Psychiatrike = Psychiatriki最新文献

Given the aggravation on the general population's quality of life due to covid-19 and the vulnerability of People Who Use Drugs (PWUD) to acute stress, the aim of the current study was to better comprehend the impact of covid-19 on quality of life and mental health of PWUD as well as their drug use patterns. Another study had been conducted prior to the covid-19 outbreak, which assessed quality of life, indicative PTSD symptoms, and drug use patterns of people who were attending an Opioid Substitution Treatment (OST), in Athens, Greece. As a continuation of the aforementioned study, the same variables were assessed in May and June 2020, after the first lockdown measures. 104 patients agreed to participate. The World Health Organization Quality of Life Questionnaire (WHOQOL) and the Post-Traumatic Stress Scale (PCL-C) were used as well as toxicology tests. The only statistically significant outcome was a reduction regarding the dimension referring to the relationship between the individual and their environment. People with low quality of life were found to experience more severe Post- Traumatic Stress Disorder (PTSD) symptoms after lockdown comparing to those with high quality of life. There was also a statistically non-significant increase in PTSD scores before and after lockdown measures. Regarding drug use patterns, the present research reveals an overall decline in drug use during quarantine. There was a statistically significant decrease in opioid (22.3%) and in benzodiazepine (35%) use after lockdown. Also, a statistically significant increase in mean scores of indicative PTSD symptoms of people who decreased opioid use during and after lockdown measures was found. In regards to amphetamine use, research findings underline a non-significant increase in use (8.7%). The pandemic's impact on the life of people on opioid substitution treatment should be taken into consideration and further studies need to be conducted in order to protect this populations' quality of life and maximize the potential benefits such as reduced access to illicit substances.

Within the last decade, there has been a growing debate regarding financial capacity and abuse as one of the most important challenges that older adults are facing in their everyday lives.1 Currently older adults are highly impacted by pre-and post-COVID-19 measures and there is a massive increase in financial exploitation reports involving older adults worldwide,2 an increase that can be attributed to a number of reasons, such as the higher rates of depression among socially isolated seniors (a diagnosis itself linked to abuse, as it can worsen elders' cognitive and physical condition by making them dependent and vulnerable), but also due to of mass redundancies, financial pressure and stress faced by younger family members (childrenandgrandchildren).3 Althoughpriorresearchemphasizedmainlyindividualcognitive aspects (e.g. financial knowledge/self-beliefs/behaviors in the financial decision-making process), the interaction with emotional and socio-cultural factors are not thoroughly examined. Unfortunately, there are scarce organized large-scale research attempts at national and none at international level to focus on financial abuse of elders suffering from different types of neurocognitive disorders as well as healthy elders, not only before the COVID-19 era, but especially during and after COVID-19 health and social crisis.4 In addition to the lack of research neglecting the cross-cultural perspective, there is also a dire need to refocus previous research attempts that mainly examine perceptions of financial abuse with experimental manipulations, not in real world situations and only from the viewpoint of the patient/family, while disregarding the attitudes and education /educational needs of healthcare experts.5 Future research questions that deserve to be examined, but still remain unanswered, are: What are the cognitive-emotional characteristics of elders prone to abuse and of the persons in their social environment? How do medical-psychiatric conditions influence elders financial abuse? What and how do individuals and groups from different social and cultural settings define-perceive financial abuse and the characteristics of the 'offender' and 'victim'? Under what real-life conditions we-as-'guardians' detect and are willing to report elder financial abuse and how can we 'protect' elders? What do we expect from the state, legal systems and the important others to do? What do elders themselves think and feel about financial abuse and how do they react? What is the 'correct reaction/directives'? What are healthcare professionals' attitudes and knowledge on this topic? Could all the above-mentioned points be taught in programmes? All the above will not only give an alternative viewpoint on this hot, complex multifaceted ethical, legal and practical issue (that many of us are concerned with, but at the same time are unwilling to systematically explore), but may assist us in understanding, planning and acting 'appropriately'. For that t

