Pub Date : 2022-06-10Epub Date: 2021-08-10DOI: 10.22365/jpsych.2021.036
Panagiotis N Papanikolopoulos, Stergios G Kaprinis
Religiosity could play an important role in the mental balance of young people, a significant portion of whom are characterized by insecurity and uncertainty about the present and the future. This article is a review of the literature on the relationship between religiosity and the mental health of adolescents and young adults. Religiosity - which includes the term spirituality - in adolescents and young adults has been shown to act as a potential protective factor against psychopathology like depression, anxiety, stress and drug use but also as an enhancer of normal psychological characteristics (e.g., resilience, self-control, personality traits). Also, religiosity is positively associated with life satisfaction. Greek literature, though limited, has highlighted the positive effects of religiosity on mental health, similar to the international literature, both in the general and clinical population. Even if most studies have reported positive associations between religiosity and mental health, a minority of other studies report mixed or fully negative associations. The difference of findings in associations between religiosity and mental health could be due to assessment problems of religiosity. Many factors have been used to evaluate religiosity, but the three-factor model (organizational, non-organizational or private, and intrinsic or subjective religiosity) is the most comprehensive model for investigating religiosity. Parents play an important role in the development of religiosity in adolescents and young adults, as they influence their psycho- emotional development. This effect is related to the degree, type and harmony of the religiosity of the parents themselves but also the parent-child bond. There are still substantial gaps in research on the mediating effect of religiosity on the mental health of young people. An example is the protective combined role of religiosity and self-control against substance use. Self-control and religiosity could play an important role in the mental balance of young adults. Although for the most part it seems that religiosity improves mental health, future work in this area should consider the mediating factors in this relationship.
{"title":"[Religiosity and mental health of adolescents and young adults: a review].","authors":"Panagiotis N Papanikolopoulos, Stergios G Kaprinis","doi":"10.22365/jpsych.2021.036","DOIUrl":"https://doi.org/10.22365/jpsych.2021.036","url":null,"abstract":"<p><p>Religiosity could play an important role in the mental balance of young people, a significant portion of whom are characterized by insecurity and uncertainty about the present and the future. This article is a review of the literature on the relationship between religiosity and the mental health of adolescents and young adults. Religiosity - which includes the term spirituality - in adolescents and young adults has been shown to act as a potential protective factor against psychopathology like depression, anxiety, stress and drug use but also as an enhancer of normal psychological characteristics (e.g., resilience, self-control, personality traits). Also, religiosity is positively associated with life satisfaction. Greek literature, though limited, has highlighted the positive effects of religiosity on mental health, similar to the international literature, both in the general and clinical population. Even if most studies have reported positive associations between religiosity and mental health, a minority of other studies report mixed or fully negative associations. The difference of findings in associations between religiosity and mental health could be due to assessment problems of religiosity. Many factors have been used to evaluate religiosity, but the three-factor model (organizational, non-organizational or private, and intrinsic or subjective religiosity) is the most comprehensive model for investigating religiosity. Parents play an important role in the development of religiosity in adolescents and young adults, as they influence their psycho- emotional development. This effect is related to the degree, type and harmony of the religiosity of the parents themselves but also the parent-child bond. There are still substantial gaps in research on the mediating effect of religiosity on the mental health of young people. An example is the protective combined role of religiosity and self-control against substance use. Self-control and religiosity could play an important role in the mental balance of young adults. Although for the most part it seems that religiosity improves mental health, future work in this area should consider the mediating factors in this relationship.</p>","PeriodicalId":20741,"journal":{"name":"Psychiatrike = Psychiatriki","volume":"33 2","pages":"157-165"},"PeriodicalIF":0.0,"publicationDate":"2022-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39309261","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-05-18DOI: 10.22365/jpsych.2022.081
V. Mavreas, S. Stylianidis
The psychological impact of pandemics, which historically appear in the human species, is described in detail in Steven Taylor's excellent book "The Psychology of Pandemics",1 which was published in 2019, a few months before the outbreak of the Covid-19 pandemic. This pandemic shows similar characteristics in terms of mental health problems to the previous ones described in the book, according to the findings of epidemiological research, both internationally and in Greece.2-5 The results of these studies show a significant increase of the prevalence of common mental disorders, especially in vulnerable groups, particularly in persons with preexisting mental disorders. The necessary restrictive measures applied, especially in the first stages of the pandemic, had an impact in the accessibility of psychiatric patients to the mental health services, both in- and outpatient ones.6 This led to decreased outpatient appointments and admissions in inpatient wards, depriving a large number of these patients from necessary treatments and interventions, often resulting in worsening their mental state or relapse of acute episodes. The lack of accessibility to mental health services, had a greater impact on persons with social and financial problems, which deteriorated during the pandemic, leading to mental health problems.3 An additional problem is that persons suffering from severe mental disorders, such as chronic psychoses, face a greater risk of infection and death by Covid-19.7 These problems, arising during the pandemic (increased prevalence of mental disorders, increase of relapses of serious mental disorders, increased risk of