Psychiatrike = Psychiatriki最新文献

Family therapy for schizophrenia has been demonstrated to be effective and is recommended by international clinical guidelines. Reviews of family therapy research conclude that interventions may prevent relapse of the disease, when symptoms are already reduced under psychotropic medication, by reducing family factors associated with relapse. The purpose of this study was to examine the effectiveness of Brief Solution Focused therapy (BSFT) in patients with schizophrenia focusing on the impact of change in family characteristics such as cohesion, conflict, organization and control on patients' psychopathology measured with BPRS. Thirty patients diagnosed with schizophrenia were randomly assigned to the control or intervention group. The intervention group received treatment according to the BSFT model, whereas the control group received the standard care for schizophrenia. The BSFT is a future-oriented psychotherapy model which encourages clients to focus on ''change-talking'' instead of ''problem-talking'' and on instances where a successful solution has been achieved. The intervention was consisted of 5 sessions delivered in 3 months. Main outcomes were patient-rated family characteristics measured by the Family Environment Scale (FES), and psychiatrist-rated symptom severity measured with the Brief Psychiatric Rating Scale (BPRS). The two groups did not differ in terms of age, sex, number of relapses, previous hospital admissions, and BPRS score at baseline. At the end of treatment compared to baseline there was a reduction of the BPRS score in the intervention group (p<0.001) whereas no statistically significant changes were noticed in the control group after 3 months. Also, following treatment, patients in the intervention group displayed reduced scores on the Conflict FES scale (p=0.001) accompanied by increased scores on the Cohesion (p=0.004), Expressiveness (p=0.004), and Active Recreational subscales (p=0.001) according to patient's perspective. These preliminary findings suggest that BSFT in patients with schizophrenia, appears to be effective in altering the global properties of the whole family system, specifically cohesion, conflict, organization and control which, in turn, have an impact on reducing patient psychopathology.

Patients with borderline personality disorders (BPD) have great difficulties with interpersonal relations. Their extreme difficulties with interpersonal relations are illustrated in psychic family interaction. Parents become the recipients of conflicts and patient's aggressive behaviour, while family stress increases due to suicidal tendency, self-injuries and substance abuse. The current report presents the introduction of group psychotherapy for parents of young adult patients with BPD, treated in a special unit of personality disorders at Eginition Hospital. The aim is, through the parallel group therapy of patients and their parents, to establish the conditions of continuing therapy for the patients as well as maintaining therapy outcomes and to construct a facilitating environment where the family's mental pain, anxieties, anger, shame, guilt and sadness can be contained. Clinical material from the first sessions of a 13-member parent group is presented to illustrate the resistances, the primitive defenses and the basic assumptions of dependency and fight-flight developing in therapeutic work with parents. Furthermore, the groups' split and hostile transference communications and the therapists' countertransference reactions are discussed. Τhe containing function of the group is described as a therapeutic process of transformation of the primitive anxieties and projective identifications, which is gradually established through the therapists' elaboration of their countertransference reactions and their tolerance to hostility and confusion. Containment facilitates the establishment of a group culture of empathic understanding for parents' unconscious resistances, denial of the illness and negative projections onto their child and the therapists, so that resistances gradually to be curbed and archaic projections to be transformed. Hence, the group is expected to function as a safe space to allow the manifestation and relief of destruction anxieties, and the expression of unuttered and intolerable emotions. Finally, the group as a mother-object is expected to be internalised as a model of positive parental care, enhancing the empathic and reflective ability of the parents so that they may repeat the parental role in a process of reparation.

Sleep disorders represent a common comorbidity among children and adolescents with autism spectrum disorder with prevalence ranging from 50 to 80%. Poor quality sleep has negative impact on individuals' cognitive functions such as self-regulation, attention, executive functions, memory, and speed of processing. The aim of this literature review was to examine the correlation between sleep and measures of attention, executive functions, and processing speed among children with autism. This review included research articles published between 2012 and May 2022 in PubMed and Scopus databases, using the keywords "sleep" AND "attention" OR "executive functions" OR "processing speed" AND "autism" AND "children". These key-words were accompanied by synonym, close-related, or underlying terms using the Boolean connector OR. 1226 results yielded but the total number of original papers was reduced to 90 after checking for duplicate publications and title/abstract screening. 68 out of the 90 articles were excluded as irrelevant to the scope of the present study, after reading the full text. As a result, 22 studies were included in the present review, which was compiled by the PRISMA protocol. Exclusion criteria were papers published in any other language rather than English, non-research articles and studies in typically developing and/or adult population. Regarding the measurement of sleep quality, most studies used subjective measures, such as questionnaires with reports and parental observations of participants' sleep habits and behaviours. In terms of measuring the under examination cognitive functions, most studies used subjective rather than objective instruments. In the case of attention, most studies tested it as a unitary construct by using questionnaires. Contrary, regarding Executive Functions, the majority of studies examined specific aspects, such inhibition, shifting and working memory, rather than executive functions as a unitary construct. Results showed a strong correlation between sleep and measures of attention, whereas results for executive functions and processing speed are less clear. Early and accurate diagnosis of sleep disorders could prove to be crucial in the regulation of these cognitive functions in children with autism, as it implies early and targeted intervention. Conclusively, further research on sleep quality improvement interventions is needed in autism individuals.