The present paper aims to highlight the importance of Mobile Mental Health Units (MMHUs) in the delivery of mental health services in remote areas in rural Greece. Since the foundation of the first MMHUs in the eighties till nowadays, those services have expanded in many rural areas and there is some evidence that they are effective in the management of patients with severe mental disorders. The care of those patients seems to contribute to a significant reduction in voluntary and involuntary acute admissions and in length of hospital stay. Cost/effectiveness analysis studies have also shown favorable results. Besides their regular clinical work, MMHUs conduct research, such as epidemiologic surveys. Other research explores the care of elderly patients in rural areas and the care of immigrants that permanently reside in Greece. Other research involves the study of psychotic disorders in the rural context, such as the long-term outcome, the patients' functioning, and the long-term treatment with benzodiazepines. Current challenges for MMHUs involve staffing, particularly for those run by public hospitals, and the retainment of highly trained personnel. Other important challenges are related to the aging of the rural population and the refugee/migrant influx. The MMHUs of the islands that initially accept the refugee flow, have already faced an increased number of new referrals. Given the disparities in mental healthcare between rural and urban areas, further enhancement of the MMHUs' operation is required, as well as continuing training of their workforce. Research at the national level is needed and could be the basis for the design and staffing of new services. The establishment of valid and broadly accepted clinical indices to measure treatment outcomes would facilitate research and ensure the recording and evaluation of the MMHUs' work and their effectiveness as well; and would highlight their utility within the contemporary health system.

This study examines the associations of the COVID -19 pandemic stressors with mental health and quality of life (QoL) of the general population in different demographic areas of Athens. The random sample of the study consisted of 602 participants, 389 (64,6%) women and 213 (35,4%) men residing in Attica (Greece). It was conducted with telephone interviews during the first wave of the pandemic. The instruments used were: World Health Organization Quality of Life Instrument (WHOQOL-BREF), Depression Anxiety Stress Scale (DASS - 21), Body Vigilance Scale (ΒVS), Dimensional Obsessive-Compulsive Scale (Category 1: contamination obsessions -decontamination compulsions) (DOCS) and a set of socio-demographic data and questions on stressors related to the COVID-19 outbreak. A range of statistical analyses were used, including descriptive statistics, examination of the questionnaires' internal consistency, calculating Cronbach's alpha coefficient, as well as multiple linear regression analyses with dependent variables the WHOQOL-BREF, DASS-21, DOCS, and BVS scales. According to the results of our study: a) The greater the extent of negative emotions due to the pandemic and the imposed restrictive measures, such as worry and fear, the higher the score of depression, anxiety, stress, obsessive-compulsive symptomatology, body vigilance and the lower the scores of the WHOQOL domains (Physical Health, Psychological Health, Social Relationships, Environment), b) the fear of being contaminated by the virus seems to have intensified depression-anxiety-stress (DASS-21), obsessive-compulsive (DOCS) and hypochondriacal (BVS) symptomatology. c) The independent variables of depression, stress and anxiety and obsessive - compulsive and hypochondriacal symptomatology were negatively associated with QoL d) The most vulnerable groups in terms of QoL and mental health indicators in our study were those with psychiatric or/and physical illness, the elderly, the unemployed during the lockdown period, those with low educational/ socioeconomic status and those living alone. In conclusion, the negative emotions associated with the COVID-19 outbreak and the imposed restrictive measures had a serious impact on mental health and QoL of the population. This and other similar findings should be taken into account by authorities and decision-makers to prevent and deal with the effects of the pandemic. Unfortunately, the COVID-19 pandemic is still continuing and the imposition of new restrictive measures is considered. This increases the relevance of research like the one presented here.

The Tobacco and Alcohol Questionnaire (TAQ) and the Cannabis Experience Questionnaire (CEQ) are two instruments employed in the evaluation of substance use. The First Episode Psychosis (FEP) study in Athens employed two versions of those questionnaires, as part of a battery of psychometric tools, detecting environmental and genetic factors associated with FEP and addressed specifically to the distinctive characteristics of patients with FEP. The goal of the present study is to present those two versions, regarding their content, their use in international research, their translation in Greek, and their test-retest reliability. The two questionnaires were translated by two independent translators and administered to 32 subjects with FEP twice, in order to be tested for test-retest reliability. Cohen's kappa was used to measure agreement between qualitative variables and ICC between quantitative variables. Significant agreement was found between the two measurements in all items of the TAQ version and almost all items of the CEQ version. Our study is an indication that both translations 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.

