Psychiatrike = Psychiatriki最新文献

Type 1 diabetes mellitus (T1D) is a chronic condition with rising prevalence. The only treatment for individuals with T1D to prevent diabetes-related complications is exogenous insulin administration. Diabetes-related technology has significantly contributed to the management of T1D by reducing the burden of living with diabetes and providing greater flexibility in insulin management during daily activities. This study presents the psychometric properties of the Greek translation of the Diabetes Impact and Device Satisfaction (DIDS) Scale, which assesses satisfaction with the use of an insulin delivery device and the impact of diabetes management on individuals with T1D. A sample of 101 adults with T1D, mostly females (71.3%), with a mean age of 38.4 years (± 11.7), completed the translated Greek version of DIDS (DIDS-Gr). Exploratory factor analysis revealed three factors: 'Device Satisfaction', 'Diabetes Management Impact', and (new factor) 'Device Usability'. The internal consistency indices (Cronbach's alpha) for the subscales were 0.86, 0.71, and 0.60, respectively. Furthermore, convergent validity was demonstrated with moderate to high positive correlations between the DIDS-Grand the Diabetes Quality of Life Brief Clinical Inventory (DQoL-BCI) and its subscales, while divergent validity was also confirmed with weaker correlations with the depression subscale of the Hospital Anxiety and Depression Scale (HADS). Additionally, test-retest reliability and differential validity were present in our study. Therefore, DIDS-Gr is a valid and reliable measure for assessing the impact of diabetes on individuals with T1D and the satisfaction with the use of an insulin delivery device in Greece.

Disasters, both natural and man-made, impose a significant burden on the mental health of individuals, communities, and societies. The frequency and intensity of disasters are increasing; 3–4fold compared to the last century, with 400–500 significant disasters/year, affecting >1.5 billion people worldwide and costing 250–400 billion dollars/year. Most natural disasters are directly or indirectly linked to climate change, itself a natural disaster of human origin. Armed conflict is another human self-infliction; 59 state-based conflicts are currently active, the highest since WW2 (Uppsala Conflict Data Program-UCDP1).The mental health impact of disasters is multifaceted, influencing both immediate and long-term mental health outcomes. Acute stress, anxiety, depression, and post-traumatic stress disorder (PTSD) represent just the direct impact of disasters on mental health. Forced displacement, economic hardship, and societal matrix disturbance can predispose survivors – especially the most vulnerable – to longer-term and indirect mental health morbidity. In some cases, there may be persistent, even transgenerational morbidity.2,3Disasters also have important systemic effects, especially in less well-developed systems, where disasters cause acuteon-chronic failures. The ethical handicap is that pressured systems fail exactly where the most vulnerable need them intact. Indeed, in disasters, mental health services are likely to fail early.2–4Disaster Psychiatry is a branch dedicated to preventing, preparing for, and responding to the mental health consequences of disasters. It relies on a range of evidence-based interventions designed to address the acute response to disasters, but more importantly, to address future disasters by prevention and preparedness. Acute disaster response refers to supporting individuals and the wider system at times of crisis. It is well covered by guidelines by the WHO/IASC, the Sphere, RCPsych, APA, and the World Psychiatric Association, Section on Disaster Psychiatry.5 Beyond practical support and good clinical care, several well-supported interventions deal with the clinical sequelae of disasters. A key intervention is Psychological First Aid (PFA), which focuses on providing immediate and practical support to individuals following a disaster. Among others, effective therapeutic interventions include Eye Movement Desensitization and Reprocessing (EMDR), Cognitive-behavioral therapy (CBT), which has emerged as a gold standard for treating PTSD in meta-research, and Exposure Therapy (ET) which has lately been enhanced by XR and AI integration.To minimize the escalation of disaster-related psychopathology, early intervention, social support, and good access to mental health services are critical. Supporting the wider system before, during, and after disasters includes psychoeducation and support for front-line responders, advising decision-makers, facilitating coordination and effective communication between

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.

Binge eating disorder (BED), the most prevalent eating disorder, carries significant physical and psychological consequences. Therefore, there is a continuous need to assess binge eating symptomatology and evaluate the effectiveness of various therapeutic interventions. The Binge Eating Scale (BES), which is a self-administered questionnaire, is widely used to assess binge eating in obese people. It examines the person' s experience of binge eating and the emotional, cognitive, and behavioural symptoms associated with it. The purpose of the present study was to translate and adapt BES in Greek, as well as to assess the factorial structure of BES and evaluate its psychometric properties. A sample of 160 participants (90% females) with a mean age of 40.7 years (SD=11.5 years) and a mean body mass index (BMI) 37.5kg/m2 (SD=9.2kg/m2) completed the BES and the Eating Disorder Examination Questionnaire (EDE-Q). An exploratory factor analysis (EFA) was carried out to assess the construct validity of the BES in a sample of patients with BED according to DSM-5 who came for therapy at the Eating Disorders Unit at Eginition Hospital and the day center "Anasa". The two-factor structure fits the data best. Regarding internal consistency, the results were acceptable, with Cronbach' s alpha equal to 0.78. The BES has high significant correlations with the Eating Concern, Weight Concern, and Shape Concern subscales and the Global Score of EDE-Q, but not with the Restrain subscale. Also, BES has correlations with the specific EDE-Q questions about the frequency of objective and subjective binge eating episodes. A high correlation was obtained with the measure of ΒΜΙ too. The Greek version of BES is a valid and reliable scale to evaluate binge eating in a clinical population diagnosed with BED.