Three years after the outbreak of COVID-19 pandemic, numerous epidemiological studies confirm its significant psychological impact. Recent meta-analyses with 50,000-70000 participants noted the increase in anxiety, depression and feelings of loneliness in the general population.1 Patients with pre-existing mental disorders were a vulnerable group at high risk of deterioration.1,2 As part of the measures to combat the pandemic, the operation of mental health services was reduced, the access to them became more difficult and the provision of supportive and psychotherapeutic interventions continued through telepsychiatry.2 Of particular interest is the study of the impact of the pandemic on patients with personality disorders (PD).3 These patients experience severe difficulties related to interpersonal relationships and identity, which lie at the basis of intense affective and behavioral manifestations.4,5 Most studies on the impact of the pandemic on patients with personality pathology have focused on borderline personality disorder (BPD).6 Social distancing measures during the pandemic and increased sense of loneliness are serious aggravating factors for patients with BPD and may cause anxieties of abandonment and rejection, social withdrawal, and feelings of emptiness. Consequently, the patients' susceptibility to risky behaviors and substance use increases.3,7 The anxieties caused by the condition, as well as the feeling of not being in control of the situation by the subject, may mobilize paranoid ideation in patients with BPD, which further exacerbates the difficulties in their interpersonal relationships.7 In a Nordic multicenter study of 1120 outpatients with PD during the first wave of the pandemic, results showed an increase in anxiety, depression, aggression, substance use, social isolation and a decrease in work activity, while the rates of suicidal behaviors remained the same.8 On the other hand, for some patients the restricted exposure to interpersonal triggers could lead to amelioration of symptoms.7 Several papers have studied the number of visits of patients with PD or patients with self-harm to hospital emergency departments during the pandemic.6,9 In the studies that examined self-injury, the psychiatric diagnosis was not recorded, but they are mentioned here because the presence of self-harm is closely associated with PD.10 The number of emergency department visits of patients with PD or self-harm was found to be increased in some papers, decreased in others, and stable in others, compared to the previous year.6,9 During the same period, however, both the distress of patients with PD and rates of self-harm thoughts in the general population increased.3,6-8 The decreased number of emergency department visits could be the result of reduced access to services or amelioration of symptomatology due to decreased social contact or sufficient remote therapy through telepsychiatry. A critical issue that mental health services provi

Exposure to traumatic life events is one of the most robust predictors for psychosis. The Childhood Trauma Questionnaire-Short Form (CTQ-SF), a version of Childhood Experience of Care and Abuse (CECAEUGEI) and a version of the Bullying Questionnaire (BQEUGEI) refer to early life adversities, traumatic episodes and bullying. Those scales belong to a battery of psychometric tools detecting environmental and genetic factors associated with First Episode Psychosis (FEP) that was employed in the Athens-FEP study. The goal of this paper is to present those three versions, regarding their content, their use in the international research, their translation in Greek and their test-retest reliability. The three questionnaires were translated by two independent translators, administered twice to 32 subjects with FEP, with a three weeks intermediate period. Intraclass correlation coefficients (ICCs) were used to investigate agreement between scores of the first and second administration. There was a statistically significant agreement for all measurements of the three questionnaires. Cronbach's a were also calculated and were acceptable and over 0.7. Our study is an indication that the translated versions are reliable, although a more thorough test of their psychometric properties is needed. Both might be used in the Greek research field as part of a broad package of psychometric tools, specifically addressed to patients with FEP.

