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Koukouriki E, Athanasopoulou E, Andreoulakis E. Feelings of Loneliness and Social Dissatisfaction in Siblings of Children with Autism Spectrum Disorders: The Role of Birth Order and Perceived Social Support. J Autism Dev Disord 2021; 52:4722-4738. [PMID: 34741232 DOI: 10.1007/s10803-021-05308-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/24/2021] [Indexed: 11/29/2022]
Abstract
Loneliness has been associated with several adverse psychosocial outcomes in childhood and adolescence. The present study aimed to investigate feelings of loneliness and social dissatisfaction in school-aged typically-developing (TD) siblings of children with an autism spectrum disorder (ASD). For this purpose, 118 siblings of children with ASD and 115 siblings of TD children and one of their parents participated in this study. Siblings of ASD-children reported higher levels of loneliness and social dissatisfaction than the controls. The hierarchical multiple regressions performed revealed that those feelings were inversely associated with being the first-born and with specific aspects of social support as perceived by the parent. The younger siblings of ASD-children seem to be in need of certain interventions beyond social support.
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Affiliation(s)
- Evangelia Koukouriki
- Special Education Laboratory, Department of Primary Education, University of Ioannina, Ioannina, Greece. .,Centre for Educational and Counseling Services of Trikala, 2 Botsari str, 42132, Trikala, Greece.
| | - Evangelini Athanasopoulou
- Community Centre for Mental Health of Children and Adolescents, Department of Child and Adolescent Psychiatry, General Hospital of Thessaloniki "G. Papanikolaou", 57010, Thessaloníki, Greece
| | - Elias Andreoulakis
- Adult Psychiatric Unit, Department of Thessaloniki, Hellenic Centre for Mental Health and Research, Thessaloníki, Greece
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Sdravou K, Emmanouilidou-Fotoulaki E, Printza A, Andreoulakis E, Beropouli S, Makris G, Fotoulaki M. Factors Associated with Feeding Problems in Young Children with Gastrointestinal Diseases. Healthcare (Basel) 2021; 9:healthcare9060741. [PMID: 34204179 PMCID: PMC8234215 DOI: 10.3390/healthcare9060741] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Revised: 06/10/2021] [Accepted: 06/11/2021] [Indexed: 11/26/2022] Open
Abstract
Feeding problems are associated with the consumption of a limited amount or restricted variety of foods and often occur in children with gastrointestinal diseases. The majority of studies to date do not use valid and reliable measurements to detect feeding problems. The aim of this cross-sectional study was to assess behavioral and skill-based feeding problems in young children with gastrointestinal diseases by using a well-established parent-reported feeding measure and identify demographic, anthropometric, and environmental factors associated with maladaptive feeding behaviors in this pediatric population. Parents completed the Greek version of the Behavioral Pediatrics Feeding Assessment Scale (BPFAS) and self-reported questionnaires assessing mealtime environment and parental feeding practices. It was found that 18.6% of the sample had abnormal Total Frequency Score (TFS) (frequency of problematic feeding behaviors) and 39.5% had abnormal Total Problem Score (TPS) (number of behaviors perceived as problematic by parents). Younger children, with lower body mass index, lower birth weight, and only children were more likely to have feeding problems. The study showed that parent-reported feeding problems are increased in young children with gastrointestinal diseases and are associated with specific aspects of mealtime environment and parental feeding practices.
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Affiliation(s)
- Katerina Sdravou
- 4th Department of Pediatrics, School of Medicine, Aristotle University of Thessaloniki, General “Papageorgiou” Hospital, 56403 Thessaloniki, Greece; (E.E.-F.); (M.F.)
