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Fountoulakis KN, Vrublevska J, Abraham S, Adorjan K, Ahmed HU, Alarcón RD, Arai K, Auwal SS, Berk M, Bjedov S, Bobes J, Bobes-Bascaran T, Bourgin-Duchesnay J, Bredicean CA, Bukelskis L, Burkadze A, Abud IIC, Castilla-Puentes R, Cetkovich M, Colon-Rivera H, Corral R, Cortez-Vergara C, Crepin P, De Berardis D, Delgado SZ, De Lucena D, De Sousa A, Di Stefano R, Dodd S, Elek LP, Elissa A, Erdelyi-Hamza B, Erzin G, Etchevers MJ, Falkai P, Farcas A, Fedotov I, Filatova V, Fountoulakis NK, Frankova I, Franza F, Frias P, Galako T, Garay CJ, Garcia-Álvarez L, García-Portilla MP, Gonda X, Gondek TM, González DM, Gould H, Grandinetti P, Grau A, Groudeva V, Hagin M, Harada T, Hasan TM, Hashim NA, Hilbig J, Hossain S, Iakimova R, Ibrahim M, Iftene F, Ignatenko Y, Irarrazaval M, Ismail Z, Ismayilova J, Jacobs A, Jakovljević M, Jakšić N, Javed A, Kafali HY, Karia S, Kazakova O, Khalifa D, Khaustova O, Koh S, Kosenko K, Koupidis SA, Lalljee A, Liewig J, Majid A, Malashonkova E, Malik K, Malik NI, Mammadzada G, Mandalia B, Marazziti D, Marčinko D, Martinez S, Matiekus E, Mejia G, Memon RS, Martínez XEM, Mickevičiūtė D, Milev R, Mohammed M, Molina-López A, Morozov P, Muhammad NS, Mustač F, Naor MS, Nassieb A, Navickas A, Okasha T, Pandova M, Panfil AL, Panteleeva L, Papava I, Patsali ME, Pavlichenko A, Pejuskovic B, Da Costa MP, Popkov M, Popovic D, Raduan NJN, Ramírez FV, Rancans E, Razali S, Rebok F, Rewekant A, Flores ENR, Rivera-Encinas MT, Saiz P, de Carmona MS, Martínez DS, Saw JA, Saygili G, Schneidereit P, Shah B, Shirasaka T, Silagadze K, Sitanggang S, Skugarevsky O, Spikina A, Mahalingappa SS, Stoyanova M, Szczegielniak A, Tamasan SC, Tavormina G, Tavormina MGM, Theodorakis PN, Tohen M, Tsapakis EM, Tukhvatullina D, Ullah I, Vaidya R, Vega-Dienstmaier JM, Vukovic O, Vysotska O, Widiasih N, Yashikhina A, Smirnova D. Non-binary gender, vulnerable populations and mental health during the COVID-19 pandemic: Data from the COVID-19 MEntal health inTernational for the general population (COMET-G) study. J Affect Disord 2024; 352:536-551. [PMID: 38382816 DOI: 10.1016/j.jad.2024.02.050] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/14/2023] [Revised: 01/31/2024] [Accepted: 02/13/2024] [Indexed: 02/23/2024]
Abstract
BACKGROUND The COVID-19 pandemic has brought significant mental health challenges, particularly for vulnerable populations, including non-binary gender individuals. The COMET international study aimed to investigate specific risk factors for clinical depression or distress during the pandemic, also in these special populations. METHODS Chi-square tests were used for initial screening to select only those variables which would show an initial significance. Risk Ratios (RR) were calculated, and a Multiple Backward Stepwise Linear Regression Analysis (MBSLRA) was followed with those variables given significant results at screening and with the presence of distress or depression or the lack of both of them. RESULTS The most important risk factors for depression were female (RR = 1.59-5.49) and non-binary gender (RR = 1.56-7.41), unemployment (RR = 1.41-6.57), not working during lockdowns (RR = 1.43-5.79), bad general health (RR = 2.74-9.98), chronic somatic disorder (RR = 1.22-5.57), history of mental disorders (depression RR = 2.31-9.47; suicide attempt RR = 2.33-9.75; psychosis RR = 2.14-10.08; Bipolar disorder RR = 2.75-12.86), smoking status (RR = 1.15-5.31) and substance use (RR = 1.77-8.01). The risk factors for distress or depression that survived MBSLRA were younger age, being widowed, living alone, bad general health, being a carer, chronic somatic disorder, not working during lockdowns, being single, self-reported history of depression, bipolar disorder, self-harm, suicide attempts and of other mental disorders, smoking, alcohol, and substance use. CONCLUSIONS Targeted preventive interventions are crucial to safeguard the mental health of vulnerable groups, emphasizing the importance of diverse samples in future research. LIMITATIONS Online data collection may have resulted in the underrepresentation of certain population groups.
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Affiliation(s)
- Konstantinos N Fountoulakis
- 3rd Department of Psychiatry, School of Medicine, Aristotle University of Thessaloniki Greece, Thessaloniki, Greece
| | | | - Seri Abraham
- Pennine Care NHS Foundation Trust, United Kingdom; Manchester Metropolitan University, Manchester, United Kingdom; Core Psychiatry Training, Health Education England North West, United Kingdom.
| | - Kristina Adorjan
- Department of Psychiatry, Ludiwig-Maximilians-University, Munich, Germany.
| | - Helal Uddin Ahmed
- Child Adolescent and Family Psychiatry, National Institute of Mental Health, Dhaka, Bangladesh
| | - Renato D Alarcón
- Section of Psychiatry and Mental Health, Universidad Peruana Cayetano Heredia, Facultad de Medicina Alberto Hurtado, Lima, Peru; Department of Psychiatry and Psychology, Mayo Clinic School of Medicine, Rochester, MN, USA.
| | - Kiyomi Arai
- School of Medicine and Health Science, Institute of Health Science Shinshu University, Matsumoto, Japan.
| | - Sani Salihu Auwal
- Department of Psychiatry, Bayero University, Kano, Nigeria; Aminu Kano Teaching Hospital, Kano, Nigeria
| | - Michael Berk
- IMPACT - the Institute for Mental and Physical Health and Clinical Translation, Deakin University, School of Medicine, Barwon Health, Geelong, Australia; Orygen The National Centre of Excellence in Youth Mental Health, Centre for Youth Mental Health, Florey Institute for Neuroscience and Mental Health and the Department of Psychiatry, The University of Melbourne, Melbourne, Australia.
| | - Sarah Bjedov
- Department of Psychiatry and Psychological Medicine, University Hospital Centre Zagreb, Zagreb, Croatia
| | - Julio Bobes
- Psychiatry Area, Department of Medicine, University of Oviedo, Oviedo, Spain; Department of Psychiatry, Hospital Universitario Central de Asturias, Oviedo, Spain.
| | - Teresa Bobes-Bascaran
- Mental Health Center of La Corredoria, Oviedo, Spain; Department of Psychology, University of Oviedo, Oviedo, Spain.
| | - Julie Bourgin-Duchesnay
- Division of Child and Adolescent Psychiatry, Department of Psychiatry, Groupe Hospitalier Nord Essonne, Orsay, France
| | - Cristina Ana Bredicean
- Department of Neuroscience, Discipline of Psychiatry, "Victor Babes" University of Medicine and Pharmacy, Timisoara, Romania
| | - Laurynas Bukelskis
- Clinic of Psychiatry, Institute of Clinical Medicine, Medical Faculty, Vilnius University, Vilnius, Lithuania
| | - Akaki Burkadze
- Mental Hub, Tbilisi, Georgia; NGO Healthcare Research and Quality Agency, Tbilisi, Georgia
| | | | - Ruby Castilla-Puentes
- Janssen Research and Development, Johnson & Johnson, American Society of Hispanic Psychiatry and WARMI Women Mental Health, Cincinnati, OH, USA.
| | - Marcelo Cetkovich
- Institute of Translational and Cognitive Neuroscience (INCyT), INECO Foundation, Favaloro University, Buenos Aires, Argentina; National Scientific and Technical Research Council (CONICET), Buenos Aires, Argentina.
| | - Hector Colon-Rivera
- APM Board Certified in General Psychiatry and Neurology, Addiction Psychiatry, & Addiction Medicine, UPMC, DDAP, Philadelphia, USA
| | - Ricardo Corral
- Department of Teaching and Research, Hospital Borda, Buenos Aires, Argentina; University of Buenos Aires, Buenos Aires, Argentina
| | | | - Piirika Crepin
- Sanitaire and Social Union for Accompaniment and Prevention, Center of Ambulatory Psychiatry of Narbonne and Lezigan, Narbonne, France
| | - Domenico De Berardis
- Department of Mental Health, Psychiatric Service of Diagnosis and Treatment, Hospital "G. Mazzini", ASL Teramo, Teramo, Italy; School of Nursing, University of L'Aquila, Italy; Department of Neuroscience and Imaging, School of Psychiatry, University of Chieti, Chieti, Italy.
| | - Sergio Zamora Delgado
- Child and Adolescent Psychiatry Department, Hospital Luis Calvo Mackenna, Santiago, Chile.
| | - David De Lucena
- Departamento de Fisiología e Farmacología, Universidade Federal do Ceará, Fortaleza, Ceará, Brazil.
| | - Avinash De Sousa
- Department of Psychiatry, Lokmanya Tilak Municipal Medical College, Mumbai, India; Desousa Foundation, Mumbai, India
| | - Ramona Di Stefano
- Department of Biotechnological and Applied Clinical Sciences, Section of Psychiatry, University of L'Aquila, L'Aquila, Italy
| | - Seetal Dodd
- IMPACT - the Institute for Mental and Physical Health and Clinical Translation, Deakin University, School of Medicine, Barwon Health, Geelong, Australia; Orygen The National Centre of Excellence in Youth Mental Health, Centre for Youth Mental Health, Florey Institute for Neuroscience and Mental Health and the Department of Psychiatry, The University of Melbourne, Melbourne, Australia; University Hospital Geelong, Barwon Health, Geelong, Victoria, Australia
| | - Livia Priyanka Elek
- Department of Psychiatry and Psychotherapy, Semmelweis University, Budapest, Hungary
| | - Anna Elissa
- Department of Psychiatry, Faculty of Medicine, Universitas Indonesia, Cipto Mangunkusumo National Referral Hospital, Jakarta, Indonesia
| | - Berta Erdelyi-Hamza
- Department of Psychiatry and Psychotherapy, Semmelweis University, Budapest, Hungary
| | - Gamze Erzin
- Psychiatry Department, Ankara Dışkapı Training and Research Hospital, Ankara, Turkey; Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University Medical Center, Maastricht, the Netherlands
| | - Martin J Etchevers
- Faculty of Psychology, University of Buenos Aires (UBA), Buenos Aires, Argentina
| | - Peter Falkai
- Department of Psychiatry, Ludiwig-Maximilians-University, Munich, Germany.
| | - Adriana Farcas
- Centre of Neuroscience, Queen's University, Kingston, Ontario, Canada.
| | - Ilya Fedotov
- Department of Psychiatry and Narcology, Ryazan State Medical University n.a. academician I.P. Pavlov, Ryazan, Russia
| | - Viktoriia Filatova
- State Budgetary Institution of the Rostov Region "Psychoneurological Dispensary", Rostov-on-Don, Russia
| | | | - Iryna Frankova
- Medical Psychology, Psychosomatic Medicine and Psychotherapy Department, Bogomolets National Medical University, Kyiv, Ukraine
| | - Francesco Franza
- "Villa dei Pini" Psychiatric Rehabilitation Center, Avellino, Italy; Psychiatric Studies Centre, Provaglio d'Iseo, Italy
| | | | - Tatiana Galako
- Department of Psychiatry, Medical Psychology and Drug Abuse, Kyrgyz State Medical Academy, Bishkek, Kyrgyz Republic
| | - Cristian J Garay
- Faculty of Psychology, University of Buenos Aires (UBA), Buenos Aires, Argentina.
| | | | - Maria Paz García-Portilla
- Psychiatry Area, Department of Medicine, University of Oviedo, Oviedo, Spain; Mental Health Center of La Ería, Oviedo, Spain.
| | - Xenia Gonda
- Department of Psychiatry and Psychotherapy, Semmelweis University, Budapest, Hungary
| | - Tomasz M Gondek
- Specialty Training Section, Polish Psychiatric Association, Wroclaw, Poland
| | | | - Hilary Gould
- Department of Psychiatry, University of California San Diego, San Diego, USA.
| | - Paolo Grandinetti
- Department of Mental Health, Psychiatric Service of Diagnosis and Treatment, Hospital "G. Mazzini", ASL Teramo, Teramo, Italy
| | - Arturo Grau
- Child and Adolescent Psychiatry Department, Hospital Luis Calvo Mackenna, Santiago, Chile; Universidad Diego Portales, Santiago, Chile
| | - Violeta Groudeva
- Department of Diagnostic Imaging, University Hospital Saint Ekaterina, Sofia, Bulgaria
| | - Michal Hagin
- Forensic Psychiatry Unit, Abarbanel Mental Health Center, Israel
| | - Takayuki Harada
- Faculty of Human Sciences, Education Bureau of the Laboratory Schools, University of Tsukuba, Tokyo, Japan
| | - Tasdik M Hasan
- Department of Primary Care & Mental Health, University of Liverpool, Liverpool, United Kingdom; Public Health Foundation, Dhaka, Bangladesh
| | - Nurul Azreen Hashim
- Department of Psychiatry, Faculty of Medicine, Universiti Teknologi MARA, Sungai Buloh, Selangor, Malaysia.
| | - Jan Hilbig
- Clinic of Psychiatry, Institute of Clinical Medicine, Medical Faculty, Vilnius University, Vilnius, Lithuania
| | - Sahadat Hossain
- Department of Public Health & Informatics, Jahangirnagar University, Dhaka, Bangladesh.
| | - Rossitza Iakimova
- Second Psychiatric Clinic, University Hospital for Active Treatment in Neurology and Psychiatry "Saint Naum", Sofia, Bulgaria
| | - Mona Ibrahim
- Okasha Institute of Psychiatry, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Felicia Iftene
- Department of Psychiatry, Queens University, Kingston, Ontario, Canada.
| | - Yulia Ignatenko
- Education Center, Mental Health Clinic No 1 n.a. N.A. Alexeev of Moscow Healthcare Department, Moscow, Russia
| | - Matias Irarrazaval
- Ministry of Health, Millenium Institute for Research in Depression and Personality, Santiago, Chile.
| | - Zaliha Ismail
- Department of Public Health Medicine, Faculty of Medicine, Universiti Teknologi MARA, Sungai Buloh, Selangor, Malaysia.
| | - Jamila Ismayilova
- National Mental Health Center of the Ministry of Health of the Republic of Azerbaijan, Baku, Azerbaijan
| | - Asaf Jacobs
- Department of Psychiatry, Westchester Medical Center Health System, Valhalla, NY, USA; New York Medical College, Valhalla, NY, USA
| | | | - Nenad Jakšić
- Department of Psychiatry and Psychological Medicine, University Hospital Centre Zagreb, Zagreb, Croatia
| | - Afzal Javed
- Institute of Applied Health Research, University of Birmingham, United Kingdom; Warwick Medical School, University of Warwick, United Kingdom; Pakistan Psychiatric Research Centre, Fountain House, Lahore, Pakistan
| | | | - Sagar Karia
- Department of Psychiatry, Lokmanya Tilak Municipal Medical College, Mumbai, India
| | | | - Doaa Khalifa
- Okasha Institute of Psychiatry, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Olena Khaustova
- Medical Psychology, Psychosomatic Medicine and Psychotherapy Department, Bogomolets National Medical University, Kyiv, Ukraine
| | - Steve Koh
- Department of Psychiatry, University of California San Diego, San Diego, USA.
| | - Korneliia Kosenko
- Psychiatry, Drug abuse and Psychology Department, Odessa National Medical University, Odessa, Ukraine
| | | | | | - Justine Liewig
- Division of Child and Adolescent Psychiatry, Department of Psychiatry, Groupe Hospitalier Nord Essonne, Orsay, France
| | - Abdul Majid
- Department of Psychiatry, SKIMS Medical College, Srinagar, India
| | - Evgeniia Malashonkova
- Division of Child and Adolescent Psychiatry, Department of Psychiatry, Groupe Hospitalier Nord Essonne, Orsay, France.
| | - Khamelia Malik
- Department of Psychiatry, Faculty of Medicine, Universitas Indonesia, Cipto Mangunkusumo National Referral Hospital, Jakarta, Indonesia
| | - Najma Iqbal Malik
- Department of Psychology, University of Sargodha, Sargodha, Pakistan.
| | - Gulay Mammadzada
- Department of Psychiatry, Azerbaijan Medical University, Baku, Azerbaijan
| | | | - Donatella Marazziti
- Department of Clinical and Experimental Medicine, Section of Psychiatry, University of Pisa, Pisa, Italy; Unicamillus, Saint Camillus International University of Health Sciences, Rome, Italy; Brain Research Foundation onus, Lucca, Italy.
| | - Darko Marčinko
- Department of Psychiatry and Psychological Medicine, University Hospital Centre Zagreb, Zagreb, Croatia; School of Medicine, University of Zagreb, Zagreb, Croatia.
| | - Stephanie Martinez
- Department of Psychiatry, University of California San Diego, San Diego, USA.
| | - Eimantas Matiekus
- Clinic of Psychiatry, Institute of Clinical Medicine, Medical Faculty, Vilnius University, Vilnius, Lithuania
| | - Gabriela Mejia
- Department of Psychiatry, University of California San Diego, San Diego, USA.
| | - Roha Saeed Memon
- Dow Medical College, Dow University of Health Sciences, Karachi, Pakistan
| | | | | | - Roumen Milev
- Department of Psychiatry, Queens University, Kingston, Ontario, Canada.
| | - Muftau Mohammed
- Department of Clinical Services, Federal Neuropsychiatric Hospital, Kaduna, Nigeria
| | - Alejandro Molina-López
- General Office for the Psychiatric Services of the Ministry of Health, Mexico City, Mexico
| | - Petr Morozov
- Department of Postgraduate Education, Russian National Research Medical University n.a. N.I. Pirogov, Moscow, Russia
| | - Nuru Suleiman Muhammad
- Department of Community Medicine, Ahmadu Bello University Teaching Hospital, Zaria, Nigeria
| | - Filip Mustač
- Department of Psychiatry and Psychological Medicine, University Hospital Centre Zagreb, Zagreb, Croatia
| | - Mika S Naor
- Sackler School of Medicine New York State American Program, Tel Aviv University, Tel Aviv-Yafo, Israel.
| | - Amira Nassieb
- Okasha Institute of Psychiatry, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Alvydas Navickas
- Clinic of Psychiatry, Institute of Clinical Medicine, Medical Faculty, Vilnius University, Vilnius, Lithuania.
| | - Tarek Okasha
- Okasha Institute of Psychiatry, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Milena Pandova
- Second Psychiatric Clinic, University Hospital for Active Treatment in Neurology and Psychiatry "Saint Naum", Sofia, Bulgaria
| | - Anca-Livia Panfil
- Compartment of Liaison Psychiatry, "Pius Brinzeu" County Emergency Clinical Hospital, Timisoara, Romania
| | - Liliya Panteleeva
- Department of Medical Psychology, Psychiatry and Psychotherapy, Kyrgyz-Russian Slavic University, Bishkek, Kyrgyz Republic
| | - Ion Papava
- Department of Neuroscience, Discipline of Psychiatry, "Victor Babes" University of Medicine and Pharmacy, Timisoara, Romania.
| | - Mikaella E Patsali
- School of Social Sciences, Hellenic Open University, Patras, Greece; Department of Internal Medicine, Nicosia General Hospital, Nicosia, Cyprus
| | - Alexey Pavlichenko
- Education Center, Mental Health Clinic No 1 n.a. N.A. Alexeev of Moscow Healthcare Department, Moscow, Russia
| | - Bojana Pejuskovic
- Faculty of Medicine, University of Belgrade, Belgrade, Serbia; Clinical Department for Crisis and Affective Disorders, Institute of Mental Health, Belgrade, Serbia
| | - Mariana Pinto Da Costa
- South London and Maudsley NHS Foundation Trust, London, United Kingdom; Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, United Kingdom; Institute of Biomedical Sciences Abel Salazar, University of Porto, Porto, Portugal
| | - Mikhail Popkov
- Department of the Introduction to Internal Medicine and Family Medicine, International Higher School of Medicine, Bishkek, Kyrgyz Republic
| | | | - Nor Jannah Nasution Raduan
- Department of Psychiatry, Faculty of Medicine, Universiti Teknologi MARA, Sungai Buloh, Selangor, Malaysia.
| | - Francisca Vargas Ramírez
- Child and Adolescent Psychiatry Department, Hospital Luis Calvo Mackenna, Santiago, Chile; Universidad Diego Portales, Santiago, Chile
| | - Elmars Rancans
- Department of Psychiatry and Narcology, Riga Stradins University, Riga, Latvia.
| | - Salmi Razali
- Department of Psychiatry, Faculty of Medicine, Universiti Teknologi MARA, Sungai Buloh, Selangor, Malaysia.
| | - Federico Rebok
- Servicio de Emergencia, Acute inpatient Unit, Hospital Moyano, Buenos Aires, Argentina; Argentine Institute of Clinical Psychiatry (IAPC), Buenos Aires, Argentina
| | - Anna Rewekant
- General Psychiatry Unit I, Greater Poland Neuropsychiatric Center, Kościan, Poland
| | | | - María Teresa Rivera-Encinas
- Centro de Investigación en Salud Pública, Facultad de Medicina, Universidad de San Martín de Porres, Instituto Nacional de Salud Mental "Honorio Delgado - Hideyo Noguchi", Lima, Peru.
| | - Pilar Saiz
- Psychiatry Area, Department of Medicine, University of Oviedo, Oviedo, Spain; Mental Health Center of La Corredoria, Oviedo, Spain.
| | | | - David Saucedo Martínez
- Department of Psychiatry, Escuela Nacional de Medicina, TEC de Monterrey, Servicio de geriatría, Hospital Universitario "José Eleuterio González" UANL, Monterrey, Nuevo León, Mexico
| | - Jo Anne Saw
- Department of Psychiatry, Faculty of Medicine, Universiti Teknologi MARA, Sungai Buloh, Selangor, Malaysia.
| | - Görkem Saygili
- Cognitive Science and Artificial Intelligence Department Tilburg University, the Netherlands
| | - Patricia Schneidereit
- Klinik für Allgemeine Psychiatrie und Psychotherapie Ost, Psychiatrische Institutsambulanz, Klinikum am Weissenhof, Weissenhof, Germany.
| | | | - Tomohiro Shirasaka
- Department of Psychiatry, Teine Keijinkai Medical Center, Sapporo, Japan
| | | | - Satti Sitanggang
- Psychiatric Unit, Pambalah Batung General Hospital, South Kalimantan, Amuntai, Indonesia
| | - Oleg Skugarevsky
- Department of Psychiatry and Medical Psychology, Belarusian State Medical University, Minsk, Belarus
| | - Anna Spikina
- Saint Petersburg Psychoneurological Dispensary No2, Saint Petersburg, Russia
| | - Sridevi Sira Mahalingappa
- Derbyshire Healthcare NHS Foundation Trust, The Liasion Team, Royal Derby Hospital, Derby, Derbyshire, United Kingdom.
| | - Maria Stoyanova
- Second Psychiatric Clinic, University Hospital for Active Treatment in Neurology and Psychiatry "Saint Naum", Sofia, Bulgaria
| | - Anna Szczegielniak
- Department of Psychiatric Rehabilitation, Department of Psychiatry and Psychotherapy, Faculty of Medical Sciences in Katowice, Medical University of Silesia, Poland
| | - Simona Claudia Tamasan
- Compartment of Liaison Psychiatry, "Pius Brinzeu" County Emergency Clinical Hospital, Timisoara, Romania
| | - Giuseppe Tavormina
- Psychiatric Studies Centre, Provaglio d'Iseo, Italy; European Depression Association and Italian Association on Depression, Brussels, Belgium; Bedforshire Center for Mental Health Research in association with the University of Cambridge, United Kingdom
| | | | | | - Mauricio Tohen
- Department of Psychiatry and Behavioral Sciences, School of Medicine, University of New Mexico, Albuquerque, NM, USA.
| | - Eva Maria Tsapakis
- "Agios Charalambos" Mental Health Clinic, Heraklion, Crete, Greece; 1st Department of Academic Psychiatry, School of Medicine, Aristotle University of Thessaloniki, Greece.
| | | | - Irfan Ullah
- Kabir Medical College, Gandhara University, Peshawar, Pakistan
| | - Ratnaraj Vaidya
- Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, United Kingdom.
| | | | - Olivera Vukovic
- Faculty of Medicine, University of Belgrade, Belgrade, Serbia; Department for Research and Education, Institute of Mental Health, Belgrade, Serbia
| | - Olga Vysotska
- Educational and Research Center - Ukrainian Family Medicine Training Center, Bogomolets National Medical University, Kyiv, Ukraine
| | - Natalia Widiasih
- Department of Psychiatry, Faculty of Medicine, Universitas Indonesia, Cipto Mangunkusumo National Referral Hospital, Jakarta, Indonesia
| | - Anna Yashikhina
- International Centre for Education and Research in Neuropsychiatry (ICERN), Samara State Medical University, Samara, Russia; Department of Psychiatry, Narcology, Psychotherapy and Clinical Psychology, Samara State Medical University, Samara, Russia
| | - Daria Smirnova
- International Centre for Education and Research in Neuropsychiatry (ICERN), Samara State Medical University, Samara, Russia; Department of Psychiatry, Narcology, Psychotherapy and Clinical Psychology, Samara State Medical University, Samara, Russia
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Fountoulakis KN, Karakatsoulis GN, Abraham S, Adorjan K, Ahmed HU, Alarcón RD, Arai K, Auwal SS, Berk M, Bjedov S, Bobes J, Bobes-Bascaran T, Bourgin-Duchesnay J, Bredicean CA, Bukelskis L, Burkadze A, Cabrera Abud II, Castilla-Puentes R, Cetkovich M, Colon-Rivera H, Corral R, Cortez-Vergara C, Crepin P, De Berardis D, Zamora Delgado S, Lucena DD, Sousa AD, Stefano RD, Dodd S, Priyanka Elek L, Elissa A, Erdelyi-Hamza B, Erzin G, Etchevers MJ, Falkai P, Farcas A, Fedotov I, Filatova V, Fountoulakis NK, Frankova I, Franza F, Frias P, Galako T, Garay CJ, Garcia-Álvarez L, García-Portilla MP, Gonda X, Gondek TM, Morera González D, Gould H, Grandinetti P, Grau A, Groudeva V, Hagin M, Harada T, Hasan TM, Azreen Hashim N, Hilbig J, Hossain S, Iakimova R, Ibrahim M, Iftene F, Ignatenko Y, Irarrazaval M, Ismail Z, Ismayilova J, Jakobs A, Jakovljević M, Jakšić N, Javed A, Kafali HY, Karia S, Kazakova O, Khalifa D, Khaustova O, Koh S, Kopishinskaia S, Kosenko K, Koupidis SA, Kovacs I, Kulig B, Lalljee A, Liewig J, Majid A, Malashonkova E, Malik K, Malik NI, Mammadzada G, Mandalia B, Marazziti D, Marčinko D, Martinez S, Matiekus E, Mejia G, Memon RS, Meza Martínez XE, Mickevičiūtė D, Milev R, Mohammed M, Molina-López A, Morozov P, Muhammad NS, Mustač F, Naor MS, Nassieb A, Navickas A, Okasha T, Pandova M, Panfil AL, Panteleeva L, Papava I, Patsali ME, Pavlichenko A, Pejuskovic B, Pinto Da Costa M, Popkov M, Popovic D, Raduan NJN, Vargas Ramírez F, Rancans E, Razali S, Rebok F, Rewekant A, Ninoska Reyes Flores E, Rivera-Encinas MT, Saiz P, Sánchez de Carmona M, Saucedo Martínez D, Saw JA, Saygili G, Schneidereit P, Shah B, Shirasaka T, Silagadze K, Sitanggang S, Skugarevsky O, Spikina A, Mahalingappa SS, Stoyanova M, Szczegielniak A, Tamasan SC, Tavormina G, Tavormina MGM, Theodorakis PN, Tohen M, Tsapakis EM, Tukhvatullina D, Ullah I, Vaidya R, Vega-Dienstmaier JM, Vrublevska J, Vukovic O, Vysotska O, Widiasih N, Yashikhina A, Prezerakos PE, Smirnova D. Somatic multicomorbidity and disability in patients with psychiatric disorders in comparison to the general population: a quasi-epidemiological investigation in 54,826 subjects from 40 countries (COMET-G study). CNS Spectr 2024; 29:126-149. [PMID: 38269574 DOI: 10.1017/s1092852924000026] [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] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/26/2024]
Abstract
BACKGROUND The prevalence of medical illnesses is high among patients with psychiatric disorders. The current study aimed to investigate multi-comorbidity in patients with psychiatric disorders in comparison to the general population. Secondary aims were to investigate factors associated with metabolic syndrome and treatment appropriateness of mental disorders. METHODS The sample included 54,826 subjects (64.73% females; 34.15% males; 1.11% nonbinary gender) from 40 countries (COMET-G study). The analysis was based on the registration of previous history that could serve as a fair approximation for the lifetime prevalence of various medical conditions. RESULTS About 24.5% reported a history of somatic and 26.14% of mental disorders. Mental disorders were by far the most prevalent group of medical conditions. Comorbidity of any somatic with any mental disorder was reported by 8.21%. One-third to almost two-thirds of somatic patients were also suffering from a mental disorder depending on the severity and multicomorbidity. Bipolar and psychotic patients and to a lesser extent depressives, manifested an earlier (15-20 years) manifestation of somatic multicomorbidity, severe disability, and probably earlier death. The overwhelming majority of patients with mental disorders were not receiving treatment or were being treated in a way that was not recommended. Antipsychotics and antidepressants were not related to the development of metabolic syndrome. CONCLUSIONS The finding that one-third to almost two-thirds of somatic patients also suffered from a mental disorder strongly suggests that psychiatry is the field with the most trans-specialty and interdisciplinary value and application points to the importance of teaching psychiatry and mental health in medical schools and also to the need for more technocratically oriented training of psychiatric residents.
