Psychiatrike = Psychiatriki最新文献

In this work 112 studies were reviewed and 21 of them were considered as more reliable and more credible. It is well known that Cognitive-Behavioural Therapy (CBT) is the most valid approach regarding its effectiveness. There are many variations of CBT used in patients with tinnitus, but the most effective appears to be the Cognitive-Behavioural Acceptance and Commitment Therapy. Also, treatment-variations consist in the use of hearing aids, and psycho-education. The Acceptance and Commitment Therapy is a third-generation psychological intervention invented by Steven Hayes in 1986. This therapy also applies to the treatment of many psychological problems, such as depression, anxiety, psychoses and substance use problems, and chronic diseases. The purpose of this therapy is not to reduce symptoms, but to improve health and behaviour changes in order for the patient to accept the inevitable pain involved in his/her condition. There are other forms of therapy that come from the broader spectrum of CBT, such as book-therapy (self-help method), rehabilitation treatment of tinnitus, and the Axiological Model based solely on cognitive psychotherapy inspired by the CBT founder, Aaron Beck. Because the latter treatment is at its first steps, there is no literature yet, and it must be considered as an experimental model. It is also well known that intervention with CBT could significantly reduce the anxiety and stress caused by tinnitus. The CBT technique incorporates many elements used to treat tinnitus, such as self-assessment, applied relaxation, cognitive restructuring, behavioral activation, and positive mental imagery. Finally, it becomes apparent that the tinnitus problem, which is serious for these patients, is increasingly affecting the psychiatric and psychotherapeutic communities.

Sixty years are coming close since the first edition of the book by Goffman on social stigma, and research that connects it with mental illness has produced significant knowledge across different scientific fields, such as psychiatry and social sciences. This paper aims at providing a review of that scientific knowledge published over the last decades, and covers the following topics: a) basic theoretical concepts related to social stigma, such as public stigma, self-stigma, structural stigma and stigma by courtesy, b) representative findings of international empirical studies in regard to public attitudes towards mental illness, c) the measurement of social stigma in mental illness and the development of methodologies, such as scales and vignettes, d) the understanding of social stigma as a mechanism of producing and reproducing social inequalities in a form of symbolic power, e) the psychological and social consequences of social stigma on people' s lives-targets of social stigma, themselves and their families, and, finally, the public campaigns designed and delivered to fight social stigma. Recent advances in the theory of social stigma, as proposed by Pescosolido & Martin, conceptualize social stigma as a dialectic process enacted within a specific socio-historical context of power relations and Link & Phelan give insights of the processes through which social stigma, either implicitly or explicitly, produced and legitimated by institutional practices. International evidence drawn by public surveys on attitudes towards mental illness show that despite the overall negative attitudes, there are some positive changes that are related to people's openness and willingness to share their mental health difficulties with others and to seek professional help. Multi-dimensional and concept specific measures are most appropriate to use. Campaigns designed and delivered to fight stigma in mental illness needs to regenerate their contents and their strategy towards the recovery model communicating to the general public messages of hope and prospect.

Although the relationship of mental health with cardiovascular dysfunction is not a recent finding, scientific data has appeared approximately at the middle of the last century. Firstly, depression was studied as a risk factor for premature death in cases of cardiovascular disease (CVD). Much later, the mechanism of psychosis and schizophrenia in the development of CVD were studied, as it was observed that most premature deaths in schizophrenia were related to cardiovascular disease. This interaction is supported both by epidemiological data and by the associated mechanisms. Inflammation, oxidative and biologic stress, and hormonal and neurotransmitter disorders in coagulation, tissue perfusion, vascular dysfunction and genetic factors get involved in these mental disorders. The combination of these pathophysiological mechanisms and the general risk factors for CVD (sex, age, smoking, systolic blood pressure, body weight, glucose levels) leads, to some extent, to increased rates of comorbidity and mortality. Patients with severe mental disorders are often not monitored and do not receive appropriate treatment for cardiovascular risk factors. In studies of patients with comorbid coronary heart disease and depression, there were signs of cardiovascular dysfunction, including increased heart rate, mainly in stress, QT prolongation and ventricular arrhythmia. At the same time, there is a dose-response relationship between the severity of depression and cardiovascular risk, with the presence of even mild symptoms of untreated depression involving some cardiovascular risk. In addition, improving the symptoms of depression through medication has been associated with increased survival. Moreover, the causes of increased mortality in patients with schizophrenia are similar to those of the general population with metabolic syndrome and diabetes mellitus, while failure to receive antipsychotic medication could lead to obesity, insulin resistance, dyslipidemia and hypertension. These data could be used as a source for future anti-inflammatory therapeutic approaches, but also for the appropriate selection of therapeutic agents, by taking a more holistic view of the patient's comorbidity. The interdisciplinary collaboration and liaison - consultation psychiatry are important factors for the timely prevention, recognition and treatment of potent complications of the cardiovascular system in mentally ill patients. The aim of this review was to present the pathophysiological mechanisms of serious mental disorders, such as depression, bipolar disorder, and schizophrenia that may be related to the development of CVD.