- Correspondence:
| | - Elpida Emmanouilidou-Fotoulaki
- 4th Department of Pediatrics, School of Medicine, Aristotle University of Thessaloniki, General “Papageorgiou” Hospital, 56403 Thessaloniki, Greece; (E.E.-F.); (M.F.)
| | - Athanasia Printza
- 1st Otolaryngology Department, School of Medicine, University Hospital AHEPA, Aristotle University of Thessaloniki, 54636 Thessaloniki, Greece;
| | - Elias Andreoulakis
- Hellenic Centre for Mental Health and Research, Department of Thessaloniki, Adult Psychiatric Unit, 36 Kaftatzoglou Str, 55337 Thessaloniki, Greece;
| | - Stavroula Beropouli
- Department of Pediatrics, General Hospital of Kozani (Mamatseio), 1 K. Mamatsiou, 50100 Kozani, Greece;
| | - Giorgos Makris
- Department of Speech and Language Therapy, School of Health Sciences, University of Peloponnese, 2400 Kalamata, Greece;
| | - Maria Fotoulaki
- 4th Department of Pediatrics, School of Medicine, Aristotle University of Thessaloniki, General “Papageorgiou” Hospital, 56403 Thessaloniki, Greece; (E.E.-F.); (M.F.)
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Sdravou K, Fotoulaki M, Emmanouilidou-Fotoulaki E, Andreoulakis E, Makris G, Sotiriadou F, Printza A. Feeding Problems in Typically Developing Young Children, a Population-Based Study. Children (Basel) 2021; 8:children8050388. [PMID: 34068336 PMCID: PMC8153308 DOI: 10.3390/children8050388] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/14/2021] [Revised: 05/11/2021] [Accepted: 05/11/2021] [Indexed: 12/16/2022]
Abstract
Feeding problems have been estimated to occur in approximately 25–45% of normally developing children. The aim of this study was to investigate the prevalence of feeding problems in typically developing young children in Greece. Child feeding behavior, parents’ feelings about their child’s feeding patterns, and parental feeding practices were also explored. Parents completed the Greek version of the Behavioral Pediatrics Feeding Assessment Scale (BPFAS). Data on 742 healthy, typically developing children aged two to seven years are presented. Overall, the majority of children in the sample showed high frequency of desirable mealtime behaviors and low frequency of undesirable mealtime behaviors. However, a significant proportion of the cohort presented with food neophobia and low consumption of vegetables. When applying test cut-off scores, it was found that 8.2% of the sample had abnormal Total Frequency Score (TFS) and 26.6% had abnormal Total Problem Score (TPS). The study showed that parent-reported feeding problems are quite common in children of typical development in Greece. Moreover, while the majority of the sample displayed a high frequency of favorable behaviors, specific child feeding behaviors are amenable to improvement.
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Affiliation(s)
- Katerina Sdravou
- 4th Department of Pediatrics, School of Medicine, Aristotle University of Thessaloniki, General “Papageorgiou” Hospital, 56403 Thessaloniki, Greece; (K.S.); (M.F.); (E.E.-F.); (F.S.)
| | - Maria Fotoulaki
- 4th Department of Pediatrics, School of Medicine, Aristotle University of Thessaloniki, General “Papageorgiou” Hospital, 56403 Thessaloniki, Greece; (K.S.); (M.F.); (E.E.-F.); (F.S.)
| | - Elpida Emmanouilidou-Fotoulaki
- 4th Department of Pediatrics, School of Medicine, Aristotle University of Thessaloniki, General “Papageorgiou” Hospital, 56403 Thessaloniki, Greece; (K.S.); (M.F.); (E.E.-F.); (F.S.)
| | - Elias Andreoulakis
- Adult Psychiatric Unit, Hellenic Centre for Mental Health and Research, Department of Thessaloniki, 36 Kaftatzoglou Str., 55337 Thessaloniki, Greece;
| | - Giorgos Makris
- Department of Speech and Language Therapy, School of Health Sciences, University of Peloponnese, 2400 Kalamata, Greece;
| | - Fotini Sotiriadou
- 4th Department of Pediatrics, School of Medicine, Aristotle University of Thessaloniki, General “Papageorgiou” Hospital, 56403 Thessaloniki, Greece; (K.S.); (M.F.); (E.E.-F.); (F.S.)