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Affiliation(s)
- Konstantinos N Fountoulakis
- 3rd Department of Psychiatry, School of Medicine, Aristotle University of Thessaloniki Greece, Thessaloniki, Greece
| | - Grigorios N Karakatsoulis
- 3rd Department of Psychiatry, School of Medicine, Aristotle University of Thessaloniki Greece, Thessaloniki, Greece
| | - Seri Abraham
- Pennine Care NHS Foundation Trust, Heywood, UK
- Manchester Metropolitan University, Manchester, UK
- Core Psychiatry Training, Health Education England North West, Manchester, UK
| | - Kristina Adorjan
- Department of Psychiatry, Ludiwig-Maximilians-University, Munich, Germany
| | - Helal Uddin Ahmed
- Child Adolescent and Family Psychiatry, National Institute of Mental Health, Dhaka, Bangladesh
| | - Renato D Alarcón
- Section of Psychiatry and Mental Health, Universidad Peruana Cayetano Heredia, Facultad de Medicina Alberto Hurtado, Lima, Peru
- Department of Psychiatry and Psychology, Mayo Clinic School of Medicine, Rochester, MN, USA
| | - Kiyomi Arai
- School of Medicine and Health Science, Institute of Health Science Shinshu University, Matsumoto, Japan
| | - Sani Salihu Auwal
- Department of Psychiatry, Bayero University, Kano, Nigeria
- Aminu Kano Teaching Hospital, Kano, Nigeria
| | - Michael Berk
- IMPACT - The Institute for Mental and Physical Health and Clinical Translation, Deakin University, School of Medicine, Barwon Health, Geelong, Australia
- Orygen The National Centre of Excellence in Youth Mental Health, Centre for Youth Mental Health, Florey Institute for Neuroscience and Mental Health and the Department of Psychiatry, The University of Melbourne, Melbourne, Australia
| | - Sarah Bjedov
- Department of Psychiatry and Psychological Medicine, University Hospital Centre Zagreb, Zagreb, Croatia
| | - Julio Bobes
- Psychiatry Area, Department of Medicine, University of Oviedo, Oviedo, Spain
- Department of Psychiatry, Hospital Universitario Central de Asturias, Oviedo, Spain
- ISPA, INEUROPA, CIBERSAM, Oviedo, Spain
| | - Teresa Bobes-Bascaran
- ISPA, INEUROPA, CIBERSAM, Oviedo, Spain
- Mental Health Center of La Corredoria, Oviedo, Spain
- Department of Psychology, University of Oviedo, Oviedo, Spain
| | - Julie Bourgin-Duchesnay
- Division of Child and Adolescent Psychiatry, Department of Psychiatry, Groupe Hospitalier Nord Essonne, Orsay, France
| | - Cristina Ana Bredicean
- Department of Neuroscience, Discipline of Psychiatry, "Victor Babes" University of Medicine and Pharmacy, Timisoara, Romania
| | - Laurynas Bukelskis
- Clinic of Psychiatry, Institute of Clinical Medicine, Medical Faculty, Vilnius University, Vilnius, Lithuania
| | - Akaki Burkadze
- Mental Hub, Tbilisi, Georgia
- NGO Healthcare Research and Quality Agency, Tbilisi, Georgia
| | | | - Ruby Castilla-Puentes
- Janssen Research and Development, Johnson & Johnson, American Society of Hispanic Psychiatry and WARMI Women Mental Health, Cincinnati, OH, USA
| | - Marcelo Cetkovich
- Institute of Translational and Cognitive Neuroscience (INCyT), INECO Foundation, Favaloro University, Buenos Aires, Argentina
- National Scientific and Technical Research Council (CONICET), Buenos Aires, Argentina
| | - Hector Colon-Rivera
- APM Board Certified in General Psychiatry and Neurology, Addiction Psychiatry, & Addiction Medicine, UPMC, DDAP, Philadelphia, PA, USA
| | - Ricardo Corral
- Department of Teaching and Research, Hospital Borda, Buenos Aires, Argentina
- University of Buenos Aires, Buenos Aires, Argentina
| | | | - Piirika Crepin
- Sanitaire and Social Union for Accompaniment and Prevention, Center of Ambulatory Psychiatry of Narbonne and Lezigan, Narbonne, France
| | - Domenico De Berardis
- Department of Mental Health, Psychiatric Service of Diagnosis and Treatment, Hospital "G. Mazzini", ASL Teramo, Teramo, Italy
- School of Nursing, University of L'Aquila, Italy
- Department of Neuroscience and Imaging, School of Psychiatry, University of Chieti, Chieti, Italy
| | - Sergio Zamora Delgado
- Child and Adolescent Psychiatry Department, Hospital Luis Calvo Mackenna, Santiago, Chile
| | - David De Lucena
- Departamento de Fisiología e Farmacología, Universidade Federal do Ceará, Fortaleza, Ceará, Brazil
| | - Avinash De Sousa
- Department of Psychiatry, Lokmanya Tilak Municipal Medical College, Mumbai, Maharashtra, India
- Desousa Foundation, Mumbai, Maharashtra, India
| | - Ramona Di Stefano
- Department of Biotechnological and Applied Clinical Sciences, Section of Psychiatry, University of L'Aquila, L'Aquila, Italy
| | - Seetal Dodd
- IMPACT - The Institute for Mental and Physical Health and Clinical Translation, Deakin University, School of Medicine, Barwon Health, Geelong, Australia
- Orygen The National Centre of Excellence in Youth Mental Health, Centre for Youth Mental Health, Florey Institute for Neuroscience and Mental Health and the Department of Psychiatry, The University of Melbourne, Melbourne, Australia
- University Hospital Geelong, Barwon Health, Geelong, Victoria, Australia
| | - Livia Priyanka Elek
- Department of Psychiatry and Psychotherapy, Semmelweis University, Budapest, Hungary
| | - Anna Elissa
- Department of Psychiatry, Faculty of Medicine, Universitas Indonesia, Cipto Mangunkusumo National Referral Hospital, Jakarta, Indonesia
| | - Berta Erdelyi-Hamza
- Department of Psychiatry and Psychotherapy, Semmelweis University, Budapest, Hungary
| | - Gamze Erzin
- Department of Psychiatry, Ankara Dışkapı Training and Research Hospital, Ankara, Turkey
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University Medical Center, Maastricht, The Netherlands
| | - Martin J Etchevers
- Faculty of Psychology, University of Buenos Aires (UBA), Buenos Aires, Argentina
| | - Peter Falkai
- Department of Psychiatry, Ludiwig-Maximilians-University, Munich, Germany
| | - Adriana Farcas
- Centre of Neuroscience, Queen's University, Kingston, Ontario, Canada
| | - Ilya Fedotov
- Department of Psychiatry and Narcology, Ryazan State Medical University n.a. Academician I.P. Pavlov, Ryazan, Russia
| | - Viktoriia Filatova
- State Budgetary Institution of the Rostov Region "Psychoneurological Dispensary", Rostov-on-Don, Russia
| | | | - Iryna Frankova
- Medical Psychology, Psychosomatic Medicine and Psychotherapy Department, Bogomolets National Medical University, Kyiv, Ukraine
| | - Francesco Franza
- "Villa dei Pini" Psychiatric Rehabilitation Center, Avellino, Italy
- Psychiatric Studies Centre, Provaglio d'Iseo, Italy
| | | | - Tatiana Galako
- Department of Psychiatry, Medical Psychology and Drug Abuse, Kyrgyz State Medical Academy, Bishkek, Kyrgyz Republic
| | - Cristian J Garay
- Faculty of Psychology, University of Buenos Aires (UBA), Buenos Aires, Argentina
| | - Leticia Garcia-Álvarez
- ISPA, INEUROPA, CIBERSAM, Oviedo, Spain
- Department of Psychology, University of Oviedo, Oviedo, Spain
| | - Maria Paz García-Portilla
- Psychiatry Area, Department of Medicine, University of Oviedo, Oviedo, Spain
- ISPA, INEUROPA, CIBERSAM, Oviedo, Spain
- Mental Health Center of La Ería, Oviedo, Spain
| | - Xenia Gonda
- Department of Psychiatry and Psychotherapy, Semmelweis University, Budapest, Hungary
| | - Tomasz M Gondek
- Specialty Training Section, Polish Psychiatric Association, Wroclaw, Poland
| | | | - Hilary Gould
- Department of Psychiatry, University of California San Diego, San Diego, USA
| | - Paolo Grandinetti
- Department of Mental Health, Psychiatric Service of Diagnosis and Treatment, Hospital "G. Mazzini", ASL Teramo, Teramo, Italy
| | - Arturo Grau
- Child and Adolescent Psychiatry Department, Hospital Luis Calvo Mackenna, Santiago, Chile
- Universidad Diego Portales, Santiago, Chile
| | - Violeta Groudeva
- Department of Diagnostic Imaging, University Hospital Saint Ekaterina, Sofia, Bulgaria
| | - Michal Hagin
- Forensic Psychiatry Unit, Abarbanel Mental Health Center, Bat Yam, Israel
| | - Takayuki Harada
- Faculty of Human Sciences, Education Bureau of the Laboratory Schools, University of Tsukuba, Tokyo, Japan
| | - Tasdik M Hasan
- Department of Primary Care and Mental Health, University of Liverpool, Liverpool, UK
- Public Health Foundation, Dhaka, Bangladesh
| | - Nurul Azreen Hashim
- Department of Psychiatry, Faculty of Medicine, Universiti Teknologi MARA, Sungai Buloh, Selangor, Malaysia
| | - Jan Hilbig
- Clinic of Psychiatry, Institute of Clinical Medicine, Medical Faculty, Vilnius University, Vilnius, Lithuania
| | - Sahadat Hossain
- Department of Public Health and Informatics, Jahangirnagar University, Dhaka, Bangladesh
| | - Rossitza Iakimova
- Second Psychiatric Clinic, University Hospital for Active Treatment in Neurology and Psychiatry "Saint Naum", Sofia, Bulgaria
| | - Mona Ibrahim
- Okasha Institute of Psychiatry, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Felicia Iftene
- Department of Psychiatry, Queens University, Kingston, ON, Canada
| | - Yulia Ignatenko
- Education Center, Mental Health Clinic No. 1 named after N.A. Alexeev of Moscow Healthcare Department, Moscow, Russia
| | - Matias Irarrazaval
- Ministry of Health, Millenium Institute for Research in Depression and Personality, Santiago, Chile
| | - Zaliha Ismail
- Department of Public Health Medicine, Faculty of Medicine, Universiti Teknologi MARA, Sungai Buloh, Selangor, Malaysia
| | - Jamila Ismayilova
- National Mental Health Center of the Ministry of Health of the Republic of Azerbaijan, Baku, Azerbaijan
| | - Asaf Jakobs
- Department of Psychiatry, Westchester Medical Center Health System, Valhalla, NY, USA
- New York Medical College, Valhalla, NY, USA
| | | | - Nenad Jakšić
- Department of Psychiatry and Psychological Medicine, University Hospital Centre Zagreb, Zagreb, Croatia
| | - Afzal Javed
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
- Warwick Medical School, University of Warwick, Coventry, UK
- Pakistan Psychiatric Research Centre, Fountain House, Lahore, Pakistan
| | | | - Sagar Karia
- Department of Psychiatry, Lokmanya Tilak Municipal Medical College, Mumbai, Maharashtra, India
| | | | - Doaa Khalifa
- Okasha Institute of Psychiatry, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Olena Khaustova
- Medical Psychology, Psychosomatic Medicine and Psychotherapy Department, Bogomolets National Medical University, Kyiv, Ukraine
| | - Steve Koh
- Department of Psychiatry, University of California San Diego, San Diego, USA
| | - Svetlana Kopishinskaia
- International Centre for Education and Research in Neuropsychiatry (ICERN), Samara State Medical University, Samara, Russia
- Kirov State Medical University, Kirov, Russia
| | - Korneliia Kosenko
- Department of Psychiatry, Drug Abuse and Psychology, Odessa National Medical University, Odessa, Ukraine
| | - Sotirios A Koupidis
- Occupational and Environmental Health Sector, Public Health Policy Department, School of Public Health, University of West Attica, Athens, Greece
| | - Illes Kovacs
- Department of Psychiatry and Psychotherapy, Semmelweis University, Budapest, Hungary
| | - Barbara Kulig
- Department of Psychiatry and Psychotherapy, Semmelweis University, Budapest, Hungary
| | | | - Justine Liewig
- Division of Child and Adolescent Psychiatry, Department of Psychiatry, Groupe Hospitalier Nord Essonne, Orsay, France
| | - Abdul Majid
- Department of Psychiatry, SKIMS Medical College, Srinagar, India
| | - Evgeniia Malashonkova
- Division of Child and Adolescent Psychiatry, Department of Psychiatry, Groupe Hospitalier Nord Essonne, Orsay, France
| | - Khamelia Malik
- Department of Psychiatry, Faculty of Medicine, Universitas Indonesia, Cipto Mangunkusumo National Referral Hospital, Jakarta, Indonesia
| | - Najma Iqbal Malik
- Department of Psychology, University of Sargodha, Sargodha, Pakistan
| | - Gulay Mammadzada
- Department of Psychiatry, Azerbaijan Medical University, Baku, Azerbaijan
| | | | - Donatella Marazziti
- Department of Clinical and Experimental Medicine, Section of Psychiatry, University of Pisa, Pisa, Italy
- Unicamillus, Saint Camillus International University of Health Sciences, Rome, Italy
- Brain Research Foundation onus, Lucca, Italy
| | - Darko Marčinko
- Department of Psychiatry and Psychological Medicine, University Hospital Centre Zagreb, Zagreb, Croatia
- School of Medicine, University of Zagreb, Zagreb, Croatia
| | - Stephanie Martinez
- Department of Psychiatry, University of California San Diego, San Diego, USA
| | - Eimantas Matiekus
- Clinic of Psychiatry, Institute of Clinical Medicine, Medical Faculty, Vilnius University, Vilnius, Lithuania
| | - Gabriela Mejia
- Department of Psychiatry, University of California San Diego, San Diego, USA
| | - Roha Saeed Memon
- Dow Medical College, Dow University of Health Sciences, Karachi, Pakistan
| | | | | | - Roumen Milev
- Department of Psychiatry, Queens University, Kingston, ON, Canada
| | - Muftau Mohammed
- Department of Clinical Services, Federal Neuropsychiatric Hospital, Kaduna, Nigeria
| | - Alejandro Molina-López
- General Office for the Psychiatric Services of the Ministry of Health, Mexico City, Mexico
| | - Petr Morozov
- Department of Postgraduate Education, Russian National Research Medical University n.a. N.I. Pirogov, Moscow, Russia
| | - Nuru Suleiman Muhammad
- Department of Community Medicine, Ahmadu Bello University Teaching Hospital, Zaria, Nigeria
| | - Filip Mustač
- Department of Psychiatry and Psychological Medicine, University Hospital Centre Zagreb, Zagreb, Croatia
| | - Mika S Naor
- Sackler School of Medicine New York State American Program, Tel Aviv University, Tel Aviv-Yafo, Israel
| | - Amira Nassieb
- Okasha Institute of Psychiatry, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Alvydas Navickas
- Clinic of Psychiatry, Institute of Clinical Medicine, Medical Faculty, Vilnius University, Vilnius, Lithuania
| | - Tarek Okasha
- Okasha Institute of Psychiatry, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Milena Pandova
- Second Psychiatric Clinic, University Hospital for Active Treatment in Neurology and Psychiatry "Saint Naum", Sofia, Bulgaria
| | - Anca-Livia Panfil
- Compartment of Liaison Psychiatry, "Pius Brinzeu" County Emergency Clinical Hospital, Timisoara, Romania
| | - Liliya Panteleeva
- Department of Medical Psychology, Psychiatry and Psychotherapy, Kyrgyz-Russian Slavic University, Bishkek, Kyrgyz Republic
| | - Ion Papava
- Department of Neuroscience, Discipline of Psychiatry, "Victor Babes" University of Medicine and Pharmacy, Timisoara, Romania
| | - Mikaella E Patsali
- School of Social Sciences, Hellenic Open University, Patras, Greece
- Department of Internal Medicine, Nicosia General Hospital, Nicosia, Cyprus
| | - Alexey Pavlichenko
- Education Center, Mental Health Clinic No. 1 named after N.A. Alexeev of Moscow Healthcare Department, Moscow, Russia
| | - Bojana Pejuskovic
- Faculty of Medicine, University of Belgrade, Belgrade, Serbia
- Clinical Department for Crisis and Affective Disorders, Institute of Mental Health, Belgrade, Serbia
| | - Mariana Pinto Da Costa
- South London and Maudsley NHS Foundation Trust, London, UK
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
- Institute of Biomedical Sciences Abel Salazar, University of Porto, Porto, Portugal
| | - Mikhail Popkov
- Department of the Introduction to Internal Medicine and Family Medicine, International Higher School of Medicine, Bishkek, Kyrgyz Republic
| | | | - Nor Jannah Nasution Raduan
- Department of Psychiatry, Faculty of Medicine, Universiti Teknologi MARA, Sungai Buloh, Selangor, Malaysia
| | - Francisca Vargas Ramírez
- Child and Adolescent Psychiatry Department, Hospital Luis Calvo Mackenna, Santiago, Chile
- Universidad Diego Portales, Santiago, Chile
| | - Elmars Rancans
- Department of Psychiatry and Narcology, Riga Stradins University, Riga, Latvia
- Riga Centre of Psychiatry and Narcology, Riga, Latvia
| | - Salmi Razali
- Department of Psychiatry, Faculty of Medicine, Universiti Teknologi MARA, Sungai Buloh, Selangor, Malaysia
| | - Federico Rebok
- Servicio de Emergencia, Acute inpatient Unit, Hospital Moyano, Buenos Aires, Argentina
- Argentine Institute of Clinical Psychiatry (IAPC), Buenos Aires, Argentina
| | - Anna Rewekant
- General Psychiatry Unit I, Greater Poland Neuropsychiatric Center, Kościan, Poland
| | | | - María Teresa Rivera-Encinas
- Centro de Investigación en Salud Pública, Facultad de Medicina, Universidad de San Martín de Porres, Instituto Nacional de Salud Mental "Honorio Delgado - Hideyo Noguchi", Lima, Perú
| | - Pilar Saiz
- Psychiatry Area, Department of Medicine, University of Oviedo, Oviedo, Spain
- ISPA, INEUROPA, CIBERSAM, Oviedo, Spain
- Mental Health Center of La Corredoria, Oviedo, Spain
| | | | - David Saucedo Martínez
- Department of Psychiatry, Escuela Nacional de Medicina, TEC de Monterrey, Servicio de geriatría. Hospital Universitario "José Eleuterio González" UANL, Monterrey, Nuevo León, Mexico
| | - Jo Anne Saw
- Department of Psychiatry, Faculty of Medicine, Universiti Teknologi MARA, Sungai Buloh, Selangor, Malaysia
| | - Görkem Saygili
- Department of Cognitive Science and Artificial Intelligence, Tilburg University, Tilburg, The Netherlands
| | - Patricia Schneidereit
- Klinik für Allgemeine Psychiatrie und Psychotherapie Ost, Psychiatrische Institutsambulanz, Klinikum am Weissenhof, Weissenhof, Germany
| | - Bhumika Shah
- DY Patil Medical College, Navi Mumbai, Maharashtra, India
| | - Tomohiro Shirasaka
- Department of Psychiatry, Teine Keijinkai Medical Center, Sapporo, Japan
| | | | - Satti Sitanggang
- Psychiatric Unit, Pambalah Batung General Hospital, South Kalimantan, Amuntai, Indonesia
| | - Oleg Skugarevsky
- Department of Psychiatry and Medical Psychology, Belarusian State Medical University, Minsk, Belarus
| | - Anna Spikina
- Saint Petersburg Psychoneurological Dispensary No. 2, Saint Petersburg, Russia
| | - Sridevi Sira Mahalingappa
- Derbyshire Healthcare NHS Foundation Trust, The Liasion Team, Royal Derby Hospital, Derby, Derbyshire, UK
| | - Maria Stoyanova
- Second Psychiatric Clinic, University Hospital for Active Treatment in Neurology and Psychiatry "Saint Naum", Sofia, Bulgaria
| | - Anna Szczegielniak
- Department of Psychiatric Rehabilitation, Department of Psychiatry and Psychotherapy, Faculty of Medical Sciences in Katowice, Medical University of Silesia, Poland
| | - Simona Claudia Tamasan
- Compartment of Liaison Psychiatry, "Pius Brinzeu" County Emergency Clinical Hospital, Timisoara, Romania
| | - Giuseppe Tavormina
- Psychiatric Studies Centre, Provaglio d'Iseo, Italy
- European Depression Association and Italian Association on Depression, Brussels, Belgium
- Bedforshire Center for Mental Health Research, University of Cambridge, Cambridge, UK
| | | | | | - Mauricio Tohen
- Department of Psychiatry and Behavioral Sciences, School of Medicine, University of New Mexico, Albuquerque, Nm, USA
| | - Eva Maria Tsapakis
- "Agios Charalambos" Mental Health Clinic, Heraklion, Crete, Greece
- 1st Department of Academic Psychiatry, School of Medicine, Aristotle University of Thessaloniki, Greece
| | - Dina Tukhvatullina
- Centre for Global Public Health, Institute of Population Health Sciences, Queen Mary University of London, London, UK
| | - Irfan Ullah
- Kabir Medical College, Gandhara University, Peshawar, Pakistan
| | - Ratnaraj Vaidya
- Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK
| | | | - Jelena Vrublevska
- Department of Psychiatry and Narcology, Riga Stradins University, Riga, Latvia
- Riga Centre of Psychiatry and Narcology, Riga, Latvia
- Institute of Public Health, Riga Stradins University, Riga, Latvia
| | - Olivera Vukovic
- Faculty of Medicine, University of Belgrade, Belgrade, Serbia
- Department of Research and Education, Institute of Mental Health, Belgrade, Serbia
| | - Olga Vysotska
- Educational and Research Center - Ukrainian Family Medicine Training Center, Bogomolets National Medical University, Kyiv, Ukraine
| | - Natalia Widiasih
- Department of Psychiatry, Faculty of Medicine, Universitas Indonesia, Cipto Mangunkusumo National Referral Hospital, Jakarta, Indonesia
| | - Anna Yashikhina
- International Centre for Education and Research in Neuropsychiatry (ICERN), Samara State Medical University, Samara, Russia
- Department of Psychiatry, Narcology, Psychotherapy and Clinical Psychology, Samara State Medical University, Samara, Russia
| | - Panagiotis E Prezerakos
- Department of Nursing, University of Peloponnese, Laboratory of Integrated Health Care, Tripoli, Greece
| | - Daria Smirnova
- International Centre for Education and Research in Neuropsychiatry (ICERN), Samara State Medical University, Samara, Russia
- Department of Psychiatry, Narcology, Psychotherapy and Clinical Psychology, Samara State Medical University, Samara, Russia
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N. Fountoulakis K, N. Karakatsoulis G, Abraham S, Adorjan K, Ahmed HU, Alarcón RD, Arai K, Auwal SS, Bobes J, Bobes-Bascaran T, Bourgin-Duchesnay J, Bredicean CA, Bukelskis L, Burkadze A, Cabrera Abud II, Castilla-Puentes R, Cetkovich M, Colon-Rivera H, Corral R, Cortez-Vergara C, Crepin P, de Berardis D, Zamora Delgado S, de Lucena D, de Sousa A, di Stefano R, Dodd S, Elek LP, Elissa A, Erdelyi-Hamza B, Erzin G, Etchevers MJ, Falkai P, Farcas A, Fedotov I, Filatova V, Fountoulakis NK, Frankova I, Franza F, Frias P, Galako T, Garay CJ, Garcia-Álvarez L, García-Portilla P, Gonda X, Gondek TM, Morera González D, Gould H, Grandinetti P, Grau A, Groudeva V, Hagin M, Harada T, Hasan TM, Azreen Hashim N, Hilbig J, Hossain S, Iakimova R, Ibrahim M, Iftene F, Ignatenko Y, Irarrazaval M, Ismail Z, Ismayilova J, Jacobs A, Jakovljević M, Jakšić N, Javed A, Yilmaz Kafali H, Karia S, Kazakova O, Khalifa D, Khaustova O, Koh S, Kopishinskaia S, Kosenko K, Koupidis SA, Kovacs I, Kulig B, Lalljee A, Liewig J, Majid A, Malashonkova E, Malik K, Iqbal Malik N, Mammadzada G, Mandalia B, Marazziti D, Marčinko D, Martinez S, Matiekus E, Mejia G, Memon RS, Meza Martínez XE, Mickevičiūtė D, Milev R, Mohammed M, Molina-López A, Morozov P, Muhammad NS, Mustač F, Naor MS, Nassieb A, Navickas A, Okasha T, Pandova M, Panfil AL, Panteleeva L, Papava I, Patsali ME, Pavlichenko A, Pejuskovic B, Pinto da Costa M, Popkov M, Popovic D, Raduan NJN, Vargas Ramírez F, Rancans E, Razali S, Rebok F, Rewekant A, Reyes Flores EN, Rivera-Encinas MT, Saiz PA, Sánchez de Carmona M, Saucedo Martínez D, Saw JA, Saygili G, Schneidereit P, Shah B, Shirasaka T, Silagadze K, Sitanggang S, Skugarevsky O, Spikina A, Mahalingappa SS, Stoyanova M, Szczegielniak A, Tamasan SC, Tavormina G, Tavormina MGM, Theodorakis PN, Tohen M, Tsapakis EM, Tukhvatullina D, Ullah I, Vaidya R, Vega-Dienstmaier JM, Vrublevska J, Vukovic O, Vysotska O, Widiasih N, Yashikhina A, Prezerakos PE, Berk M, Levaj S, Smirnova D. Results of the COVID-19 mental health international for the health professionals (COMET-HP) study: depression, suicidal tendencies and conspiracism. Soc Psychiatry Psychiatr Epidemiol 2023; 58:1387-1410. [PMID: 36867224 PMCID: PMC9982799 DOI: 10.1007/s00127-023-02438-8] [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] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2022] [Accepted: 02/02/2023] [Indexed: 03/04/2023]
Abstract
INTRODUCTION The current study aimed to investigate the rates of anxiety, clinical depression, and suicidality and their changes in health professionals during the COVID-19 outbreak. MATERIALS AND METHODS The data came from the larger COMET-G study. The study sample includes 12,792 health professionals from 40 countries (62.40% women aged 39.76 ± 11.70; 36.81% men aged 35.91 ± 11.00 and 0.78% non-binary gender aged 35.15 ± 13.03). Distress and clinical depression were identified with the use of a previously developed cut-off and algorithm, respectively. STATISTICAL ANALYSIS Descriptive statistics were calculated. Chi-square tests, multiple forward stepwise linear regression analyses, and Factorial Analysis of Variance (ANOVA) tested relations among variables. RESULTS Clinical depression was detected in 13.16% with male doctors and 'non-binary genders' having the lowest rates (7.89 and 5.88% respectively) and 'non-binary gender' nurses and administrative staff had the highest (37.50%); distress was present in 15.19%. A significant percentage reported a deterioration in mental state, family dynamics, and everyday lifestyle. Persons with a history of mental disorders had higher rates of current depression (24.64% vs. 9.62%; p < 0.0001). Suicidal tendencies were at least doubled in terms of RASS scores. Approximately one-third of participants were accepting (at least to a moderate degree) a non-bizarre conspiracy. The highest Relative Risk (RR) to develop clinical depression was associated with a history of Bipolar disorder (RR = 4.23). CONCLUSIONS The current study reported findings in health care professionals similar in magnitude and quality to those reported earlier in the general population although rates of clinical depression, suicidal tendencies, and adherence to conspiracy theories were much lower. However, the general model of factors interplay seems to be the same and this could be of practical utility since many of these factors are modifiable.