The prevalence of chronic diseases, especially depression, has been increasing worldwide. Health professionals have an important role in screening and early detection of the disorder, to prevent possible damage such as disability and dependence. With aging, sensory impairments can occur, such as visual and hearing losses, which can lead to isolation contributing to the development of depressive symptoms. The objective of this study was to analyze the relationship between depressive symptoms, social isolation, and self-perception of visual complaints and hearing loss in middle-aged and older adults. It was a cross-sectional quantitative study, in Três Lagoas, state of Mato Grosso do Sul, Brazil, with 300 participants of both sexes, aged 45 years and over, registered in the Primary Health Care network. Data were collected using a structured questionnaire with sociodemographic data and the questions "Do you consider yourself socially isolated?", "Do you have a vision and/or a hearing problem capable of stopping you from performing a daily life activity?" and "If yes, do you use a hearing aid and/or glasses or contact lenses?". Depressive symptoms were assessed using the Center for Epidemiological Studies - Depression (CES-D) scale with a cut-off score adapted for age. Data were analyzed with binary logistic regression, with the presence of depressive symptoms being the dependent variable. Values of p≤0.05 were considered significant. The majority of the sample were women (65.7%), with an average age of 60.9 years, 56.7% were classified with depressive symptoms, 27.0% considered themselves socially isolated, 84.7% reported visual acuity loss (70.7% used glasses) and 17.3% reported hearing loss (2.3% used hearing aids). Social isolation (OR = 6.0), visual complaints (OR = 3.85), and hearing loss (OR = 4.67) were related to the presence of depressive symptoms. Moreover, being married (OR = 0.51) was a protective factor in these participants. The results showed the importance of early diagnosis of depressive symptoms. The correction of visual and hearing deficits is highlighted, as these may be related to symptoms of depression. Health professionals in Primary Health Care should be able to monitor depressive symptoms, visual and hearing complaints, and to promote social interaction.

First Episode Psychosis (FEP) emergence and clinical outcome might be attributed to various parameters, wherein gene - environment interaction plays a pivotal role in. Four specified psychometric tools, that have been used for the evaluation of possible environmental, social and psychological parameters involved in the etiopathology and clinical course of psychosis are the following: Social Environment Assessment Tool (SEAT), Discrimination (DISC), Brief Core-Schema Scales (BCSS) and Life-Threatening Events-Brief Life-Events Questionnaire (LTE-Q). These tools were used in the Athens-FEP Study assessment schedule, which investigates the gene-environment interaction among patients presenting with FEP. The goal of the present study is to present them in regard to their content, their use in international literature, their translation in Greek, and their test-retest reliability. SEAT, DISC and BCSS were provided to the Athens FEP Study by the European Network of National Schizophrenia Network studying Gene-Environment interactions (EUGEI) research project. LTE-Q was already translated into Greek and was selected as befitting the purposes of the FEP-Study. The EUGEI instruments were translated into Greek language by two independent translators for each instrument. All translators were qualified in the administration of the English version of the scales after being trained online through a comprehensive work-package training set provided by the EUGEI. The principal investigator of the Athens-FEP project checked and approved the final versions of the questionnaires. The four tools were administered to 32 subjects, all diagnosed with FEP, participating in the Athens-FEP project. Intraclass correlation coefficients (ICCs) were used to assess the agreement between scores of the four questionnaires after first and second administration. The scales were administered to our subjects twice, with an intermediate period of three weeks between the first and second administrations, by three qualified researchers. There was a statistically significant agreement for almost all measurements of the four questionnaires, except for the frequency dimension of DISC. Agreement between those measurements was very high (ICCs>0.8). Our study is an indication that the Greek versions of the psychometric tools are reliable, although a more thorough test of their psychometric properties is needed. All four questionnaires have unique properties that differentiate them from other similar tools. Moreover, the DISC is the only discrimination scale translated into Greek. More importantly, the translated questionnaires are part of a broad, well-established research package of psychometric tools, suitable for the evaluation of environmental risk factors potentially involved in early psychosis, which might represent a valuable scientific resource in the Greek research field.

Globally, there has been growing evidence pointing to a relationship among suicides, seasonality and socioeconomic factors. This study aims at investigating the seasonal suicide patterns, the effect of gender on these patterns, the trend of these patterns and whether the suicides are associated with economic and social risk factors. The objects of the current study have been the seasonal suicide patterns in Greece during 1980-2018 (39 years), as well as their interrelation with a variety of socioeconomic risk factors, however for a shorter period (21 years) due to unavailability of aggregated data provided by the Hellenic Statistical Authority (ELSTAT). The Walter-Elwood test was applied in order to investigate seasonality. Poisson regression models were applied to investigate the relationship amongst seasonality, socioeconomic risk factors and monthly suicides. The best variable subset was selected according to the leaps and bounds algorithm. A total of 15,692 suicides were recorded. In the total sample, as well as, in men, a peak was documented in May - June, whereas females mostly peaked in July. Among the risk factors under investigation, an increase in marriage rates appeared to have significantly lowered the number of suicides, while a rise in unemployment rates exhibited a statistically non-significant increase in suicides.. The findings of the study suggest distinct sex-oriented seasonal patterns and a protective effect of marriage.