"Suffering" patients' wishes concerning hastening their own death by means of euthanasia, raised by personal, psychological, social and other motives, are becoming increasingly common. This raises controversies and marks challenges within both the scientific community and the public. The aim of this study is to investigate physicians' attitudes towards euthanasia and its correlation with their spirituality. The final sample consisted of 93 physicians (64.5% men), whose attitudes on euthanasia who were evaluated using Euthanasia Attitude Scale (EAS) and Daily Spiritual Experience Scale (DSES). Physicians' attitudes correlate with their specialty (p=0.037), years of service (p=0.037), as well as the number of end stage patients they cared for and died within the last 12 months (p=0.016). Oncologists and other physicians with similar specialty, those with longer clinical experience and those who treat more end-stage patients to strongly oppose to the above practices. Spirituality, estimated with Daily Spiritual Experience Scale -DSES, is correlated with a negative attitude toward euthanasia (p<0.001). Finally, a considerable gap in physicians' training regarding the management of end stage patients has been highlighted. Physicians are opposed to euthanasia and they require the acquisition of competencies in end-of-life care in order to fulfill their profession's current and future demands in the domain of palliative care.

Prevalence of dementia or of milder form of cognitive impairment is increasing and a pharmaceutical treatment remains pending. These facts underline the need of identifying modifiable factors and targeted interventions that could reduce the incidence or control disease progression. Physical activity (PA) has been shown to have a beneficial effect on cognitive function, however findings to date remain controversial. The aim of this systematic review is to summarize the most recent data from clinical studies investigating the relationship between cognitive impairment and PA in adults older than 60 years of age. For this purpose, PubMed, Scopus and Google Scholar, search was conducted, and a total of thirty-five studies were selected to review. Eleven studies investigated the effect of PA on individuals without cognitive impairment and seven of them presented some significant improvement, mostly on specific cognitive domains and only one in global cognition. Fourteen studies included populations with mild cognitive impairment (MCI) and twelve of them reported significant improvements in cognitive function. The majority of them presented a beneficial effect on global cognition and executive function. Finally, nine studies investigated interventions on populations with a diagnosis of dementia and only four of them showed any cognitive benefit following their interventions. There was no consistent observed association of a specific type of exercise and greater improvement or improvement in certain domains of cognition nor was there a minimum duration of intervention required for the improvements to take effect. In conclusion, the majority of the latest published literature suggests a protective role of PA on cognitive function. People with MCI seem to benefit the most from PA interventions, benefits in people with normal cognition are more subtle and harder to detect, while findings from studies in people with dementia remain contradictory. As findings are not currently in total agreement, further long-term prospective intervention studies are required in order to elucidate the reasons of this heterogeneity.

We briefly present a case series of six patients hospitalized in the Department of Psychiatry, University General Hospital of Ioannina, between the first (starting March 23, 2020) and the second (starting November 7, 2020) lockdown in Greece who presented with COVID-19 - related delusional ideas. All patients had negative PCR prior to admission and no history of COVID-19 infection.The first three of our cases were admitted during the first lockdown, between March 23 and May 4, one involuntary and the other two voluntary. The first one was diagnosed with acute and transient psychosis (F23 - First Episode Psychosis) and the other two with psychotic depression (F32.3). Three additional patients were admitted voluntary after the end of the first lockdown. One was diagnosed with acute and transient psychosis (F23-First Episode Psychosis) and the other two were relapses of a known psychiatric disorder (Bipolar disorder F31.5 and Psychotic depression F32.3). At follow-up six months after discharge all patients were in remission following antipsychotic medication, among other medicines. These cases reveal that COVID-19 pandemic may have an impact on the delusional content of new or preexisting psychotic disorders during the COVID-19 pandemic.