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Affiliation(s)
- Konstantinos N. Fountoulakis
- 3rd Department of Psychiatry, School of Medicine, Aristotle University of Thessaloniki Greece, Thessaloniki, Greece
| | - Grigorios N. Karakatsoulis
- 3rd Department of Psychiatry, School of Medicine, Aristotle University of Thessaloniki Greece, Thessaloniki, Greece
| | - Seri Abraham
- Pennine Care NHS Foundation Trust, Ashton-under-Lyne, UK
- Manchester Metropolitan University, Manchester, UK
- Core Psychiatry Training, Health Education England North West, Manchester, UK
| | - Kristina Adorjan
- Department of Psychiatry, Ludiwig-Maximilians-University, Munich, Germany
| | - Helal Uddin Ahmed
- Child Adolescent and Family Psychiatry, National Institute of Mental Health, Dhaka, Bangladesh
| | - Renato D. Alarcón
- Section of Psychiatry and Mental Health, Universidad Peruana Cayetano Heredia, Facultad de Medicina Alberto Hurtado, Lima, Peru
- Department of Psychiatry and Psychology, Mayo Clinic School of Medicine, Rochester, MN USA
| | - Kiyomi Arai
- School of Medicine and Health Science, Institute of Health Science Shinshu University, Matsumoto, Japan
| | - Sani Salihu Auwal
- Department of Psychiatry, Bayero University, Kano, Nigeria
- Aminu Kano Teaching Hospital, Kano, Nigeria
| | - Julio Bobes
- Psychiatry Area, Department of Medicine, University of Oviedo, ISPA, INEUROPA. CIBERSAM, Oviedo, Spain
- Department of Psychiatry, Hospital Universitario Central de Asturias, ISPA, INEUROPA. CIBERSAM, Oviedo, Spain
| | - Teresa Bobes-Bascaran
- Mental Health Center of La Corredoria, ISPA, INEUROPA. CIBERSAM, Oviedo, Spain
- Department of Psychology, University of Oviedo, ISPA, INEUROPA. CIBERSAM, Oviedo, Spain
| | - Julie Bourgin-Duchesnay
- Division of Child and Adolescent Psychiatry, Department of Psychiatry, Groupe Hospitalier Nord Essonne, Orsay, France
| | - Cristina Ana Bredicean
- Department of Neuroscience, Discipline of Psychiatry, “Victor Babes” University of Medicine and Pharmacy, Timisoara, Romania
| | - Laurynas Bukelskis
- Clinic of Psychiatry, Institute of Clinical Medicine, Medical Faculty, Vilnius University, Vilnius, Lithuania
| | - Akaki Burkadze
- Mental Hub, Tbilisi, Georgia
- NGO Healthcare Research and Quality Agency, Tbilisi, Georgia
| | | | - Ruby Castilla-Puentes
- Janssen Research and Development, Johnson and Johnson, American Society of Hispanic Psychiatry and WARMI Women Mental Health, Cincinnati, OH USA
| | - Marcelo Cetkovich
- Institute of Translational and Cognitive Neuroscience (INCyT), INECO Foundation, Favaloro University, Buenos Aires, Argentina
- National Scientific and Technical Research Council (CONICET), Buenos Aires, Argentina
| | - Hector Colon-Rivera
- APM Board Certified in General Psychiatry and Neurology, Addiction Psychiatry, and Addiction Medicine, UPMC, DDAP, Philadelphia, USA
| | - Ricardo Corral
- Department of Teaching and Research, Hospital Borda, Buenos Aires, Argentina
- University of Buenos Aires, Buenos Aires, Argentina
| | | | - Piirika Crepin
- Sanitaire and Social Union for Accompaniment and Prevention, Center of Ambulatory Psychiatry of Narbonne and Lezigan, Narbonne, France
| | - Domenico de Berardis
- Department of Mental Health, Psychiatric Service of Diagnosis and Treatment, Hospital “G. Mazzini”, ASL Teramo, Teramo, Italy
- School of Nursing, University of L’Aquila, L’Aquila, Italy
- Department of Neuroscience and Imaging, School of Psychiatry, University of Chieti, Chieti, Italy
| | - Sergio Zamora Delgado
- Child and Adolescent Psychiatry Department, Hospital Luis Calvo Mackenna, Santiago, Chile
| | - David de Lucena
- Departamento de Fisiología E Farmacología, Universidade Federal Do Ceará, Fortaleza, Ceará Brazil
| | - Avinash de Sousa
- Department of Psychiatry, Lokmanya Tilak Municipal Medical College, Mumbai, India
- Desousa Foundation, Mumbai, India
| | - Ramona di Stefano
- Department of Biotechnological and Applied Clinical Sciences, Section of Psychiatry, University of L’Aquila, L’Aquila, Italy
| | - Seetal Dodd
- IMPACT–the Institute for Mental and Physical Health and Clinical Translation, Deakin University, School of Medicine, Barwon Health, Geelong, Australia
- Orygen The National Centre of Excellence in Youth Mental Health, Centre for Youth Mental Health, Florey Institute for Neuroscience and Mental Health and the Department of Psychiatry, The University of Melbourne, Melbourne, Australia
- University Hospital Geelong, Barwon Health, Geelong, VIC Australia
| | - Livia Priyanka Elek
- Department of Psychiatry and Psychotherapy, Semmelweis University, Budapest, Hungary
| | - Anna Elissa
- Department of Psychiatry, Faculty of Medicine, Universitas Indonesia, Cipto Mangunkusumo National Referral Hospital, Jakarta, Indonesia
| | - Berta Erdelyi-Hamza
- Department of Psychiatry and Psychotherapy, Semmelweis University, Budapest, Hungary
| | - Gamze Erzin
- Psychiatry Department, Ankara Dışkapı Training and Research Hospital, Ankara, Turkey
| | - Martin J. Etchevers
- Faculty of Psychology, University of Buenos Aires (UBA), Buenos Aires, Argentina
| | - Peter Falkai
- Department of Psychiatry, Ludiwig-Maximilians-University, Munich, Germany
| | - Adriana Farcas
- Centre of Neuroscience, Queen’s University, Kingston, ON Canada
| | - Ilya Fedotov
- Department of Psychiatry and Narcology, Ryazan State Medical University N.a. Academician I.P. Pavlov, Ryazan, Russia
| | - Viktoriia Filatova
- State Budgetary Institution of the Rostov Region “Psychoneurological Dispensary”, Rostov-On-Don, Russia
| | | | - Iryna Frankova
- Medical Psychology, Psychosomatic Medicine and Psychotherapy Department, Bogomolets National Medical University, Kiev, Ukraine
| | - Francesco Franza
- Villa Dei Pini Psychiatric Rehabilitation Center, Avellino, Italy
- Psychiatric Studies Centre, Provaglio d’Iseo, Italy
| | | | - Tatiana Galako
- Department of Psychiatry, Medical Psychology and Drug Abuse, Kyrgyz State Medical Academy, Bishkek, Kyrgyz Republic
| | - Cristian J. Garay
- Faculty of Psychology, University of Buenos Aires (UBA), Buenos Aires, Argentina
| | | | - Paz García-Portilla
- Psychiatry Area, Department of Medicine, University of Oviedo, ISPA, INEUROPA. CIBERSAM, Oviedo, Spain
- Mental Health Center of La Ería, ISPA, INEUROPA. CIBERSAM, Oviedo, Spain
| | - Xenia Gonda
- Department of Psychiatry and Psychotherapy, Semmelweis University, Budapest, Hungary
| | - Tomasz M. Gondek
- Specialty Training Section, Polish Psychiatric Association, Wroclaw, Poland
| | | | - Hilary Gould
- Department of Psychiatry, University of California San Diego, San Diego, USA
| | - Paolo Grandinetti
- Department of Mental Health, Psychiatric Service of Diagnosis and Treatment, Hospital “G. Mazzini”, ASL Teramo, Teramo, Italy
| | - Arturo Grau
- Child and Adolescent Psychiatry Department, Hospital Luis Calvo Mackenna, Santiago, Chile
- Universidad Diego Portales, Santiago, Chile
| | - Violeta Groudeva
- Department of Diagnostic Imaging, University Hospital Saint Ekaterina, Sofia, Bulgaria
| | - Michal Hagin
- Forensic Psychiatry Unit, Abarbanel Mental Health Center, Bat Yam, Israel
| | - Takayuki Harada
- Faculty of Human Sciences, Education Bureau of the Laboratory Schools, University of Tsukuba, Tokyo, Japan
| | - Tasdik M. Hasan
- Department of Primary Care and Mental Health, University of Liverpool, Liverpool, UK
- Public Health Foundation, Dhaka, Bangladesh
| | - Nurul Azreen Hashim
- Department of Psychiatry, Faculty of Medicine, Universiti Teknologi MARA, Sungai Buloh, Selangor, Malaysia
| | - Jan Hilbig
- Clinic of Psychiatry, Institute of Clinical Medicine, Medical Faculty, Vilnius University, Vilnius, Lithuania
| | - Sahadat Hossain
- Department of Public Health and Informatics, Jahangirnagar University, Dhaka, Bangladesh
| | - Rossitza Iakimova
- Second Psychiatric Clinic, University Hospital for Active Treatment in Neurology and Psychiatry “Saint Naum”, Sofia, Bulgaria
| | - Mona Ibrahim
- Faculty of Medicine, Okasha Institute of Psychiatry, Ain Shams University, Cairo, Egypt
| | - Felicia Iftene
- Department of Psychiatry, Queens University, Kingston, ON Canada
| | - Yulia Ignatenko
- Mental Health Clinic No 1 N.a. N.A. Alexeev of Moscow Healthcare Department, Education Center, Moscow, Russia
| | - Matias Irarrazaval
- Ministry of Health, Millenium Institute for Research in Depression and Personality, Santiago, Chile
| | - Zaliha Ismail
- Department of Public Health Medicine, Faculty of Medicine, Universiti Teknologi MARA, Sungai Buloh, Selangor, Malaysia
| | - Jamila Ismayilova
- National Mental Health Center of the Ministry of Health of the Republic of Azerbaijan, Baku, Azerbaijan
| | - Asaf Jacobs
- Department of Psychiatry, Westchester Medical Center Health System, Valhalla, NY USA
- New York Medical College, Valhalla, NY USA
| | | | - Nenad Jakšić
- Department of Psychiatry and Psychological Medicine, University Hospital Centre Zagreb, Zagreb, Croatia
| | - Afzal Javed
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
- Warwick Medical School, University of Warwick, Coventry, UK
- Psychiatric Research Centre, Fountain House, Lahore, Pakistan
| | | | - Sagar Karia
- Department of Psychiatry, Lokmanya Tilak Municipal Medical College, Mumbai, India
| | | | - Doaa Khalifa
- Faculty of Medicine, Okasha Institute of Psychiatry, Ain Shams University, Cairo, Egypt
| | - Olena Khaustova
- Medical Psychology, Psychosomatic Medicine and Psychotherapy Department, Bogomolets National Medical University, Kiev, Ukraine
| | - Steve Koh
- Department of Psychiatry, University of California San Diego, San Diego, USA
| | - Svetlana Kopishinskaia
- International Centre for Education and Research in Neuropsychiatry (ICERN), Samara State Medical University, Samara, Russia
- Kirov State Medical University, Kirov, Russia
| | - Korneliia Kosenko
- Drug Abuse and Psychology Department, Odessa National Medical University, Odessa, Ukraine
| | - Sotirios A. Koupidis
- Occupational and Environmental Health Sector, Public Health Policy Department, School of Public Health, University of West Attica, Athens, Greece
| | - Illes Kovacs
- Department of Psychiatry and Psychotherapy, Semmelweis University, Budapest, Hungary
| | - Barbara Kulig
- Department of Psychiatry and Psychotherapy, Semmelweis University, Budapest, Hungary
| | | | - Justine Liewig
- Division of Child and Adolescent Psychiatry, Department of Psychiatry, Groupe Hospitalier Nord Essonne, Orsay, France
| | - Abdul Majid
- Department of Psychiatry, SKIMS Medical College, Srinagar, India
| | - Evgeniia Malashonkova
- Division of Child and Adolescent Psychiatry, Department of Psychiatry, Groupe Hospitalier Nord Essonne, Orsay, France
| | - Khamelia Malik
- Department of Psychiatry, Faculty of Medicine, Universitas Indonesia, Cipto Mangunkusumo National Referral Hospital, Jakarta, Indonesia
| | - Najma Iqbal Malik
- Department of Psychology, University of Sargodha, Sargodha, Pakistan
| | - Gulay Mammadzada
- Department of Psychiatry, Azerbaijan Medical University, Baku, Azerbaijan
| | | | - Donatella Marazziti
- Department of Clinical and Experimental Medicine, Section of Psychiatry, University of Pisa, Pisa, Italy
- Unicamillus, Saint Camillus International University of Health Sciences, Rome, Italy
- Brain Research Foundation Onus, Lucca, Italy
| | - Darko Marčinko
- Department of Psychiatry and Psychological Medicine, University Hospital Centre Zagreb, Zagreb, Croatia
- School of Medicine, University of Zagreb, Zagreb, Croatia
| | - Stephanie Martinez
- Department of Psychiatry, University of California San Diego, San Diego, USA
| | - Eimantas Matiekus
- Clinic of Psychiatry, Institute of Clinical Medicine, Medical Faculty, Vilnius University, Vilnius, Lithuania
| | - Gabriela Mejia
- Department of Psychiatry, University of California San Diego, San Diego, USA
| | - Roha Saeed Memon
- Dow Medical College, Dow University of Health Sciences, Karachi, Pakistan
| | | | | | - Roumen Milev
- Department of Psychiatry, Queens University, Kingston, ON Canada
| | - Muftau Mohammed
- Department of Clinical Services, Federal Neuropsychiatric Hospital, Kaduna, Nigeria
| | - Alejandro Molina-López
- General Office for the Psychiatric Services of the Ministry of Health, Mexico City, Mexico
| | - Petr Morozov
- Department of Postgraduate Education, Russian National Research Medical University N.a. N.I. Pirogov, Moscow, Russia
| | - Nuru Suleiman Muhammad
- Department of Community Medicine, Ahmadu Bello University Teaching Hospital, Zaria, Nigeria
| | - Filip Mustač
- Department of Psychiatry and Psychological Medicine, University Hospital Centre Zagreb, Zagreb, Croatia
| | - Mika S. Naor
- Sackler School of Medicine New York State American Program, Tel Aviv University, Tel Aviv-Yafo, Israel
| | - Amira Nassieb
- Faculty of Medicine, Okasha Institute of Psychiatry, Ain Shams University, Cairo, Egypt
| | - Alvydas Navickas
- Clinic of Psychiatry, Institute of Clinical Medicine, Medical Faculty, Vilnius University, Vilnius, Lithuania
| | - Tarek Okasha
- Faculty of Medicine, Okasha Institute of Psychiatry, Ain Shams University, Cairo, Egypt
| | - Milena Pandova
- Second Psychiatric Clinic, University Hospital for Active Treatment in Neurology and Psychiatry “Saint Naum”, Sofia, Bulgaria
| | - Anca-Livia Panfil
- Compartment of Liaison Psychiatry, “Pius Brinzeu” County Emergency Clinical Hospital, Timisoara, Romania
| | - Liliya Panteleeva
- Department of Medical Psychology, Psychiatry and Psychotherapy, Kyrgyz-Russian Slavic University, Bishkek, Kyrgyz Republic
| | - Ion Papava
- Department of Neuroscience, Discipline of Psychiatry, “Victor Babes” University of Medicine and Pharmacy, Timisoara, Romania
| | - Mikaella E. Patsali
- School of Social Sciences, Hellenic Open University, Patras, Greece
- Department of Internal Medicine, Nicosia General Hospital, Nicosia, Cyprus
| | - Alexey Pavlichenko
- Ministry of Health, Millenium Institute for Research in Depression and Personality, Santiago, Chile
| | - Bojana Pejuskovic
- Faculty of Medicine, University of Belgrade, Belgrade, Serbia
- Clinical Department for Crisis and Affective Disorders, Institute of Mental Health, Belgrade, Serbia
| | | | - Mikhail Popkov
- Department of the Introduction to Internal Medicine and Family Medicine, International Higher School of Medicine, Bishkek, Kyrgyz Republic
| | | | - Nor Jannah Nasution Raduan
- Department of Psychiatry, Faculty of Medicine, Universiti Teknologi MARA, Sungai Buloh, Selangor, Malaysia
| | - Francisca Vargas Ramírez
- Child and Adolescent Psychiatry Department, Hospital Luis Calvo Mackenna, Santiago, Chile
- Universidad Diego Portales, Santiago, Chile
| | - Elmars Rancans
- Department of Psychiatry and Narcology, Riga Stradins University, Riga, Latvia
- Riga Centre of Psychiatry and Narcology, Riga, Latvia
| | - Salmi Razali
- Department of Psychiatry, Faculty of Medicine, Universiti Teknologi MARA, Sungai Buloh, Selangor, Malaysia
| | - Federico Rebok
- Servicio de Emergencia, Acute Inpatient Unit, Hospital Moyano, Buenos Aires, Argentina
- Argentine Institute of Clinical Psychiatry (IAPC), Buenos Aires, Argentina
| | - Anna Rewekant
- General Psychiatry Unit I, Greater Poland Neuropsychiatric Center, Kościan, Poland
| | | | - María Teresa Rivera-Encinas
- Centro de Investigación en Salud Pública, Facultad de Medicina, Universidad de San Martín de Porres, Instituto Nacional de Salud Mental “Honorio Delgado – Hideyo Noguchi”, Lima, Perú
| | - Pilar A. Saiz
- Psychiatry Area, Department of Medicine, University of Oviedo, ISPA, INEUROPA. CIBERSAM, Oviedo, Spain
| | | | - David Saucedo Martínez
- Department of Psychiatry, Escuela Nacional de Medicina, TEC de Monterrey. Servicio de Geriatría. Hospital Universitario “José Eleuterio González” UANL, Monterrey, Nuevo León México
| | - Jo Anne Saw
- Department of Psychiatry, Faculty of Medicine, Universiti Teknologi MARA, Sungai Buloh, Selangor, Malaysia
| | - Görkem Saygili
- Assistant Professor at Cognitive Science and Artificial Intelligence Department, Tilburg University, Tilburg, The Netherlands
| | - Patricia Schneidereit
- Klinik Für Allgemeine Psychiatrie Und Psychotherapie Ost, Psychiatrische Institutsambulanz, Klinikum Am Weissenhof, Weissenhof, Germany
| | | | - Tomohiro Shirasaka
- Department of Psychiatry, Teine Keijinkai Medical Center, Sapporo, Japan
| | | | - Satti Sitanggang
- Psychiatric Unit, Pambalah Batung General Hospital, South Kalimantan, Amuntai, Indonesia
| | - Oleg Skugarevsky
- Department of Psychiatry and Medical Psychology, Belarusian State Medical University, Minsk, Belarus
| | - Anna Spikina
- Saint Petersburg Psychoneurological Dispensary No2, Saint Petersburg, Russia
| | - Sridevi Sira Mahalingappa
- Derbyshire Healthcare NHS Foundation Trust, The Liasion Team, Royal Derby Hospital, Derby, Derbyshire UK
| | - Maria Stoyanova
- Second Psychiatric Clinic, University Hospital for Active Treatment in Neurology and Psychiatry “Saint Naum”, Sofia, Bulgaria
| | - Anna Szczegielniak
- Department of Psychiatric Rehabilitation, Department of Psychiatry and Psychotherapy, Faculty of Medical Sciences in Katowice, Medical University of Silesia, Katowice, Poland
| | - Simona Claudia Tamasan
- Compartment of Liaison Psychiatry, “Pius Brinzeu” County Emergency Clinical Hospital, Timisoara, Romania
| | - Giuseppe Tavormina
- Psychiatric Studies Centre, Provaglio d’Iseo, Italy
- European Depression Association and Italian Association on Depression, Brussels, Belgium
- Bedforshire Center for Mental Health Research, in association with the University of Cambridge, Cambridge, UK
| | | | | | - Mauricio Tohen
- Department of Psychiatry and Behavioral Sciences, School of Medicine, University of New Mexico, Albuquerque, NM USA
| | - Eva-Maria Tsapakis
- Agios Charalambos Mental Health Clinic, Heraklion, Crete Greece
- 1st Department of Academic Psychiatry, School of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Dina Tukhvatullina
- Centre for Global Public Health, Institute of Population Health Sciences, Queen Mary University of London, London, UK
| | - Irfan Ullah
- Kabir Medical College, Gandhara University, Peshawar, Pakistan
| | - Ratnaraj Vaidya
- Faculty of Medical Sciences, Newcastle University, Newcastle Upon Tyne, UK
| | | | - Jelena Vrublevska
- Department of Psychiatry and Narcology, Riga Stradins University, Riga, Latvia
- Riga Centre of Psychiatry and Narcology, Riga, Latvia
- Department of Psychiatry, Narcology, Psychotherapy and Clinical Psychology, Samara State Medical University, Samara, Russia
| | - Olivera Vukovic
- Department of Internal Medicine, Nicosia General Hospital, Nicosia, Cyprus
- Institute of Public Health, Riga Stradins University, Riga, Latvia
| | - Olga Vysotska
- Department for Research and Education, Institute of Mental Health, Belgrade, Serbia
| | - Natalia Widiasih
- Department of Psychiatry, Faculty of Medicine, Universitas Indonesia, Cipto Mangunkusumo National Referral Hospital, Jakarta, Indonesia
| | - Anna Yashikhina
- International Centre for Education and Research in Neuropsychiatry (ICERN), Samara State Medical University, Samara, Russia
- Educational and Research Center–Ukrainian Family Medicine Training Center, Bogomolets National Medical University, Kiev, Ukraine
| | - Panagiotis E. Prezerakos
- Department of Psychiatry, Narcology, Psychotherapy and Clinical Psychology, Samara State Medical University, Samara, Russia
| | - Michael Berk
- IMPACT–the Institute for Mental and Physical Health and Clinical Translation, Deakin University, School of Medicine, Barwon Health, Geelong, Australia
- Orygen The National Centre of Excellence in Youth Mental Health, Centre for Youth Mental Health, Florey Institute for Neuroscience and Mental Health and the Department of Psychiatry, The University of Melbourne, Melbourne, Australia
| | - Sarah Levaj
- Department of Psychiatry and Psychological Medicine, University Hospital Centre Zagreb, Zagreb, Croatia
| | - Daria Smirnova
- International Centre for Education and Research in Neuropsychiatry (ICERN), Samara State Medical University, Samara, Russia
- Department of Nursing, University of Peloponnese, Laboratory of Integrated Health Care, Tripoli, Greece
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Vukovic O, Folpini G, Wong EL, Leoncino L, Terraneo G, Albaqami MD, Petrozza A, Cortecchia D. Structural effects on the luminescence properties of CsPbI 3 nanocrystals. Nanoscale 2023; 15:5712-5719. [PMID: 36880499 PMCID: PMC10035506 DOI: 10.1039/d2nr06345j] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/12/2022] [Accepted: 02/14/2023] [Indexed: 06/18/2023]
Abstract
Metal halide perovskite nanocrystals (NCs) are promising for photovoltaic and light-emitting applications. Due to the softness of their crystal lattice, structural modifications have a critical impact on their optoelectronic properties. Here we investigate the size-dependent optoelectronic properties of CsPbI3 NCs ranging from 7 to 17 nm, employing temperature and pressure as thermodynamic variables to modulate the energetics of the system and selectively tune the interatomic distances. By temperature-dependent photoluminescence spectroscopy, we have found that luminescence quenching channels exhibit increased non-radiative losses and weaker exciton-phonon coupling in bigger particles, in turn affecting the luminescence efficiency. Through pressure-dependent measurements up to 2.5 GPa, supported by XRD characterization, we revealed a NC-size dependent solid-solid phase transition from the γ-phase to the δ-phase. Importantly, the optical response to these structural changes strongly depends on the size of the NC. Our findings provide an interesting guideline to correlate the size and structural and optoelectronic properties of CsPbI3 NCs, important for engineering the functionalities of this class of soft semiconductors.
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Affiliation(s)
- Olivera Vukovic
- Centre for Nano Science and Technology (CNST@PoliMi), Istituto Italiano di Tecnologia, Via Pascoli 70, Milan 20133, Italy.
- Molecular Materials and Nanosystems & Institute for Complex Molecular Systems, Eindhoven University of Technology, 5600 MB Eindhoven, The Netherlands
- Université de Pau & Pays Adour, CNRS, IPREM UMR 5254, 2 Avenue du Président Angot, Pau F-64053, France
| | - Giulia Folpini
- Centre for Nano Science and Technology (CNST@PoliMi), Istituto Italiano di Tecnologia, Via Pascoli 70, Milan 20133, Italy.
| | - E Laine Wong
- Centre for Nano Science and Technology (CNST@PoliMi), Istituto Italiano di Tecnologia, Via Pascoli 70, Milan 20133, Italy.
| | - Luca Leoncino
- Electron Microscopy Facility, Istituto Italiano di Tecnologia, Via Morego 30, Genova 16163, Italy
| | - Giancarlo Terraneo
- Laboratory of Supramolecular and Bio-Nanomaterials (SupraBioNanoLab), Department of Chemistry, Materials, and Chemical Engineering "Giulio Natta", Politecnico di Milano, via L. Mancinelli 7, 20131 Milano, Italy
| | - Munirah D Albaqami
- Chemistry Department, College of Science, King Saud University, Riyadh 11451, Saudi Arabia
| | - Annamaria Petrozza
- Centre for Nano Science and Technology (CNST@PoliMi), Istituto Italiano di Tecnologia, Via Pascoli 70, Milan 20133, Italy.
- Chemistry Department, College of Science, King Saud University, Riyadh 11451, Saudi Arabia
| | - Daniele Cortecchia
- Centre for Nano Science and Technology (CNST@PoliMi), Istituto Italiano di Tecnologia, Via Pascoli 70, Milan 20133, Italy.
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Fountoulakis KN, Karakatsoulis GN, Abraham S, Adorjan K, Ahmed HU, Alarcón RD, Arai K, Auwal SS, Berk M, Bjedov S, Bobes J, Bobes-Bascaran T, Bourgin-Duchesnay J, Bredicean CA, Bukelskis L, Burkadze A, Abud IIC, Castilla-Puentes R, Cetkovich M, Colon-Rivera H, Corral R, Cortez-Vergara C, Crepin P, De Berardis D, Delgado SZ, De Lucena D, De Sousa A, Stefano RD, Dodd S, Elek LP, Elissa A, Erdelyi-Hamza B, Erzin G, Etchevers MJ, Falkai P, Farcas A, Fedotov I, Filatova V, Fountoulakis NK, Frankova I, Franza F, Frias P, Galako T, Garay CJ, Garcia-Álvarez L, García-Portilla MP, Gonda X, Gondek TM, González DM, Gould H, Grandinetti P, Grau A, Groudeva V, Hagin M, Harada T, Hasan TM, Hashim NA, Hilbig J, Hossain S, Iakimova R, Ibrahim M, Iftene F, Ignatenko Y, Irarrazaval M, Ismail Z, Ismayilova J, Jacobs A, Jakovljević M, Jakšić N, Javed A, Kafali HY, Karia S, Kazakova O, Khalifa D, Khaustova O, Koh S, Kopishinskaia S, Kosenko K, Koupidis SA, Kovacs I, Kulig B, Lalljee A, Liewig J, Majid A, Malashonkova E, Malik K, Malik NI, Mammadzada G, Mandalia B, Marazziti D, Marčinko D, Martinez S, Matiekus E, Mejia G, Memon RS, Martínez XEM, Mickevičiūtė D, Milev R, Mohammed M, Molina-López A, Morozov P, Muhammad NS, Mustač F, Naor MS, Nassieb A, Navickas A, Okasha T, Pandova M, Panfil AL, Panteleeva L, Papava I, Patsali ME, Pavlichenko A, Pejuskovic B, Da Costa MP, Popkov M, Popovic D, Raduan NJN, Ramírez FV, Rancans E, Razali S, Rebok F, Rewekant A, Flores ENR, Rivera-Encinas MT, Saiz P, de Carmona MS, Martínez DS, Saw JA, Saygili G, Schneidereit P, Shah B, Shirasaka T, Silagadze K, Sitanggang S, Skugarevsky O, Spikina A, Mahalingappa SS, Stoyanova M, Szczegielniak A, Tamasan SC, Tavormina G, Tavormina MGM, Theodorakis PN, Tohen M, Tsapakis EM, Tukhvatullina D, Ullah I, Vaidya R, Vega-Dienstmaier JM, Vrublevska J, Vukovic O, Vysotska O, Widiasih N, Yashikhina A, Prezerakos PE, Smirnova D. The effect of different degrees of lockdown and self-identified gender on anxiety, depression and suicidality during the COVID-19 pandemic: Data from the international COMET-G study. Psychiatry Res 2022; 315:114702. [PMID: 35839639 PMCID: PMC9247180 DOI: 10.1016/j.psychres.2022.114702] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [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: 03/15/2022] [Revised: 06/16/2022] [Accepted: 06/29/2022] [Indexed: 01/01/2023]
Abstract
INTRODUCTION During the COVID-19 pandemic various degrees of lockdown were applied by countries around the world. It is considered that such measures have an adverse effect on mental health but the relationship of measure intensity with the mental health effect has not been thoroughly studied. Here we report data from the larger COMET-G study pertaining to this question. MATERIAL AND METHODS During the COVID-19 pandemic, data were gathered with an online questionnaire from 55,589 participants from 40 countries (64.85% females aged 35.80 ± 13.61; 34.05% males aged 34.90±13.29 and 1.10% other aged 31.64±13.15). Anxiety was measured with the STAI, depression with the CES-D and suicidality with the RASS. Distress and probable depression were identified with the use of a previously developed cut-off and algorithm respectively. STATISTICAL ANALYSIS It included the calculation of Relative Risk (RR), Factorial ANOVA and Multiple backwards stepwise linear regression analysis RESULTS: Approximately two-thirds were currently living under significant restrictions due to lockdown. For both males and females the risk to develop clinical depression correlated significantly with each and every level of increasing lockdown degree (RR 1.72 and 1.90 respectively). The combined lockdown and psychiatric history increased RR to 6.88 The overall relationship of lockdown with severity of depression, though significant was small. CONCLUSIONS The current study is the first which reports an almost linear relationship between lockdown degree and effect in mental health. Our findings, support previous suggestions concerning the need for a proactive targeted intervention to protect mental health more specifically in vulnerable groups.
