation)
• inter-individual differences in perception, handling and processing of unspecific symptoms of sickness

Keywords: Sickness Behavior, Social Distancing, Depression, Infection, Psychoneuroimmunology

Important Note: All contributions to this Research Topic must be within the scope of the section and journal to which they are submitted, as defined in their mission statements. Frontiers reserves the right to guide an out-of-scope manuscript to a more suitable section or journal at any stage of peer review.

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