Psychiatrike = Psychiatriki最新文献

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

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.