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.

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.

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.

Τhe aim of this longitudinal study was to investigate the effect of the COVID-19 pandemic on the mental health and quality of life (QoL) of the general population in the region of Attica, Greece, during the third year of the pandemic (2022), and tο compare the findings with those of a survey conducted in the first year (2020). Our sample consisted of 130 participants and the study was conducted through phone interviews. The instruments used were: the World Health Organisation QoL instrument, the Depression-Anxiety-Stress Scale, the Body Vigilance Scale, the Dimensional Obsessive-Compulsive Scale, as well as socio-demographic data and questions on stressors related to COVID-19. The findings of the study were the following: (1) Regarding the comparison of the variables between the first and the third year of the pandemic in the total sample: a) In comparison to the first year, in the third year we observed a significant decrease in negative feelings caused by the pandemic; b) obsessive compulsive (OC) and hypochondriacal symptomatology were significantly reduced, and the fact that participants felt safe following vaccination had a statistically significant effect on this decrease; c) job insecurity was aggravated; d) QoL remained low and even deteriorated in the Environment domain; f) no changes were found in Depression-Stress. (2) Regarding participants who were contaminated, there was a significant increase in negative feelings during the third year of the pandemic. Moreover, QoL decreased in the Physical, Psychological health, Environment domains, as well as in OC symptomatology. (3) Depression-Stress, hypochondriacal symptomatology, and the case of contamination were the predominant factors negatively associated with the dependent variables of QoL. (4) Vaccination was found to contribute to high levels of the QoL Environment domain score. (5) Anxiety, hypochondriacal symptomatology, fear of contamination, and negative feelings seemed to predict OC symptomatology. (6) The most vulnerable groups, in terms of QoL and mental health, were men, older and lower-educated people. Overall, it was found that the negative psychosocial impact of the pandemic persisted, especially on people who had fallen ill during the third year of the pandemic. Therefore, targeted psychotherapeutic interventions should be implemented, especially for those who got infected.

Esketamine is a non-selective, competitive antagonist of the N-methyl-D-aspartate (NMDA) receptor in the brain. Through NMDA receptor antagonism, esketamine causes a transient increase in glutamate release, leading to increases in neurotrophic signaling and restoration of synaptic function in brain regions involved in mood regulation and emotional behavior. Several randomized clinical trials have shown its effectiveness in reducing the symptoms of depression in some people, despite its short-term side effects that include mainly disorientation, dizziness, nausea, and increased blood pressure. In 2019, the United States Food and Drug Administration (FDA) as well as the European Medicines Agency approved the use of esketamine nasal spray in combination with an oral antidepressant for treatment-resistant depression in adults. Our study aimed to evaluate the effectiveness of this new therapeutic proposal in a case series of five Greek patients with treatment- resistant depression. Intranasal esketamine was administered under medical supervision in combination with an oral antidepressant. Depressive symptoms were evaluated at three time points (baseline, end of treatment, and one-year post-treatment) using the Montgomery-Åsberg Depression Rating Scale (MADRS), the Patient Health Questionnaire (PHQ-9), the CGI Clinical Global Impression Scale, and the Perceived Deficits Questionnaire for Depression (PDQ-D). Possible side effects were assessed using the Richmond Suppression Agitation Scale (RASS), the Sheehan Disability Scale (SDS), the CADSS Disruptive States Scale, and a predefined list of adverse events (AEs) and serious adverse events (SAEs). Patients followed an individualized treatment plan for seven to twelve months depending on the achievement of an adequate response. Statistical analysis of the results revealed a significant improvement (p<0.05) on all scales used. All participants maintained their level of improvement at follow-up after twelve months. Adverse effects were found to be mild and tolerable. It is worth noting that significant side effects were reported only by the two patients with comorbid personality disorder. The results, despite limited to a small sample, indicate the positive effect of esketamine on the stable reduction of depressive symptoms among patients with resistant depression, even after the completion of treatment.

Telepsychiatry is an effective tool to support and provide mental health services to prison inmates. In Greece, telepsychiatry was formally applied in two correctional facilities in 2018. The objective of this study was to compare inmates' perceptions and satisfaction with telepsychiatry versus face-to-face consultation. The sample consisted of 100 male inmates with a multicultural background and prior experience with both methods of services provision. The data were obtained through a Demographic Data Questionnaire, a Participant Satisfaction Questionnaire to assess satisfaction with face-to-face psychiatric services, and another Participant Satisfaction Questionnaire to assess satisfaction with telepsychiatric services. The results have shown a higher level of satisfaction with telepsychiatry compared to face-to-face care. Statistically significant improvements (all p-values <0.001) were noted in: waiting times, support for relapse prevention, follow up, quality of mental health care, quality of care in the management of psychiatric problems and related medication, behaviour of psychiatrists, duration of the assessment, sense of comfort, and confidentiality. Telepsychiatry has proved to be an acceptable way of approaching and supporting inmates in Greece, with most of the participants expressing high acceptance, satisfaction, and preference rates. Implications for additional research and further development of telepsychiatry are discussed.