Psychiatrike = Psychiatriki最新文献

The current number of dementia cases in Europe stands at 7.7 million, a figure projected to double by 2050. Caregivers of individuals with dementia experience a heightened burden compared to those caring for other chronically ill individuals, increasing the risk of depression and stress disorders. This systematic literature review, following PRISMA guidelines, explores the prevalence of anxiety and depressive symptoms in dementia caregivers. Searches in academic databases, restricted to studies from the last 15 years, identified 85 articles with 16 meeting the inclusion criteria. Results indicate significant caregiver burden, diminished self-reported quality of life, and a propensity for clinical depression. Depression and anxiety symptoms were more pronounced among female caregivers. Caregiver depression correlated with increased emergency department utilization by dementia patients, with a surge in depressive symptoms reported during the COVID-19 pandemic. Caregiving for dementia patients was associated with burnout, adversely impacting caregiver quality of life. Depression and anxiety symptoms in caregivers correlated with substance use. Sociodemographic variables, including low socioeconomic status, high urbanization levels, and older age, were associated with caregiver depression. Caregivers of individuals with Alzheimer's disease reported higher anxiety, burden, and depression scores compared to those assisting individuals with other dementias, particularly when neuropsychiatric symptoms were evident. The identification of the factors that are linked to the mental burden of caregivers allows mental health professionals to enhance symptom detection and provide tailored support, ultimately alleviating caregiver burden and improving dementia care quality. Systematic professional assistance and training opportunities through health policies can effectively alleviate caregiver burden.

In recent decades, a growing body of research has emphasized the unique nature of substance abuse among women, necessitating a gender-specific approach and thus individualized therapeutic interventions.The purpose of this study, based on the existential approach, was to examine whether symptoms of several behavioral addictions (shopping, sex, gambling and betting, eating) and alcohol use disorder correlate with death anxiety, lack of meaning in life, and levels of mental resilience in a convenience sample of women. A total of 3,176 women participated in this online study and completed a demographic characteristics questionnaire, the Shorter PROMIS Questionnaire (SPQ), the Meaning in Life Questionnaire (MLQ), the Connor-Davidson Resilience Scale (CD-RISC), and the Death Anxiety Scale (DAS).The results showed a significant negative correlation between the "Presence of meaning in life" subscale and all addiction symptoms subscales (shopping, p<0.001; sex, p<0.001; gambling and betting, p=0.006; food, p<0.001, and alcohol use, p<0.001). Conversely, the "Search for meaning in life" subscale showed a significant positive correlation with all addiction symptoms subscales (shopping, sex, gambling and betting, food, and alcohol use, p<0.001). Resilience emerged as a protective factor, showing significant negative correlations with symptoms of sex addiction (p<0.001), alcohol use disorder (p<0.001), shopping addiction (p<0.001), and food addiction (p<0.001) addiction, although the correlation coefficients were small (ranging from -0.07 to -0.21), indicating a weak or no correlation. Participants with higher death anxiety also showed more symptoms of gambling and betting addiction (p<0.001), shopping addiction (p<0.001), and food addiction (p<0.001). Women who were married and had a university degree showed fewer symptoms of sex addiction (â = - 0.079; p = 0.004 / â = - 0.118; p = 0.001), alcohol use disorder (â = -0.105; p = 0.011 / â = -0.158; p = 0.004), and gambling addiction (â = -0.055; p < 0.001 / â = -0.091; p < 0.001), while women aged 18-25 displayed significantly lower symptoms of shopping and food addiction. Marriage and higher levels of education emerged as protective factors against certain types of addictive behaviors. In conclusion, this research showed a meaningful relationship between the lack of meaning in life and death anxiety with the manifestation of behavioral addiction symptoms and alcohol use. Also, the presence of mental resilience may act as a protective factor against gambling and betting addiction, shopping addiction, and food addiction, but not against sex addiction and alcohol use disorder.