infection and death by Covid-19, increased prevalence in those infected, especially those in the ICUs, problems of accessibility) underline the chronic insufficiencies of the mental health care system, which in many countries, especially in Greece, is fragmented and is not covering adequately the mental health needs of the population. A series of articles in prestigious mental health journals point out the problem and propose solutions, in order to correct insufficiencies and create a new strong mental health system through a series of activities.8-10 These articles underline the problems known for decades and propose the following solutions for enhancing the existing mental health system, not only to cover additional needs created by the pandemic, but leading to a new mental health system covering adequately the needs of the population: (1) Strengthening leadership and governance, with interventions to politicians and administrators, in order to understand mental health issues, and provide services in terms of inclusivity, equity and accountability. (2) Supporting financially evidence-based services, adopting policies to counteract the social determinants of mental health, as well as the additional needs created by the pandemic. (3) Promoting programmes targeting vulnerable groups, especially those related to social determinant
流行病的心理影响历史上出现在人类身上，在史蒂文·泰勒(Steven Taylor)的优秀著作《流行病的心理学》(The Psychology of pandemic)中有详细描述，该书于2019年出版，就在2019冠状病毒病大流行爆发的几个月前。根据国际和希腊流行病学研究的结果，这次大流行病在精神健康问题方面与书中所述的前几次具有相似的特点。2-5这些研究的结果表明，普通精神障碍的流行率显著增加，特别是在弱势群体中，特别是在已有精神障碍的人群中。6 .实施的必要限制措施，特别是在大流行的最初阶段，对精神病患者获得精神保健服务(包括住院和门诊)产生了影响这导致门诊预约和住院人数减少，使大量这些患者无法得到必要的治疗和干预，往往导致他们的精神状态恶化或急性发作复发。缺乏获得心理健康服务的机会对有社会和经济问题的人产生了更大的影响，这种情况在大流行病期间恶化，导致心理健康问题另一个问题是，患有严重精神障碍(如慢性精神病)的人在大流行期间面临更大的感染和死亡风险(精神障碍患病率增加，严重精神障碍复发增加，Covid-19感染和死亡风险增加，感染者，特别是重症监护病房患者的患病率增加)。可获得性问题)强调了精神卫生保健系统的长期不足，在许多国家，特别是在希腊，该系统是分散的，不能充分满足人口的精神卫生需求。在著名的心理健康期刊上发表了一系列文章，指出了问题并提出了解决方案，以期通过一系列活动纠正不足，建立一个新的强大的心理健康体系。8-10这些文章强调了几十年来已知的问题，并提出了以下解决办法，以加强现有的精神卫生系统，不仅要满足大流行造成的额外需求，而且要建立一个新的精神卫生系统，充分满足人口的需求:(1)加强领导和治理，对政治家和行政人员进行干预，以便了解心理健康问题，并在包容、公平和问责制方面提供服务。(2)在财政上支持以证据为基础的服务，采取政策应对心理健康的社会决定因素以及大流行病造成的额外需求。(3)在利益攸关方的积极参与下，促进针对弱势群体的方案，特别是与社会决定因素有关的方案，重点是消除耻辱和提高心理健康素养。(4)加强三个层面的精神卫生服务，重点是社区精神卫生服务、家庭治疗、弱势群体特殊服务、Covid-19感染者和死者亲属服务、应对Covid-19的卫生服务人员服务、利用“远程医疗”服务、采用信息系统协助服务并与应对Covid-19的服务机构密切合作。(5)利用世界卫生组织(世卫组织)的卫生保健计划，对初级保健工作人员进行心理健康方面的培训，并将他们与特殊心理健康服务联系起来。(6)在利益攸关方、非政府组织和民间社会的参与下，实施促进精神健康和预防精神障碍的方案。(7)完善精神卫生信息系统，并将其与应对Covid-19的并行系统连接起来。(8)加强和资助精神卫生研究，从流行病学和服务研究到神经生物学，以及旨在为改进精神卫生服务系统和通过社交媒体提供服务和干预措施提供创新解决方案的研究。(9)利用世卫组织的WHOQualityRights等评估工具，保护精神病人的权利，旨在提供高质量的服务。
{"title":"COVID-19 pandemic and the mental health care system.","authors":"V. Mavreas, S. Stylianidis","doi":"10.22365/jpsych.2022.081","DOIUrl":"https://doi.org/10.22365/jpsych.2022.081","url":null,"abstract":"The psychological impact of pandemics, which historically appear in the human species, is described in detail in Steven Taylor's excellent book \"The Psychology of Pandemics\",1 which was published in 2019, a few months before the outbreak of the Covid-19 pandemic. This pandemic shows similar characteristics in terms of mental health problems to the previous ones described in the book, according to the findings of epidemiological research, both internationally and in Greece.2-5 The results of these studies show a significant increase of the prevalence of common mental disorders, especially in vulnerable groups, particularly in persons with preexisting mental disorders. The necessary restrictive measures applied, especially in the first stages of the pandemic, had an impact in the accessibility of psychiatric patients to the mental health services, both in- and outpatient ones.6 This led to decreased outpatient appointments and admissions in inpatient wards, depriving a large number of these patients from necessary treatments and interventions, often resulting in worsening their mental state or relapse of acute episodes. The lack of accessibility to mental health services, had a greater impact on persons with social and financial problems, which deteriorated during the pandemic, leading to mental health problems.3 An additional problem is that persons suffering from severe mental disorders, such as chronic psychoses, face a greater risk of infection and death by Covid-19.7 These problems, arising during the pandemic (increased prevalence of mental disorders, increase of relapses of serious mental disorders, increased risk of infection and death by Covid-19, increased prevalence in those infected, especially those in the ICUs, problems of accessibility) underline the chronic insufficiencies of the mental health care system, which in many countries, especially in Greece, is fragmented and is not covering adequately the mental health needs of the population. A series of articles in prestigious mental health journals point out the problem and propose solutions, in order to correct insufficiencies and create a new strong mental health system through a series of activities.8-10 These articles underline the problems known for decades and propose the following solutions for enhancing the existing mental health system, not only to cover additional needs created by the pandemic, but leading to a new mental health system covering adequately the needs of the population: (1) Strengthening leadership and governance, with interventions to politicians and administrators, in order to understand mental health issues, and provide services in terms of inclusivity, equity and accountability. (2) Supporting financially evidence-based services, adopting policies to counteract the social determinants of mental health, as well as the additional needs created by the pandemic. (3) Promoting programmes targeting vulnerable groups, especially those related to social determinant","PeriodicalId":20741,"journal":{"name":"Psychiatrike = Psychiatriki","volume":"4 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-05-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74287280","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-04-27DOI: 10.22365/jpsych.2022.074
I. Giannopoulou, Lida Mourloukou, V. Efstathiou, A. Douzenis, P. Ferentinos