| | - Athanasia Printza
- 1st Otolaryngology Department, School of Medicine, Aristotle University of Thessaloniki, University Hospital AHEPA, 54636 Thessaloniki, Greece
- Correspondence:
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Sdravou K, Emmanouilidou-Fotoulaki E, Printza A, Andreoulakis E, Evangeliou A, Fotoulaki M. Mealtime Environment and Control of Food Intake in Healthy Children and in Children with Gastrointestinal Diseases. Children (Basel) 2021; 8:children8020077. [PMID: 33498758 PMCID: PMC7912501 DOI: 10.3390/children8020077] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/29/2020] [Revised: 01/14/2021] [Accepted: 01/20/2021] [Indexed: 12/15/2022]
Abstract
Parental feeding practices and mealtime routine significantly influence a child’s eating behavior. The aim of this study was to investigate the mealtime environment in healthy children and children with gastrointestinal diseases. We conducted a cross-sectional case–control study among 787 healthy, typically developing children and 141 children with gastrointestinal diseases, aged two to seven years. Parents were asked to provide data on demographics and describe their mealtime environment by answering to 24 closed-ended questions. It was found that the majority of the children had the same number of meals every day and at the same hour. Parents of both groups exerted considerable control on the child’s food intake by deciding both when and what their child eats. Almost one third of the parents also decided how much their child eats. The two groups differed significantly in nine of the 24 questions. The study showed that both groups provided structured and consistent mealtime environments. However, a significant proportion of children did not control how much they eat which might impede their ability to self-regulate eating. The presence of a gastrointestinal disease was found to be associated with reduced child autonomy, hampered hunger cues and frequent use of distractions during meals.
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Affiliation(s)
- Katerina Sdravou
- 4th Department of Pediatrics, School of Medicine, Aristotle University of Thessaloniki, General “Papageorgiou” Hospital, 56403 Thessaloniki, Greece; (E.E.-F.); (A.E.); (M.F.)
- Correspondence:
| | - Elpida Emmanouilidou-Fotoulaki
- 4th Department of Pediatrics, School of Medicine, Aristotle University of Thessaloniki, General “Papageorgiou” Hospital, 56403 Thessaloniki, Greece; (E.E.-F.); (A.E.); (M.F.)
| | - Athanasia Printza
- 1st E.N.T. Department, School of Medicine, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece;
| | - Elias Andreoulakis
- Hellenic Centre for Mental Health and Research, Adult Psychiatric Unit, Department of Thessaloniki, 55337 Thessaloniki, Greece;
| | - Athanasios Evangeliou
- 4th Department of Pediatrics, School of Medicine, Aristotle University of Thessaloniki, General “Papageorgiou” Hospital, 56403 Thessaloniki, Greece; (E.E.-F.); (A.E.); (M.F.)
| | - Maria Fotoulaki
- 4th Department of Pediatrics, School of Medicine, Aristotle University of Thessaloniki, General “Papageorgiou” Hospital, 56403 Thessaloniki, Greece; (E.E.-F.); (A.E.); (M.F.)
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Koukouriki E, Soulis SG, Andreoulakis E. Depressive symptoms of autism spectrum disorder children's siblings in Greece: Associations with parental anxiety and social support. Autism 2020; 25:529-544. [PMID: 33086862 DOI: 10.1177/1362361320966847] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
LAY ABSTRACT Typically developing siblings of children with autism spectrum disorders are often found to exhibit elevated levels of stress and depressive symptoms compared to siblings of typically developing children or siblings of children with other disabilities. Besides the behavioral problems of the child with autism and certain demographic characteristics that have been recognized as factors associated with typically developing siblings' psychological distress, the role of parental mental health and the social support from the family has not been studied sufficiently. The goal of this study is to assess depressive symptoms in 85 Greek school-aged typically developing siblings of children with autism and to investigate for any associations between siblings' depressive symptoms on one hand and demographics, parental mental health, and perceived social support on the other hand. It was found that typically developing siblings had higher levels of depressive symptoms compared to children from a general population sample. In addition, parental anxiety and social support from the family as perceived by the parents themselves were identified as independently associated with typically developing siblings' depressive symptoms. Of note, perceived social support failed to attenuate the association between parental anxiety and siblings' depressive symptoms. These results highlight the importance of assessing both parental and typically developing siblings' psychological state to implement interventions addressed to the needs of all family members.