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Affiliation(s)
- Konstantinos N. Fountoulakis
- 3rd Department of Psychiatry, School of Medicine, Aristotle University of Thessaloniki Greece, Thessaloniki, Greece
| | - Grigorios N. Karakatsoulis
- 3rd Department of Psychiatry, School of Medicine, Aristotle University of Thessaloniki Greece, Thessaloniki, Greece,Corresponding author
| | - Seri Abraham
- Pennine Care NHS Foundation Trust, United Kingdom,Manchester Metropolitan University, Manchester, United Kingdom,Core Psychiatry training, Health Education England North West, United Kingdom
| | - Kristina Adorjan
- Department of Psychiatry, Ludiwig-Maximilians-University, Munich, Germany
| | - Helal Uddin Ahmed
- Child Adolescent and Family Psychiatry, National Institute of Mental Health, Dhaka, Bangladesh
| | - Renato D. Alarcón
- Section of Psychiatry and Mental Health, Universidad Peruana Cayetano Heredia, Facultad de Medicina Alberto Hurtado, Lima, Peru,Department of Psychiatry and Psychology, Mayo Clinic School of Medicine, Rochester, MN, United States of America
| | - Kiyomi Arai
- School of Medicine and Health Science, Institute of Health Science Shinshu University, Matsumoto, Japan
| | - Sani Salihu Auwal
- Department of Psychiatry, Bayero University, Kano, Nigeria,Aminu Kano Teaching Hospital, Kano, Nigeria
| | - Michael Berk
- IMPACT – the Institute for Mental and Physical Health and Clinical Translation, Deakin University, School of Medicine, Barwon Health, Geelong, Australia,Orygen The National Centre of Excellence in Youth Mental Health, Centre for Youth Mental Health, Florey Institute for Neuroscience and Mental Health and the Department of Psychiatry, The University of Melbourne, Melbourne, Australia
| | - Sarah Bjedov
- Department of Psychiatry and Psychological Medicine, University Hospital Centre Zagreb, Zagreb, Croatia
| | - Julio Bobes
- Psychiatry Area, Department of Medicine, University of Ovied, ISPA, INEUROPA. CIBERSAM, Oviedo, Spain,Department of Psychiatry, Hospital Universitario Central de Asturias, Oviedo, ISPA, INEUROPA. CIBERSAM, Spain
| | - Teresa Bobes-Bascaran
- Mental Health Center of La Corredoria, Oviedo, ISPA, INEUROPA. CIBERSAM, Spain,Department of Psychology, University of Oviedo, Oviedo, ISPA, INEUROPA. CIBERSAM, Spain
| | - Julie Bourgin-Duchesnay
- Division of Child and Adolescent Psychiatry, Department of Psychiatry, Groupe Hospitalier Nord Essonne, Orsay, France
| | - Cristina Ana Bredicean
- Department of Neuroscience, Discipline of Psychiatry, "Victor Babes" University of Medicine and Pharmacy, Timisoara, Romania
| | - Laurynas Bukelskis
- Clinic of Psychiatry, Institute of Clinical Medicine, Medical Faculty, Vilnius University, Vilnius, Lithuania
| | - Akaki Burkadze
- Mental Hub, Tbilisi, Georgia,NGO Healthcare Research and Quality Agency, Tbilisi, Georgia
| | | | - Ruby Castilla-Puentes
- Janssen Research and Development, Johnson & Johnson, American Society of Hispanic Psychiatry and WARMI Women Mental Health, Cincinnati, Ohio, United States
| | - Marcelo Cetkovich
- Institute of Translational and Cognitive Neuroscience (INCyT), INECO Foundation, Favaloro University, Buenos Aires, Argentina,National Scientific and Technical Research Council (CONICET), Buenos Aires, Argentina
| | - Hector Colon-Rivera
- APM Board Certified in General Psychiatry and Neurology, Addiction Psychiatry & Addiction Medicine, UPMC, DDAP, Philadelphia, United States
| | - Ricardo Corral
- Department of Teaching and Research, Hospital Borda, Buenos Aires, Argentina,University of Buenos Aires, Buenos Aires, Argentina
| | | | - Piirika Crepin
- Sanitaire and Social Union for Accompaniment and Prevention, Center of Ambulatory Psychiatry of Narbonne and Lezigan, Narbonne, France
| | - Domenico De Berardis
- Department of Mental Health, Psychiatric Service of Diagnosis and Treatment, Hospital “G. Mazzini”, ASL Teramo, Teramo, Italy,School of Nursing, University of L'Aquila, Italy,Department of Neuroscience and Imaging, School of Psychiatry, University of Chieti, Chieti, Italy
| | - Sergio Zamora Delgado
- Child and Adolescent Psychiatry Department, Hospital Luis Calvo Mackenna, Santiago, Chile
| | - David De Lucena
- Departamento de Fisiología e Farmacología, Universidade Federal do Ceará, Fortaleza, Ceará, Brazil
| | - Avinash De Sousa
- Department of Psychiatry, Lokmanya Tilak Municipal Medical College, Mumbai, India,Desousa Foundation, Mumbai, India
| | - Ramona Di Stefano
- Department of Biotechnological and Applied Clinical Sciences, Section of Psychiatry, University of L'Aquila, L'Aquila, Italy
| | - Seetal Dodd
- IMPACT – the Institute for Mental and Physical Health and Clinical Translation, Deakin University, School of Medicine, Barwon Health, Geelong, Australia,Orygen The National Centre of Excellence in Youth Mental Health, Centre for Youth Mental Health, Florey Institute for Neuroscience and Mental Health and the Department of Psychiatry, The University of Melbourne, Melbourne, Australia,University Hospital Geelong, Barwon Health, Geelong, Victoria, Australia
| | - Livia Priyanka Elek
- Department of Psychiatry and Psychotherapy, Semmelweis University, Budapest, Hungary
| | - Anna Elissa
- Department of Psychiatry, Faculty of Medicine, Universitas Indonesia, Cipto Mangunkusumo National Referral Hospital, Jakarta, Indonesia
| | - Berta Erdelyi-Hamza
- Department of Psychiatry and Psychotherapy, Semmelweis University, Budapest, Hungary
| | - Gamze Erzin
- Psychiatry department, Ankara dışkapı training and research hospital, Ankara, Turkey,Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University Medical Center, Maastricht, the Netherlands
| | - Martin J. Etchevers
- Faculty of Psychology, University of Buenos Aires (UBA), Buenos Aires, Argentina
| | - Peter Falkai
- Department of Psychiatry, Ludiwig-Maximilians-University, Munich, Germany
| | - Adriana Farcas
- Centre of Neuroscience, Queen's University, Kingston, Ontario, Canada
| | - Ilya Fedotov
- Department of Psychiatry and Narcology, Ryazan State Medical University n.a. academician I.P. Pavlov, Ryazan, Russia
| | - Viktoriia Filatova
- State Budgetary Institution of the Rostov Region "Psychoneurological Dispensary", Rostov-on-Don, Russia
| | | | - Iryna Frankova
- Medical Psychology, Psychosomatic Medicine and Psychotherapy Department, Bogomolets National Medical University, Kyiv, Ukraine
| | - Francesco Franza
- “Villa dei Pini” Psychiatric Rehabilitation Center, Avellino, Italy,Psychiatric Studies Centre, Provaglio d'Iseo, Italy
| | | | - Tatiana Galako
- Department of Psychiatry, Medical Psychology and Drug Abuse, Kyrgyz State Medical Academy, Bishkek, Kyrgyz Republic
| | - Cristian J. Garay
- Faculty of Psychology, University of Buenos Aires (UBA), Buenos Aires, Argentina
| | | | - Maria Paz García-Portilla
- Psychiatry Area, Department of Medicine, University of Ovied, ISPA, INEUROPA. CIBERSAM, Oviedo, Spain,Mental Health Center of La Ería, Oviedo, ISPA, INEUROPA. CIBERSAM, Spain
| | - Xenia Gonda
- Department of Psychiatry and Psychotherapy, Semmelweis University, Budapest, Hungary
| | - Tomasz M. Gondek
- Specialty Training Section, Polish Psychiatric Association, Wroclaw, Poland
| | | | - Hilary Gould
- Department of Psychiatry, University of California San Diego, San Diego, United States
| | - Paolo Grandinetti
- Department of Mental Health, Psychiatric Service of Diagnosis and Treatment, Hospital “G. Mazzini”, ASL Teramo, Teramo, Italy
| | - Arturo Grau
- Child and Adolescent Psychiatry Department, Hospital Luis Calvo Mackenna, Santiago, Chile,Universidad Diego Portales, Santiago, Chile
| | - Violeta Groudeva
- Department of Diagnostic Imaging, University Hospital Saint Ekaterina, Sofia, Bulgaria
| | - Michal Hagin
- Forensic Psychiatry Unit, Abarbanel Mental Health Center, Israel
| | - Takayuki Harada
- Faculty of Human Sciences, Education Bureau of the Laboratory Schools, University of Tsukuba, Tokyo, Japan
| | - Tasdik M. Hasan
- Department of Primary Care & Mental Health, University of Liverpool, Liverpool, United Kingdom,Public Health Foundation, Dhaka, Bangladesh
| | - Nurul Azreen Hashim
- Department of Psychiatry, Faculty of Medicine, Universiti Teknologi MARA, Sungai Buloh, Selangor, Malaysia
| | - Jan Hilbig
- Clinic of Psychiatry, Institute of Clinical Medicine, Medical Faculty, Vilnius University, Vilnius, Lithuania
| | - Sahadat Hossain
- Department of Public Health & Informatics, Jahangirnagar University, Dhaka, Bangladesh
| | - Rossitza Iakimova
- Second Psychiatric Clinic, University Hospital for Active Treatment in Neurology and Psychiatry "Saint Naum", Sofia, Bulgaria
| | - Mona Ibrahim
- Okasha Institute of Psychiatry, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Felicia Iftene
- Department of Psychiatry, Queens University, Kingston, Ontario, Canada
| | - Yulia Ignatenko
- Education center, Mental Health Clinic No 1n.a. N.A. Alexeev of Moscow Healthcare Department, Moscow, Russia
| | - Matias Irarrazaval
- Ministry of Health, Millenium Institute for Research in Depression and Personality, Santiago, Chile
| | - Zaliha Ismail
- Department of Public Health Medicine, Faculty of Medicine, Universiti Teknologi MARA, Sungai Buloh, Selangor, Malaysia
| | - Jamila Ismayilova
- National Mental Health Center of the Ministry of Health of the Republic of Azerbaijan, Baku, Azerbaijan
| | - Asaf Jacobs
- Department of Psychiatry, Westchester Medical Center Health System, Valhalla, NY, United States,New York Medical College, Valhalla, NY, United States
| | | | - Nenad Jakšić
- Department of Psychiatry and Psychological Medicine, University Hospital Centre Zagreb, Zagreb, Croatia
| | - Afzal Javed
- Institute of Applied Health Research, University of Birmingham, United Kingdom,Warwick Medical School, University of Warwick, United Kingdom,Pakistan Psychiatric Research Centre, Fountain House, Lahore, Pakistan
| | | | - Sagar Karia
- Department of Psychiatry, Lokmanya Tilak Municipal Medical College, Mumbai, India
| | | | - Doaa Khalifa
- Okasha Institute of Psychiatry, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Olena Khaustova
- Medical Psychology, Psychosomatic Medicine and Psychotherapy Department, Bogomolets National Medical University, Kyiv, Ukraine
| | - Steve Koh
- Department of Psychiatry, University of California San Diego, San Diego, United States
| | - Svetlana Kopishinskaia
- International Centre for Education and Research in Neuropsychiatry (ICERN), Samara State Medical University, Samara, Russia,Kirov State Medical University, Kirov, Russia
| | - Korneliia Kosenko
- Psychiatry, Drug abuse and Psychology Department, Odessa National Medical University, Odessa, Ukraine
| | | | - Illes Kovacs
- Department of Psychiatry and Psychotherapy, Semmelweis University, Budapest, Hungary
| | - Barbara Kulig
- Department of Psychiatry and Psychotherapy, Semmelweis University, Budapest, Hungary
| | | | - Justine Liewig
- Division of Child and Adolescent Psychiatry, Department of Psychiatry, Groupe Hospitalier Nord Essonne, Orsay, France
| | - Abdul Majid
- Department of Psychiatry, SKIMS Medical College, Srinagar, India
| | - Evgeniia Malashonkova
- Division of Child and Adolescent Psychiatry, Department of Psychiatry, Groupe Hospitalier Nord Essonne, Orsay, France
| | - Khamelia Malik
- Department of Psychiatry, Faculty of Medicine, Universitas Indonesia, Cipto Mangunkusumo National Referral Hospital, Jakarta, Indonesia
| | - Najma Iqbal Malik
- Department of Psychology, University of Sargodha, Sargodha, Pakistan
| | - Gulay Mammadzada
- Department of Psychiatry, Azerbaijan Medical University, Baku, Azerbaijan
| | | | - Donatella Marazziti
- Department of Clinical and Experimental Medicine, Section of Psychiatry, University of Pisa, Pisa, Italy,Unicamillus, Saint Camillus International University of Health Sciences, Rome, Italy,Brain Research Foundation onus, Lucca, Italy
| | - Darko Marčinko
- Department of Psychiatry and Psychological Medicine, University Hospital Centre Zagreb, Zagreb, Croatia,School of Medicine, University of Zagreb, Zagreb, Croatia
| | - Stephanie Martinez
- Department of Psychiatry, University of California San Diego, San Diego, United States
| | - Eimantas Matiekus
- Clinic of Psychiatry, Institute of Clinical Medicine, Medical Faculty, Vilnius University, Vilnius, Lithuania
| | - Gabriela Mejia
- Department of Psychiatry, University of California San Diego, San Diego, United States
| | - Roha Saeed Memon
- Dow Medical College, Dow University of Health Sciences, Karachi, Pakistan
| | | | | | - Roumen Milev
- Department of Psychiatry, Queens University, Kingston, Ontario, Canada
| | - Muftau Mohammed
- Department of Clinical Services, Federal Neuropsychiatric Hospital, Kaduna, Nigeria
| | - Alejandro Molina-López
- General Office for the Psychiatric Services of the Ministry of Health, Mexico City, Mexico
| | - Petr Morozov
- Department of Postgraduate Education, Russian National Research Medical University n.a. N.I. Pirogov, Moscow, Russia
| | - Nuru Suleiman Muhammad
- Department of Community Medicine, Ahmadu Bello University Teaching Hospital, Zaria, Nigeria
| | - Filip Mustač
- Department of Psychiatry and Psychological Medicine, University Hospital Centre Zagreb, Zagreb, Croatia
| | - Mika S. Naor
- Sackler School of Medicine New York State American Program, Tel Aviv University, Tel Aviv-Yafo, Israel
| | - Amira Nassieb
- Okasha Institute of Psychiatry, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Alvydas Navickas
- Clinic of Psychiatry, Institute of Clinical Medicine, Medical Faculty, Vilnius University, Vilnius, Lithuania
| | - Tarek Okasha
- Okasha Institute of Psychiatry, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Milena Pandova
- Second Psychiatric Clinic, University Hospital for Active Treatment in Neurology and Psychiatry "Saint Naum", Sofia, Bulgaria
| | - Anca-Livia Panfil
- Compartment of Liaison Psychiatry, “Pius Brinzeu” County Emergency Clinical Hospital, Timisoara, Romania
| | - Liliya Panteleeva
- Department of Medical Psychology, Psychiatry and Psychotherapy, Kyrgyz-Russian Slavic University, Bishkek, Kyrgyz Republic
| | - Ion Papava
- Department of Neuroscience, Discipline of Psychiatry, "Victor Babes" University of Medicine and Pharmacy, Timisoara, Romania
| | - Mikaella E. Patsali
- School of Social Sciences, Hellenic Open University, Patras, Greece,Department of Internal Medicine, Nicosia General Hospital, Nicosia, Cyprus
| | - Alexey Pavlichenko
- Education center, Mental Health Clinic No 1n.a. N.A. Alexeev of Moscow Healthcare Department, Moscow, Russia
| | - Bojana Pejuskovic
- Faculty of Medicine, University of Belgrade, Belgrade, Serbia,Clinical Department for Crisis and Affective Disorders, Institute of Mental Health, Belgrade, Serbia
| | - Mariana Pinto Da Costa
- South London and Maudsley NHS Foundation Trust, London, United Kingdom,Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, United Kingdom,Institute of Biomedical Sciences Abel Salazar, University of Porto, Porto, Portugal
| | - Mikhail Popkov
- Department of the Introduction to Internal Medicine and Family Medicine, International Higher School of Medicine, Bishkek, Kyrgyz Republic
| | | | - Nor Jannah Nasution Raduan
- Department of Psychiatry, Faculty of Medicine, Universiti Teknologi MARA, Sungai Buloh, Selangor, Malaysia
| | - Francisca Vargas Ramírez
- Child and Adolescent Psychiatry Department, Hospital Luis Calvo Mackenna, Santiago, Chile,Universidad Diego Portales, Santiago, Chile
| | - Elmars Rancans
- Department of Psychiatry and Narcology, Riga Stradins University, Riga, Latvia,Riga Centre of Psychiatry and Narcology, Riga, Latvia
| | - Salmi Razali
- Department of Psychiatry, Faculty of Medicine, Universiti Teknologi MARA, Sungai Buloh, Selangor, Malaysia
| | - Federico Rebok
- Servicio de Emergencia, Acute inpatient Unit, Hospital Moyano, Buenos Aires, Argentina,Argentine Institute of Clinical Psychiatry (IAPC), Buenos Aires, Argentina
| | - Anna Rewekant
- General Psychiatry Unit I, Greater Poland Neuropsychiatric Center, Kościan, Poland
| | | | - María Teresa Rivera-Encinas
- Centro de Investigación en Salud Pública, Facultad de Medicina, Universidad de San Martín de Porres, Instituto Nacional de Salud Mental “Honorio Delgado – Hideyo Noguchi”, Lima, Perú
| | - Pilar Saiz
- Psychiatry Area, Department of Medicine, University of Ovied, ISPA, INEUROPA. CIBERSAM, Oviedo, Spain,Mental Health Center of La Corredoria, Oviedo, ISPA, INEUROPA. CIBERSAM, Spain
| | | | - David Saucedo Martínez
- Department of Psychiatry. Escuela Nacional de Medicina, TEC de Monterrey. Servicio de geriatría. Hospital Universitario "José Eleuterio González" UANL. Monterrey, Nuevo León Mexico
| | - Jo Anne Saw
- Department of Psychiatry, Faculty of Medicine, Universiti Teknologi MARA, Sungai Buloh, Selangor, Malaysia
| | - Görkem Saygili
- Assistant Professor at Cognitive Science and Artificial Intelligence Department Tilburg University, United States
| | - Patricia Schneidereit
- Klinik für Allgemeine Psychiatrie und Psychotherapie Ost, Psychiatrische Institutsambulanz, Klinikum am Weissenhof, Weissenhof, Germany
| | | | - Tomohiro Shirasaka
- Department of Psychiatry, Teine Keijinkai Medical Center, Sapporo, Japan
| | | | - Satti Sitanggang
- Psychiatric Unit, Pambalah Batung General Hospital, South Kalimantan, Amuntai, Indonesia
| | - Oleg Skugarevsky
- Department of Psychiatry and Medical Psychology, Belarusian State Medical University, Minsk, Belarus
| | - Anna Spikina
- Saint Petersburg Psychoneurological Dispensary No2, Saint Petersburg, Russia
| | - Sridevi Sira Mahalingappa
- Derbyshire Healthcare NHS Foundation Trust, The Liasion Team, Royal Derby Hospital, Derby, Derbyshire, United Kingdom
| | - Maria Stoyanova
- Second Psychiatric Clinic, University Hospital for Active Treatment in Neurology and Psychiatry "Saint Naum", Sofia, Bulgaria
| | - Anna Szczegielniak
- Department of Psychiatric Rehabilitation, Department of Psychiatry and Psychotherapy, Faculty of Medical Sciences in Katowice, Medical University of Silesia, Poland
| | - Simona Claudia Tamasan
- Compartment of Liaison Psychiatry, “Pius Brinzeu” County Emergency Clinical Hospital, Timisoara, Romania
| | - Giuseppe Tavormina
- Psychiatric Studies Centre, Provaglio d'Iseo, Italy,European Depression Association and Italian Association on Depression, Brussels, Belgium,Bedforshire Center for Mental Health Research in association with the University of Cambridge, United Kingdom
| | | | | | - Mauricio Tohen
- Department of Psychiatry and Behavioral Sciences, School of Medicine, University of New Mexico, Albuquerque, New Mexico, United States of America
| | - Eva Maria Tsapakis
- ″Agios Charalambos" Mental Health Clinic, Heraklion, Crete, Greece,1st Department of Academic Psychiatry, School of Medicine, Aristotle University of Thessaloniki, Greece
| | - Dina Tukhvatullina
- Centre for Global Public Health, Institute of Population Health Sciences, Queen Mary University of London, London, United Kingdom
| | - Irfan Ullah
- Kabir Medical College, Gandhara University, Peshawar, Pakistan
| | - Ratnaraj Vaidya
- Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, United Kingdom
| | | | - Jelena Vrublevska
- Department of Psychiatry and Narcology, Riga Stradins University, Riga, Latvia,Riga Centre of Psychiatry and Narcology, Riga, Latvia,Institute of Public Health, Riga Stradins University, Riga, Latvia
| | - Olivera Vukovic
- Faculty of Medicine, University of Belgrade, Belgrade, Serbia,Department for Research and Education, Institute of Mental Health, Belgrade, Serbia
| | - Olga Vysotska
- Educational and Research Center - Ukrainian Family Medicine Training Center, Bogomolets National Medical University, Kyiv, Ukraine
| | - Natalia Widiasih
- Department of Psychiatry, Faculty of Medicine, Universitas Indonesia, Cipto Mangunkusumo National Referral Hospital, Jakarta, Indonesia
| | - Anna Yashikhina
- International Centre for Education and Research in Neuropsychiatry (ICERN), Samara State Medical University, Samara, Russia,Department of Psychiatry, Narcology, Psychotherapy and Clinical Psychology, Samara State Medical University, Samara, Russia
| | - Panagiotis E. Prezerakos
- Department of Nursing, University of Peloponnese, Laboratory of Integrated Health Care, Tripoli, Greece
| | - Daria Smirnova
- International Centre for Education and Research in Neuropsychiatry (ICERN), Samara State Medical University, Samara, Russia,Department of Psychiatry, Narcology, Psychotherapy and Clinical Psychology, Samara State Medical University, Samara, Russia
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Fountoulakis KN, Karakatsoulis G, Abraham S, Adorjan K, Ahmed HU, Alarcón RD, Arai K, Auwal SS, Berk M, Bjedov S, Bobes J, Bobes-Bascaran T, Bourgin-Duchesnay J, Bredicean CA, Bukelskis L, Burkadze A, Abud IIC, Castilla-Puentes R, Cetkovich M, Colon-Rivera H, Corral R, Cortez-Vergara C, Crepin P, De Berardis D, Zamora Delgado S, De Lucena D, De Sousa A, Stefano RD, Dodd S, Elek LP, Elissa A, Erdelyi-Hamza B, Erzin G, Etchevers MJ, Falkai P, Farcas A, Fedotov I, Filatova V, Fountoulakis NK, Frankova I, Franza F, Frias P, Galako T, Garay CJ, Garcia-Álvarez L, García-Portilla MP, Gonda X, Gondek TM, González DM, Gould H, Grandinetti P, Grau A, Groudeva V, Hagin M, Harada T, Hasan MT, Hashim NA, Hilbig J, Hossain S, Iakimova R, Ibrahim M, Iftene F, Ignatenko Y, Irarrazaval M, Ismail Z, Ismayilova J, Jacobs A, Jakovljević M, Jakšić N, Javed A, Kafali HY, Karia S, Kazakova O, Khalifa D, Khaustova O, Koh S, Kopishinskaia S, Kosenko K, Koupidis SA, Kovacs I, Kulig B, Lalljee A, Liewig J, Majid A, Malashonkova E, Malik K, Malik NI, Mammadzada G, Mandalia B, Marazziti D, Marčinko D, Martinez S, Matiekus E, Mejia G, Memon RS, Martínez XEM, Mickevičiūtė D, Milev R, Mohammed M, Molina-López A, Morozov P, Muhammad NS, Mustač F, Naor MS, Nassieb A, Navickas A, Okasha T, Pandova M, Panfil AL, Panteleeva L, Papava I, Patsali ME, Pavlichenko A, Pejuskovic B, Pinto Da Costa M, Popkov M, Popovic D, Raduan NJN, Ramírez FV, Rancans E, Razali S, Rebok F, Rewekant A, Flores ENR, Rivera-Encinas MT, Saiz P, de Carmona MS, Martínez DS, Saw JA, Saygili G, Schneidereit P, Shah B, Shirasaka T, Silagadze K, Sitanggang S, Skugarevsky O, Spikina A, Mahalingappa SS, Stoyanova M, Szczegielniak A, Tamasan SC, Tavormina G, Tavormina MGM, Theodorakis PN, Tohen M, Tsapakis EM, Tukhvatullina D, Ullah I, Vaidya R, Vega-Dienstmaier JM, Vrublevska J, Vukovic O, Vysotska O, Widiasih N, Yashikhina A, Prezerakos PE, Smirnova D. Results of the COVID-19 mental health international for the general population (COMET-G) study. Eur Neuropsychopharmacol 2022; 54:21-40. [PMID: 34758422 PMCID: PMC8609892 DOI: 10.1016/j.euroneuro.2021.10.004] [Citation(s) in RCA: 65] [Impact Index Per Article: 32.5] [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: 08/16/2021] [Revised: 10/05/2021] [Accepted: 10/08/2021] [Indexed: 11/30/2022]
Abstract
INTRODUCTION There are few published empirical data on the effects of COVID-19 on mental health, and until now, there is no large international study. MATERIAL AND METHODS During the COVID-19 pandemic, an online questionnaire gathered data from 55,589 participants from 40 countries (64.85% females aged 35.80 ± 13.61; 34.05% males aged 34.90±13.29 and 1.10% other aged 31.64±13.15). Distress and probable depression were identified with the use of a previously developed cut-off and algorithm respectively. STATISTICAL ANALYSIS Descriptive statistics were calculated. Chi-square tests, multiple forward stepwise linear regression analyses and Factorial Analysis of Variance (ANOVA) tested relations among variables. RESULTS Probable depression was detected in 17.80% and distress in 16.71%. A significant percentage reported a deterioration in mental state, family dynamics and everyday lifestyle. Persons with a history of mental disorders had higher rates of current depression (31.82% vs. 13.07%). At least half of participants were accepting (at least to a moderate degree) a non-bizarre conspiracy. The highest Relative Risk (RR) to develop depression was associated with history of Bipolar disorder and self-harm/attempts (RR = 5.88). Suicidality was not increased in persons without a history of any mental disorder. Based on these results a model was developed. CONCLUSIONS The final model revealed multiple vulnerabilities and an interplay leading from simple anxiety to probable depression and suicidality through distress. This could be of practical utility since many of these factors are modifiable. Future research and interventions should specifically focus on them.
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Affiliation(s)
- Konstantinos N Fountoulakis
- 3(rd) Department of Psychiatry, School of Medicine, Aristotle University of Thessaloniki Greece, Thessaloniki, Greece.
| | - Grigorios Karakatsoulis
- 3(rd) Department of Psychiatry, School of Medicine, Aristotle University of Thessaloniki Greece, Thessaloniki, Greece.
| | - Seri Abraham
- Pennine Care NHS Foundation Trust, United Kingdom; Manchester Metropolitan University, Manchester, United Kingdom; Core Psychiatry training, Health Education England North West, United Kingdom.
| | - Kristina Adorjan
- Department of Psychiatry, Ludiwig-Maximilians-University, Munich, Germany.
| | - Helal Uddin Ahmed
- Child Adolescent and Family Psychiatry, National Institute of Mental Health, Dhaka, Bangladesh.
| | - Renato D Alarcón
- Section of Psychiatry and Mental Health, Universidad Peruana Cayetano Heredia, Facultad de Medicina Alberto Hurtado, Lima, Peru; Department of Psychiatry and Psychology, Mayo Clinic School of Medicine, Rochester, MN, USA.
| | - Kiyomi Arai
- School of Medicine and Health Science, Institute of Health Science Shinshu University, Matsumoto, Japan.
| | - Sani Salihu Auwal
- Department of Psychiatry, Bayero University, Kano, Nigeria; Aminu Kano Teaching Hospital, Kano, Nigeria.
| | - Michael Berk
- IMPACT - the Institute for Mental and Physical Health and Clinical Translation, Deakin University, School of Medicine, Barwon Health, Geelong, Australia; Orygen The National Centre of Excellence in Youth Mental Health, Centre for Youth Mental Health, Florey Institute for Neuroscience and Mental Health and the Department of Psychiatry, The University of Melbourne, Melbourne, Australia.
| | - Sarah Bjedov
- Department of Psychiatry and Psychological Medicine, University Hospital Centre Zagreb, Zagreb, Croatia.
| | - Julio Bobes
- Psychiatry Area, Department of Medicine, University of Oviedo, Oviedo, Spain, ISPA, INEUROPA. CIBERSAM; Department of Psychiatry, Hospital Universitario Central de Asturias, Oviedo, Spain, ISPA, INEUROPA. CIBERSAM.
| | - Teresa Bobes-Bascaran
- Mental Health Center of La Corredoria, Oviedo, Spain, ISPA, INEUROPA. CIBERSAM; Department of Psychology, University of Oviedo, Oviedo, Spain, ISPA, INEUROPA. CIBERSAM.
| | - Julie Bourgin-Duchesnay
- Division of Child and Adolescent Psychiatry, Department of Psychiatry, Groupe Hospitalier Nord Essonne, Orsay, France.
| | - Cristina Ana Bredicean
- Department of Neuroscience, Discipline of Psychiatry, "Victor Babes" University of Medicine and Pharmacy, Timisoara, Romania.
| | - Laurynas Bukelskis
- Clinic of Psychiatry, Institute of Clinical Medicine, Medical Faculty, Vilnius University, Vilnius, Lithuania.
| | - Akaki Burkadze
- Mental Hub, Tbilisi, Georgia; NGO Healthcare Research and Quality Agency, Tbilisi, Georgia.
| | | | - Ruby Castilla-Puentes
- Janssen Research and Development, Johnson & Johnson, American Society of Hispanic Psychiatry and WARMI Women Mental Health, Cincinnati, Ohio, USA.
| | - Marcelo Cetkovich
- Institute of Translational and Cognitive Neuroscience (INCyT), INECO Foundation, Favaloro University, Buenos Aires, Argentina; National Scientific and Technical Research Council (CONICET), Buenos Aires, Argentina.
| | - Hector Colon-Rivera
- APM Board Certified in General Psychiatry and Neurology, Addiction Psychiatry, & Addiction Medicine, UPMC, DDAP, Philadelphia, USA.
| | - Ricardo Corral
- Department of Teaching and Research, Hospital Borda, Buenos Aires, Argentina; University of Buenos Aires, Buenos Aires, Argentina.
| | | | - Piirika Crepin
- Sanitaire and Social Union for Accompaniment and Prevention, Center of Ambulatory Psychiatry of Narbonne and Lezigan, Narbonne, France.
| | - Domenico De Berardis
- Department of Mental Health, Psychiatric Service of Diagnosis and Treatment, Hospital "G. Mazzini", ASL Teramo, Teramo, Italy; School of Nursing, University of L'Aquila, Italy; Department of Neuroscience and Imaging, School of Psychiatry, University of Chieti, Chieti, Italy.
| | - Sergio Zamora Delgado
- Child and Adolescent Psychiatry Department, Hospital Luis Calvo Mackenna, Santiago, Chile.
| | - David De Lucena
- Departamento de Fisiología e Farmacología, Universidade Federal do Ceará, Fortaleza, Ceará, Brazil.
| | - Avinash De Sousa
- Department of Psychiatry, Lokmanya Tilak Municipal Medical College, Mumbai, India; Desousa Foundation, Mumbai, India.
| | - Ramona Di Stefano
- University Hospital Geelong, Barwon Health, Geelong, Victoria, Australia.
| | - Seetal Dodd
- IMPACT - the Institute for Mental and Physical Health and Clinical Translation, Deakin University, School of Medicine, Barwon Health, Geelong, Australia; Orygen The National Centre of Excellence in Youth Mental Health, Centre for Youth Mental Health, Florey Institute for Neuroscience and Mental Health and the Department of Psychiatry, The University of Melbourne, Melbourne, Australia; University Hospital Geelong, Barwon Health, Geelong, Victoria, Australia.
| | - Livia Priyanka Elek
- Department of Psychiatry, Faculty of Medicine, Universitas Indonesia, Cipto Mangunkusumo National Referral Hospital, Jakarta, Indonesia.
| | - Anna Elissa
- Psychiatry department, Ankara dışkapı training and research hospital, Ankara, Turkey.
| | - Berta Erdelyi-Hamza
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University Medical Center, Maastricht, The Netherlands.
| | - Gamze Erzin
- Faculty of Psychology, University of Buenos Aires (UBA), Buenos Aires, Argentina; Centre of Neuroscience, Queen's University, Kingston, Ontario, Canada.
| | - Martin J Etchevers
- Department of Psychiatry and Narcology, Ryazan State Medical University n.a. academician I.P. Pavlov, Ryazan, Russia.
| | - Peter Falkai
- Department of Psychiatry, Ludiwig-Maximilians-University, Munich, Germany.
| | - Adriana Farcas
- State Budgetary Institution of the Rostov Region "Psychoneurological Dispensary", Rostov-on-Don, Russia.
| | - Ilya Fedotov
- State Budgetary Institution of the Rostov Region "Psychoneurological Dispensary", Rostov-on-Don, Russia.
| | - Viktoriia Filatova
- State Budgetary Institution of the Rostov Region "Psychoneurological Dispensary", Rostov-on-Don, Russia.
| | | | - Iryna Frankova
- Medical Psychology, Psychosomatic Medicine and Psychotherapy Department, Bogomolets National Medical University, Kyiv, Ukraine.