The closure of the Balkan migration route in 2016, had implications for unaccompanied refugee minors (URMs), given that the vast majority, who perceived Greece as "stopover" for their desired final destination, were forced to remain in the country for an indeterminate period of time. This created for URMs a challenging situation of living "in limbo" uncertain about their future awaiting for a long time the outcome of their asylum application. This cross-sectional study aimed to explore the mental health of URMs, who arrived in Greece in 2016. The sample comprised 90 URMs (76 boys), aged 13-17 years, consisting of 46 Syrians and 44 originating from other countries. Participants completed socio-demographic information and a range of clinical measures, including Children's Revised Impact of Events Scale (CRIES), Depression Self-Rating Scale (DSRS), Children's Post-Traumatic Cognitions Inventory (cPTCI), a measure of trauma exposure and perceived social support. Syrian URMs were significantly more likely than URMs originating from other countries to score within the probable clinical depression range (71.7% versus 47.7% respectively, p=0.020), to display probable posttraumatic stress disorder (PTSD), i.e., score within clinically significant range of posttraumatic stress symptoms and negative post-trauma cognitions (87% versus 65.9%, p=0.018), and meet the comorbidity PTSD/depression criterion (65.2% versus 40.9%, p=0.021). Multiple linear stepwise regression analyses showed that legal status (seeking asylum in Europe through family reunification procedure) significantly predicted higher levels of depressive symptoms (β=0.29, p=0.004), posttraumatic stress symptoms (β=0.21, p=0.034) and negative cognitions (β=0.33, p=0.001). The total number of stressful/traumatic experiences and male gender were found to be significantly related only with posttraumatic symptoms severity score (β=0.29, p=0.003), whereas lower levels of perceived social support were associated with increased levels of depressive symptoms (β=0.24, p=0.018) and negative cognitions and appraisals of the world and the self (β=0.26, p=0.008). These findings highlight the burden of living "in limbo" situation and add weight to the argument for amending restrictive EU asylum policies and accelerating the family reunification procedure under Dublin-III Regulation, as well as the pressing need for improved URMs access to mental health services and psychosocial support.
{"title":"Mental health of unaccompanied refugee minors in Greece living \"in limbo\".","authors":"I. Giannopoulou, Lida Mourloukou, V. Efstathiou, A. Douzenis, P. Ferentinos","doi":"10.22365/jpsych.2022.074","DOIUrl":"https://doi.org/10.22365/jpsych.2022.074","url":null,"abstract":"The closure of the Balkan migration route in 2016, had implications for unaccompanied refugee minors (URMs), given that the vast majority, who perceived Greece as \"stopover\" for their desired final destination, were forced to remain in the country for an indeterminate period of time. This created for URMs a challenging situation of living \"in limbo\" uncertain about their future awaiting for a long time the outcome of their asylum application. This cross-sectional study aimed to explore the mental health of URMs, who arrived in Greece in 2016. The sample comprised 90 URMs (76 boys), aged 13-17 years, consisting of 46 Syrians and 44 originating from other countries. Participants completed socio-demographic information and a range of clinical measures, including Children's Revised Impact of Events Scale (CRIES), Depression Self-Rating Scale (DSRS), Children's Post-Traumatic Cognitions Inventory (cPTCI), a measure of trauma exposure and perceived social support. Syrian URMs were significantly more likely than URMs originating from other countries to score within the probable clinical depression range (71.7% versus 47.7% respectively, p=0.020), to display probable posttraumatic stress disorder (PTSD), i.e., score within clinically significant range of posttraumatic stress symptoms and negative post-trauma cognitions (87% versus 65.9%, p=0.018), and meet the comorbidity PTSD/depression criterion (65.2% versus 40.9%, p=0.021). Multiple linear stepwise regression analyses showed that legal status (seeking asylum in Europe through family reunification procedure) significantly predicted higher levels of depressive symptoms (β=0.29, p=0.004), posttraumatic stress symptoms (β=0.21, p=0.034) and negative cognitions (β=0.33, p=0.001). The total number of stressful/traumatic experiences and male gender were found to be significantly related only with posttraumatic symptoms severity score (β=0.29, p=0.003), whereas lower levels of perceived social support were associated with increased levels of depressive symptoms (β=0.24, p=0.018) and negative cognitions and appraisals of the world and the self (β=0.26, p=0.008). These findings highlight the burden of living \"in limbo\" situation and add weight to the argument for amending restrictive EU asylum policies and accelerating the family reunification procedure under Dublin-III Regulation, as well as the pressing need for improved URMs access to mental health services and psychosocial support.","PeriodicalId":20741,"journal":{"name":"Psychiatrike = Psychiatriki","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-04-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90036582","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-04-27DOI: 10.22365/jpsych.2022.073
C. N. Amadi, C. Orish, C. Frazzoli, O. Orisakwe
Autism is a complex spectrum of disorders with genetic, epigenetic, autoimmune, oxidative stress, and environmental etiologies. Treatment of ASD using dietary approach is a promising strategy, especially owing to its safety and availability. Our study critically analysed the roles and efficacy of antioxidants, probiotics, prebiotics, camel milk and vitamin D. This systematic review provides an updated synopsis of human studies that investigated therapeutic benefits of these dietary interventions in autism. A total of 943 papers were identified out of which 21 articles were included in the systematic review. The selected studies investigated the impact of 5 different dietary supplementations in ASD symptom and behaviours. These agents include; antioxidants/polyphenolic compounds, probiotics, prebiotics, camel milk and vitamin D. From the results of the present review, antioxidants/polyphenolic compounds decreased the levels of inflammatory cytokines and improved behavioural symptoms. Probiotics improved behavioural and GI symptoms as well as restored gut microbiota equilibrium. Prebiotics decreased levels of inflammatory cytokines, improved behavioural and GI symptoms and improved gut microbiota. Vitamin D improved behavioural symptoms and offered protective effects against neurotoxicity. Camel milk reduced inflammatory responses and oxidative stress. Given the chronic nature as well as early onset of ASD, dietary supplements become useful to complement nutritional deficiencies in children with ASD. Key benefits of these agents stem from their ability to target multiple physiological areas via the gut brain-axis and are devoid of potential harmful or aggravating effects on ASD patients. The evidence collated in this review propose that dietary intervention may provide a new platform for the management of autism.