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Affiliation(s)
- Evangelia Koukouriki
- University of Ioannina, Greece.,Hellenic Ministry of Education and Religious Affairs, Greece
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Sdravou K, Printza A, Andreoulakis E, Sotiriadou F, Evangeliou A, Fotoulaki M. Parental feeding practices data in healthy children and children with gastrointestinal diseases. Data Brief 2020; 31:106036. [PMID: 32728605 PMCID: PMC7381492 DOI: 10.1016/j.dib.2020.106036] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2020] [Revised: 07/12/2020] [Accepted: 07/13/2020] [Indexed: 01/15/2023] Open
Abstract
Parental feeding practices significantly influence child eating behavior. The data for this article was from a cross-sectional case control larger study that aimed to record parental practices to manage feeding problems in children with typical development and children with gastrointestinal diseases. A set of 23 Likert-type questions was used to investigate parental practices. Demographic and anthropometric data were obtained via a structured set of questions. In total 765 parents of healthy children and 136 parents of children with gastrointestinal diseases aged one to seven years participated in the study. Healthy controls were recruited from kindergartens located in various geographical areas in Greece. Children with gastrointestinal diseases were recruited from a Pediatric Gastroenterology Outpatient Clinic. Descriptive measures (i.e. frequencies, percentages, means and standard deviations) alongside with statistical analysis measures are presented in this article. Chi-square tests and U-tests were performed for the purpose of the comparison between the two groups. Spearman's rho correlation coefficient was also calculated for inter-item correlations among the 23-items of the questionnaire.
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Affiliation(s)
- Katerina Sdravou
- 4th Department of Pediatrics, School of Medicine, Aristotle University of Thessaloniki, Ring Road, N. Eukarpia, Thessaloniki, Greece
| | - Athanasia Printza
- 1st Otolaryngology Department, School of Medicine, Aristotle University of Thessaloniki, Greece
| | - Elias Andreoulakis
- Department of Thessaloniki, Adult Psychiatric Unit, Hellenic Centre for Mental Health and Research, Greece
| | - Fotini Sotiriadou
- 4th Department of Pediatrics, School of Medicine, Aristotle University of Thessaloniki, Ring Road, N. Eukarpia, Thessaloniki, Greece
| | - Athanasios Evangeliou
- 4th Department of Pediatrics, School of Medicine, Aristotle University of Thessaloniki, Ring Road, N. Eukarpia, Thessaloniki, Greece
| | - Maria Fotoulaki
- 4th Department of Pediatrics, School of Medicine, Aristotle University of Thessaloniki, Ring Road, N. Eukarpia, Thessaloniki, Greece
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Paika V, Andreoulakis E, Ntountoulaki E, Papaioannou D, Kotsis K, Siafaka V, Fountoulakis KN, Pargament KI, Carvalho AF, Hyphantis T. The Greek-Orthodox version of the Brief Religious Coping (B-RCOPE) instrument: psychometric properties in three samples and associations with mental disorders, suicidality, illness perceptions, and quality of life. Ann Gen Psychiatry 2017; 16:13. [PMID: 28239407 PMCID: PMC5314716 DOI: 10.1186/s12991-017-0136-4] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2016] [Accepted: 02/11/2017] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND The B-RCOPE is a brief measure assessing religious coping. We aimed to assess the psychometric properties of its Greek version in people with and without long-term conditions (LTCs). Associations between religious coping and mental illness, suicidality, illness perceptions, and quality of life were also investigated. METHODS The B-RCOPE was administered to 351 patients with diabetes, chronic pulmonary obstructive disease (COPD), and rheumatic diseases attending either the emergency department (N = 74) or specialty clinics (N = 302) and 127 people without LTCs. Diagnosis of mental disorders was established by the MINI. Associations with depressive symptom severity (PHQ-9), suicidal risk (RASS), illness perceptions (B-IPQ), and health-related quality of life (WHOQOL-BREF) were also investigated. RESULTS The Greek version of B-RCOPE showed a coherent two-dimensional factor structure with remarkable stability across the three samples corresponding to the positive (PRC) and negative (NRC) religious coping dimensions. Cronbach's alphas were 0.91-0.96 and 0.77-0.92 for the PRC and NRC dimensions, respectively. Furthermore, NRC was associated with poorer mental health, greater depressive symptom severity and suicidality, and impaired HRQoL. In patients with LTCs, PRC correlated with lower perceived illness timeline, while NRC was associated with greater perceived illness consequences, lower perceived treatment control, greater illness concern, and lower illness comprehensibility. CONCLUSIONS These findings indicate that the Greek-Orthodox B-RCOPE version may reliably assess religious coping. In addition, negative religious coping (i.e., religious struggle) is associated with adverse illness perceptions, and thus may detrimentally impact adaptation to medical illness. These findings deserve replication in prospective studies.