| | - Francesco Franza
- "Villa dei Pini" Psychiatric Rehabilitation Center, Avellino, Italy; Psychiatric Studies Centre, Provaglio d'Iseo, Italy.
| | | | - Tatiana Galako
- Department of Psychiatry, Medical Psychology and Drug Abuse, Kyrgyz State Medical Academy, Bishkek, Kyrgyz Republic.
| | - Cristian J Garay
- Faculty of Psychology, University of Buenos Aires (UBA), Buenos Aires, Argentina.
| | - Leticia Garcia-Álvarez
- Department of Psychology, University of Oviedo, Oviedo, Spain, ISPA, INEUROPA. CIBERSAM.
| | - Maria Paz García-Portilla
- Psychiatry Area, Department of Medicine, University of Oviedo, Oviedo, Spain, ISPA, INEUROPA. CIBERSAM; Mental Health Center of La Ería, Oviedo, Spain, ISPA, INEUROPA. CIBERSAM.
| | - Xenia Gonda
- Department of Psychiatry and Psychotherapy, Semmelweis University, Budapest, Hungary.
| | - Tomasz M Gondek
- Specialty Training Section, Polish Psychiatric Association, Wroclaw, Poland.
| | | | - Hilary Gould
- Department of Psychiatry, University of California San Diego, San Diego, USA.
| | - Paolo Grandinetti
- Department of Mental Health, Psychiatric Service of Diagnosis and Treatment, Hospital "G. Mazzini", ASL Teramo, Teramo, Italy.
| | - Arturo Grau
- Child and Adolescent Psychiatry Department, Hospital Luis Calvo Mackenna, Santiago, Chile; Forensic Psychiatry Unit, Abarbanel Mental Health Center, Israel.
| | - Violeta Groudeva
- Faculty of Human Sciences, Education Bureau of the Laboratory Schools, University of Tsukuba, Tokyo, Japan.
| | - Michal Hagin
- Department of Primary Care & Mental Health, University of Liverpool, Liverpool, United Kingdom.
| | | | - M Tasdik Hasan
- Department of Primary Care & Mental Health, University of Liverpool, Liverpool, United Kingdom; Public Health Foundation, Dhaka, Bangladesh.
| | - Nurul Azreen Hashim
- Second Psychiatric Clinic, University Hospital for Active Treatment in Neurology and Psychiatry "Saint Naum", Sofia, Bulgaria.
| | | | - Sahadat Hossain
- Department of Public Health & Informatics, Jahangirnagar University, Dhaka, Bangladesh.
| | - Rossitza Iakimova
- Department of Psychiatry, Queens University, Kingston, Ontario, Canada.
| | - Mona Ibrahim
- Okasha Institute of Psychiatry, Faculty of Medicine, Ain Shams University, Cairo, Egypt.
| | - Felicia Iftene
- Ministry of Health, Millenium Institute for Research in Depression and Personality, Santiago, Chile.
| | - Yulia Ignatenko
- Department of Public Health Medicine, Faculty of Medicine, Universiti Teknologi MARA, Sungai Buloh, Selangor, Malaysia.
| | - Matias Irarrazaval
- National Mental Health Center of the Ministry of Health of the Republic of Azerbaijan, Baku, Azerbaijan.
| | - Zaliha Ismail
- Department of Psychiatry, Westchester Medical Center Health System, Valhalla, NY, USA.
| | | | - Asaf Jacobs
- Department of Psychiatry, Westchester Medical Center Health System, Valhalla, NY, USA; New York Medical College, Valhalla, NY, USA.
| | | | - Nenad Jakšić
- Department of Psychiatry and Psychological Medicine, University Hospital Centre Zagreb, Zagreb, Croatia.
| | - Afzal Javed
- Pakistan Psychiatric Research Centre, Fountain House, Lahore, Pakistan; Child Psychiatry Department, Ankara city hospital, Ankara, Turkey; Faculty of Medicine, Lund University, Malmö, Sweden.
| | - Helin Yilmaz Kafali
- International Centre for Education and Research in Neuropsychiatry (ICERN), Samara State Medical University, Samara, Russia.
| | - Sagar Karia
- Department of Psychiatry, Lokmanya Tilak Municipal Medical College, Mumbai, India.
| | | | - Doaa Khalifa
- Okasha Institute of Psychiatry, Faculty of Medicine, Ain Shams University, Cairo, Egypt.
| | - Olena Khaustova
- Medical Psychology, Psychosomatic Medicine and Psychotherapy Department, Bogomolets National Medical University, Kyiv, Ukraine.
| | - Steve Koh
- Department of Psychiatry, University of California San Diego, San Diego, USA.
| | - Svetlana Kopishinskaia
- Kirov State Medical University, Kirov, Russia; Psychiatry, Drug abuse and Psychology Department, Odessa National Medical University, Odessa, Ukraine.
| | | | - Sotirios A Koupidis
- Occupational and Environmental Health Sector, Department of Public Health Policy, School of Public Health, University of West Attica, Greece.
| | - Illes Kovacs
- Department of Psychiatry and Psychotherapy, Semmelweis University, Budapest, Hungary.
| | - Barbara Kulig
- Department of Psychiatry and Psychotherapy, Semmelweis University, Budapest, Hungary.
| | | | - Justine Liewig
- Division of Child and Adolescent Psychiatry, Department of Psychiatry, Groupe Hospitalier Nord Essonne, Orsay, France.
| | - Abdul Majid
- Department of Psychology, University of Sargodha, Sargodha, Pakistan.
| | - Evgeniia Malashonkova
- Division of Child and Adolescent Psychiatry, Department of Psychiatry, Groupe Hospitalier Nord Essonne, Orsay, France.
| | - Khamelia Malik
- Department of Psychiatry, Faculty of Medicine, Universitas Indonesia, Cipto Mangunkusumo National Referral Hospital, Jakarta, Indonesia.
| | - Najma Iqbal Malik
- Department of Psychiatry, Azerbaijan Medical University, Baku, Azerbaijan.
| | - Gulay Mammadzada
- Department of Clinical and Experimental Medicine, Section of Psychiatry, University of Pisa, Pisa, Italy.
| | | | - Donatella Marazziti
- Unicamillus, Saint Camillus International University of Health Sciences, Rome, Italy; Brain Research Foundation onus, Lucca, Italy; Dow Medical College, Dow University of Health Sciences, Karachi, Pakistan.
| | - Darko Marčinko
- Department of Psychiatry and Psychological Medicine, University Hospital Centre Zagreb, Zagreb, Croatia; School of Medicine, University of Zagreb, Zagreb, Croatia.
| | - Stephanie Martinez
- Department of Mental Health, Psychiatric Service of Diagnosis and Treatment, Hospital "G. Mazzini", ASL Teramo, Teramo, Italy.
| | - Eimantas Matiekus
- Clinic of Psychiatry, Institute of Clinical Medicine, Medical Faculty, Vilnius University, Vilnius, Lithuania.
| | - Gabriela Mejia
- Department of Mental Health, Psychiatric Service of Diagnosis and Treatment, Hospital "G. Mazzini", ASL Teramo, Teramo, Italy.
| | - Roha Saeed Memon
- Dow Medical College, Dow University of Health Sciences, Karachi, Pakistan.
| | | | - Dalia Mickevičiūtė
- Department of Clinical Services, Federal Neuropsychiatric Hospital, Kaduna, Nigeria.
| | - Roumen Milev
- Psychiatry department, Ankara dışkapı training and research hospital, Ankara, Turkey.
| | - Muftau Mohammed
- General Office for the Psychiatric Services of the Ministry of Health, Mexico City, Mexico.
| | - Alejandro Molina-López
- Department of Postgraduate Education, Russian National Research Medical University n.a. N.I. Pirogov, Moscow, Russia.
| | - Petr Morozov
- Department of Community Medicine, Ahmadu Bello University Teaching Hospital, Zaria, Nigeria.
| | - Nuru Suleiman Muhammad
- Sackler School of Medicine New York State American Program, Tel Aviv University, Tel Aviv-Yafo, Israel.
| | - Filip Mustač
- Department of Psychiatry and Psychological Medicine, University Hospital Centre Zagreb, Zagreb, Croatia.
| | - Mika S Naor
- Compartment of Liaison Psychiatry, "Pius Brinzeu" County Emergency Clinical Hospital, Timisoara, Romania.
| | - Amira Nassieb
- Okasha Institute of Psychiatry, Faculty of Medicine, Ain Shams University, Cairo, Egypt.
| | - Alvydas Navickas
- Clinic of Psychiatry, Institute of Clinical Medicine, Medical Faculty, Vilnius University, Vilnius, Lithuania.
| | - Tarek Okasha
- Okasha Institute of Psychiatry, Faculty of Medicine, Ain Shams University, Cairo, Egypt.
| | - Milena Pandova
- Second Psychiatric Clinic, University Hospital for Active Treatment in Neurology and Psychiatry "Saint Naum", Sofia, Bulgaria.
| | - Anca-Livia Panfil
- Department of Medical Psychology, Psychiatry and Psychotherapy, Kyrgyz-Russian Slavic University, Bishkek, Kyrgyz Republic.
| | - Liliya Panteleeva
- School of Social Sciences, Hellenic Open University, Patras, Greece.
| | - Ion Papava
- Department of Neuroscience, Discipline of Psychiatry, "Victor Babes" University of Medicine and Pharmacy, Timisoara, Romania.
| | - Mikaella E Patsali
- School of Social Sciences, Hellenic Open University, Patras, Greece; Department of Internal Medicine, Nicosia General Hospital, Nicosia, Cyprus.
| | - Alexey Pavlichenko
- Education center, Mental Health Clinic No 1n.a. N.A. Alexeev of Moscow Healthcare Department, Moscow, Russia.
| | - Bojana Pejuskovic
- Faculty of Medicine, University of Belgrade, Belgrade, Serbia; Clinical Department for Crisis and Affective Disorders, Institute of Mental Health, Belgrade, Serbia.
| | - Mariana Pinto Da Costa
- South London and Maudsley NHS Foundation Trust, London, United Kingdom; Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, United Kingdom; Institute of Biomedical Sciences Abel Salazar, University of Porto, Porto, Portugal.
| | - Mikhail Popkov
- Department of the Introduction to Internal Medicine and Family Medicine, International Higher School of Medicine, Bishkek, Kyrgyz Republic.
| | - Dina Popovic
- Abarbanel Mental Health Center, Bat-Yam, Israel.
| | - Nor Jannah Nasution Raduan
- Department of Psychiatry, Faculty of Medicine, Universiti Teknologi MARA, Sungai Buloh, Selangor, Malaysia.
| | - Francisca Vargas Ramírez
- Child and Adolescent Psychiatry Department, Hospital Luis Calvo Mackenna, Santiago, Chile; Universidad Diego Portales, Santiago, Chile.
| | - Elmars Rancans
- Department of Psychiatry and Narcology, Riga Stradins University, Riga, Latvia; Riga Centre of Psychiatry and Narcology, Riga, Latvia.
| | - Salmi Razali
- Department of Biotechnological and Applied Clinical Sciences, Section of Psychiatry, University of L'Aquila, L'Aquila, Italy.
| | - Federico Rebok
- Servicio de Emergencia, Acute inpatient Unit, Hospital Moyano, Buenos Aires, Argentina; Argentine Institute of Clinical Psychiatry (IAPC), Buenos Aires, Argentina.
| | - Anna Rewekant
- General Psychiatry Unit I, Greater Poland Neuropsychiatric Center, Kościan, Poland.
| | | | - María Teresa Rivera-Encinas
- Centro de Investigación en Salud Pública, Facultad de Medicina, Universidad de San Martín de Porres, Instituto Nacional de Salud Mental "Honorio Delgado - Hideyo Noguchi", Lima, Perú.
| | - Pilar Saiz
- Psychiatry Area, Department of Medicine, University of Oviedo, Oviedo, Spain, ISPA, INEUROPA. CIBERSAM; Mental Health Center of La Corredoria, Oviedo, Spain, ISPA, INEUROPA. CIBERSAM.
| | | | - David Saucedo Martínez
- Department of Psychiatry. Escuela Nacional de Medicina, TEC de Monterrey. Servicio de geriatría. Hospital Universitario "José Eleuterio González" UANL. Monterrey, Nuevo León México.
| | - Jo Anne Saw
- Department of Psychiatry, Faculty of Medicine, Universiti Teknologi MARA, Sungai Buloh, Selangor, Malaysia.
| | - Görkem Saygili
- Assistant Professor at Cognitive Science and Artificial Intelligence Department Tilburg University.
| | - Patricia Schneidereit
- Klinik für Allgemeine Psychiatrie und Psychotherapie Ost, Psychiatrische Institutsambulanz, Klinikum am Weissenhof, Weissenhof, Germany.
| | | | - Tomohiro Shirasaka
- Department of Psychiatry, Teine Keijinkai Medical Center, Sapporo, Japan.
| | | | - Satti Sitanggang
- Psychiatric Unit, Pambalah Batung General Hospital, South Kalimantan, Amuntai, Indonesia.
| | - Oleg Skugarevsky
- Department of Psychiatry and Medical Psychology, Belarusian State Medical University, Minsk, Belarus.
| | - Anna Spikina
- Saint Petersburg Psychoneurological Dispensary No2, Saint Petersburg, Russia.
| | - Sridevi Sira Mahalingappa
- Derbyshire Healthcare NHS Foundation Trust, The Liasion Team, Royal Derby Hospital, Derby, Derbyshire, United Kingdom.
| | - Maria Stoyanova
- Okasha Institute of Psychiatry, Faculty of Medicine, Ain Shams University, Cairo, Egypt.
| | - Anna Szczegielniak
- Department of Psychoprophylaxis, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, Katowice, Poland.
| | - Simona Claudia Tamasan
- Department of Medical Psychology, Psychiatry and Psychotherapy, Kyrgyz-Russian Slavic University, Bishkek, Kyrgyz Republic.
| | - Giuseppe Tavormina
- Psychiatric Studies Centre, Provaglio d'Iseo, Italy; European Depression Association and Italian Association on Depression, Brussels, Belgium; Bedforshire Center for Mental Health Research in association with the University of Cambridge, United Kingdom.
| | | | | | - Mauricio Tohen
- Department of Psychiatry and Behavioral Sciences, School of Medicine, University of New Mexico, Albuquerque, New Mexico, USA.
| | - Eva Maria Tsapakis
- ″Agios Charalambos" Mental Health Clinic, Heraklion, Crete, Greece; 1st Department of Academic Psychiatry, School of Medicine, Aristotle University of Thessaloniki, Greece.
| | - Dina Tukhvatullina
- Centre for Global Public Health, Institute of Population Health Sciences, Queen Mary University of London, London, United Kingdom.
| | - Irfan Ullah
- Kabir Medical College, Gandhara University, Peshawar, Pakistan.
| | - Ratnaraj Vaidya
- Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, United Kingdom.
| | | | - Jelena Vrublevska
- Department of Psychiatry and Narcology, Riga Stradins University, Riga, Latvia; Riga Centre of Psychiatry and Narcology, Riga, Latvia; Institute of Public Health, Riga Stradins University, Riga, Latvia.
| | - Olivera Vukovic
- Servicio de Emergencia, Acute inpatient Unit, Hospital Moyano, Buenos Aires, Argentina; Department for Research and Education, Institute of Mental Health, Belgrade, Serbia.
| | - Olga Vysotska
- Educational and Research Center - Ukrainian Family Medicine Training Center, Bogomolets National Medical University, Kyiv, Ukraine.
| | - Natalia Widiasih
- Department of Psychiatry and Psychotherapy, Semmelweis University, Budapest, Hungary.
| | - Anna Yashikhina
- International Centre for Education and Research in Neuropsychiatry (ICERN), Samara State Medical University, Samara, Russia; Department for Research and Education, Institute of Mental Health, Belgrade, Serbia.
| | - Panagiotis E Prezerakos
- Department of Nursing, University of Peloponnese, Laboratory of Integrated Health Care, Tripoli, Greece.
| | - Daria Smirnova
- International Centre for Education and Research in Neuropsychiatry (ICERN), Samara State Medical University, Samara, Russia; Department of Psychiatry, Narcology, Psychotherapy and Clinical Psychology, Samara State Medical University, Samara, Russia.
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7
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Maric NP, Pejovic-Milovancevic M, Vukovic O, Colovic O, Miljevic C, Pejuskovic B, Kostic M, Milosavljevic M, Mandic-Maravic V, Munjiza A, Lukic B, Podgorac A, Vezmar M, Parojcic A, Vranes T, Knezevic G. Determinants of quality of life among individuals seeking mental health care after termination of state of emergency due to the coronavirus disease 2019 pandemic. Medicine (Baltimore) 2021; 100:e26854. [PMID: 34397861 PMCID: PMC8341307 DOI: 10.1097/md.0000000000026854] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/26/2020] [Revised: 06/23/2021] [Accepted: 07/19/2021] [Indexed: 01/04/2023] Open
Abstract
ABSTRACT Prompted by the need to measure the impact of the coronavirus disease 2019 on main areas of quality of life related to mental health (MH), the COV-19-impact on quality of life (COV19-QoL) scale has been developed recently. We measured how patients seeking face-to-face MH care perceived the coronavirus disease 2019 impact on QoL and how socio-demographic factors, stress, and personality contributed to QoL in this diagnostically diverse population.Patients aged 18 to 65 years (n = 251) who came for the first time to the outpatient units during the 6-week index-period (May 21-July 1, 2020) were included. The cross-sectional assessment involved sociodemographic variables, working diagnosis, personality traits (7-dimension model, including HEXACO and DELTA), stress (list of threatening experiences and proximity to virus), and COV19-QoL.The perceived impact of the pandemic on QoL was above the theoretical mean of a 5-point scale (COV19-Qol = 3.1 ± 1.2). No association between total COV19-QoL score, sociodemographic parameters, and working diagnoses was found in the present sample. After testing whether positional (threatening experiences), or dispositional (personality) factors were predominant in the perceived impact of COV-19 on QoL, significant predictors of the outcome were personality traits Disintegration (B = 0.52; P < .01) and Emotionality (B = 0.18; P < .05).It seems that pervasiveness and uncertainty of the pandemic threat triggers-especially in those high on Disintegration trait-a chain of mental events with the decrease of QoL as a final result. Present findings could be used to establish a profile of MH help seeking population in relation to this biological disaster, and to further explore QoL and personality in different contexts.
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Affiliation(s)
- Nadja P. Maric
- Faculty of Medicine, University of Belgrade, Belgrade, Serbia
- Institute of Mental Health, Belgrade, Serbia
| | | | - Olivera Vukovic
- Faculty of Medicine, University of Belgrade, Belgrade, Serbia
- Institute of Mental Health, Belgrade, Serbia
| | | | - Cedo Miljevic
- Faculty of Medicine, University of Belgrade, Belgrade, Serbia
- Institute of Mental Health, Belgrade, Serbia
| | - Bojana Pejuskovic
- Faculty of Medicine, University of Belgrade, Belgrade, Serbia
- Institute of Mental Health, Belgrade, Serbia
| | - Milutin Kostic
- Faculty of Medicine, University of Belgrade, Belgrade, Serbia
- Institute of Mental Health, Belgrade, Serbia
| | - Maja Milosavljevic
- Faculty of Medicine, University of Belgrade, Belgrade, Serbia
- Institute of Mental Health, Belgrade, Serbia
| | - Vanja Mandic-Maravic
- Faculty of Medicine, University of Belgrade, Belgrade, Serbia
- Institute of Mental Health, Belgrade, Serbia
| | - Ana Munjiza
- Faculty of Medicine, University of Belgrade, Belgrade, Serbia
- Institute of Mental Health, Belgrade, Serbia
| | | | | | | | | | | | - Goran Knezevic
- Department of Psychology, Faculty of Philosophy, University of Belgrade, Belgrade, Serbia
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8
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Topalovic N, Mazic S, Nesic D, Vukovic O, Cumic J, Laketic D, Stasevic Karlicic I, Pantic I. Association between Chromatin Structural Organization of Peripheral Blood Neutrophils and Self-Perceived Mental Stress: Gray-Level Co-occurrence Matrix Analysis. Microsc Microanal 2021; 27:1-7. [PMID: 34334154 DOI: 10.1017/s143192762101240x] [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] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Methods based on the evaluation of textural patterns in microscopy, such as the “gray-level co-occurrence matrix” (GLCM) analysis are modern and innovative computer and mathematical algorithms that can be used to quantify subtle structural changes in cells and their organelles. Potential application of GLCM method in the fields of psychophysiology and psychiatry to this date has not been systematically investigated. The main objective of our study was to test the existence and strength of the association between chromatin structural organization of peripheral blood neutrophils and levels of self-perceived mental stress. The research was done on a sample of 100 healthy student athletes, and the Depression, Anxiety, and Stress Scales (DASS-21) were used for the estimation of psychological distress. Chromatin textural homogeneity and uniformity were negatively correlated (p < 0.01) with mental distress and had relatively good discriminatory power in differentiating participants with normal and elevated stress levels. As an addition, we propose the creation of a machine learning model based on binomial logistic regression that uses these and other GLCM features to predict stress elevation. To the best of our knowledge, these results are one of the first to establish the link between neutrophil chromatin structural organization quantified by the GLCM method and indicators of normal psychological functioning.
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Affiliation(s)
- Nikola Topalovic
- University of Belgrade, Faculty of Medicine, Institute of Medical Physiology, Visegradska 26/II, RS-11129, Belgrade, Serbia
| | - Sanja Mazic
- University of Belgrade, Faculty of Medicine, Institute of Medical Physiology, Visegradska 26/II, RS-11129, Belgrade, Serbia
| | - Dejan Nesic
- University of Belgrade, Faculty of Medicine, Institute of Medical Physiology, Visegradska 26/II, RS-11129, Belgrade, Serbia
| | - Olivera Vukovic
- University of Belgrade, Faculty of Medicine, Institute of Mental Health, Palmoticeva 37, RS-11000, Belgrade, Serbia
| | - Jelena Cumic
- University of Belgrade, Faculty of Medicine, University Clinical Centre of Serbia, Dr. Koste Todorovica 8, RS-11129, Belgrade, Serbia
| | - Darko Laketic
- University of Belgrade, Faculty of Medicine, Institute of Anatomy, Dr Subotica 4/2, RS-11129, Belgrade, Serbia
| | | | - Igor Pantic
- University of Belgrade, Faculty of Medicine, Institute of Medical Physiology, Visegradska 26/II, RS-11129, Belgrade, Serbia
- University of Haifa, 199 Abba Hushi Blvd. Mount Carmel, HaifaIL-3498838, Israel
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9
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Vujcic Trkulja M, Tomicevic-Dubljevic J, Tosevski DL, Vukovic O, Toskovic O. Development of Evidence-Based Rehabilitation Practice in Botanical Garden for People With Mental Health Disorders. HERD 2021; 14:242-257. [PMID: 33858211 DOI: 10.1177/19375867211007941] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [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
AIM This article aims to make clearer, with supporting evidence, the clinical benefits of the nature-based rehabilitation program (NBRP) and the restorative values of visiting botanical garden for people with stress-related mental disorders. BACKGROUND Throughout the years, nature-based therapy has been acknowledged as a valuable rehabilitation practice that integrates specially designed natural environments and nature-related activities for people with mental health conditions. SUBJECT AND METHODS The comparative analyses of parallel conducted the NBRP at botanical garden and occupational therapy realised at the Day Hospital of the Institute of Mental Health in Belgrade included 27 participants divided into two groups. The data collection employed a mixed method combining a Clinical Global Impression (CGI) Scale and on-site observations. RESULTS The positive findings on the psychological recovery of the participants seem to be related to NBRP. The restorative potential of the garden was recognized through the observed interaction between participants and the natural entities employed through the various themed activities. The observed landscape elements especially solitary plant specimens or tall and single-form trees within the garden can be embraced as design guidelines for the development of an evidence-based practice that can support the recovery process of people with mental health conditions. CONCLUSION Our findings endorse that ongoing social development and progressive urbanization have broadened the interest in scientific research involving nature-based solutions that help preserve the physical and mental health of people in low- and middle-income Western Balkan countries with a high prevalence of mental disorders in the urban environment that relates to social inequalities and natural disasters.
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Affiliation(s)
- Maja Vujcic Trkulja
- Environment and Sustainable Development, 217879Singidunum University, Belgrade, Serbia
| | - Jelena Tomicevic-Dubljevic
- Department of Landscape Architecture and Horticulture, Faculty of Forestry, 54801University of Belgrade, Serbia
| | | | - Olivera Vukovic
- Department of Psychiatry, School of Medicine, 54801University of Belgrade, Serbia.,Institute of Mental Health, Belgrade, Serbia
| | - Oliver Toskovic
- Laboratory for Experimental Psychology, Faculty of Philosophy, 54801University of Belgrade, Serbia
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10
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Nikolic S, Perunicic Mladenovic I, Vukovic O, Barišić J, Švrakić D, Milovanović S. Individual and Gender Differences in Personality Influence the Diagnosis of Major Depressive Disorder. Psychiatr Danub 2020; 32:97-104. [PMID: 32303039 DOI: 10.24869/psyd.2020.97] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
BACKGROUND In order to explore whether gender differences are present in self-reports on personality measures when all Major Depressive Disorder (MDD) participants are diagnosed at an equal intensity, the aim of this study was to investigate individual and gender differences in personality between healthy participants and those suffering from severe feature MDD. SUBJECTS AND METHODS The sample consisted of 632 participants: 385 in the healthy control group and 247 MDD, the latter comprised of patients in their first diagnosed episode or recurrent. The Hamilton Depression Rating Scale (HAM-D) was used to measure symptom severity. Beck's Depression Inventory was administered when depression symptoms had lessened, establishing it as minor when filling out the personality questionnaire (NEO-PI-R). RESULTS The results indicate a broad difference in personality between the healthy control and the MDD groups. High neuroticism and low extraversion, accompanied by low scores on openness and conscientiousness, were the most important personality dimensions in understanding distinctions. While agreeableness did not indicate any important role, it did significantly influence the understanding of gender differences within groups. Females were found more agreeable in both groups, but those from the healthy group were also more open and conscientiousness than healthy males. Females from the MDD group were found to be also higher on neuroticism than males of the same group. CONCLUSIONS A general conclusion from the study is that personality dimensions are more important in understanding vulnerability to depression in comparison to gender differences in personality within groups. As females in the MDD group tend to self-report higher levels of agreeableness and neuroticism than do males in the same group when the level of their depression is categorized as equal MDD-severe type, this may influence practitioners to unequally diagnose depression in males and females.
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11
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Fountoulakis KN, Dragioti E, Theofilidis AT, Wikilund T, Atmatzidis X, Nimatoudis I, Thys E, Wampers M, Hranov L, Hristova T, Aptalidis D, Milev R, Iftene F, Spaniel F, Knytl P, Furstova P, From T, Karlsson H, Walta M, Salokangas RKR, Azorin JM, Bouniard J, Montant J, Juckel G, Haussleiter IS, Douzenis A, Michopoulos I, Ferentinos P, Smyrnis N, Mantonakis L, Nemes Z, Gonda X, Vajda D, Juhasz A, Shrivastava A, Waddington J, Pompili M, Comparelli A, Corigliano V, Rancans E, Navickas A, Hilbig J, Bukelskis L, Injac Stevovic L, Vodopic S, Esan O, Oladele O, Osunbote C, Rybakowski JΚ, Wojciak P, Domowicz K, Figueira ML, Linhares L, Crawford J, Panfil AL, Smirnova D, Izmailova O, Lecic-Tosevski D, Temmingh H, Howells F, Bobes J, Garcia-Portilla MP, García-Alvarez L, Erzin G, Karadağ H, De Sousa A, Bendre A, Hoschl C, Bredicean C, Papava I, Vukovic O, Pejuskovic B, Russell V, Athanasiadis L, Konsta A, Stein D, Berk M, Dean O, Tandon R, Kasper S, De Hert. M. Staging of Schizophrenia With the Use of PANSS: An International Multi-Center Study. Int J Neuropsychopharmacol 2019; 22:681-697. [PMID: 31563956 PMCID: PMC6872964 DOI: 10.1093/ijnp/pyz053] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [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: 07/19/2019] [Revised: 07/19/2019] [Accepted: 09/25/2019] [Indexed: 12/30/2022] Open
Abstract
INTRODUCTION A specific clinically relevant staging model for schizophrenia has not yet been developed. The aim of the current study was to evaluate the factor structure of the PANSS and develop such a staging method. METHODS Twenty-nine centers from 25 countries contributed 2358 patients aged 37.21 ± 11.87 years with schizophrenia. Analysis of covariance, Exploratory Factor Analysis, Discriminant Function Analysis, and inspection of resultant plots were performed. RESULTS Exploratory Factor Analysis returned 5 factors explaining 59% of the variance (positive, negative, excitement/hostility, depression/anxiety, and neurocognition). The staging model included 4 main stages with substages that were predominantly characterized by a single domain of symptoms (stage 1: positive; stages 2a and 2b: excitement/hostility; stage 3a and 3b: depression/anxiety; stage 4a and 4b: neurocognition). There were no differences between sexes. The Discriminant Function Analysis developed an algorithm that correctly classified >85% of patients. DISCUSSION This study elaborates a 5-factor solution and a clinical staging method for patients with schizophrenia. It is the largest study to address these issues among patients who are more likely to remain affiliated with mental health services for prolonged periods of time.