{"title":"Dietary interventions for autism spectrum disorder: An updated systematic review of human studies.","authors":"C. N. Amadi, C. Orish, C. Frazzoli, O. Orisakwe","doi":"10.22365/jpsych.2022.073","DOIUrl":"https://doi.org/10.22365/jpsych.2022.073","url":null,"abstract":"Autism is a complex spectrum of disorders with genetic, epigenetic, autoimmune, oxidative stress, and environmental etiologies. Treatment of ASD using dietary approach is a promising strategy, especially owing to its safety and availability. Our study critically analysed the roles and efficacy of antioxidants, probiotics, prebiotics, camel milk and vitamin D. This systematic review provides an updated synopsis of human studies that investigated therapeutic benefits of these dietary interventions in autism. A total of 943 papers were identified out of which 21 articles were included in the systematic review. The selected studies investigated the impact of 5 different dietary supplementations in ASD symptom and behaviours. These agents include; antioxidants/polyphenolic compounds, probiotics, prebiotics, camel milk and vitamin D. From the results of the present review, antioxidants/polyphenolic compounds decreased the levels of inflammatory cytokines and improved behavioural symptoms. Probiotics improved behavioural and GI symptoms as well as restored gut microbiota equilibrium. Prebiotics decreased levels of inflammatory cytokines, improved behavioural and GI symptoms and improved gut microbiota. Vitamin D improved behavioural symptoms and offered protective effects against neurotoxicity. Camel milk reduced inflammatory responses and oxidative stress. Given the chronic nature as well as early onset of ASD, dietary supplements become useful to complement nutritional deficiencies in children with ASD. Key benefits of these agents stem from their ability to target multiple physiological areas via the gut brain-axis and are devoid of potential harmful or aggravating effects on ASD patients. The evidence collated in this review propose that dietary intervention may provide a new platform for the management of autism.","PeriodicalId":20741,"journal":{"name":"Psychiatrike = Psychiatriki","volume":"128 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-04-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77971849","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-04-27DOI: 10.22365/jpsych.2022.077
Maria Koumparou, P. Bakas, K. Pantos, M. Economou, G. Chrousos
Komiya et al recently sent a letter to the editor1 raising issues of reliability and validity of our study "Stress Management and in Vitro Fertilization (IVF): A Pilot Randomized Controlled Trial".2 Their comments focused on the default of the registration, the absence of any mention of case dropout, the ambiguity in the details of IVF treatment and the lack of specific figures on the background of the participants. However, the principles of CONSORT 2010 cannot be applied to Pilot Randomized and Feasibility Trials, only to Randomized Trials (RTs) or Randomized Controlled Trials (RCTs). Similarly, the CONSORT Extension 2016 suggested some principles for Pilot and Feasibility Trials, but again it does not directly apply to internal pilot studies, non-randomized pilot and feasibility studies, or phase II studies.3,4 Many international journals do not require registration for Pilot and Feasibility Trials, but only for RTs or RCTs,5 granted that clinical trial registration is not an indicator of low risk of bias.6 Thanks to the useful comments by Komiya et al, our article2 now includes online "Supplementary Materials" in which we clarify all their points one by one. Specifically, the Material and Method section of Supplementary Materials includes details for the Registration, the Flow Chart and the IVF Treatment, and the Results section includes details for the Background of the Participants. Thus, we believe that the level of reliability and validity of the study can be now examined and ensured.