Long-acting injectable antipsychotics (LAIs) hold an important place in the therapeutic management of patients with schizophrenia and other psychoses. They offer advantages, such as knowledge of whether patients follow the medical advice that is given, stable pharmacokinetics and better correlation between the administered dose and the plasma levels of the drug, regular follow-up and reduced risk of overdose. Knowledge of the best way to administer LAIs is important in clinical practice because it maximizes the efficacy of the drug and minimizes the side-effects. This knowledge is facilitated through understanding both the pharmacokinetics and the pharmaceutical forms of these drugs because it provides necessary information concerning their mode of action. Currently in Greece, two first-generation (haloperidol and zuclopenthixol) and four newer LAIs (risperidone, olanzapine, paliperidone and aripiprazole) are in circulation. Their pharmaceutical form facilitates the delayed delivery of the drug during a period of weeks, thus increasing the time interval needed for the drug administration in order to maintain plasma therapeutic concentrations under stable state conditions. This is achieved by creating an extravascular drug reservoir (depot) in the skeletal muscles from which the drug is slowly released into the systemic circulation. The rate of removal of LAIs is regulated by the slow rate of absorption in the site of injection and the phenomenon of their increased half-life is called flip-flop pharmacokinetics. Their rate of absorption from skeletal muscles depends on factors, such as the injection technique, the pharmaceutical form of the drug, the distribution of fat tissue and the blood supply of the muscle. First-generation LAIs are characterized chemically by an esterified drug molecule that is dissolved in oil vehicle. The esterified drug is then hydrolyzed rapidly by plasma esterases allowing the entrance of the drug into the brain. On the contrary, newer LAIs are aqueous- based formulations characterized by various pharmaceutical forms: microspheres (risperidone), pamoic acid crystal (olanzapine), nanocrystals (paliperidone), dry drug- suspension with water (aripiprazole). Among newer drugs, risperidone and aripiprazole must be administered orally concurrently with the LAI for an initial time period. Furthermore, risperidone is the only LAI administered every 2 weeks and 3-monthly paliperidone is the only one administered every 3 months. All the other LAIs (1st generation and atypical) are usually administered every 4 weeks. This paper reviews the pharmacokinetic and pharmaceutical characteristics of these drugs. It also provides information concerning basic elements of LAI pharmacokinetics in order to understand these characteristics better.

Anxiety disorders affect approximately one in six people, causing significant problems in their quality of life and that of their families with a significant percentage of mentally ill people not showing compliance with treatment or not receiving appropriate treatment. Research data therefore reveal the need to develop new and effective interventions that will improve the compliance and therapeutic management of the mentally ill. Because of the recent technological advancement, the field of electronic mental health applications (MHapps) offers unique opportunities which can contribute to self-management of mental health problems and patient compliance, as well as to development of preventive and therapeutic interventions. Mental health applications (MHapps) offer a unique opportunity for expanding availability and quality of treatment of mental health disorders, however few applications have been carefully assessed so far making their effectiveness questionable. The present study investigated the effect of MHapp FiD (Feel-Identity) on anxiety- an innovative electronic prototype application-in a sample of adults over a two-week period. Participants made daily use of the application, based on self-monitoring and self-recording in accordance with the Cognitive Behavioural Therapy protocol, with feedback interventions being fully automated. In order to investigate anxiety levels, the STAI questionnaire (State & Trait Anxiety Inventory) was administered over three different time periods: before the use of MHapp FiD, following the first week after its use, and following the second week after its use. The results between the 3 groups of application usage, showed a statistically significant decrease of the average TRAIT anxiety levels between the 1st and the 3rd administration, i.e., after two weeks of application usage, equal to -3.020 units (Mean Difference = -3.020, p-value = 0.006 <0.01), and a statistically significant drop of the average total anxiety levels, between the administration of the 2nd and the 3rd administration, i.e., over the second week of application usage, equal to -5.388 units (Mean Difference = -5.388, p-value = 0.029 <0.05). Τhere was no statistically significant difference as to the average STATE anxiety levels. The results showed a correlation between the daily use of the FiD application and the reduction of anxiety, providing a promising perspective for dissemination of the application in clinical populations with the addition of more functions and interventions.

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.