The COVID-19 pandemic emerged suddenly, profoundly impacting the lives of us all, including mental health workers (MHW). This unprecedented crisis introduced significant challenges for MHW, exposing them to increased risks of psychological distress. This systematic review aims to evaluate the psychopathological effects of the COVID-19 pandemic on MHW. Additionally, it seeks to explore factors-social, regional, occupational, and others-influencing these effects. A systematic search was conducted across PubMed, PsycINFO, and Embase databases following PRISMA guidelines. A total of 2621 citations were screened, with 29 studies meeting the inclusion criteria for analysis. Our review focused exclusively on studies utilizing validated measurement tools to ensure reliability. Our findings revealed a high prevalence of anxiety, depression, stress, trauma-related disorders, and burnout among mental health nurses and other MHW during the COVID-19 pandemic, with significant variations based on regional, occupational, gender, and other demographic factors. Depressive symptoms ranged from 16.8% to 52.2%, and anxiety levels varied from 9.7% to 63% among MHW. Interestingly, MHW exhibited lower rates of depression and anxiety compared to other healthcare workers and the general population, possibly indicating higher resilience. Factors such as younger age, female gender, profession, work setting, fear of COVID-19, and workload were associated with increased psychological distress. Our review also underscores the need for more systematically accurate trauma research, particularly in how trauma is defined and assessed during global crises. While the consistency in study findings highlights the considerable effect of the pandemic, we observed differences that suggest the influence of multiple interacting factors. The lack of longitudinal studies and comparative data limits the ability to determine changes over time and differences with other groups. The COVID-19 pandemic significantly affected the mental health of those responsible for caring for the mental health of others, with considerable variations influenced by multiple interacting factors. Our findings highlight the critical need for protective protocols and psychological support systems to mitigate adverse effects on MHW during global crises. The variance in impact across different countries, in relation to local, political, cultural, and other factors, provides a foundation for future research.

The gut microbiome, which comprises symbiotic bacteria colonizing the human digestive tract, undergoes dynamic changes during the lifespan, as evidenced by the fact that the number of species and the diversity of their composition decrease significantly with age. The aim of this review is to illuminate bilateral neuroimmunological pathways that determine the role of gut microbiome dysbiosis, not only as a cause but also as a byproduct of many neurodegenerative diseases of the CNS, such as Alzheimer's disease (AD) and Parkinson's disease (PD), but also in the frame of several behavioral and psychiatric pathological conditions such as depressive and anxiety disorders, schizophrenia, and autism spectrum disorder (ASD). Dysbiosis, in particular, reveals a model of "deceptive" mimicry of host molecules that might cause abnormal folding ("misfolding") and pathological aggregation of Aβ-peptide, leading to its dispersion through the gut-brain axis, precipitating microglia cell activation. By controlling myelination at the prefrontal cortex (PFC), a crucial area for multifaceted cognitive behavior, forecasting, and decision-making, the gut/microbiome-brain axis influences mood and social behavior, since major depressive disorder is correlated to white matter disturbance in the PFC, due to disregulations in the expression of myelin-related mRNA in this area. The gut microbiome is altered in psychosis compared to healthy controls, while medication with antipsychotics may result in reduced microbial community diversity. The vagus nerve, as a key element of the parasympathetic nervous system, regulating immune responses, may "detect" gut microbiome metabolites and transfer this intestinal information to the CNS, through its afferents, as in a "pseudo-neurotransmission" process. Scientific interest towards microbiome-based therapies increases as psychobiotics (which are strains of probiotics/prebiotics with specific properties to influence the gut-brain axis) appear to be able to exercise a beneficial effect in many CNS disorders. Lifestyle modifications, such as dietary interventions via psychobiotics intake that might enhance the gut microbiome's ability to produce beneficial metabolites that exert therapeutic effects on intestinal permeability, cognitive function, and immunity, may reveal new research pathways and therapeutic directions leading to a radical change of the "epistemology paradigm" as far as prevention and treatment of major neuro-psychiatric disorders is concerned.