{"title":"Authors Reply: Regarding \"Stress Management and in Vitro Fertilization (IVF): A Pilot Randomized Controlled Trial\".","authors":"Maria Koumparou, P. Bakas, K. Pantos, M. Economou, G. Chrousos","doi":"10.22365/jpsych.2022.077","DOIUrl":"https://doi.org/10.22365/jpsych.2022.077","url":null,"abstract":"Komiya et al recently sent a letter to the editor1 raising issues of reliability and validity of our study \"Stress Management and in Vitro Fertilization (IVF): A Pilot Randomized Controlled Trial\".2 Their comments focused on the default of the registration, the absence of any mention of case dropout, the ambiguity in the details of IVF treatment and the lack of specific figures on the background of the participants. However, the principles of CONSORT 2010 cannot be applied to Pilot Randomized and Feasibility Trials, only to Randomized Trials (RTs) or Randomized Controlled Trials (RCTs). Similarly, the CONSORT Extension 2016 suggested some principles for Pilot and Feasibility Trials, but again it does not directly apply to internal pilot studies, non-randomized pilot and feasibility studies, or phase II studies.3,4 Many international journals do not require registration for Pilot and Feasibility Trials, but only for RTs or RCTs,5 granted that clinical trial registration is not an indicator of low risk of bias.6 Thanks to the useful comments by Komiya et al, our article2 now includes online \"Supplementary Materials\" in which we clarify all their points one by one. Specifically, the Material and Method section of Supplementary Materials includes details for the Registration, the Flow Chart and the IVF Treatment, and the Results section includes details for the Background of the Participants. Thus, we believe that the level of reliability and validity of the study can be now examined and ensured.","PeriodicalId":20741,"journal":{"name":"Psychiatrike = Psychiatriki","volume":"39 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-04-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76513206","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-04-27DOI: 10.22365/jpsych.2022.076
S. Komiya, M. Banno, Yuki Itagaki
Koumparou et al.1 recently published a randomized controlled trial (RCT) on the effectiveness of psychological interventions (stress management training, SMT) for women planning in vitro fertilization (IVF). They concluded that while the effect of SMT was limited in terms of IVF outcome, it resulted in a significant reduction of stress levels in infertile patients. Since most women undergoing infertility treatment are exposed to high psychological stress,2 this study may be of great value in demonstrating the need for proactive SMT to maintain infertile women's mental health and motivation to continue treatment. However, we are concerned that the reliability of this RCT has been compromised in several ways. First, the registration of the RCT was not clearly stated. According to The CONsolidated Standards of Reporting Trials (CONSORT) 2010 guidelines, a prospective registration of the RCT is required, which prevents unnecessary concerns about the bias of results selection.3,4 Second, the lack of specific figures on the background of the participants in the case and control groups risks distorting the RCT results. The article states that there was no significant difference between the two groups. However, since aging and prolonged infertility treatment increase the psychological burden on infertile patients,5 detailed background information is necessary to interpret the results of an RCT accurately. Selection bias could not be determined, which weakened the validity of this RCT. Furthermore, the absence of any mention of case dropout makes the conclusions of this RCT uncertain; a discussion of cases demonstrating difficulty in completing an 8-week psychological program would clarify whether temporary SMT would show efficacy for patients. Finally, it is essential to note that the details of IVF have not been clarified. Since the timing of the SMT and IVF-ET cycles or details of the IVF-ET protocol were not shown, this RCT could not be used as a reference for IVF facilities to actually operate SMT. There is no doubt that psychological interventions are necessary for infertile patients exposed to high psychological stress, but this RCT has many details that have not been clarified, and the conclusions are attenuated. As details become clearer, this RCT will provide a foundation for the active use of SMT in infertility treatment settings.
Koumparou et al.1最近发表了一项随机对照试验(RCT)，研究心理干预(压力管理训练，SMT)对计划体外受精(IVF)的妇女的有效性。他们得出结论，尽管SMT对试管婴儿结果的影响有限，但它显著降低了不孕患者的压力水平。由于大多数接受不孕症治疗的妇女都暴露在高心理压力下，2本研究可能在证明需要积极的SMT来维持不孕症妇女的心理健康和继续治疗的动力方面具有重要价值。然而，我们担心这项随机对照试验的可靠性在几个方面受到了损害。首先，RCT的注册没有明确规定。根据联合试验报告标准(CONSORT) 2010指南，RCT的前瞻性注册是必需的，这可以防止对结果选择偏差的不必要的担忧。3,4其次，缺乏病例和对照组参与者背景的具体数据可能会扭曲RCT结果。文章指出，两组之间没有显著差异。然而，由于老龄化和长期的不孕症治疗增加了不孕症患者的心理负担，因此需要详细的背景信息才能准确地解释一项RCT的结果。无法确定选择偏倚，这削弱了该RCT的有效性。此外，没有提及病例退出，使得该RCT的结论不确定;对难以完成8周心理治疗项目的病例进行讨论，将阐明临时SMT是否对患者有效。最后，必须指出的是，试管婴儿的细节尚未澄清。由于没有显示SMT和IVF- et周期的时间或IVF- et方案的细节，因此该随机对照试验不能作为IVF机构实际操作SMT的参考。毫无疑问，心理干预对于暴露于高心理压力下的不孕症患者是必要的，但本RCT有许多细节没有得到澄清，结论有所弱化。随着细节变得更加清晰，这项随机对照试验将为在不孕症治疗环境中积极使用SMT提供基础。
{"title":"Regarding \"Stress management and In Vitro Fertilization (IVF): A pilot randomized controlled trial\".","authors":"S. Komiya, M. Banno, Yuki Itagaki","doi":"10.22365/jpsych.2022.076","DOIUrl":"https://doi.org/10.22365/jpsych.2022.076","url":null,"abstract":"Koumparou et al.1 recently published a randomized controlled trial (RCT) on the effectiveness of psychological interventions (stress management training, SMT) for women planning in vitro fertilization (IVF). They concluded that while the effect of SMT was limited in terms of IVF outcome, it resulted in a significant reduction of stress levels in infertile patients. Since most women undergoing infertility treatment are exposed to high psychological stress,2 this study may be of great value in demonstrating the need for proactive SMT to maintain infertile women's mental health and motivation to continue treatment. However, we are concerned that the reliability of this RCT has been compromised in several ways. First, the registration of the RCT was not clearly stated. According to The CONsolidated Standards of Reporting Trials (CONSORT) 2010 guidelines, a prospective registration of the RCT is required, which prevents unnecessary concerns about the bias of results selection.3,4 Second, the lack of specific figures on the background of the participants in the case and control groups risks distorting the RCT results. The article states that there was no significant difference between the two groups. However, since aging and prolonged infertility treatment increase the psychological burden on infertile patients,5 detailed background information is necessary to interpret the results of an RCT accurately. Selection bias could not be determined, which weakened the validity of this RCT. Furthermore, the absence of any mention of case dropout makes the conclusions of this RCT uncertain; a discussion of cases demonstrating difficulty in completing an 8-week psychological program would clarify whether temporary SMT would show efficacy for patients. Finally, it is essential to note that the details of IVF have not been clarified. Since the timing of the SMT and IVF-ET cycles or details of the IVF-ET protocol were not shown, this RCT could not be used as a reference for IVF facilities to actually operate SMT. There is no doubt that psychological interventions are necessary for infertile patients exposed to high psychological stress, but this RCT has many details that have not been clarified, and the conclusions are attenuated. As details become clearer, this RCT will provide a foundation for the active use of SMT in infertility treatment settings.","PeriodicalId":20741,"journal":{"name":"Psychiatrike = Psychiatriki","volume":"43 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-04-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84530916","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-04-27DOI: 10.22365/jpsych.2022.075
Y. Kasvikis, T. Mitsopoulou, E. Alexiou
Patients with Panic Disorder and / or Agoraphobia (PD +/- Ag) attribute their mental health more to external factors and less to internal, while after behavior treatment (BT) their external attributions decrease and internal attributions increase. We examined whether these cognitive changes observed at the end of BT, begin earlier. Forty patients with PD +/- Ag were assessed on the Multidimensional Health Locus of Control Scale, before and after the diagnostic and psychoeducational sessions that precede the clinical implementation of BT. Decreased health attributions to significant others (t = 4.22, p < 0.01), and an increase trend to self (t = -0.78, p = 0.43) were observed, which are compatible with the active role patients need to adopt in the clinical application of BT.