Theophrastus (381-278 B.C.), was the first to adopt the term character for the description of distinct inner psychological and moral features of an individual. In his classic book 'Characters' in a simple style wording he analyses some of his contemporary individuals. The character "Αναίσθητος" (Anaisthetos) has been translated in English as "The Obtuse Man" and in Modern Greek both as "Αναίσθητος", meaning lack of appreciation and "Βραδύνους", meaning slowness of mind. Theophrastus' description of this particular character is compatible with the co-occurrence in an adult of two Neurodevelopmental Disorders: the Attention-Deficit Hyperactivity Disorder (ADHD) and the Social Pragmatic Communication Disorder (SPCD), according to the 5th Diagnostic and Statistical Manual of Mental Disorders. Ten out of the twelve statements support the possible occurrence of ADHD while five of them the occurrence of SPCD. The description does not justify a diagnosis of an intellectual disability; therefore, we consider that in the Modern Greek vocabulary the original term «Αναίσθητος» ("Anaisthetos"), meaning lack of appreciation, is more accurately corresponding to this particular Theophrastus's character than "Βραδύνους" ("Obtuse"), which indicates the presence of low intellectual capacities. Also the lack of repetitive and restrictive interests and behaviours excludes Autism Spectrum Disorder as a possible diagnosis. Minor psychiatric disorders and traits according to the Peripatic School were attributed to the lack of rational control over appetites and behavior. Accordingly, «Αναίσθητος» is a phenomenological description of a stigmatizing inappropriate social behavior and the only help that might give is in increasing self-awareness. In our contemporary clinical practice, though, the early recognition and appropriate treatment of Neurodevelopmental Disorders in affected individuals, leads to a better clinical care and may diminish stigmatization. The co-existence of these two disorders in a character in such a different historical context reinforces their validity as diagnostic constructs and provides an example of co-occurrence of Neurodevelopmental Disorders.

The COVID-19 outbreak has been accompanied by a massive infodemic: an overabundance of information, some accurate and some not. At this pandemic we have seen a large scale of fake news and misinformation, leading to anti-vaccine, anti-mask, and anti-5G protests.1 Fake news is intentionally misleading and deceptive news that is written and published with the intent to damage an entity or a person. They may contain false, misleading, imposter, manipulated or fabricated content. Much of the discourse on fake news conflates three notions, named "information disorders": (a) Misinformation: false information someone shares without knowing it's untrue, (b) Disinformation: false information that's shared with the intention to harm or mislead, and (c) Malinformation: true information that's used to harm others.2 False beliefs generally arise through the same mechanisms that establish accurate beliefs. People appear to encode all new information as if it were true and later tag the information as being either true or false. Different cognitive, social and affective factors lead people to form or endorse misinformed views. The emotional content of the information shared also affects false-belief formation. An angry mood can boost misinformation sharing, while social exclusion, which is likely to induce a negative mood, can increase susceptibility to conspiratorial content.3 As shown by the Illusory Truth Effect, repeated exposure to an article, whether real or fake, increases people's perceptions of its accuracy. In social media, falsehood seems to diffuse significantly farther, faster, deeper, and more broadly than the truth in all categories of information, and the effects are more pronounced for false political news than for false news about terrorism, natural disasters, and science. Moreover, although prior knowledge of a statement leads people to confirm the statement the next time, they see it (confirmation bias), novelty facilitates decision making since it updates our understanding of the world.4 The fitness value of accurate information seems so obvious, while self-deception seems to threaten such hard-won informational gains. Then, why has not it selected out? The American evolutionary biologist and sociobiologist Robert Trivers5 suggested that although our senses have evolved to give us an exquisitely detailed perception of the outside world, as soon as that information hits our brains, it often becomes biased and distorted, usually without conscious effort. Why should this be so? For Trivers, the evolutionary origins of the human propensity for self-deception lie in the adaptive benefits of deceiving others. An animal becomes a better liar when it believes its own lies, or we deceive ourselves the better to deceive others. Deception in animals is the transmission of misinformation by one animal to another, and natural selection favors deceptive signaling when aggression either confers a great benefit to signalers or imposes a great cost to