To the Editors, Tzeferakos et al. highlighted that drugs of abuse consumption may have substantially varied during the coronavirus disease 2019 (COVID-19) pandemic.1 To provide additional insights on this matter, we accessed Google Trends (Google Inc. Mountain View, CA, US) using the keywords "cannabis," "cocaine," and "heroin" under the specification "drug" (and thereby overcoming potential language differences), setting the geographical location to either "United States" (US) or "worldwide", within the past 5 years (i.e., from July 2017 to July 2022). The weekly Google Trends score for these search terms, thus reflecting their Web popularity and consumption,2 was downloaded into a Microsoft Excel file (Microsoft, Redmond, WA, United States). We divided the search period into "pre-COVID" (between July 2017 and February 2020) and COVID (between March 2020 and July 2022). The weekly Google Trends scores, mirroring the weekly local volume of Google search for the given terms, were reported as median and interquartile range (IQR), whilst their differences were compared with Mann-Whitney test (Analyse-it Software Ltd, Leeds, UK). The study was conducted in accordance with the Declaration of Helsinki, under the terms of relevant local legislation. The results of this infodemiological analysis are shown in figure 1. During the COVID-19 pandemic, the volume of Google searches for all the three terms "cannabis," "cocaine," and "heroin" decrease substantially compared to the pre-COVID period both in the US and worldwide. Specifically, the weekly Google Trends score in the US declined from 64 (IQR, 60-66) to 62 (IQR, 58-64; -3%, p=0.003) for cannabis, from 57 (IQR, 54-60) to 46 (IQR, 45-48; -19%, p<0.001) for cocaine, and from 39 (IQR, 35-43) to 27 (IQR, 25-28; -32%, p<0.001) for heroin, respectively. An even sharper decline in the weekly Google Trends score for cannabis was noted setting the location to "worldwide", since the median weekly Google Trends score declined from 61 (IQR, 58-63) to 54 (IQR, 51-56; -11%; p<0.001), whilst the variation of the other two search terms exactly mirrored that seen in the use, i.e., from 63 (IQR, 61-66) to 51 (IQR, 49-53; -19%, p<0.001) for cocaine and from 44 (IQR, 38-48) to 30 (IQR, 27-33; -32%, p<0.001) for heroin, respectively. Several lines of evidence now attest that COVID-19 is generating a dramatic psychological burden, increasing the risk of developing important threat appraisals,3 and thus potentially paving the way to enhanced use of drugs of abuse. Unlike this preamble, however, the results of our infodemiological analysis seemingly attest that the use of the three mostly widespread addictive drugs may have instead significantly declined both worldwide and in the US during the COVID-19 pandemic. Besides the objective problems of obtaining these drugs during periods of social restrictions and lockdown,4 the availability of several drugs and medicines has been jeopardized throughout the ongoing COVID-19 p

COVID-19 pandemic and its socio-economic consequences have been influencing considerably the Greek population and especially those people that are vulnerable or are actually suffering from a mental disorder. Considering eating disorders (ED) there are reports of a number of factors that increase the stress experienced by patients. The most important of them are:1 A. Quarantine and house confinement. Many ED patients report poor relationships with other family members or in some cases falling victims of some type of abusive behavior by other family members. Prolonged compulsory house confinement could have a negative impact in the course of ED. It should be noted that a similar negative impact of the pandemic has been observed in family members that have unsuccessfully tried to balance the need of the patients with the need of the rest of the family. B. Changes in exercising. Quarantine has severely influenced patients that have been doing vigorous and compulsive exercise. C. Food fear. During the first quarantine in March 2020, there were rumors of forthcoming extreme shortages of necessary products and food. D. Restrictions in the access to mental health facilities and therapists. In many countries, a substantial number of mental health programs were temporarily shut down during the first wave of the pandemic. E. Isolation of people residing alone in cities far away from the family home. F. Financial adversities due to slow down of economic activities causes by quarantine. g. Increase in obsessive fear concerning body health and food purity due to orthorexia nervosa onset or relapse.2 Research conducted during the pandemic showed that women suffering from ED reported more often than men increase in ED symptomatology, in the number of hours spent exercising and in the intensity of preoccupation with their body image and social appearance.2 A meta-analysis of ED studies during the pandemic showed that 65% of the patients reported a deterioration of ED symptomatology.3 Contrary to the above, the longitudinal studies that were included in the meta-analysis did not report any substantial difference in BMI and ed symptomatology before and after the first quarantine.3 Anorexia nervosa patients seemed to be more influenced than patients suffering from bulimia nervosa and ED non otherwise specified.3 Other longitudinal studies reported that bulimia nervosa patients were greatly influenced during the quarantine showing signs of slower remission or even relapse of the bulimic symptoms.4 Family conflict and intense fear for the life of loved ones could predict a relapse of the ED symptomatology.4 Young people were often caught in the following dilemma. On the one hand, consumption of palatable food could be used as a coping mechanism for regulating emotions such as anxiety, sorrow, and loneliness caused by prolonged house isolation. On the other hand, the increasing presence in the virtual reality environment of social networks has intensified the nee