惊恐障碍和/或广场恐怖症(PD +/- Ag)患者的心理健康多归因于外部因素，少归因于内部因素，而行为治疗(BT)后其外部归因减少，内部归因增加。我们检查了在BT结束时观察到的这些认知变化是否开始得更早。对40例PD +/- Ag患者在临床实施BT前进行诊断和心理教育前后的多维健康控制源量表进行评估，发现对显著他人的健康归因减少(t = 4.22, p < 0.01)，对自我的健康归因增加(t = -0.78, p = 0.43)，这与患者在临床应用BT时需要采取的积极作用相一致。
{"title":"Cognitive changes in health locus of control attributions after behavioral analysis in patients with panic disorder and/or agoraphobia.","authors":"Y. Kasvikis, T. Mitsopoulou, E. Alexiou","doi":"10.22365/jpsych.2022.075","DOIUrl":"https://doi.org/10.22365/jpsych.2022.075","url":null,"abstract":"Patients with Panic Disorder and / or Agoraphobia (PD +/- Ag) attribute their mental health more to external factors and less to internal, while after behavior treatment (BT) their external attributions decrease and internal attributions increase. We examined whether these cognitive changes observed at the end of BT, begin earlier. Forty patients with PD +/- Ag were assessed on the Multidimensional Health Locus of Control Scale, before and after the diagnostic and psychoeducational sessions that precede the clinical implementation of BT. Decreased health attributions to significant others (t = 4.22, p < 0.01), and an increase trend to self (t = -0.78, p = 0.43) were observed, which are compatible with the active role patients need to adopt in the clinical application of BT.","PeriodicalId":20741,"journal":{"name":"Psychiatrike = Psychiatriki","volume":"39 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-04-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85045878","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-03-28Epub Date: 2021-11-26DOI: 10.22365/jpsych.2021.043
Nafsika Malikentzou, Athanasios Douzenis, Fotios Chatzinikolaou, Panagiota Bali, Ioannis Michopoulos
We aimed to examine and compare the attitudes of physicians and law professionals on modern bioethical issues. Euthanasia, physician assisted suicide and abortion were selected for this study, as they underline the conflict between human life as a fundamental value, and the individual's right to self-determination. The demand of euthanasia and physician assisted suicide services reflects each person's right to decide on the way their life will end, while the legalization of abortion determines the individual's right to self-determination. These are complex issues with moral, religious and social implications, and as such tend to divide public opinion. In order to investigate their attitudes, physicians of all specialties, as well as law professionals from all over Greece, were invited to participate in the study. In total, 220 professionals responded to the call and participated in the survey. The professionals involved showed fairly high rates of agreement in all the issues studied, but a significant difference in results was found when the occupation of participants was set as a criterion, with physicians being more negative to euthanasia, physician assisted suicide and abortion than lawyers. Religiousness, age and male sex were negatively correlated with "positive" attitudes towards euthanasia, physician assisted suicide and abortion. Moreover, participants' attitudes towards euthanasia and physician assisted suicide were found to predict their attitudes towards abortion, indicating a single ideological direction of agreement or disagreement, accordingly. Individuals' attitudes and opinions are complicated issues, not easy to be categorized. However, it is of scientific interest to shape a legislative framework that is close to the social consensus, ideological evolution and moral needs. This study tried to pave the way for a modern approach to the issues of euthanasia, physician assisted suicide and abortion.