Persons with mental health disorders are vulnerable, with demanding care needs. This cross-sectional study aimed to report on their vaccination coverage against COVID-19 and common vaccine-preventable diseases. The study was conducted from September to November 2022 at the psychiatric outpatient settings of Venizeleion General Hospital of Heraklion, Crete, Greece, and the Mental Health Center of Heraklion. Information was collected via personal medical interview and prescription data. The study population included 361 participants, with a mean age of 49.8±14.3 years, 59.0% women. The most common diagnoses were recurrent depressive disorder (24.1%), schizophrenia (22.7%), anxiety disorder (21.3%), and bipolar disorder (15.7%). Vaccination coverage against seasonal influenza for 2020, 2021, and 2022 was 43.2%, 39.8%, and 40.7%, respectively. Pneumococcal vaccination included the conjugate (28.8%) and polysaccharide (7.7%) vaccines. Vaccination against Tetanus, Diphtheria, Pertussis (TDP) accounted for 11.0%, Hepatitis B for 5.8%, and Herpes Zoster for 27.1%. COVID-19 vaccination, with at least one booster dose, reached a high 73.6%. Patients with severe mental illness, 139 out of 361, were less likely to have contracted COVID-19 (50/139, 35.9%) than those without (108/222, 46.6%), (p=0.018). Coverage with polysaccharide vaccine, TDP, and Hepatitis B, was very low. Patients annually vaccinated for influenza in the last three consecutive years were most likely to be fully vaccinated for pneumococcal disease and for COVID-19 (with at least one booster dose). Future research and clinical practice should focus on identifying patients at risk of not receiving preventive services, such as vaccines.

The negative consequences of the COVID-19 pandemic and the subsequent restrictive measures on the mental health and well-being of the population and psychiatric patients have been widely recognized. Patients' treatment attendance and engagement with mental health services had been negatively affected by the pandemic, whereas patients were less likely to receive timely outpatient care. The pandemic also impacted the use of inpatient services. The aim of the present study was to explore the variability of attendance and admissions to a general hospital psychiatric ward over a 12-month interval after the onset of the pandemic (March 2020), compared to the respective 12-month pre-pandemic interval. A retrospective, observational pre/post study was performed, involving a general hospital psychiatric ward in Corfu, Northwest Greece, which serves an insular catchment area of approximately 100,000 inhabitants. For data analysis, c- and u-charts of statistical process control charts were employed, using monthly data (March 2019 to February 2021). Overall, a significant decline in attendance rates was observed, mostly accounted for by a 26.5% reduction in voluntary attendance rates (1516 patients prior vs. 1114 patients after the onset of the pandemic). The involuntary commitment of patients did not differ between the two periods (106 prior vs. 100 after the onset of the pandemic). Admission rates did not change significantly between the two periods. Diagnoses that exhibited significant variance in examinations between the two study periods were mood disorders and personality disorders, whereas there was no significant variation in the number of admissions across different diagnoses. Length of hospital stay increased significantly by 13.2% over the first year of the pandemic, from 25.57 days (Md= 13, IQR= 22) during the pre-COVID-19 period to 28.95 days (Md= 22, IQR= 28) during the COVID-19 period. Patients with schizophrenia and related disorders (Mean= 34.25 days, SD= 43.19) and mood disorders (Mean= 26.26, SD= 33.48) had prolonged hospital stays compared to other diagnoses. These findings highlight significant shifts in psychiatric care delivery during the pandemic and underscore the need for targeted interventions to address the evolving demands on mental health services during public health crises.