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Affiliation(s)
- Vassiliki Paika
- Department of Psychiatry, Faculty of Medicine, School of Health Sciences, University of Ioannina, 45110 Ioannina, Greece
| | - Elias Andreoulakis
- Third Department of Psychiatry, School of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Elisavet Ntountoulaki
- Department of Psychiatry, Faculty of Medicine, School of Health Sciences, University of Ioannina, 45110 Ioannina, Greece
| | - Dimitra Papaioannou
- Department of Psychiatry, Faculty of Medicine, School of Health Sciences, University of Ioannina, 45110 Ioannina, Greece
| | - Konstantinos Kotsis
- Department of Psychiatry, Faculty of Medicine, School of Health Sciences, University of Ioannina, 45110 Ioannina, Greece
| | - Vassiliki Siafaka
- Department of Speech and Language Therapy, Technological Educational Institute of Epirus, Ioannina, Greece
| | - Konstantinos N Fountoulakis
- Third Department of Psychiatry, School of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Kenneth I Pargament
- Department of Psychology, Bowling Green State University, Bowling Green, OH USA
| | - Andre F Carvalho
- Department of Clinical Medicine and Translational Psychiatry Research Group, Faculty of Medicine, Federal University of Ceará, Fortaleza, CE Brazil
| | - Thomas Hyphantis
- Department of Psychiatry, Faculty of Medicine, School of Health Sciences, University of Ioannina, 45110 Ioannina, Greece
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Hyphantis T, Goulia P, Zerdes I, Solomou S, Andreoulakis E, Carvalho AF, Pavlidis N. Sense of Coherence and Defense Style Predict Sleep Difficulties in Early Non-metastatic Colorectal Cancer. Dig Dis Sci 2016; 61:273-82. [PMID: 26289259 DOI: 10.1007/s10620-015-3843-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2015] [Accepted: 08/02/2015] [Indexed: 12/09/2022]
Abstract
BACKGROUND Sleep disturbances are common in cancer patients, but little is known about the complex interplay between the background psychological profile, coping with health stressors capacities and psychological distress in the formation of sleep difficulties in colorectal cancer. AIMS To study the course and to identify psychological predictors of sleep difficulties in early non-metastatic colorectal cancer patients over a one-year period. METHODS In this 1-year prospective study, we assessed in 84 early non-metastatic colorectal cancer patients the association of psychological distress (SCL-90-R), sense of coherence (SOC-29), and defense styles (Defense Style Questionnaire) with sleep difficulties (SCL-90-R) in multiple regression models. Eighty-two patients with breast cancer and 50 patients with cancer of unknown primary site served as disease controls, and 84 matched for age and sex alleged healthy individuals served as healthy controls. RESULTS Colorectal cancer patients presented more sleep difficulties compared to healthy participants but fewer than patients with breast cancer and cancer of unknown primary site. Colorectal cancer patients' trouble falling asleep (p = 0.033) and wakening up early in the morning (p < 0.001) deteriorated over time. Sleep that was restless or disturbed was independently associated with low SOC (p = 0.046) and maladaptive defenses (p = 0.008). Anxiety symptoms (p < 0.001) predicted deterioration in trouble falling asleep, while depressive symptoms (p = 0.022) and self-sacrificing defense style (p = 0.049) predicted deterioration in wakening up early in the morning. CONCLUSIONS Psychological parameters and coping with health stressors capacities are independently associated with sleep difficulties in colorectal cancer patients, indicating the need for psychological interventions aiming at improving adjustment to the disease.