{"title":"Modern bioethical issues: Euthanasia, physician assisted suicide and abortion. Comparative study of attitudes between physicians and law professionals.","authors":"Nafsika Malikentzou, Athanasios Douzenis, Fotios Chatzinikolaou, Panagiota Bali, Ioannis Michopoulos","doi":"10.22365/jpsych.2021.043","DOIUrl":"https://doi.org/10.22365/jpsych.2021.043","url":null,"abstract":"<p><p>We aimed to examine and compare the attitudes of physicians and law professionals on modern bioethical issues. Euthanasia, physician assisted suicide and abortion were selected for this study, as they underline the conflict between human life as a fundamental value, and the individual's right to self-determination. The demand of euthanasia and physician assisted suicide services reflects each person's right to decide on the way their life will end, while the legalization of abortion determines the individual's right to self-determination. These are complex issues with moral, religious and social implications, and as such tend to divide public opinion. In order to investigate their attitudes, physicians of all specialties, as well as law professionals from all over Greece, were invited to participate in the study. In total, 220 professionals responded to the call and participated in the survey. The professionals involved showed fairly high rates of agreement in all the issues studied, but a significant difference in results was found when the occupation of participants was set as a criterion, with physicians being more negative to euthanasia, physician assisted suicide and abortion than lawyers. Religiousness, age and male sex were negatively correlated with \"positive\" attitudes towards euthanasia, physician assisted suicide and abortion. Moreover, participants' attitudes towards euthanasia and physician assisted suicide were found to predict their attitudes towards abortion, indicating a single ideological direction of agreement or disagreement, accordingly. Individuals' attitudes and opinions are complicated issues, not easy to be categorized. However, it is of scientific interest to shape a legislative framework that is close to the social consensus, ideological evolution and moral needs. This study tried to pave the way for a modern approach to the issues of euthanasia, physician assisted suicide and abortion.</p>","PeriodicalId":20741,"journal":{"name":"Psychiatrike = Psychiatriki","volume":"33 1","pages":"49-55"},"PeriodicalIF":0.0,"publicationDate":"2022-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39802149","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-03-28Epub Date: 2021-11-26DOI: 10.22365/jpsych.2021.040
Hüseyin Çaksen
Family is very important for development of children. Divorce is a life event with a high level of stress for the entire family. Children are dependent on parents and disadvantaged during divorce because it is out of their control.1 Herein, we present our observations about children whose parents separated or divorced to increase the awareness of physicians about the negative effects of divorce. Individuals affected by parental divorce have a higher risk of developing a variety of mental health conditions including emotional and behavioral disorders, poor school performance, depression, anxiety, suicidal ideation, suicide attempt, distress, smoking and substance abuse.2,3 Externalizing problems in girls precede and predict later parental divorce. Post-divorce problems in children vary by raters, and may depend on the time lapse since divorce.4 Lansford et al 5 noted that early parental divorce/separation is more negatively related to trajectories of internalizing and externalizing problems than is later divorce/separation, whereas later divorce/separation is more negatively related to grades. In another study, divorce in parents was significantly associated with higher alcohol use disorder, higher cigarette dependence and higher water pipe dependence in adolescents.6 In the study of Tullius et al 7 the levels of both internalizing and externalizing problems were significantly higher in the period after parental divorce, but not in the period before divorce, with a persistent and increasing effect over the follow-up periods compared to adolescents not experiencing divorce. Zeratsion et al 8 reported that parental divorce in late adolescence does not lead to mental health problems, as has been shown before, while such problems may prevail among young adolescents. This does not mean that parental divorce creates less problems in late adolescence than before but these youths might have developed adjustment abilities against health effects as divorce have turned to be more common. In our clinical practice, we have also observed various emotional, behavioral, psychosomatic, and conversion disorders in children, particularly in preadolescents and adolescents, before and/or after a separation or divorce of parents. Children often lack information and skills to overcome the challenges that the divorce carries. Conflicting relationships between parents make up the biggest obstacle that makes it difficult for a child to successfully deal with changes in the family. Even though parents deal with heavy feelings, it is desirable to put them the child and his interests in the first place. In order to stabilize the family system, 2 to 4 years are usually needed.1 Physicians can assist families by providing support and advice, and advocating for children within systems that serve separating families. Physicians can provide information so that individuals who work with such children recognize, and are sensitive to, their individual needs, and provide support
{"title":"The effects of parental divorce on children.","authors":"Hüseyin Çaksen","doi":"10.22365/jpsych.2021.040","DOIUrl":"https://doi.org/10.22365/jpsych.2021.040","url":null,"abstract":"<p><p>Family is very important for development of children. Divorce is a life event with a high level of stress for the entire family. Children are dependent on parents and disadvantaged during divorce because it is out of their control.1 Herein, we present our observations about children whose parents separated or divorced to increase the awareness of physicians about the negative effects of divorce. Individuals affected by parental divorce have a higher risk of developing a variety of mental health conditions including emotional and behavioral disorders, poor school performance, depression, anxiety, suicidal ideation, suicide attempt, distress, smoking and substance abuse.2,3 Externalizing problems in girls precede and predict later parental divorce. Post-divorce problems in children vary by raters, and may depend on the time lapse since divorce.4 Lansford et al 5 noted that early parental divorce/separation is more negatively related to trajectories of internalizing and externalizing problems than is later divorce/separation, whereas later divorce/separation is more negatively related to grades. In another study, divorce in parents was significantly associated with higher alcohol use disorder, higher cigarette dependence and higher water pipe dependence in adolescents.6 In the study of Tullius et al 7 the levels of both internalizing and externalizing problems were significantly higher in the period after parental divorce, but not in the period before divorce, with a persistent and increasing effect over the follow-up periods compared to adolescents not experiencing divorce. Zeratsion et al 8 reported that parental divorce in late adolescence does not lead to mental health problems, as has been shown before, while such problems may prevail among young adolescents. This does not mean that parental divorce creates less problems in late adolescence than before but these youths might have developed adjustment abilities against health effects