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Affiliation(s)
- Konstantinos N Fountoulakis
- 3rd Department of Psychiatry, Faculty of Medicine, School of Health Sciences, Aristotle University of Thessaloniki,Greece,Correspondence to: Konstantinos N. Fountoulakis, 6, Odysseos str (1 Parodos Ampelonon str.), 55535 Pylaia Thessaloniki, Greece ()
| | - Elena Dragioti
- Department of Medical and Health Sciences (IMH), Faculty of Health Sciences, Linköping University, Linköping, Sweden,Hallunda Psychiatric Outpatient Clinic, Stockholm Psychiatric Southwest Clinic, Karolinska Huddinge University Hospital,Sweden
| | - Antonis T Theofilidis
- 3rd Department of Psychiatry, Faculty of Medicine, School of Health Sciences, Aristotle University of Thessaloniki,Greece
| | - Tobias Wikilund
- Department of Medical and Health Sciences (IMH), Faculty of Health Sciences, Linköping University, Linköping, Sweden,Hallunda Psychiatric Outpatient Clinic, Stockholm Psychiatric Southwest Clinic, Karolinska Huddinge University Hospital,Sweden
| | - Xenofon Atmatzidis
- Department of Medical and Health Sciences (IMH), Faculty of Health Sciences, Linköping University, Linköping, Sweden,Hallunda Psychiatric Outpatient Clinic, Stockholm Psychiatric Southwest Clinic, Karolinska Huddinge University Hospital,Sweden
| | - Ioannis Nimatoudis
- 3rd Department of Psychiatry, Faculty of Medicine, School of Health Sciences, Aristotle University of Thessaloniki,Greece
| | - Erik Thys
- University Psychiatric Centre KU Leuven, Kortenberg and Department of Neurosciences KU, Leuven, Belgium
| | - Martien Wampers
- University Psychiatric Centre KU Leuven, Kortenberg and Department of Neurosciences KU, Leuven, Belgium
| | - Luchezar Hranov
- University Multiprofile Hospital for Active Treatment in Neurology and Psychiatry “Sveti Naum”, Sofia, Bulgaria
| | - Trayana Hristova
- University Multiprofile Hospital for Active Treatment in Neurology and Psychiatry “Sveti Naum”, Sofia, Bulgaria
| | - Daniil Aptalidis
- University Multiprofile Hospital for Active Treatment in Neurology and Psychiatry “Sveti Naum”, Sofia, Bulgaria
| | - Roumen Milev
- Department of Psychiatry, Queen’s University, Providence Care Hospital, Kingston, Ontario, Canada
| | - Felicia Iftene
- Department of Psychiatry, Queen’s University, Providence Care Hospital, Kingston, Ontario, Canada
| | - Filip Spaniel
- National Institute of Mental Health, Klecany, Czech Republic
| | - Pavel Knytl
- National Institute of Mental Health, Klecany, Czech Republic
| | - Petra Furstova
- National Institute of Mental Health, Klecany, Czech Republic
| | - Tiina From
- Department of Psychiatry, University of Turku, Turku, Finland
| | - Henry Karlsson
- Department of Psychiatry, University of Turku, Turku, Finland
| | - Maija Walta
- Department of Psychiatry, University of Turku, Turku, Finland
| | | | - Jean-Michel Azorin
- Department of Psychiatry, Sainte Marguerite University Hospital, Marseille, France,Timone Institute of Neuroscience, CNRS and Aix-Marseille University, Marseille, France
| | - Justine Bouniard
- Department of Psychiatry, Sainte Marguerite University Hospital, Marseille, France,Timone Institute of Neuroscience, CNRS and Aix-Marseille University, Marseille, France
| | - Julie Montant
- Department of Psychiatry, Sainte Marguerite University Hospital, Marseille, France,Timone Institute of Neuroscience, CNRS and Aix-Marseille University, Marseille, France
| | - Georg Juckel
- Department of Psychiatry, Ruhr University Bochum, LWL-University Hospital, Bochum, Germany
| | - Ida S Haussleiter
- Department of Psychiatry, Ruhr University Bochum, LWL-University Hospital, Bochum, Germany
| | - Athanasios Douzenis
- 2nd Department of Psychiatry, National and Kapodistrian University of Athens, Athens, Greece
| | - Ioannis Michopoulos
- 2nd Department of Psychiatry, National and Kapodistrian University of Athens, Athens, Greece
| | - Panagiotis Ferentinos
- 2nd Department of Psychiatry, National and Kapodistrian University of Athens, Athens, Greece
| | - Nikolaos Smyrnis
- Department of Psychiatry, National and Kapodistrian University of Athens School of Medicine, Eginition Hospital, Athens, Greece
| | - Leonidas Mantonakis
- Department of Psychiatry, National and Kapodistrian University of Athens School of Medicine, Eginition Hospital, Athens, Greece
| | | | - Xenia Gonda
- Department of Psychiatry and Psychotherapy, Semmelweis University, Budapest, Hungary
| | - Dora Vajda
- Department of Psychiatry and Psychotherapy, Semmelweis University, Budapest, Hungary
| | - Anita Juhasz
- Department of Psychiatry and Psychotherapy, Semmelweis University, Budapest, Hungary
| | | | - John Waddington
- Molecular and Cellular Therapeutics, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Maurizio Pompili
- Department of Neurosciences, Mental Health and Sensory Organs, Suicide Prevention Center, Sant’Andrea Hospital, Sapienza University of Rome, Rome, Italy
| | - Anna Comparelli
- Department of Neurosciences, Mental Health and Sensory Organs, Suicide Prevention Center, Sant’Andrea Hospital, Sapienza University of Rome, Rome, Italy
| | - Valentina Corigliano
- Department of Neurosciences, Mental Health and Sensory Organs, Suicide Prevention Center, Sant’Andrea Hospital, Sapienza University of Rome, Rome, Italy
| | - Elmars Rancans
- Department of Psychiatry and Narcology, Riga Stradins University, Riga, Latvia
| | - Alvydas Navickas
- Clinic of Psychiatric, Faculty of Medicine, Vilnius University, Vilnius, Lithuania,Psychosocial Rehabilitation Department of the Vilnius Mental Health Center, Department for Psychosis Treatment of the Vilnius Mental Health Center, Vilnius, Lithuania
| | - Jan Hilbig
- Clinic of Psychiatric, Faculty of Medicine, Vilnius University, Vilnius, Lithuania,Psychosocial Rehabilitation Department of the Vilnius Mental Health Center, Department for Psychosis Treatment of the Vilnius Mental Health Center, Vilnius, Lithuania
| | - Laurynas Bukelskis
- Clinic of Psychiatric, Faculty of Medicine, Vilnius University, Vilnius, Lithuania,Psychosocial Rehabilitation Department of the Vilnius Mental Health Center, Department for Psychosis Treatment of the Vilnius Mental Health Center, Vilnius, Lithuania
| | - Lidija Injac Stevovic
- Clinical Department of Psychiatry, Clinical Centre of Montenegro, Podgorica, Montenegro,Department of Psychiatry, School of Medicine, University of Montenegro, Dzona Dzeksona bb, Podgorica, Montenegro,Clinical Department of Neurology, Clinical Centre of Montenegro, Dzona Dzeksona bb, Podgorica, Montenegro
| | - Sanja Vodopic
- Clinical Department of Psychiatry, Clinical Centre of Montenegro, Podgorica, Montenegro,Department of Psychiatry, School of Medicine, University of Montenegro, Dzona Dzeksona bb, Podgorica, Montenegro,Clinical Department of Neurology, Clinical Centre of Montenegro, Dzona Dzeksona bb, Podgorica, Montenegro
| | - Oluyomi Esan
- Department of Psychiatry, College of Medicine, University of Ibadan,Nigeria
| | - Oluremi Oladele
- Department of Psychiatry, College of Medicine, University of Ibadan,Nigeria
| | | | - Janusz Κ Rybakowski
- Department of Adult Psychiatry, Poznan University of Medical Sciences, Poznan, Poland
| | - Pawel Wojciak
- Department of Adult Psychiatry, Poznan University of Medical Sciences, Poznan, Poland
| | - Klaudia Domowicz
- Department of Adult Psychiatry, Poznan University of Medical Sciences, Poznan, Poland
| | - Maria Luisa Figueira
- Department of Psychiatry and Mental Health, Santa Maria University Hospital, Lisbon, Portugal
| | - Ludgero Linhares
- Department of Psychiatry and Mental Health, Santa Maria University Hospital, Lisbon, Portugal
| | - Joana Crawford
- Department of Psychiatry and Mental Health, Santa Maria University Hospital, Lisbon, Portugal
| | | | - Daria Smirnova
- Samara State Medical University, Department of Psychiatry, Samara Psychiatric Hospital, Inpatient Unit, Russia
| | - Olga Izmailova
- Samara State Medical University, Department of Psychiatry, Samara Psychiatric Hospital, Inpatient Unit, Russia
| | - Dusica Lecic-Tosevski
- Institute of Mental Health, Belgrade, Serbia,Serbian Academy of Sciences and Arts, Belgrade, Serbia
| | - Henk Temmingh
- Department of Psychiatry and Mental Health, University of Cape Town Cape Town, Western Cape, South Africa
| | - Fleur Howells
- Department of Psychiatry and Mental Health, University of Cape Town Cape Town, Western Cape, South Africa
| | - Julio Bobes
- Department of Psychiatry, University of Oviedo and Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Oviedo, Spain
| | - Maria Paz Garcia-Portilla
- Department of Psychiatry, University of Oviedo and Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Oviedo, Spain
| | - Leticia García-Alvarez
- Department of Psychiatry, University of Oviedo and Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Oviedo, Spain
| | - Gamze Erzin
- Psychiatry Department, Diskapi Yildirim Beyazit Training and Research Hospital, Ankara, Turkey
| | - Hasan Karadağ
- Psychiatry Department, Diskapi Yildirim Beyazit Training and Research Hospital, Ankara, Turkey
| | - Avinash De Sousa
- Department of Psychiatry Lokmanya Tilak Municipal Medical College Mumbai, India
| | - Anuja Bendre
- Department of Psychiatry Lokmanya Tilak Municipal Medical College Mumbai, India
| | - Cyril Hoschl
- National Institute of Mental Health, Klecany, Czech Republic
| | | | - Ion Papava
- University of Medicine and Pharmacy of Timisoara, Romania
| | - Olivera Vukovic
- Institute of Mental Health, School of Medicine, University of Belgrade, Belgrade, Serbia
| | - Bojana Pejuskovic
- Department of Psychiatry, Royal College of Surgeons in Ireland, Beaumont Hospital, Dublin, Ireland
| | - Vincent Russell
- Department of Psychiatry, Royal College of Surgeons in Ireland, Beaumont Hospital, Dublin, Ireland
| | - Loukas Athanasiadis
- 1st Department of Psychiatry, Faculty of Medicine, School of Health Sciences, Aristotle University of Thessaloniki, Greece
| | - Anastasia Konsta
- 1st Department of Psychiatry, Faculty of Medicine, School of Health Sciences, Aristotle University of Thessaloniki, Greece
| | - Dan Stein
- MRC Unit on Risk and Resilience in Mental Disorders, Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa
| | - Michael Berk
- Deakin University, IMPACT Strategic Research Centre, School of Medicine, Barwon Health, Geelong, Australia,Orygen, The National Centre of Excellence in Youth Mental Health and the Centre for Youth Mental Health, the Florey Institute for Neuroscience and Mental Health and the Department of Psychiatry, University of Melbourne, Parkville, Australia
| | - Olivia Dean
- Deakin University, School of Medicine, IMPACT Strategic Research Centre, Barwon Health, Geelong, Australia
| | - Rajiv Tandon
- Department of Psychiatry, University of Florida, ***, FL
| | - Siegfried Kasper
- Department of Psychiatry and Psychotherapy, Medical University of Vienna, Vienna, Austria
| | - Marc De Hert.
- University Psychiatric Centre KU Leuven, Kortenberg and Department of Neurosciences KU, Leuven, Belgium
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12
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Pesic D, Lecic-Tosevski D, Kalanj M, Vukovic O, Mitkovic-Voncina M, Peljto A, Mulder R. Multiple Faces of Personality Domains: Revalidating the Proposed Domains. Psychiatr Danub 2019; 31:182-188. [PMID: 31291222 DOI: 10.24869/psyd.2019.182] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
BACKGROUND Despite relatively consistent findings regarding the number of personality pathology domains, differences in domain structure remain. Recently the proposed ICD-11 domains were partially validated in a sample of patients with major depression producing five domains: Detached, Anankastic, Negative Emotional, Antisocial and Borderline. The aim of our study was to attempt to cross-validate these findings in a sample of patients primarily diagnosed with personality disorder (PD). SUBJECTS AND METHODS All subjects were assessed by Structured Clinical Interview for the DSM-IV Axis II PD. Exploratory factor analysis (EFA) was applied on fifty seven DSM PD symptoms selected to represent the five proposed domains. RESULTS SCID II data were collected from a total of 223 subjects. The EFA extracted five factors. The first factor labeled as borderline-internalizing constituted of borderline together with avoidant and dependent items, the second, labeled as disinhibited/ borderline externalizing, incorporated narcissistic and histrionic items. The other three separate factors in our study labeled as antisocial, anankastic and detached, were less robust. CONCLUSIONS In our study five personality pathology domains were partly replicated. The most robust findings support the existence of the two factors, borderline-internalizing and disinhibited/borderline externalizing. However, the EFA was performed on a relatively low prevalence symptoms distribution, particularly for antisocial and schizoid factors.
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Affiliation(s)
- Danilo Pesic
- Institute of Mental Health, Palmoticeva 37, 11000 Belgrade, Serbia
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13
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Chaturvedi SK, Manche Gowda S, Ahmed HU, Alosaimi FD, Andreone N, Bobrov A, Bulgari V, Carrà G, Castelnuovo G, de Girolamo G, Gondek T, Jovanovic N, Kamala T, Kiejna A, Lalic N, Lecic-Tosevski D, Minhas F, Mutiso V, Ndetei D, Rabbani G, Somruk S, Srikanta S, Taj R, Valentini U, Vukovic O, Wölwer W, Cimino L, Nouwen A, Lloyd C, Sartorius N. More anxious than depressed: prevalence and correlates in a 15-nation study of anxiety disorders in people with type 2 diabetes mellitus. Gen Psychiatr 2019; 32:e100076. [PMID: 31552386 PMCID: PMC6738670 DOI: 10.1136/gpsych-2019-100076] [Citation(s) in RCA: 38] [Impact Index Per Article: 7.6] [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: 04/10/2019] [Revised: 07/11/2019] [Accepted: 07/14/2019] [Indexed: 01/02/2023] Open
Abstract
Background Anxiety disorder, one of the highly disabling, prevalent and common mental disorders, is known to be more prevalent in persons with type 2 diabetes mellitus (T2DM) than the general population, and the comorbid presence of anxiety disorders is known to have an impact on the diabetes outcome and the quality of life. However, the information on the type of anxiety disorder and its prevalence in persons with T2DM is limited. Aims To assess the prevalence and correlates of anxiety disorder in people with type 2 diabetes in different countries. Methods People aged 18–65 years with diabetes and treated in outpatient settings were recruited in 15 countries and underwent a psychiatric interview with the Mini-International Neuropsychiatric Interview. Demographic and medical record data were collected. Results A total of 3170 people with type 2 diabetes (56.2% women; with mean (SD) duration of diabetes 10.01 (7.0) years) participated. The overall prevalence of anxiety disorders in type 2 diabetic persons was 18%; however, 2.8% of the study population had more than one type of anxiety disorder. The most prevalent anxiety disorders were generalised anxiety disorder (8.1%) and panic disorder (5.1%). Female gender, presence of diabetic complications, longer duration of diabetes and poorer glycaemic control (HbA1c levels) were significantly associated with comorbid anxiety disorder. A higher prevalence of anxiety disorders was observed in Ukraine, Saudi Arabia and Argentina with a lower prevalence in Bangladesh and India. Conclusions Our international study shows that people with type 2 diabetes have a high prevalence of anxiety disorders, especially women, those with diabetic complications, those with a longer duration of diabetes and poorer glycaemic control. Early identification and appropriate timely care of psychiatric problems of people with type 2 diabetes is warranted.
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Affiliation(s)
- Santosh K Chaturvedi
- Department of Psychiatry, National Institute of Mental Health and Neuro-Sciences, Bangalore, India
| | - Shayanth Manche Gowda
- Department of Psychiatry, National Institute of Mental Health and Neuro-Sciences, Bangalore, India
| | - Helal Uddin Ahmed
- Child Adolescent and Family Psychiatry, National Institute of Mental Health, Dhaka, Bangladesh
| | - Fahad D Alosaimi
- Department of Psychiatry, King Saud University, Riyadh, Saudi Arabia
| | | | - Alexey Bobrov
- National Research Centre for Psychiatry and Narcology, Moscow, Russia
| | - Viola Bulgari
- IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
| | | | | | | | - Tomasz Gondek
- Department of Psychiatry, Wroclaw Medical University, Wroclaw, Poland
| | | | - Thummala Kamala
- Samatvam Endocrinology Diabetes Center and Jnana Sanjeevini Diabetes Hospital and Medical Center, Bangalore, India
| | | | | | | | - Fareed Minhas
- Center for Global Mental Health, Rawalpindi, Pakistan
| | | | | | - Golam Rabbani
- Child Adolescent and Family Psychiatry, National Institute of Mental Health, Dhaka, Bangladesh
| | | | - Sathyanarayana Srikanta
- Samatvam Endocrinology Diabetes Center and Jnana Sanjeevini Diabetes Hospital and Medical Center, Bangalore, India
| | - Rizwan Taj
- Pakistan Institute of Medical Sciences, Islamabad, Pakistan
| | - Umberto Valentini
- IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
| | | | - Wolfgang Wölwer
- Department of Psychiatry and Psychotherapy, Medical Faculty, University of Düsseldorf, Dusseldorf, Germany
| | | | - Arie Nouwen
- Department of Psychiatry, National Institute of Mental Health and Neuro-Sciences, Bangalore, India.,Child Adolescent and Family Psychiatry, National Institute of Mental Health, Dhaka, Bangladesh.,Department of Psychiatry, King Saud University, Riyadh, Saudi Arabia.,IRCCS Ospedale Sacro Cuore Don Calabria, Negrar, Italy.,National Research Centre for Psychiatry and Narcology, Moscow, Russia.,IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy.,University of Milano-Bicocca, Bicocca, Italy.,Department of Psychology, Catholic University, Milan, Italy.,Department of Psychiatry, Wroclaw Medical University, Wroclaw, Poland.,Institute of Mental Health, Belgrade, Serbia.,Samatvam Endocrinology Diabetes Center and Jnana Sanjeevini Diabetes Hospital and Medical Center, Bangalore, India.,University of Lower Silesia, Wroclaw, Poland.,Center for Global Mental Health, Rawalpindi, Pakistan.,University of Nairobi, Nairobi, Kenya.,Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.,Pakistan Institute of Medical Sciences, Islamabad, Pakistan.,Department of Psychiatry and Psychotherapy, Medical Faculty, University of Düsseldorf, Dusseldorf, Germany.,ProConsult, Owings Mills, Maryland, USA
| | - Cathy Lloyd
- Department of Psychiatry, National Institute of Mental Health and Neuro-Sciences, Bangalore, India.,Child Adolescent and Family Psychiatry, National Institute of Mental Health, Dhaka, Bangladesh.,Department of Psychiatry, King Saud University, Riyadh, Saudi Arabia.,IRCCS Ospedale Sacro Cuore Don Calabria, Negrar, Italy.,National Research Centre for Psychiatry and Narcology, Moscow, Russia.,IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy.,University of Milano-Bicocca, Bicocca, Italy.,Department of Psychology, Catholic University, Milan, Italy.,Department of Psychiatry, Wroclaw Medical University, Wroclaw, Poland.,Institute of Mental Health, Belgrade, Serbia.,Samatvam Endocrinology Diabetes Center and Jnana Sanjeevini Diabetes Hospital and Medical Center, Bangalore, India.,University of Lower Silesia, Wroclaw, Poland.,Center for Global Mental Health, Rawalpindi, Pakistan.,University of Nairobi, Nairobi, Kenya.,Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.,Pakistan Institute of Medical Sciences, Islamabad, Pakistan.,Department of Psychiatry and Psychotherapy, Medical Faculty, University of Düsseldorf, Dusseldorf, Germany.,ProConsult, Owings Mills, Maryland, USA
| | - Norman Sartorius
- Department of Psychiatry, National Institute of Mental Health and Neuro-Sciences, Bangalore, India.,Child Adolescent and Family Psychiatry, National Institute of Mental Health, Dhaka, Bangladesh.,Department of Psychiatry, King Saud University, Riyadh, Saudi Arabia.,IRCCS Ospedale Sacro Cuore Don Calabria, Negrar, Italy.,National Research Centre for Psychiatry and Narcology, Moscow, Russia.,IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy.,University of Milano-Bicocca, Bicocca, Italy.,Department of Psychology, Catholic University, Milan, Italy.,Department of Psychiatry, Wroclaw Medical University, Wroclaw, Poland.,Institute of Mental Health, Belgrade, Serbia.,Samatvam Endocrinology Diabetes Center and Jnana Sanjeevini Diabetes Hospital and Medical Center, Bangalore, India.,University of Lower Silesia, Wroclaw, Poland.,Center for Global Mental Health, Rawalpindi, Pakistan.,University of Nairobi, Nairobi, Kenya.,Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.,Pakistan Institute of Medical Sciences, Islamabad, Pakistan.,Department of Psychiatry and Psychotherapy, Medical Faculty, University of Düsseldorf, Dusseldorf, Germany.,ProConsult, Owings Mills, Maryland, USA
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14
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Lloyd CE, Nouwen A, Sartorius N, Ahmed HU, Alvarez A, Bahendeka S, Basangwa D, Bobrov AE, Boden S, Bulgari V, Burti L, Chaturvedi SK, Cimino LC, Gaebel W, de Girolamo G, Gondek TM, de Braude MG, Guntupalli A, Heinze MG, Ji L, Hong X, Khan A, Kiejna A, Kokoszka A, Kamala T, Lalic NM, Lecic Tosevski D, Mankovsky B, Li M, Musau A, Müssig K, Ndetei D, Rabbani G, Srikanta SS, Starostina EG, Shevchuk M, Taj R, Vukovic O, Wölwer W, Xin Y. Prevalence and correlates of depressive disorders in people with Type 2 diabetes: results from the International Prevalence and Treatment of Diabetes and Depression (INTERPRET-DD) study, a collaborative study carried out in 14 countries. Diabet Med 2018; 35:760-769. [PMID: 29478265 DOI: 10.1111/dme.13611] [Citation(s) in RCA: 69] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/21/2018] [Indexed: 01/23/2023]
Abstract
AIMS To assess the prevalence and management of depressive disorders in people with Type 2 diabetes in different countries. METHODS People with diabetes aged 18-65 years and treated in outpatient settings were recruited in 14 countries and underwent a psychiatric interview. Participants completed the Patient Health Questionnaire and the Problem Areas in Diabetes scale. Demographic and medical record data were collected. RESULTS A total of 2783 people with Type 2 diabetes (45.3% men, mean duration of diabetes 8.8 years) participated. Overall, 10.6% were diagnosed with current major depressive disorder and 17.0% reported moderate to severe levels of depressive symptomatology (Patient Health Questionnaire scores >9). Multivariable analyses showed that, after controlling for country, current major depressive disorder was significantly associated with gender (women) (P<0.0001), a lower level of education (P<0.05), doing less exercise (P<0.01), higher levels of diabetes distress (P<0.0001) and a previous diagnosis of major depressive disorder (P<0.0001). The proportion of those with either current major depressive disorder or moderate to severe levels of depressive symptomatology who had a diagnosis or any treatment for their depression recorded in their medical records was extremely low and non-existent in many countries (0-29.6%). CONCLUSIONS Our international study, the largest of this type ever undertaken, shows that people with diabetes frequently have depressive disorders and also significant levels of depressive symptoms. Our findings indicate that the identification and appropriate care for psychological and psychiatric problems is not the norm and suggest a lack of the comprehensive approach to diabetes management that is needed to improve clinical outcomes.
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Affiliation(s)
- C E Lloyd
- The Open University, School of Health, Wellbeing and Social Care, UK
| | - A Nouwen
- Department of Psychology, Middlesex University, UK
| | - N Sartorius
- Association for the Improvement of Mental Health Programmes, Switzerland
| | - H U Ahmed
- Child Adolescent & Family Psychiatry, National Institute of Mental Health (NIMH), Dhaka, Bangladesh
| | - A Alvarez
- Hospital Italiano de Buenos Aires, Argentina
| | - S Bahendeka
- Mother Kevin Post Graduate Medical School, Uganda Martyrs University, Kampala, Uganda
| | - D Basangwa
- Mother Kevin Post Graduate Medical School, Uganda Martyrs University, Kampala, Uganda
| | - A E Bobrov
- Federal Medical Research Centre for Psychiatry and Narcology, Moscow, Russia
| | - S Boden
- The Open University, School of Health, Wellbeing and Social Care, UK
| | - V Bulgari
- Psychiatric Epidemiology and Evaluation Unit, Saint John of God Clinical Research Centre, Brescia, Italy
- PhD School in Psychology, Catholic University of the Sacred Heart, Milan, Italy
| | - L Burti
- Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Italy
| | - S K Chaturvedi
- National Institute of Mental Health & Neurosciences, Bangalore, India
| | | | - W Gaebel
- Department of Psychiatry and Psychotherapy, Medical Faculty, Heinrich Heine University, Düsseldorf, Germany
| | - G de Girolamo
- Psychiatric Epidemiology and Evaluation Unit, Saint John of God Clinical Research Centre, Brescia, Italy
| | - T M Gondek
- Department of Psychiatry, Wroclaw Medical University, Wroclaw, Poland
| | | | - A Guntupalli
- School of Health, Wellbeing and Social Care, The Open University, UK
| | - M G Heinze
- Universidad Nacional Autónoma de México, Mexico City, Mexico
| | - L Ji
- People's Hospital, Peking University, Beijing, China
| | - X Hong
- Department of Psychological Medicine, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - A Khan
- Pakistan Institute of Medical Sciences, Pakistan
| | - A Kiejna
- University of Lower Silesia, Wroclaw, Poland
- Department of Psychiatry, Medical University, Wroclaw, Poland
| | - A Kokoszka
- II Department of Psychiatry, Medical University of Warsaw, Warszawa, Poland
| | - T Kamala
- Diabetes Centre and Jnana Sanjeevini Medical Centre, Bangalore, India
| | - N M Lalic
- Clinic for Endocrinology, Belgrade University School of Medicine, Serbian Academy of Sciences and Arts, Belgrade
| | - D Lecic Tosevski
- Institute of Mental Health, Belgrade University School of Medicine, Serbian Academy of Sciences and Arts, Belgrade, Serbia
| | - B Mankovsky
- Department of Diabetology, National Medical Academy for Postgraduate Education, Ukraine
| | - M Li
- School of Nursing, Peking University, Beijing, China
| | - A Musau
- Africa Mental Health Foundation, Kenya
| | - K Müssig
- Institute for Clinical Diabetology, German Diabetes Centre
- Leibniz Centre for Diabetes Research at Heinrich Heine University Düsseldorf, Düsseldorf, Germany
- Department of Endocrinology and Diabetology, Medical Faculty, Heinrich Heine University, Düsseldorf, Germany
- German Centre for Diabetes Research (DZD), München-Neuherberg, Germany
| | - D Ndetei
- University of Nairobi, Africa Mental Health Foundation, Kenya
| | - G Rabbani
- Popular Medical College, Dhaka, Bangladesh
| | - S S Srikanta
- Samatvam Endocrinology Diabetes Centre and Jnana Sanjeevini Medical Centre, Bangalore, India
| | - E G Starostina
- Department of Endocrinology, Moscow Regional Clinical and Research Institute, Russia
| | - M Shevchuk
- Department of Diabetology, National Medical Academy for Postgraduate Education, Kiev, Ukraine
| | - R Taj
- Pakistan Institute of Medical Sciences, Pakistan
| | - O Vukovic
- Institute of Mental Health, Belgrade University School of Medicine, Serbian Academy of Sciences and Arts, Belgrade, Serbia
| | - W Wölwer
- Department of Psychiatry and Psychotherapy, Medical Faculty, Heinrich Heine University, Düsseldorf, Germany
| | - Y Xin
- Clinical Research Centre, Peking University Sixth Hospital, Clinical Research Centre, Peking University Institute of Mental Health, Key Laboratory of Mental Health, Ministry of Health (Peking University), National Clinical Research Centre for Mental Disorders (Peking University Sixth Hospital), Beijing, China
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15
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Vujcic M, Tomicevic-Dubljevic J, Grbic M, Lecic-Tosevski D, Vukovic O, Toskovic O. Nature based solution for improving mental health and well-being in urban areas. Environ Res 2017; 158:385-392. [PMID: 28688269 DOI: 10.1016/j.envres.2017.06.030] [Citation(s) in RCA: 60] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/02/2016] [Revised: 06/22/2017] [Accepted: 06/24/2017] [Indexed: 05/22/2023]
Abstract
The general disproportion of urban development and the socio-economical crisis in Serbia, followed by a number of acute and chronic stressors, as well as years of accumulated trauma, prevented the parallel physical, mental and social adaptation of society as a whole. These trends certainly affected the quality of mental health and well-being, particularly on the vulnerable urban population, increasing the absolute number of people with depression, stress and psychosomatic disorders. This study was pioneering in Serbia and was conducted in collaboration with the Faculty of Forestry, the Institute of Mental Health and the Botanical Garden in Belgrade, in order to understand how spending time and performing horticulture therapy in specially designed urban green environments can improve mental health. The participants were psychiatric patients (n=30), users of the day hospital of the Institute who were randomly selected for the study, and the control group, assessed for depression, anxiety and stress before and after the intervention, using a DASS21 scale. During the intervention period the study group stayed in the Botanical garden and participated in a special programme of horticulture therapy. In order to exclude any possible "special treatment'' or ''placebo effect", the control group was included in occupational art therapy while it continued to receive conventional therapy. The test results indicated that nature based therapy had a positive influence on the mental health and well-being of the participants. Furthermore, the difference in the test results of the subscale stress before and after the intervention for the study group was F1.28 = 5.442 and p<;.05. According to socio demographic and clinical variables, the interesting trend was recorded on the subscale of anxiety showing that the male participants in the study group were more anxious, with the most pronounced inflection noted on this scale after treatment. The results of this study have shown that recuperation from stress, depression and anxiety was possible and much more complete when participants were involved in horticulture therapy as a nature-based solution for improving mental health.
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Affiliation(s)
- Maja Vujcic
- Department of Landscape Architecture and Horticulture, Faculty of Forestry, University of Belgrade, Serbia.
| | - Jelena Tomicevic-Dubljevic
- Department of Landscape Architecture and Horticulture, Faculty of Forestry, University of Belgrade, Serbia.
| | - Mihailo Grbic
- Department of Landscape Architecture and Horticulture, Faculty of Forestry, University of Belgrade, Serbia.
| | - Dusica Lecic-Tosevski
- Department of Psychiatry, Belgrade University School of Medicine, Serbian Academy of Sciences and Arts, Belgrade, Serbia.
| | - Olivera Vukovic
- Department of Psychiatry, Belgrade University School of Medicine, Head of Day Hospital for Adults at the Institute of Mental Health in Belgrade, Serbia.
| | - Oliver Toskovic
- Laboratory for Experimental Psychology, Faculty of Philosophy, University of Belgrade, Serbia.