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Affiliation(s)
- Thomas Hyphantis
- Department of Psychiatry, Faculty of Medicine, School of Health Sciences, University of Ioannina, Ioannina, 45110, Greece.
| | - Panagiota Goulia
- Department of Psychiatry, Faculty of Medicine, School of Health Sciences, University of Ioannina, Ioannina, 45110, Greece
| | - Ioannis Zerdes
- Department of Psychiatry, Faculty of Medicine, School of Health Sciences, University of Ioannina, Ioannina, 45110, Greece
| | - Solomis Solomou
- Department of Psychiatry, Faculty of Medicine, School of Health Sciences, University of Ioannina, Ioannina, 45110, Greece
| | - Elias Andreoulakis
- 3rd Department of Psychiatry, Aristotle University of Thessaloniki, University Campus, Thessaloniki, 54124, Greece
| | - André F Carvalho
- Department of Clinical Medicine, Faculty of Medicine, Federal University of Ceará, Fortaleza, CE, Brazil
| | - Nicholas Pavlidis
- Department of Medical Oncology, Faculty of Medicine, School of Health Sciences, University of Ioannina, Ioannina, 45110, Greece
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Freitas TH, Hyphantis TN, Andreoulakis E, Quevedo J, Miranda HL, Alves GS, Souza MH, Braga LL, Pargament KI, Soczynska JK, McIntyre RS, Carvalho AF. Religious coping and its influence on psychological distress, medication adherence, and quality of life in inflammatory bowel disease. Braz J Psychiatry 2015; 37:219-27. [DOI: 10.1590/1516-4446-2014-1507] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Affiliation(s)
| | | | | | - João Quevedo
- The University of Texas Medical School at Houston, USA; Universidade do Extremo Sul Catarinense, Brazil
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Freitas TH, Andreoulakis E, Alves GS, Miranda HLL, Braga LLBC, Hyphantis T, Carvalho AF. Associations of sense of coherence with psychological distress and quality of life in inflammatory bowel disease. World J Gastroenterol 2015; 21:6713-6727. [PMID: 26074710 PMCID: PMC4458782 DOI: 10.3748/wjg.v21.i21.6713] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/28/2014] [Revised: 01/12/2015] [Accepted: 02/05/2015] [Indexed: 02/06/2023] Open
Abstract
AIM: To investigate the relationship between sense of coherence, psychological distress and health related quality of life in inflammatory bowel disease (IBD).
METHODS: This cross-sectional study enrolled a consecutive sample of 147 IBD (aged 45.1 ± 14.1 years; 57.1% female) patients recruited from a tertiary gastroenterology service. Sixty-four participants met diagnostic criteria for Crohn’s disease, while eighty-three patients had ulcerative colitis. Socio-demographic data (education, age, race, gender, gross monthly income and marital status), disease-related variables (illness activity, relapse rate in past 2 years, history of surgery and time since diagnosis), sense of coherence (Antonovsky’s SOC scale), psychological distress symptoms (Hospital Anxiety and Depression Scale) and health-related quality of life (HRQoL; WHOQOL-Bref) were assessed. Hierarchical multiple regression analyses were performed to identify factors that are independently associated with psychological distress and HRQoL in patients with IBD and to provide indications for possible moderating or mediating effects. In addition, formal moderation and mediation analyses (Sobel tests) were performed to confirm potential moderators/mediators of the relationship between SOC, psychological distress symptoms and HRQoL.