as divorce have turned to be more common. In our clinical practice, we have also observed various emotional, behavioral, psychosomatic, and conversion disorders in children, particularly in preadolescents and adolescents, before and/or after a separation or divorce of parents. Children often lack information and skills to overcome the challenges that the divorce carries. Conflicting relationships between parents make up the biggest obstacle that makes it difficult for a child to successfully deal with changes in the family. Even though parents deal with heavy feelings, it is desirable to put them the child and his interests in the first place. In order to stabilize the family system, 2 to 4 years are usually needed.1 Physicians can assist families by providing support and advice, and advocating for children within systems that serve separating families. Physicians can provide information so that individuals who work with such children recognize, and are sensitive to, their individual needs, and provide support","PeriodicalId":20741,"journal":{"name":"Psychiatrike = Psychiatriki","volume":"33 1","pages":"81-82"},"PeriodicalIF":0.0,"publicationDate":"2022-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39801699","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-02-21DOI: 10.22365/jpsych.2022.072
E. Mellos, T. Paparrigopoulos
The COVID-19 pandemic is associated with increased levels of anxiety, fear, sadness, difficulty adjusting, symptoms of post-traumatic stress disorder and suicidality, both in the general population and specific subgroups. The presence of this type of psychopathology increases the risk of involvement with or worsens the use of addictive substances and alcohol as a maladaptive coping strategy.1 According to these data, people with substance use disorders are a population at high risk for COVID-19 infection and serious illness. Α large controlled retrospective case study in the US found that people with substance use disorders are significantly more vulnerable to COVID-19 and its complications (primarily those with opioid use disorder OR = 10.21 and with tobacco use disorder OR = 8.25), and that the course and outcome of the disease (hospitalization, death) was worse than in non-dependent individuals. The main culprits are increased physical co-morbidity (frequent respiratory and cardiovascular problems), poor health and living conditions, marginalization and difficulties in accessing health services. 2,3 Ιnternational epidemiological data during the first months of the pandemic regarding the use of addictive substances do not lead to safe conclusions. A cross-sectional online epidemiological study conducted on a sample of 36,538 adults from 21 European countries between April and July 2020 found an overall decrease in alcohol use, which was mainly attributed to the reduction of heavy episodic consumption, while at the same time an increase in alcohol consumption among people with severe alcohol use was recorded. Τhe use of cannabis and nicotine showed increasing trends, as well as the use of cocaine, but to a lesser extent, while the use of MDMA (ecstasy) showed a decrease.4 In a review of 45 cross-sectional studies conducted between December 2019 and November 2020, alcohol use was on the rise overall, despite geographical variations, as was the use of other addictive substances, cannabis in particular.5 It should be noted that those who increased alcohol use during quarantine were those exhibiting higher levels of negative emotionality mechanisms.6 In Greece, an online cross-sectional survey in April 2020 in the general population during the first lockdown showed a reduction in alcohol use (43.7% of alcohol users reduced or quit), a reduction in cannabis (67.3% quit), while 33.3% increased nicotine use. These changes were attributed to the limitation of alcohol availability, social distancing, changes in daily routine and income reduction.7,8 Also, wastewater samples from Athens, analyzed by the Laboratory of Analytical Chemistry of EKPA, showed a significant increase in the use of cocaine (67%), amphetamine (350%) and methamphetamine (37%), and a decrease in the use of MDMA (- 38%) during the first lockdown, compared to the corresponding period of the previous year.9 Analysis of wastewater samples from other European cities "suggest that levels o
{"title":"Substance use during the COVID-19 pandemic: What is really happening?","authors":"E. Mellos, T. Paparrigopoulos","doi":"10.22365/jpsych.2022.072","DOIUrl":"https://doi.org/10.22365/jpsych.2022.072","url":null,"abstract":"The COVID-19 pandemic is associated with increased levels of anxiety, fear, sadness, difficulty adjusting, symptoms of post-traumatic stress disorder and suicidality, both in the general population and specific subgroups. The presence of this type of psychopathology increases the risk of involvement with or worsens the use of addictive substances and alcohol as a maladaptive coping strategy.1 According to these data, people with substance use disorders are a population at high risk for COVID-19 infection and serious illness. Α large controlled retrospective case study in the US found that people with substance use disorders are significantly more vulnerable to COVID-19 and its complications (primarily those with opioid use disorder OR = 10.21 and with tobacco use disorder OR = 8.25), and that the course and outcome of the disease (hospitalization, death) was worse than in non-dependent individuals. The main culprits are increased physical co-morbidity (frequent respiratory and cardiovascular problems), poor health and living conditions, marginalization and difficulties in accessing health services. 2,3 Ιnternational epidemiological data during the first months of the pandemic regarding the use of addictive substances do not lead to safe conclusions. A cross-sectional online epidemiological study conducted on a sample of 36,538 adults from 21 European countries between April and July 2020 found an overall decrease in alcohol use, which was mainly attributed to the reduction of heavy episodic consumption, while at the same time an increase in alcohol consumption among people with severe alcohol use was recorded. Τhe use of cannabis and nicotine showed increasing trends, as well as the use of cocaine, but to a lesser extent, while the use of MDMA (ecstasy) showed a decrease.4 In a review of 45 cross-sectional studies conducted between December 2019 and November 2020, alcohol use was on the rise overall, despite geographical variations, as was the use of other addictive substances, cannabis in particular.5 It should be noted that those who increased alcohol use during quarantine were those exhibiting higher levels of negative emotionality mechanisms.6 In Greece, an online cross-sectional survey in April 2020 in the general population during the first lockdown showed a reduction in alcohol use (43.7% of alcohol users reduced or quit), a reduction in cannabis (67.3% quit), while 33.3% increased nicotine use. These changes were attributed to the limitation of alcohol availability, social distancing, changes in daily routine and income reduction.7,8 Also, wastewater samples from Athens, analyzed by the Laboratory of Analytical Chemistry of EKPA, showed a significant increase in the use of cocaine (67%), amphetamine (350%) and methamphetamine (37%), and a decrease in the use of MDMA (- 38%) during the first lockdown, compared to the corresponding period of the previous year.9 Analysis of wastewater samples from other European cities \"suggest that levels o","PeriodicalId":20741,"journal":{"name":"Psychiatrike = Psychiatriki","volume":"4 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81190565","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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