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16
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Fountoulakis KN, Kawohl W, Theodorakis PN, Kerkhof AJFM, Navickas A, Höschl C, Lecic-Tosevski D, Sorel E, Rancans E, Palova E, Juckel G, Isacsson G, Jagodic HK, Botezat-Antonescu I, Warnke I, Rybakowski J, Azorin JM, Cookson J, Waddington J, Pregelj P, Demyttenaere K, Hranov LG, Stevovic LI, Pezawas L, Adida M, Figuera ML, Pompili M, Jakovljević M, Vichi M, Perugi G, Andreassen O, Vukovic O, Mavrogiorgou P, Varnik P, Bech P, Dome P, Winkler P, Salokangas RKR, From T, Danileviciute V, Gonda X, Rihmer Z, Benhalima JF, Grady A, Leadholm AKK, Soendergaard S, Nordt C, Lopez-Ibor J, Lopez-Ibor J. Relationship of suicide rates to economic variables in Europe: 2000-2011. Br J Psychiatry 2014; 205:486-96. [PMID: 25359926 DOI: 10.1192/bjp.bp.114.147454] [Citation(s) in RCA: 70] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
BACKGROUND It is unclear whether there is a direct link between economic crises and changes in suicide rates. AIMS The Lopez-Ibor Foundation launched an initiative to study the possible impact of the economic crisis on European suicide rates. METHOD Data was gathered and analysed from 29 European countries and included the number of deaths by suicide in men and women, the unemployment rate, the gross domestic product (GDP) per capita, the annual economic growth rate and inflation. RESULTS There was a strong correlation between suicide rates and all economic indices except GPD per capita in men but only a correlation with unemployment in women. However, the increase in suicide rates occurred several months before the economic crisis emerged. CONCLUSIONS Overall, this study confirms a general relationship between the economic environment and suicide rates; however, it does not support there being a clear causal relationship between the current economic crisis and an increase in the suicide rate.
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Affiliation(s)
- Konstantinos N Fountoulakis
- Konstantinos N. Fountoulakis, MD, Associate Professor of Psychiatry, 3rd Department of Psychiatry, School of Medicine, Aristotle University of Thessaloniki, Greece; Wolfram Kawohl, MD, Center for Social Psychiatry, Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, Zurich, Switzerland; Pavlos N. Theodorakis, MD, Mental Health Hospitals Trust of Attica 'Dafni & Dromokaiteio' and WHO National Counterpart for Mental Health, Athens, Greece; Ad J. F. M. Kerkhof, MD, Faculty of Psychology and Education, Department of Clinical Psychology, VU University Amsterdam, Amsterdam, The Netherlands; Alvydas Navickas, MD, PhD, Associate Professor, Psychiatric Clinic, Vilnius University Medical Faculty, Vilnius, Lithuania; Cyril Höschl, MD, Prague Psychiatric Center/NIMH, Czech Republic; Dusica Lecic-Tosevski, MD, Professor of Psychiatry, Belgrade University School of Medicine and Institute of Mental Health, WHO Collaborating Centre, Belgrade, Serbia; Eliot Sorel, MD, The George Washington University, School of Medicine & School of Public Health, Washington DC, USA; Elmars Rancans, MD, PhD, Chair of the Department of Psychiatry and Narcology, Riga Stradins University, Latvia; Eva Palova, MD, Department of Psychiatry, University Hospital, Slovakia; Georg Juckel, MD, PhD, Department of Psychiatry, Ruhr University Bochum, LWL-University Hospital, Bochum, Germany; Goran Isacsson, MD, Associate Professor, Department of Clinical Neuroscience, Karolinska Institutet, Sweden; Helena Korosec Jagodic, Psychiatric Hospital Vojnik, Vojnik, Slovenia; Ileana Botezat-Antonescu, MD, Associate Professor, National Mental Health Center and Anti-drug, Bucharest, Romania; Ingeborg Warnke, PhD, Center for Social Psychiatry, Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, Zurich, Switzerland; Janusz Rybakowski, Department of Adult Psychiatry, Poznan University of Medical Sciences, Poznan, Poland; Je
| | - Wolfram Kawohl
- Konstantinos N. Fountoulakis, MD, Associate Professor of Psychiatry, 3rd Department of Psychiatry, School of Medicine, Aristotle University of Thessaloniki, Greece; Wolfram Kawohl, MD, Center for Social Psychiatry, Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, Zurich, Switzerland; Pavlos N. Theodorakis, MD, Mental Health Hospitals Trust of Attica 'Dafni & Dromokaiteio' and WHO National Counterpart for Mental Health, Athens, Greece; Ad J. F. M. Kerkhof, MD, Faculty of Psychology and Education, Department of Clinical Psychology, VU University Amsterdam, Amsterdam, The Netherlands; Alvydas Navickas, MD, PhD, Associate Professor, Psychiatric Clinic, Vilnius University Medical Faculty, Vilnius, Lithuania; Cyril Höschl, MD, Prague Psychiatric Center/NIMH, Czech Republic; Dusica Lecic-Tosevski, MD, Professor of Psychiatry, Belgrade University School of Medicine and Institute of Mental Health, WHO Collaborating Centre, Belgrade, Serbia; Eliot Sorel, MD, The George Washington University, School of Medicine & School of Public Health, Washington DC, USA; Elmars Rancans, MD, PhD, Chair of the Department of Psychiatry and Narcology, Riga Stradins University, Latvia; Eva Palova, MD, Department of Psychiatry, University Hospital, Slovakia; Georg Juckel, MD, PhD, Department of Psychiatry, Ruhr University Bochum, LWL-University Hospital, Bochum, Germany; Goran Isacsson, MD, Associate Professor, Department of Clinical Neuroscience, Karolinska Institutet, Sweden; Helena Korosec Jagodic, Psychiatric Hospital Vojnik, Vojnik, Slovenia; Ileana Botezat-Antonescu, MD, Associate Professor, National Mental Health Center and Anti-drug, Bucharest, Romania; Ingeborg Warnke, PhD, Center for Social Psychiatry, Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, Zurich, Switzerland; Janusz Rybakowski, Department of Adult Psychiatry, Poznan University of Medical Sciences, Poznan, Poland; Je
| | - Pavlos N Theodorakis
- Konstantinos N. Fountoulakis, MD, Associate Professor of Psychiatry, 3rd Department of Psychiatry, School of Medicine, Aristotle University of Thessaloniki, Greece; Wolfram Kawohl, MD, Center for Social Psychiatry, Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, Zurich, Switzerland; Pavlos N. Theodorakis, MD, Mental Health Hospitals Trust of Attica 'Dafni & Dromokaiteio' and WHO National Counterpart for Mental Health, Athens, Greece; Ad J. F. M. Kerkhof, MD, Faculty of Psychology and Education, Department of Clinical Psychology, VU University Amsterdam, Amsterdam, The Netherlands; Alvydas Navickas, MD, PhD, Associate Professor, Psychiatric Clinic, Vilnius University Medical Faculty, Vilnius, Lithuania; Cyril Höschl, MD, Prague Psychiatric Center/NIMH, Czech Republic; Dusica Lecic-Tosevski, MD, Professor of Psychiatry, Belgrade University School of Medicine and Institute of Mental Health, WHO Collaborating Centre, Belgrade, Serbia; Eliot Sorel, MD, The George Washington University, School of Medicine & School of Public Health, Washington DC, USA; Elmars Rancans, MD, PhD, Chair of the Department of Psychiatry and Narcology, Riga Stradins University, Latvia; Eva Palova, MD, Department of Psychiatry, University Hospital, Slovakia; Georg Juckel, MD, PhD, Department of Psychiatry, Ruhr University Bochum, LWL-University Hospital, Bochum, Germany; Goran Isacsson, MD, Associate Professor, Department of Clinical Neuroscience, Karolinska Institutet, Sweden; Helena Korosec Jagodic, Psychiatric Hospital Vojnik, Vojnik, Slovenia; Ileana Botezat-Antonescu, MD, Associate Professor, National Mental Health Center and Anti-drug, Bucharest, Romania; Ingeborg Warnke, PhD, Center for Social Psychiatry, Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, Zurich, Switzerland; Janusz Rybakowski, Department of Adult Psychiatry, Poznan University of Medical Sciences, Poznan, Poland; Je
| | - Ad J F M Kerkhof
- Konstantinos N. Fountoulakis, MD, Associate Professor of Psychiatry, 3rd Department of Psychiatry, School of Medicine, Aristotle University of Thessaloniki, Greece; Wolfram Kawohl, MD, Center for Social Psychiatry, Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, Zurich, Switzerland; Pavlos N. Theodorakis, MD, Mental Health Hospitals Trust of Attica 'Dafni & Dromokaiteio' and WHO National Counterpart for Mental Health, Athens, Greece; Ad J. F. M. Kerkhof, MD, Faculty of Psychology and Education, Department of Clinical Psychology, VU University Amsterdam, Amsterdam, The Netherlands; Alvydas Navickas, MD, PhD, Associate Professor, Psychiatric Clinic, Vilnius University Medical Faculty, Vilnius, Lithuania; Cyril Höschl, MD, Prague Psychiatric Center/NIMH, Czech Republic; Dusica Lecic-Tosevski, MD, Professor of Psychiatry, Belgrade University School of Medicine and Institute of Mental Health, WHO Collaborating Centre, Belgrade, Serbia; Eliot Sorel, MD, The George Washington University, School of Medicine & School of Public Health, Washington DC, USA; Elmars Rancans, MD, PhD, Chair of the Department of Psychiatry and Narcology, Riga Stradins University, Latvia; Eva Palova, MD, Department of Psychiatry, University Hospital, Slovakia; Georg Juckel, MD, PhD, Department of Psychiatry, Ruhr University Bochum, LWL-University Hospital, Bochum, Germany; Goran Isacsson, MD, Associate Professor, Department of Clinical Neuroscience, Karolinska Institutet, Sweden; Helena Korosec Jagodic, Psychiatric Hospital Vojnik, Vojnik, Slovenia; Ileana Botezat-Antonescu, MD, Associate Professor, National Mental Health Center and Anti-drug, Bucharest, Romania; Ingeborg Warnke, PhD, Center for Social Psychiatry, Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, Zurich, Switzerland; Janusz Rybakowski, Department of Adult Psychiatry, Poznan University of Medical Sciences, Poznan, Poland; Je
| | - Alvydas Navickas
- Konstantinos N. Fountoulakis, MD, Associate Professor of Psychiatry, 3rd Department of Psychiatry, School of Medicine, Aristotle University of Thessaloniki, Greece; Wolfram Kawohl, MD, Center for Social Psychiatry, Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, Zurich, Switzerland; Pavlos N. Theodorakis, MD, Mental Health Hospitals Trust of Attica 'Dafni & Dromokaiteio' and WHO National Counterpart for Mental Health, Athens, Greece; Ad J. F. M. Kerkhof, MD, Faculty of Psychology and Education, Department of Clinical Psychology, VU University Amsterdam, Amsterdam, The Netherlands; Alvydas Navickas, MD, PhD, Associate Professor, Psychiatric Clinic, Vilnius University Medical Faculty, Vilnius, Lithuania; Cyril Höschl, MD, Prague Psychiatric Center/NIMH, Czech Republic; Dusica Lecic-Tosevski, MD, Professor of Psychiatry, Belgrade University School of Medicine and Institute of Mental Health, WHO Collaborating Centre, Belgrade, Serbia; Eliot Sorel, MD, The George Washington University, School of Medicine & School of Public Health, Washington DC, USA; Elmars Rancans, MD, PhD, Chair of the Department of Psychiatry and Narcology, Riga Stradins University, Latvia; Eva Palova, MD, Department of Psychiatry, University Hospital, Slovakia; Georg Juckel, MD, PhD, Department of Psychiatry, Ruhr University Bochum, LWL-University Hospital, Bochum, Germany; Goran Isacsson, MD, Associate Professor, Department of Clinical Neuroscience, Karolinska Institutet, Sweden; Helena Korosec Jagodic, Psychiatric Hospital Vojnik, Vojnik, Slovenia; Ileana Botezat-Antonescu, MD, Associate Professor, National Mental Health Center and Anti-drug, Bucharest, Romania; Ingeborg Warnke, PhD, Center for Social Psychiatry, Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, Zurich, Switzerland; Janusz Rybakowski, Department of Adult Psychiatry, Poznan University of Medical Sciences, Poznan, Poland; Je
| | - Cyril Höschl
- Konstantinos N. Fountoulakis, MD, Associate Professor of Psychiatry, 3rd Department of Psychiatry, School of Medicine, Aristotle University of Thessaloniki, Greece; Wolfram Kawohl, MD, Center for Social Psychiatry, Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, Zurich, Switzerland; Pavlos N. Theodorakis, MD, Mental Health Hospitals Trust of Attica 'Dafni & Dromokaiteio' and WHO National Counterpart for Mental Health, Athens, Greece; Ad J. F. M. Kerkhof, MD, Faculty of Psychology and Education, Department of Clinical Psychology, VU University Amsterdam, Amsterdam, The Netherlands; Alvydas Navickas, MD, PhD, Associate Professor, Psychiatric Clinic, Vilnius University Medical Faculty, Vilnius, Lithuania; Cyril Höschl, MD, Prague Psychiatric Center/NIMH, Czech Republic; Dusica Lecic-Tosevski, MD, Professor of Psychiatry, Belgrade University School of Medicine and Institute of Mental Health, WHO Collaborating Centre, Belgrade, Serbia; Eliot Sorel, MD, The George Washington University, School of Medicine & School of Public Health, Washington DC, USA; Elmars Rancans, MD, PhD, Chair of the Department of Psychiatry and Narcology, Riga Stradins University, Latvia; Eva Palova, MD, Department of Psychiatry, University Hospital, Slovakia; Georg Juckel, MD, PhD, Department of Psychiatry, Ruhr University Bochum, LWL-University Hospital, Bochum, Germany; Goran Isacsson, MD, Associate Professor, Department of Clinical Neuroscience, Karolinska Institutet, Sweden; Helena Korosec Jagodic, Psychiatric Hospital Vojnik, Vojnik, Slovenia; Ileana Botezat-Antonescu, MD, Associate Professor, National Mental Health Center and Anti-drug, Bucharest, Romania; Ingeborg Warnke, PhD, Center for Social Psychiatry, Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, Zurich, Switzerland; Janusz Rybakowski, Department of Adult Psychiatry, Poznan University of Medical Sciences, Poznan, Poland; Je
| | - Dusica Lecic-Tosevski
- Konstantinos N. Fountoulakis, MD, Associate Professor of Psychiatry, 3rd Department of Psychiatry, School of Medicine, Aristotle University of Thessaloniki, Greece; Wolfram Kawohl, MD, Center for Social Psychiatry, Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, Zurich, Switzerland; Pavlos N. Theodorakis, MD, Mental Health Hospitals Trust of Attica 'Dafni & Dromokaiteio' and WHO National Counterpart for Mental Health, Athens, Greece; Ad J. F. M. Kerkhof, MD, Faculty of Psychology and Education, Department of Clinical Psychology, VU University Amsterdam, Amsterdam, The Netherlands; Alvydas Navickas, MD, PhD, Associate Professor, Psychiatric Clinic, Vilnius University Medical Faculty, Vilnius, Lithuania; Cyril Höschl, MD, Prague Psychiatric Center/NIMH, Czech Republic; Dusica Lecic-Tosevski, MD, Professor of Psychiatry, Belgrade University School of Medicine and Institute of Mental Health, WHO Collaborating Centre, Belgrade, Serbia; Eliot Sorel, MD, The George Washington University, School of Medicine & School of Public Health, Washington DC, USA; Elmars Rancans, MD, PhD, Chair of the Department of Psychiatry and Narcology, Riga Stradins University, Latvia; Eva Palova, MD, Department of Psychiatry, University Hospital, Slovakia; Georg Juckel, MD, PhD, Department of Psychiatry, Ruhr University Bochum, LWL-University Hospital, Bochum, Germany; Goran Isacsson, MD, Associate Professor, Department of Clinical Neuroscience, Karolinska Institutet, Sweden; Helena Korosec Jagodic, Psychiatric Hospital Vojnik, Vojnik, Slovenia; Ileana Botezat-Antonescu, MD, Associate Professor, National Mental Health Center and Anti-drug, Bucharest, Romania; Ingeborg Warnke, PhD, Center for Social Psychiatry, Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, Zurich, Switzerland; Janusz Rybakowski, Department of Adult Psychiatry, Poznan University of Medical Sciences, Poznan, Poland; Je
| | - Eliot Sorel
- Konstantinos N. Fountoulakis, MD, Associate Professor of Psychiatry, 3rd Department of Psychiatry, School of Medicine, Aristotle University of Thessaloniki, Greece; Wolfram Kawohl, MD, Center for Social Psychiatry, Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, Zurich, Switzerland; Pavlos N. Theodorakis, MD, Mental Health Hospitals Trust of Attica 'Dafni & Dromokaiteio' and WHO National Counterpart for Mental Health, Athens, Greece; Ad J. F. M. Kerkhof, MD, Faculty of Psychology and Education, Department of Clinical Psychology, VU University Amsterdam, Amsterdam, The Netherlands; Alvydas Navickas, MD, PhD, Associate Professor, Psychiatric Clinic, Vilnius University Medical Faculty, Vilnius, Lithuania; Cyril Höschl, MD, Prague Psychiatric Center/NIMH, Czech Republic; Dusica Lecic-Tosevski, MD, Professor of Psychiatry, Belgrade University School of Medicine and Institute of Mental Health, WHO Collaborating Centre, Belgrade, Serbia; Eliot Sorel, MD, The George Washington University, School of Medicine & School of Public Health, Washington DC, USA; Elmars Rancans, MD, PhD, Chair of the Department of Psychiatry and Narcology, Riga Stradins University, Latvia; Eva Palova, MD, Department of Psychiatry, University Hospital, Slovakia; Georg Juckel, MD, PhD, Department of Psychiatry, Ruhr University Bochum, LWL-University Hospital, Bochum, Germany; Goran Isacsson, MD, Associate Professor, Department of Clinical Neuroscience, Karolinska Institutet, Sweden; Helena Korosec Jagodic, Psychiatric Hospital Vojnik, Vojnik, Slovenia; Ileana Botezat-Antonescu, MD, Associate Professor, National Mental Health Center and Anti-drug, Bucharest, Romania; Ingeborg Warnke, PhD, Center for Social Psychiatry, Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, Zurich, Switzerland; Janusz Rybakowski, Department of Adult Psychiatry, Poznan University of Medical Sciences, Poznan, Poland; Je
| | - Elmars Rancans
- Konstantinos N. Fountoulakis, MD, Associate Professor of Psychiatry, 3rd Department of Psychiatry, School of Medicine, Aristotle University of Thessaloniki, Greece; Wolfram Kawohl, MD, Center for Social Psychiatry, Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, Zurich, Switzerland; Pavlos N. Theodorakis, MD, Mental Health Hospitals Trust of Attica 'Dafni & Dromokaiteio' and WHO National Counterpart for Mental Health, Athens, Greece; Ad J. F. M. Kerkhof, MD, Faculty of Psychology and Education, Department of Clinical Psychology, VU University Amsterdam, Amsterdam, The Netherlands; Alvydas Navickas, MD, PhD, Associate Professor, Psychiatric Clinic, Vilnius University Medical Faculty, Vilnius, Lithuania; Cyril Höschl, MD, Prague Psychiatric Center/NIMH, Czech Republic; Dusica Lecic-Tosevski, MD, Professor of Psychiatry, Belgrade University School of Medicine and Institute of Mental Health, WHO Collaborating Centre, Belgrade, Serbia; Eliot Sorel, MD, The George Washington University, School of Medicine & School of Public Health, Washington DC, USA; Elmars Rancans, MD, PhD, Chair of the Department of Psychiatry and Narcology, Riga Stradins University, Latvia; Eva Palova, MD, Department of Psychiatry, University Hospital, Slovakia; Georg Juckel, MD, PhD, Department of Psychiatry, Ruhr University Bochum, LWL-University Hospital, Bochum, Germany; Goran Isacsson, MD, Associate Professor, Department of Clinical Neuroscience, Karolinska Institutet, Sweden; Helena Korosec Jagodic, Psychiatric Hospital Vojnik, Vojnik, Slovenia; Ileana Botezat-Antonescu, MD, Associate Professor, National Mental Health Center and Anti-drug, Bucharest, Romania; Ingeborg Warnke, PhD, Center for Social Psychiatry, Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, Zurich, Switzerland; Janusz Rybakowski, Department of Adult Psychiatry, Poznan University of Medical Sciences, Poznan, Poland; Je
| | - Eva Palova
- Konstantinos N. Fountoulakis, MD, Associate Professor of Psychiatry, 3rd Department of Psychiatry, School of Medicine, Aristotle University of Thessaloniki, Greece; Wolfram Kawohl, MD, Center for Social Psychiatry, Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, Zurich, Switzerland; Pavlos N. Theodorakis, MD, Mental Health Hospitals Trust of Attica 'Dafni & Dromokaiteio' and WHO National Counterpart for Mental Health, Athens, Greece; Ad J. F. M. Kerkhof, MD, Faculty of Psychology and Education, Department of Clinical Psychology, VU University Amsterdam, Amsterdam, The Netherlands; Alvydas Navickas, MD, PhD, Associate Professor, Psychiatric Clinic, Vilnius University Medical Faculty, Vilnius, Lithuania; Cyril Höschl, MD, Prague Psychiatric Center/NIMH, Czech Republic; Dusica Lecic-Tosevski, MD, Professor of Psychiatry, Belgrade University School of Medicine and Institute of Mental Health, WHO Collaborating Centre, Belgrade, Serbia; Eliot Sorel, MD, The George Washington University, School of Medicine & School of Public Health, Washington DC, USA; Elmars Rancans, MD, PhD, Chair of the Department of Psychiatry and Narcology, Riga Stradins University, Latvia; Eva Palova, MD, Department of Psychiatry, University Hospital, Slovakia; Georg Juckel, MD, PhD, Department of Psychiatry, Ruhr University Bochum, LWL-University Hospital, Bochum, Germany; Goran Isacsson, MD, Associate Professor, Department of Clinical Neuroscience, Karolinska Institutet, Sweden; Helena Korosec Jagodic, Psychiatric Hospital Vojnik, Vojnik, Slovenia; Ileana Botezat-Antonescu, MD, Associate Professor, National Mental Health Center and Anti-drug, Bucharest, Romania; Ingeborg Warnke, PhD, Center for Social Psychiatry, Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, Zurich, Switzerland; Janusz Rybakowski, Department of Adult Psychiatry, Poznan University of Medical Sciences, Poznan, Poland; Je
| | - Georg Juckel
- Konstantinos N. Fountoulakis, MD, Associate Professor of Psychiatry, 3rd Department of Psychiatry, School of Medicine, Aristotle University of Thessaloniki, Greece; Wolfram Kawohl, MD, Center for Social Psychiatry, Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, Zurich, Switzerland; Pavlos N. Theodorakis, MD, Mental Health Hospitals Trust of Attica 'Dafni & Dromokaiteio' and WHO National Counterpart for Mental Health, Athens, Greece; Ad J. F. M. Kerkhof, MD, Faculty of Psychology and Education, Department of Clinical Psychology, VU University Amsterdam, Amsterdam, The Netherlands; Alvydas Navickas, MD, PhD, Associate Professor, Psychiatric Clinic, Vilnius University Medical Faculty, Vilnius, Lithuania; Cyril Höschl, MD, Prague Psychiatric Center/NIMH, Czech Republic; Dusica Lecic-Tosevski, MD, Professor of Psychiatry, Belgrade University School of Medicine and Institute of Mental Health, WHO Collaborating Centre, Belgrade, Serbia; Eliot Sorel, MD, The George Washington University, School of Medicine & School of Public Health, Washington DC, USA; Elmars Rancans, MD, PhD, Chair of the Department of Psychiatry and Narcology, Riga Stradins University, Latvia; Eva Palova, MD, Department of Psychiatry, University Hospital, Slovakia; Georg Juckel, MD, PhD, Department of Psychiatry, Ruhr University Bochum, LWL-University Hospital, Bochum, Germany; Goran Isacsson, MD, Associate Professor, Department of Clinical Neuroscience, Karolinska Institutet, Sweden; Helena Korosec Jagodic, Psychiatric Hospital Vojnik, Vojnik, Slovenia; Ileana Botezat-Antonescu, MD, Associate Professor, National Mental Health Center and Anti-drug, Bucharest, Romania; Ingeborg Warnke, PhD, Center for Social Psychiatry, Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, Zurich, Switzerland; Janusz Rybakowski, Department of Adult Psychiatry, Poznan University of Medical Sciences, Poznan, Poland; Je
| | - Goran Isacsson
- Konstantinos N. Fountoulakis, MD, Associate Professor of Psychiatry, 3rd Department of Psychiatry, School of Medicine, Aristotle University of Thessaloniki, Greece; Wolfram Kawohl, MD, Center for Social Psychiatry, Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, Zurich, Switzerland; Pavlos N. Theodorakis, MD, Mental Health Hospitals Trust of Attica 'Dafni & Dromokaiteio' and WHO National Counterpart for Mental Health, Athens, Greece; Ad J. F. M. Kerkhof, MD, Faculty of Psychology and Education, Department of Clinical Psychology, VU University Amsterdam, Amsterdam, The Netherlands; Alvydas Navickas, MD, PhD, Associate Professor, Psychiatric Clinic, Vilnius University Medical Faculty, Vilnius, Lithuania; Cyril Höschl, MD, Prague Psychiatric Center/NIMH, Czech Republic; Dusica Lecic-Tosevski, MD, Professor of Psychiatry, Belgrade University School of Medicine and Institute of Mental Health, WHO Collaborating Centre, Belgrade, Serbia; Eliot Sorel, MD, The George Washington University, School of Medicine & School of Public Health, Washington DC, USA; Elmars Rancans, MD, PhD, Chair of the Department of Psychiatry and Narcology, Riga Stradins University, Latvia; Eva Palova, MD, Department of Psychiatry, University Hospital, Slovakia; Georg Juckel, MD, PhD, Department of Psychiatry, Ruhr University Bochum, LWL-University Hospital, Bochum, Germany; Goran Isacsson, MD, Associate Professor, Department of Clinical Neuroscience, Karolinska Institutet, Sweden; Helena Korosec Jagodic, Psychiatric Hospital Vojnik, Vojnik, Slovenia; Ileana Botezat-Antonescu, MD, Associate Professor, National Mental Health Center and Anti-drug, Bucharest, Romania; Ingeborg Warnke, PhD, Center for Social Psychiatry, Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, Zurich, Switzerland; Janusz Rybakowski, Department of Adult Psychiatry, Poznan University of Medical Sciences, Poznan, Poland; Je
| | - Helena Korosec Jagodic
- Konstantinos N. Fountoulakis, MD, Associate Professor of Psychiatry, 3rd Department of Psychiatry, School of Medicine, Aristotle University of Thessaloniki, Greece; Wolfram Kawohl, MD, Center for Social Psychiatry, Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, Zurich, Switzerland; Pavlos N. Theodorakis, MD, Mental Health Hospitals Trust of Attica 'Dafni & Dromokaiteio' and WHO National Counterpart for Mental Health, Athens, Greece; Ad J. F. M. Kerkhof, MD, Faculty of Psychology and Education, Department of Clinical Psychology, VU University Amsterdam, Amsterdam, The Netherlands; Alvydas Navickas, MD, PhD, Associate Professor, Psychiatric Clinic, Vilnius University Medical Faculty, Vilnius, Lithuania; Cyril Höschl, MD, Prague Psychiatric Center/NIMH, Czech Republic; Dusica Lecic-Tosevski, MD, Professor of Psychiatry, Belgrade University School of Medicine and Institute of Mental Health, WHO Collaborating Centre, Belgrade, Serbia; Eliot Sorel, MD, The George Washington University, School of Medicine & School of Public Health, Washington DC, USA; Elmars Rancans, MD, PhD, Chair of the Department of Psychiatry and Narcology, Riga Stradins University, Latvia; Eva Palova, MD, Department of Psychiatry, University Hospital, Slovakia; Georg Juckel, MD, PhD, Department of Psychiatry, Ruhr University Bochum, LWL-University Hospital, Bochum, Germany; Goran Isacsson, MD, Associate Professor, Department of Clinical Neuroscience, Karolinska Institutet, Sweden; Helena Korosec Jagodic, Psychiatric Hospital Vojnik, Vojnik, Slovenia; Ileana Botezat-Antonescu, MD, Associate Professor, National Mental Health Center and Anti-drug, Bucharest, Romania; Ingeborg Warnke, PhD, Center for Social Psychiatry, Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, Zurich, Switzerland; Janusz Rybakowski, Department of Adult Psychiatry, Poznan University of Medical Sciences, Poznan, Poland; Je
| | - Ileana Botezat-Antonescu
- Konstantinos N. Fountoulakis, MD, Associate Professor of Psychiatry, 3rd Department of Psychiatry, School of Medicine, Aristotle University of Thessaloniki, Greece; Wolfram Kawohl, MD, Center for Social Psychiatry, Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, Zurich, Switzerland; Pavlos N. Theodorakis, MD, Mental Health Hospitals Trust of Attica 'Dafni & Dromokaiteio' and WHO National Counterpart for Mental Health, Athens, Greece; Ad J. F. M. Kerkhof, MD, Faculty of Psychology and Education, Department of Clinical Psychology, VU University Amsterdam, Amsterdam, The Netherlands; Alvydas Navickas, MD, PhD, Associate Professor, Psychiatric Clinic, Vilnius University Medical Faculty, Vilnius, Lithuania; Cyril Höschl, MD, Prague Psychiatric Center/NIMH, Czech Republic; Dusica Lecic-Tosevski, MD, Professor of Psychiatry, Belgrade University School of Medicine and Institute of Mental Health, WHO Collaborating Centre, Belgrade, Serbia; Eliot Sorel, MD, The George Washington University, School of Medicine & School of Public Health, Washington DC, USA; Elmars Rancans, MD, PhD, Chair of the Department of Psychiatry and Narcology, Riga Stradins University, Latvia; Eva Palova, MD, Department of Psychiatry, University Hospital, Slovakia; Georg Juckel, MD, PhD, Department of Psychiatry, Ruhr University Bochum, LWL-University Hospital, Bochum, Germany; Goran Isacsson, MD, Associate Professor, Department of Clinical Neuroscience, Karolinska Institutet, Sweden; Helena Korosec Jagodic, Psychiatric Hospital Vojnik, Vojnik, Slovenia; Ileana Botezat-Antonescu, MD, Associate Professor, National Mental Health Center and Anti-drug, Bucharest, Romania; Ingeborg Warnke, PhD, Center for Social Psychiatry, Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, Zurich, Switzerland; Janusz Rybakowski, Department of Adult Psychiatry, Poznan University of Medical Sciences, Poznan, Poland; Je
| | - Ingeborg Warnke