RESULTS: Lower SOC scores (std beta= -0.504; P < 0.001), female gender (std beta = 0.176; P = 0.021) and White race (std beta = 0.164; P = 0.033) were independently associated with higher levels of depressive symptoms, while lower levels of SOC (std beta = -0.438; P < 0.001) and higher relapse rate (std beta = 0.161; P = 0.033) were independently associated with more severe anxiety symptoms. A significant interaction between time since diagnosis and SOC was found with regard to the severity of depressive or anxiety symptoms, as the interaction term (time since diagnosis X SOC) had beta coefficients of -0.191 (P = 0.009) and -0.172 (P = 0.026), respectively. Lower levels of anxiety symptoms (std beta = -0.369; P < 0.001), higher levels of SOC (std beta = 0.231; P = 0.016) and non-White race (std beta = -0.229; P = 0.006), i.e., mixed-race, which represented the reference category, were independently associated with higher levels of overall HRQoL. Anxiety symptoms were the most potent independent correlate of most aspects of HRQoL. In addition, anxiety mediated the association between SOC and satisfaction with health, as well as its relationship with physical, mental, and social relations HRQoL. Depressive symptoms also mediated the association between SOC and mental HRQoL.
CONCLUSION: Our data indicated that SOC is an important construct, as it influences psychological distress and has significant albeit indirect effects on several HRQoL domains in IBD.
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Goulia P, Voulgari PV, Tsifetaki N, Andreoulakis E, Drosos AA, Carvalho AF, Hyphantis T. Sense of coherence and self-sacrificing defense style as predictors of psychological distress and quality of life in rheumatoid arthritis: a 5-year prospective study. Rheumatol Int 2014; 35:691-700. [PMID: 25240430 DOI: 10.1007/s00296-014-3134-8] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2014] [Accepted: 09/11/2014] [Indexed: 12/26/2022]
Abstract
Individual differences in adjustment during a disease's course determine psychological response and outcome. This study aimed to investigate prospectively whether coping with health stressors and self-sacrificing defense style could predict psychological adjustment and health-related quality of life (HRQoL) in patients with rheumatoid arthritis (RA). Seventy-four consecutive RA patients attending a rheumatology clinic were assessed for psychological distress (SCL-90-R), sense of coherence (SOC scale), self-sacrificing defense style (Defense Style Questionnaire-88), disease activity (DAS-28), pain, disability (Health Assessment Questionnaire) and HRQoL (World Health Organization Quality of Life Instrument, Short Form) at baseline and 5 years later. Multiple regression and moderator analyses were carried out. The results showed that disease activity (p < .001), pain (p = .005), psychological distress (p = .031), social relations HRQoL (p = .042) and environment HRQoL (p = .020) significantly improved over time. SOC was found an independent predictor of improvement in psychological distress (p = .003), overall general health (p = .002) and social relations HRQoL (p = .004); self-sacrificing independently predicted environment HRQoL (p = .042). The self-sacrificing defense style moderated the relationships between improvement in pain and improvement in overall general health (p = .024) and between improvement in pain and improvement in social relations HRQoL (p = .006). These findings indicate that, in RA, SOC predicts improvement in psychological distress and HRQoL over time, while a self-sacrificing defense style moderates the relationship of pain with HRQoL in the long term. These variables may partly explain inter-individual differences in adaptation to RA. Therefore, the design of psychotherapeutic trials targeting the patients' defensive profiles and coping with health stressors capacities is an important research perspective.