Anaesthesiologists actively involved with COVID-19 are at increased risk for post-traumatic stress syndrome (PTSS). We assessed the PTSD and possible determinants of anaesthesiologists in COVID-19 referral hospitals in the post-COVID-19 era with the validated PTSD Checklist for DSM-5 (PCL-5) and the Eysenck Personality Questionnaire (EPQ). A multicenter cross-sectional survey was conducted among anaesthesiologists working in the 7 COVID-19 referral university/tertiary hospitals during November 2022 (post-COVID-19 era) in Greece. PCL-5 is a 20-item, 5-point Likert scale self-report measure, scored in two different ways to ensure a provisional diagnosis of PTSS. Eysenck Personality Questionnaire (EPQ) explores 3 main dimensions of personality, whereas the Lie (L) scale serves as a measure of "dishonesty". Multivariate logistic regression analysis was performed to identify predicting factors of PTSS using the stepwise forward method. One hundred doctors (response rate 85%) from 7 hospitals (72% females, median age 46 [33-51.5] years) participated. The overall Cronbach's alpha for PCL-5 was 0.946. According to each scoring, 18% and 23% of responders were diagnosed with PTSS, respectively, while 7% were classified as suffering from probable PTSD. Interestingly, children (OR=0.17, p=0.048) and the satisfaction with job position (OR=0.211, p=0.024) exhibited a protective effect against PTSS. On the other hand, family obligations were identified as an aggravating factor (OR=4.274, p=0.026). Concerning personality traits, only neuroticism was identified as a statistically significant independent factor predicting PTSS (OR=1.524, p=0.001). Finally, job ranking was also a statistically significant independent factor predicting PTSS, with a 3 times risk augmentation for each level in the job hierarchy (from Residents towards Academics) (OR=3.034, p=0.022). In the post-COVID-19 era, up to 23% of Greek anaesthesiologists working in referral hospitals suffered from PTSS. Children and job satisfaction exhibited a protective role in contrast to higher ranks of the job hierarchy.

People who suffer from severe mental health disorders are also at high risk of developing other serious health problems. Unhealthy lifestyle behaviors combined with low self-care and low health literacy among people with severe mental health disorders highlight the need to design health promotion interventions in this population group. A qualitative study was carried out with the aim of investigating the perceptions among mental health professionals on the health promotion needs of people with severe mental health disorders through the co-production approach. Two focus groups were conducted with 20 mental health professionals working in mental health community settings in Attica, Greece. The data was analyzed using thematic analysis. Regarding health promotion needs, four major themes emerged: 1) psycho-education, 2) self-care skills, 3) institutional interventions, and 4) experiential education. Concerning co-production in health promotion, three main themes emerged: 1) participatory process, 2) services evaluation, and 3) co-production training. The findings of the study provide valuable insights into the perceptions of mental health professionals and can be taken into account in contributing to the design and implementation of health promotion programs for people with severe mental health disorders.

Dementia is a clinical syndrome for which the benefits of palliative care have been recognized. The aim of this study was to investigate the knowledge and educational needs of mental health physicians and nurses and also their perceptions of their competence regarding palliative care for the elderly with dementia. A total of 96 mental health professionals (doctors, nurses) working in a public psychiatric hospital and its allied community mental health settings participated in the study. The Palliative Care Quiz for Nursing (PCQN) was used to detect their knowledge on palliative care as well as a questionnaire to collect participants' demographics, their perceptions about their competence on palliative care provision and their educational needs on the basics domains of palliative care for the elderly with dementia. Results revealed participants' significant lack of knowledge (PCQN =7.79/20) and low perception of competence regarding palliative care for aged persons with dementia. Participants who were psychiatrists, who had work experience between 16-20 years and provided care to more than ten patients with terminal dementia per year, showed higher PCQN scores in statistically significant level (p=0.001). The majority (93.6%) of participants considered training in palliative care for dementia patients as necessary, particularly in providing information to family/carers, relieving the psychosocial burden of family/carers, managing the terminal stage of dementia, providing information to dementia patients and planning their advanced care. Findings of this study could inform the design of training programs on palliative care for the elderly with dementia in Greece.