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Affiliation(s)
- Panagiota Goulia
- Faculty of Medicine, Department of Psychiatry, Medical School, School of Health Sciences, University of Ioannina, 45110, Ioannina, Greece
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12
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Andreoulakis E, Nimatoudis I, Ierodiakonou-Benou I, Iacovides A. Psychiatric symptoms accompanying multiple sclerosis onset: a case report. J Neuropsychiatry Clin Neurosci 2014; 26:E06-9. [PMID: 24763769 DOI: 10.1176/appi.neuropsych.13030055] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Fountoulakis KN, Gonda X, Andreoulakis E, Fokas K, Iacovides A. No differences between drug naive and drug experienced unipolar depressed patients in terms of neurobiological testing: a cross sectional study. J Psychiatr Res 2013; 47:1984-90. [PMID: 24074518 DOI: 10.1016/j.jpsychires.2013.09.004] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/25/2013] [Revised: 08/20/2013] [Accepted: 09/09/2013] [Indexed: 11/18/2022]
Abstract
Successful antidepressant treatment has been associated with concomitant changes in brain function, consolidated as long as treatment is continued and remission is preserved. The present study aimed at assessing the impact of prior antidepressant treatment on brain function in currently depressed but unmedicated individuals by investigating for any differences between antidepressant-naïve vs. antidepressant-experienced subjects. Fifty right-handed patients (22 medication-naïve vs. 28 medication-experienced), suffering from major depression participated in the study. They all underwent a standardised clinical interview and psychometric assessment combined with neurobiological tests (brain SPECT, Dexamethasone Suppression Test, Dexfenfluramine Challenge Test, electro-oculogram, flash-electroretinogram and flash-visual evoked potentials and pattern-reversal visual evoked potentials). No significant differences between medication-naïve and medication-experienced depressed subjects were found in terms of the neurobiological markers assessed, after controlling for age, sex, age at onset, number of depressive episodes, depression subtype (melancholic, atypical or undifferentiated) and severity of current episode. Unmedicated currently depressed patients, no matter their previous exposure to antidepressants, show similar changes in brain function. This does not necessarily mean that antidepressants do not have a long term effect on brain physiology, since not all patients relapse. However, it seems that those patients who relapse after stopping medication, seem to 'regress' to an 'as if never medicated' state, with regard to brain function. These findings might suggest that continuous maintenance treatment with antidepressants is essential for patients at high risk to relapse. Alternatively, they might suggest that our methodology assesses only a shallow and mainly state part of the pathophysiology of depression.
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Affiliation(s)
- Konstantinos N Fountoulakis
- 3rd Department of Psychiatry, Medical School, Aristotle University of Thessaloniki, 1st Parodos Ampelonon Street, 55535 Pylaia, Thessaloniki, Greece.
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14
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Fountoulakis KN, Andreoulakis E, Iacovides A. Possible polyneuritis cranialis in a psychotic patient: diagnostic and therapeutic dilemmas. J Neuropsychiatry Clin Neurosci 2013; 24:E26-7. [PMID: 23224471 DOI: 10.1176/appi.neuropsych.11100250] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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15
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Andreoulakis E, Hyphantis T, Kandylis D, Iacovides A. Depression in diabetes mellitus: a comprehensive review. Hippokratia 2012; 16:205-214. [PMID: 23935284 PMCID: PMC3738724] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
Although the prevalence of a mental disorder, in general, in patients with diabetes mellitus is regarded to be comparable to the general population, an increased prevalence of depressive disorders, often comorbid with anxiety, has been reported in patients with diabetes mellitus. The co-occurrence of depression in diabetes is attributed to a variety of factors, including the psychological and psychosocial impact of the disease, a potential common genetic susceptibility and common pathophysiological abnormalities involving neuroimmunological and neuroendocrinical pathways, as well as microvascular brain lesions due to diabetes mellitus. However, issues concerning pathogenesis and causality of this high co-occurrence are not fully determined yet. Still, the presence of depression in patients with diabetes mellitus is of vast importance, as it is usually associated with poor disease control, adverse health outcomes and quality of life impairment. This article aims to provide a comprehensive review of epidemiological findings, clinical considerations and management strategies concerning depression in patients with diabetes mellitus.
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Affiliation(s)
- E Andreoulakis
- 3 Department of Psychiatry, Aristotle University of Thessaloniki, Thessaloniki, Greece
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