- Konstantinos N. Fountoulakis, MD, Associate Professor of Psychiatry, 3rd Department of Psychiatry, School of Medicine, Aristotle University of Thessaloniki, Greece; Wolfram Kawohl, MD, Center for Social Psychiatry, Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, Zurich, Switzerland; Pavlos N. Theodorakis, MD, Mental Health Hospitals Trust of Attica 'Dafni & Dromokaiteio' and WHO National Counterpart for Mental Health, Athens, Greece; Ad J. F. M. Kerkhof, MD, Faculty of Psychology and Education, Department of Clinical Psychology, VU University Amsterdam, Amsterdam, The Netherlands; Alvydas Navickas, MD, PhD, Associate Professor, Psychiatric Clinic, Vilnius University Medical Faculty, Vilnius, Lithuania; Cyril Höschl, MD, Prague Psychiatric Center/NIMH, Czech Republic; Dusica Lecic-Tosevski, MD, Professor of Psychiatry, Belgrade University School of Medicine and Institute of Mental Health, WHO Collaborating Centre, Belgrade, Serbia; Eliot Sorel, MD, The George Washington University, School of Medicine & School of Public Health, Washington DC, USA; Elmars Rancans, MD, PhD, Chair of the Department of Psychiatry and Narcology, Riga Stradins University, Latvia; Eva Palova, MD, Department of Psychiatry, University Hospital, Slovakia; Georg Juckel, MD, PhD, Department of Psychiatry, Ruhr University Bochum, LWL-University Hospital, Bochum, Germany; Goran Isacsson, MD, Associate Professor, Department of Clinical Neuroscience, Karolinska Institutet, Sweden; Helena Korosec Jagodic, Psychiatric Hospital Vojnik, Vojnik, Slovenia; Ileana Botezat-Antonescu, MD, Associate Professor, National Mental Health Center and Anti-drug, Bucharest, Romania; Ingeborg Warnke, PhD, Center for Social Psychiatry, Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, Zurich, Switzerland; Janusz Rybakowski, Department of Adult Psychiatry, Poznan University of Medical Sciences, Poznan, Poland; Je
| | - Janusz Rybakowski
- Konstantinos N. Fountoulakis, MD, Associate Professor of Psychiatry, 3rd Department of Psychiatry, School of Medicine, Aristotle University of Thessaloniki, Greece; Wolfram Kawohl, MD, Center for Social Psychiatry, Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, Zurich, Switzerland; Pavlos N. Theodorakis, MD, Mental Health Hospitals Trust of Attica 'Dafni & Dromokaiteio' and WHO National Counterpart for Mental Health, Athens, Greece; Ad J. F. M. Kerkhof, MD, Faculty of Psychology and Education, Department of Clinical Psychology, VU University Amsterdam, Amsterdam, The Netherlands; Alvydas Navickas, MD, PhD, Associate Professor, Psychiatric Clinic, Vilnius University Medical Faculty, Vilnius, Lithuania; Cyril Höschl, MD, Prague Psychiatric Center/NIMH, Czech Republic; Dusica Lecic-Tosevski, MD, Professor of Psychiatry, Belgrade University School of Medicine and Institute of Mental Health, WHO Collaborating Centre, Belgrade, Serbia; Eliot Sorel, MD, The George Washington University, School of Medicine & School of Public Health, Washington DC, USA; Elmars Rancans, MD, PhD, Chair of the Department of Psychiatry and Narcology, Riga Stradins University, Latvia; Eva Palova, MD, Department of Psychiatry, University Hospital, Slovakia; Georg Juckel, MD, PhD, Department of Psychiatry, Ruhr University Bochum, LWL-University Hospital, Bochum, Germany; Goran Isacsson, MD, Associate Professor, Department of Clinical Neuroscience, Karolinska Institutet, Sweden; Helena Korosec Jagodic, Psychiatric Hospital Vojnik, Vojnik, Slovenia; Ileana Botezat-Antonescu, MD, Associate Professor, National Mental Health Center and Anti-drug, Bucharest, Romania; Ingeborg Warnke, PhD, Center for Social Psychiatry, Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, Zurich, Switzerland; Janusz Rybakowski, Department of Adult Psychiatry, Poznan University of Medical Sciences, Poznan, Poland; Je
| | - Jean Michel Azorin
- Konstantinos N. Fountoulakis, MD, Associate Professor of Psychiatry, 3rd Department of Psychiatry, School of Medicine, Aristotle University of Thessaloniki, Greece; Wolfram Kawohl, MD, Center for Social Psychiatry, Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, Zurich, Switzerland; Pavlos N. Theodorakis, MD, Mental Health Hospitals Trust of Attica 'Dafni & Dromokaiteio' and WHO National Counterpart for Mental Health, Athens, Greece; Ad J. F. M. Kerkhof, MD, Faculty of Psychology and Education, Department of Clinical Psychology, VU University Amsterdam, Amsterdam, The Netherlands; Alvydas Navickas, MD, PhD, Associate Professor, Psychiatric Clinic, Vilnius University Medical Faculty, Vilnius, Lithuania; Cyril Höschl, MD, Prague Psychiatric Center/NIMH, Czech Republic; Dusica Lecic-Tosevski, MD, Professor of Psychiatry, Belgrade University School of Medicine and Institute of Mental Health, WHO Collaborating Centre, Belgrade, Serbia; Eliot Sorel, MD, The George Washington University, School of Medicine & School of Public Health, Washington DC, USA; Elmars Rancans, MD, PhD, Chair of the Department of Psychiatry and Narcology, Riga Stradins University, Latvia; Eva Palova, MD, Department of Psychiatry, University Hospital, Slovakia; Georg Juckel, MD, PhD, Department of Psychiatry, Ruhr University Bochum, LWL-University Hospital, Bochum, Germany; Goran Isacsson, MD, Associate Professor, Department of Clinical Neuroscience, Karolinska Institutet, Sweden; Helena Korosec Jagodic, Psychiatric Hospital Vojnik, Vojnik, Slovenia; Ileana Botezat-Antonescu, MD, Associate Professor, National Mental Health Center and Anti-drug, Bucharest, Romania; Ingeborg Warnke, PhD, Center for Social Psychiatry, Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, Zurich, Switzerland; Janusz Rybakowski, Department of Adult Psychiatry, Poznan University of Medical Sciences, Poznan, Poland; Je
| | - John Cookson
- Konstantinos N. Fountoulakis, MD, Associate Professor of Psychiatry, 3rd Department of Psychiatry, School of Medicine, Aristotle University of Thessaloniki, Greece; Wolfram Kawohl, MD, Center for Social Psychiatry, Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, Zurich, Switzerland; Pavlos N. Theodorakis, MD, Mental Health Hospitals Trust of Attica 'Dafni & Dromokaiteio' and WHO National Counterpart for Mental Health, Athens, Greece; Ad J. F. M. Kerkhof, MD, Faculty of Psychology and Education, Department of Clinical Psychology, VU University Amsterdam, Amsterdam, The Netherlands; Alvydas Navickas, MD, PhD, Associate Professor, Psychiatric Clinic, Vilnius University Medical Faculty, Vilnius, Lithuania; Cyril Höschl, MD, Prague Psychiatric Center/NIMH, Czech Republic; Dusica Lecic-Tosevski, MD, Professor of Psychiatry, Belgrade University School of Medicine and Institute of Mental Health, WHO Collaborating Centre, Belgrade, Serbia; Eliot Sorel, MD, The George Washington University, School of Medicine & School of Public Health, Washington DC, USA; Elmars Rancans, MD, PhD, Chair of the Department of Psychiatry and Narcology, Riga Stradins University, Latvia; Eva Palova, MD, Department of Psychiatry, University Hospital, Slovakia; Georg Juckel, MD, PhD, Department of Psychiatry, Ruhr University Bochum, LWL-University Hospital, Bochum, Germany; Goran Isacsson, MD, Associate Professor, Department of Clinical Neuroscience, Karolinska Institutet, Sweden; Helena Korosec Jagodic, Psychiatric Hospital Vojnik, Vojnik, Slovenia; Ileana Botezat-Antonescu, MD, Associate Professor, National Mental Health Center and Anti-drug, Bucharest, Romania; Ingeborg Warnke, PhD, Center for Social Psychiatry, Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, Zurich, Switzerland; Janusz Rybakowski, Department of Adult Psychiatry, Poznan University of Medical Sciences, Poznan, Poland; Je
| | - John Waddington
- Konstantinos N. Fountoulakis, MD, Associate Professor of Psychiatry, 3rd Department of Psychiatry, School of Medicine, Aristotle University of Thessaloniki, Greece; Wolfram Kawohl, MD, Center for Social Psychiatry, Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, Zurich, Switzerland; Pavlos N. Theodorakis, MD, Mental Health Hospitals Trust of Attica 'Dafni & Dromokaiteio' and WHO National Counterpart for Mental Health, Athens, Greece; Ad J. F. M. Kerkhof, MD, Faculty of Psychology and Education, Department of Clinical Psychology, VU University Amsterdam, Amsterdam, The Netherlands; Alvydas Navickas, MD, PhD, Associate Professor, Psychiatric Clinic, Vilnius University Medical Faculty, Vilnius, Lithuania; Cyril Höschl, MD, Prague Psychiatric Center/NIMH, Czech Republic; Dusica Lecic-Tosevski, MD, Professor of Psychiatry, Belgrade University School of Medicine and Institute of Mental Health, WHO Collaborating Centre, Belgrade, Serbia; Eliot Sorel, MD, The George Washington University, School of Medicine & School of Public Health, Washington DC, USA; Elmars Rancans, MD, PhD, Chair of the Department of Psychiatry and Narcology, Riga Stradins University, Latvia; Eva Palova, MD, Department of Psychiatry, University Hospital, Slovakia; Georg Juckel, MD, PhD, Department of Psychiatry, Ruhr University Bochum, LWL-University Hospital, Bochum, Germany; Goran Isacsson, MD, Associate Professor, Department of Clinical Neuroscience, Karolinska Institutet, Sweden; Helena Korosec Jagodic, Psychiatric Hospital Vojnik, Vojnik, Slovenia; Ileana Botezat-Antonescu, MD, Associate Professor, National Mental Health Center and Anti-drug, Bucharest, Romania; Ingeborg Warnke, PhD, Center for Social Psychiatry, Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, Zurich, Switzerland; Janusz Rybakowski, Department of Adult Psychiatry, Poznan University of Medical Sciences, Poznan, Poland; Je
| | - Peter Pregelj
- Konstantinos N. Fountoulakis, MD, Associate Professor of Psychiatry, 3rd Department of Psychiatry, School of Medicine, Aristotle University of Thessaloniki, Greece; Wolfram Kawohl, MD, Center for Social Psychiatry, Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, Zurich, Switzerland; Pavlos N. Theodorakis, MD, Mental Health Hospitals Trust of Attica 'Dafni & Dromokaiteio' and WHO National Counterpart for Mental Health, Athens, Greece; Ad J. F. M. Kerkhof, MD, Faculty of Psychology and Education, Department of Clinical Psychology, VU University Amsterdam, Amsterdam, The Netherlands; Alvydas Navickas, MD, PhD, Associate Professor, Psychiatric Clinic, Vilnius University Medical Faculty, Vilnius, Lithuania; Cyril Höschl, MD, Prague Psychiatric Center/NIMH, Czech Republic; Dusica Lecic-Tosevski, MD, Professor of Psychiatry, Belgrade University School of Medicine and Institute of Mental Health, WHO Collaborating Centre, Belgrade, Serbia; Eliot Sorel, MD, The George Washington University, School of Medicine & School of Public Health, Washington DC, USA; Elmars Rancans, MD, PhD, Chair of the Department of Psychiatry and Narcology, Riga Stradins University, Latvia; Eva Palova, MD, Department of Psychiatry, University Hospital, Slovakia; Georg Juckel, MD, PhD, Department of Psychiatry, Ruhr University Bochum, LWL-University Hospital, Bochum, Germany; Goran Isacsson, MD, Associate Professor, Department of Clinical Neuroscience, Karolinska Institutet, Sweden; Helena Korosec Jagodic, Psychiatric Hospital Vojnik, Vojnik, Slovenia; Ileana Botezat-Antonescu, MD, Associate Professor, National Mental Health Center and Anti-drug, Bucharest, Romania; Ingeborg Warnke, PhD, Center for Social Psychiatry, Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, Zurich, Switzerland; Janusz Rybakowski, Department of Adult Psychiatry, Poznan University of Medical Sciences, Poznan, Poland; Je
| | - Koen Demyttenaere
- Konstantinos N. Fountoulakis, MD, Associate Professor of Psychiatry, 3rd Department of Psychiatry, School of Medicine, Aristotle University of Thessaloniki, Greece; Wolfram Kawohl, MD, Center for Social Psychiatry, Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, Zurich, Switzerland; Pavlos N. Theodorakis, MD, Mental Health Hospitals Trust of Attica 'Dafni & Dromokaiteio' and WHO National Counterpart for Mental Health, Athens, Greece; Ad J. F. M. Kerkhof, MD, Faculty of Psychology and Education, Department of Clinical Psychology, VU University Amsterdam, Amsterdam, The Netherlands; Alvydas Navickas, MD, PhD, Associate Professor, Psychiatric Clinic, Vilnius University Medical Faculty, Vilnius, Lithuania; Cyril Höschl, MD, Prague Psychiatric Center/NIMH, Czech Republic; Dusica Lecic-Tosevski, MD, Professor of Psychiatry, Belgrade University School of Medicine and Institute of Mental Health, WHO Collaborating Centre, Belgrade, Serbia; Eliot Sorel, MD, The George Washington University, School of Medicine & School of Public Health, Washington DC, USA; Elmars Rancans, MD, PhD, Chair of the Department of Psychiatry and Narcology, Riga Stradins University, Latvia; Eva Palova, MD, Department of Psychiatry, University Hospital, Slovakia; Georg Juckel, MD, PhD, Department of Psychiatry, Ruhr University Bochum, LWL-University Hospital, Bochum, Germany; Goran Isacsson, MD, Associate Professor, Department of Clinical Neuroscience, Karolinska Institutet, Sweden; Helena Korosec Jagodic, Psychiatric Hospital Vojnik, Vojnik, Slovenia; Ileana Botezat-Antonescu, MD, Associate Professor, National Mental Health Center and Anti-drug, Bucharest, Romania; Ingeborg Warnke, PhD, Center for Social Psychiatry, Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, Zurich, Switzerland; Janusz Rybakowski, Department of Adult Psychiatry, Poznan University of Medical Sciences, Poznan, Poland; Je
| | - Luchezar G Hranov
- Konstantinos N. Fountoulakis, MD, Associate Professor of Psychiatry, 3rd Department of Psychiatry, School of Medicine, Aristotle University of Thessaloniki, Greece; Wolfram Kawohl, MD, Center for Social Psychiatry, Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, Zurich, Switzerland; Pavlos N. Theodorakis, MD, Mental Health Hospitals Trust of Attica 'Dafni & Dromokaiteio' and WHO National Counterpart for Mental Health, Athens, Greece; Ad J. F. M. Kerkhof, MD, Faculty of Psychology and Education, Department of Clinical Psychology, VU University Amsterdam, Amsterdam, The Netherlands; Alvydas Navickas, MD, PhD, Associate Professor, Psychiatric Clinic, Vilnius University Medical Faculty, Vilnius, Lithuania; Cyril Höschl, MD, Prague Psychiatric Center/NIMH, Czech Republic; Dusica Lecic-Tosevski, MD, Professor of Psychiatry, Belgrade University School of Medicine and Institute of Mental Health, WHO Collaborating Centre, Belgrade, Serbia; Eliot Sorel, MD, The George Washington University, School of Medicine & School of Public Health, Washington DC, USA; Elmars Rancans, MD, PhD, Chair of the Department of Psychiatry and Narcology, Riga Stradins University, Latvia; Eva Palova, MD, Department of Psychiatry, University Hospital, Slovakia; Georg Juckel, MD, PhD, Department of Psychiatry, Ruhr University Bochum, LWL-University Hospital, Bochum, Germany; Goran Isacsson, MD, Associate Professor, Department of Clinical Neuroscience, Karolinska Institutet, Sweden; Helena Korosec Jagodic, Psychiatric Hospital Vojnik, Vojnik, Slovenia; Ileana Botezat-Antonescu, MD, Associate Professor, National Mental Health Center and Anti-drug, Bucharest, Romania; Ingeborg Warnke, PhD, Center for Social Psychiatry, Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, Zurich, Switzerland; Janusz Rybakowski, Department of Adult Psychiatry, Poznan University of Medical Sciences, Poznan, Poland; Je
| | - Lidija Injac Stevovic
- Konstantinos N. Fountoulakis, MD, Associate Professor of Psychiatry, 3rd Department of Psychiatry, School of Medicine, Aristotle University of Thessaloniki, Greece; Wolfram Kawohl, MD, Center for Social Psychiatry, Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, Zurich, Switzerland; Pavlos N. Theodorakis, MD, Mental Health Hospitals Trust of Attica 'Dafni & Dromokaiteio' and WHO National Counterpart for Mental Health, Athens, Greece; Ad J. F. M. Kerkhof, MD, Faculty of Psychology and Education, Department of Clinical Psychology, VU University Amsterdam, Amsterdam, The Netherlands; Alvydas Navickas, MD, PhD, Associate Professor, Psychiatric Clinic, Vilnius University Medical Faculty, Vilnius, Lithuania; Cyril Höschl, MD, Prague Psychiatric Center/NIMH, Czech Republic; Dusica Lecic-Tosevski, MD, Professor of Psychiatry, Belgrade University School of Medicine and Institute of Mental Health, WHO Collaborating Centre, Belgrade, Serbia; Eliot Sorel, MD, The George Washington University, School of Medicine & School of Public Health, Washington DC, USA; Elmars Rancans, MD, PhD, Chair of the Department of Psychiatry and Narcology, Riga Stradins University, Latvia; Eva Palova, MD, Department of Psychiatry, University Hospital, Slovakia; Georg Juckel, MD, PhD, Department of Psychiatry, Ruhr University Bochum, LWL-University Hospital, Bochum, Germany; Goran Isacsson, MD, Associate Professor, Department of Clinical Neuroscience, Karolinska Institutet, Sweden; Helena Korosec Jagodic, Psychiatric Hospital Vojnik, Vojnik, Slovenia; Ileana Botezat-Antonescu, MD, Associate Professor, National Mental Health Center and Anti-drug, Bucharest, Romania; Ingeborg Warnke, PhD, Center for Social Psychiatry, Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, Zurich, Switzerland; Janusz Rybakowski, Department of Adult Psychiatry, Poznan University of Medical Sciences, Poznan, Poland; Je
| | - Lucas Pezawas
- Konstantinos N. Fountoulakis, MD, Associate Professor of Psychiatry, 3rd Department of Psychiatry, School of Medicine, Aristotle University of Thessaloniki, Greece; Wolfram Kawohl, MD, Center for Social Psychiatry, Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, Zurich, Switzerland; Pavlos N. Theodorakis, MD, Mental Health Hospitals Trust of Attica 'Dafni & Dromokaiteio' and WHO National Counterpart for Mental Health, Athens, Greece; Ad J. F. M. Kerkhof, MD, Faculty of Psychology and Education, Department of Clinical Psychology, VU University Amsterdam, Amsterdam, The Netherlands; Alvydas Navickas, MD, PhD, Associate Professor, Psychiatric Clinic, Vilnius University Medical Faculty, Vilnius, Lithuania; Cyril Höschl, MD, Prague Psychiatric Center/NIMH, Czech Republic; Dusica Lecic-Tosevski, MD, Professor of Psychiatry, Belgrade University School of Medicine and Institute of Mental Health, WHO Collaborating Centre, Belgrade, Serbia; Eliot Sorel, MD, The George Washington University, School of Medicine & School of Public Health, Washington DC, USA; Elmars Rancans, MD, PhD, Chair of the Department of Psychiatry and Narcology, Riga Stradins University, Latvia; Eva Palova, MD, Department of Psychiatry, University Hospital, Slovakia; Georg Juckel, MD, PhD, Department of Psychiatry, Ruhr University Bochum, LWL-University Hospital, Bochum, Germany; Goran Isacsson, MD, Associate Professor, Department of Clinical Neuroscience, Karolinska Institutet, Sweden; Helena Korosec Jagodic, Psychiatric Hospital Vojnik, Vojnik, Slovenia; Ileana Botezat-Antonescu, MD, Associate Professor, National Mental Health Center and Anti-drug, Bucharest, Romania; Ingeborg Warnke, PhD, Center for Social Psychiatry, Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, Zurich, Switzerland; Janusz Rybakowski, Department of Adult Psychiatry, Poznan University of Medical Sciences, Poznan, Poland; Je
| | - Marc Adida
- Konstantinos N. Fountoulakis, MD, Associate Professor of Psychiatry, 3rd Department of Psychiatry, School of Medicine, Aristotle University of Thessaloniki, Greece; Wolfram Kawohl, MD, Center for Social Psychiatry, Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, Zurich, Switzerland; Pavlos N. Theodorakis, MD, Mental Health Hospitals Trust of Attica 'Dafni & Dromokaiteio' and WHO National Counterpart for Mental Health, Athens, Greece; Ad J. F. M. Kerkhof, MD, Faculty of Psychology and Education, Department of Clinical Psychology, VU University Amsterdam, Amsterdam, The Netherlands; Alvydas Navickas, MD, PhD, Associate Professor, Psychiatric Clinic, Vilnius University Medical Faculty, Vilnius, Lithuania; Cyril Höschl, MD, Prague Psychiatric Center/NIMH, Czech Republic; Dusica Lecic-Tosevski, MD, Professor of Psychiatry, Belgrade University School of Medicine and Institute of Mental Health, WHO Collaborating Centre, Belgrade, Serbia; Eliot Sorel, MD, The George Washington University, School of Medicine & School of Public Health, Washington DC, USA; Elmars Rancans, MD, PhD, Chair of the Department of Psychiatry and Narcology, Riga Stradins University, Latvia; Eva Palova, MD, Department of Psychiatry, University Hospital, Slovakia; Georg Juckel, MD, PhD, Department of Psychiatry, Ruhr University Bochum, LWL-University Hospital, Bochum, Germany; Goran Isacsson, MD, Associate Professor, Department of Clinical Neuroscience, Karolinska Institutet, Sweden; Helena Korosec Jagodic, Psychiatric Hospital Vojnik, Vojnik, Slovenia; Ileana Botezat-Antonescu, MD, Associate Professor, National Mental Health Center and Anti-drug, Bucharest, Romania; Ingeborg Warnke, PhD, Center for Social Psychiatry, Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, Zurich, Switzerland; Janusz Rybakowski, Department of Adult Psychiatry, Poznan University of Medical Sciences, Poznan, Poland; Je
| | - Maria Luisa Figuera
- Konstantinos N. Fountoulakis, MD, Associate Professor of Psychiatry, 3rd Department of Psychiatry, School of Medicine, Aristotle University of Thessaloniki, Greece; Wolfram Kawohl, MD, Center for Social Psychiatry, Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, Zurich, Switzerland; Pavlos N. Theodorakis, MD, Mental Health Hospitals Trust of Attica 'Dafni & Dromokaiteio' and WHO National Counterpart for Mental Health, Athens, Greece; Ad J. F. M. Kerkhof, MD, Faculty of Psychology and Education, Department of Clinical Psychology, VU University Amsterdam, Amsterdam, The Netherlands; Alvydas Navickas, MD, PhD, Associate Professor, Psychiatric Clinic, Vilnius University Medical Faculty, Vilnius, Lithuania; Cyril Höschl, MD, Prague Psychiatric Center/NIMH, Czech Republic; Dusica Lecic-Tosevski, MD, Professor of Psychiatry, Belgrade University School of Medicine and Institute of Mental Health, WHO Collaborating Centre, Belgrade, Serbia; Eliot Sorel, MD, The George Washington University, School of Medicine & School of Public Health, Washington DC, USA; Elmars Rancans, MD, PhD, Chair of the Department of Psychiatry and Narcology, Riga Stradins University, Latvia; Eva Palova, MD, Department of Psychiatry, University Hospital, Slovakia; Georg Juckel, MD, PhD, Department of Psychiatry, Ruhr University Bochum, LWL-University Hospital, Bochum, Germany; Goran Isacsson, MD, Associate Professor, Department of Clinical Neuroscience, Karolinska Institutet, Sweden; Helena Korosec Jagodic, Psychiatric Hospital Vojnik, Vojnik, Slovenia; Ileana Botezat-Antonescu, MD, Associate Professor, National Mental Health Center and Anti-drug, Bucharest, Romania; Ingeborg Warnke, PhD, Center for Social Psychiatry, Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, Zurich, Switzerland; Janusz Rybakowski, Department of Adult Psychiatry, Poznan University of Medical Sciences, Poznan, Poland; Je
| | - Maurizio Pompili
- Konstantinos N. Fountoulakis, MD, Associate Professor of Psychiatry, 3rd Department of Psychiatry, School of Medicine, Aristotle University of Thessaloniki, Greece; Wolfram Kawohl, MD, Center for Social Psychiatry, Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, Zurich, Switzerland; Pavlos N. Theodorakis, MD, Mental Health Hospitals Trust of Attica 'Dafni & Dromokaiteio' and WHO National Counterpart for Mental Health, Athens, Greece; Ad J. F. M. Kerkhof, MD, Faculty of Psychology and Education, Department of Clinical Psychology, VU University Amsterdam, Amsterdam, The Netherlands; Alvydas Navickas, MD, PhD, Associate Professor, Psychiatric Clinic, Vilnius University Medical Faculty, Vilnius, Lithuania; Cyril Höschl, MD, Prague Psychiatric Center/NIMH, Czech Republic; Dusica Lecic-Tosevski, MD, Professor of Psychiatry, Belgrade University School of Medicine and Institute of Mental Health, WHO Collaborating Centre, Belgrade, Serbia; Eliot Sorel, MD, The George Washington University, School of Medicine & School of Public Health, Washington DC, USA; Elmars Rancans, MD, PhD, Chair of the Department of Psychiatry and Narcology, Riga Stradins University, Latvia; Eva Palova, MD, Department of Psychiatry, University Hospital, Slovakia; Georg Juckel, MD, PhD, Department of Psychiatry, Ruhr University Bochum, LWL-University Hospital, Bochum, Germany; Goran Isacsson, MD, Associate Professor, Department of Clinical Neuroscience, Karolinska Institutet, Sweden; Helena Korosec Jagodic, Psychiatric Hospital Vojnik, Vojnik, Slovenia; Ileana Botezat-Antonescu, MD, Associate Professor, National Mental Health Center and Anti-drug, Bucharest, Romania; Ingeborg Warnke, PhD, Center for Social Psychiatry, Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, Zurich, Switzerland; Janusz Rybakowski, Department of Adult Psychiatry, Poznan University of Medical Sciences, Poznan, Poland; Je
| | - Miro Jakovljević
- Konstantinos N. Fountoulakis, MD, Associate Professor of Psychiatry, 3rd Department of Psychiatry, School of Medicine, Aristotle University of Thessaloniki, Greece; Wolfram Kawohl, MD, Center for Social Psychiatry, Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, Zurich, Switzerland; Pavlos N. Theodorakis, MD, Mental Health Hospitals Trust of Attica 'Dafni & Dromokaiteio' and WHO National Counterpart for Mental Health, Athens, Greece; Ad J. F. M. Kerkhof, MD, Faculty of Psychology and Education, Department of Clinical Psychology, VU University Amsterdam, Amsterdam, The Netherlands; Alvydas Navickas, MD, PhD, Associate Professor, Psychiatric Clinic, Vilnius University Medical Faculty, Vilnius, Lithuania; Cyril Höschl, MD, Prague Psychiatric Center/NIMH, Czech Republic; Dusica Lecic-Tosevski, MD, Professor of Psychiatry, Belgrade University School of Medicine and Institute of Mental Health, WHO Collaborating Centre, Belgrade, Serbia; Eliot Sorel, MD, The George Washington University, School of Medicine & School of Public Health, Washington DC, USA; Elmars Rancans, MD, PhD, Chair of the Department of Psychiatry and Narcology, Riga Stradins University, Latvia; Eva Palova, MD, Department of Psychiatry, University Hospital, Slovakia; Georg Juckel, MD, PhD, Department of Psychiatry, Ruhr University Bochum, LWL-University Hospital, Bochum, Germany; Goran Isacsson, MD, Associate Professor, Department of Clinical Neuroscience, Karolinska Institutet, Sweden; Helena Korosec Jagodic, Psychiatric Hospital Vojnik, Vojnik, Slovenia; Ileana Botezat-Antonescu, MD, Associate Professor, National Mental Health Center and Anti-drug, Bucharest, Romania; Ingeborg Warnke, PhD, Center for Social Psychiatry, Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, Zurich, Switzerland; Janusz Rybakowski, Department of Adult Psychiatry, Poznan University of Medical Sciences, Poznan, Poland; Je
| | - Monica Vichi
- Konstantinos N. Fountoulakis, MD, Associate Professor of Psychiatry, 3rd Department of Psychiatry, School of Medicine, Aristotle University of Thessaloniki, Greece; Wolfram Kawohl, MD, Center for Social Psychiatry, Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, Zurich, Switzerland; Pavlos N. Theodorakis, MD, Mental Health Hospitals Trust of Attica 'Dafni & Dromokaiteio' and WHO National Counterpart for Mental Health, Athens, Greece; Ad J. F. M. Kerkhof, MD, Faculty of Psychology and Education, Department of Clinical Psychology, VU University Amsterdam, Amsterdam, The Netherlands; Alvydas Navickas, MD, PhD, Associate Professor, Psychiatric Clinic, Vilnius University Medical Faculty, Vilnius, Lithuania; Cyril Höschl, MD, Prague Psychiatric Center/NIMH, Czech Republic; Dusica Lecic-Tosevski, MD, Professor of Psychiatry, Belgrade University School of Medicine and Institute of Mental Health, WHO Collaborating Centre, Belgrade, Serbia; Eliot Sorel, MD, The George Washington University, School of Medicine & School of Public Health, Washington DC, USA; Elmars Rancans, MD, PhD, Chair of the Department of Psychiatry and Narcology, Riga Stradins University, Latvia; Eva Palova, MD, Department of Psychiatry, University Hospital, Slovakia; Georg Juckel, MD, PhD, Department of Psychiatry, Ruhr University Bochum, LWL-University Hospital, Bochum, Germany; Goran Isacsson, MD, Associate Professor, Department of Clinical Neuroscience, Karolinska Institutet, Sweden; Helena Korosec Jagodic, Psychiatric Hospital Vojnik, Vojnik, Slovenia; Ileana Botezat-Antonescu, MD, Associate Professor, National Mental Health Center and Anti-drug, Bucharest, Romania; Ingeborg Warnke, PhD, Center for Social Psychiatry, Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, Zurich, Switzerland; Janusz Rybakowski, Department of Adult Psychiatry, Poznan University of Medical Sciences, Poznan, Poland; Je
| | - Giulio Perugi
- Konstantinos N. Fountoulakis, MD, Associate Professor of Psychiatry, 3rd Department of Psychiatry, School of Medicine, Aristotle University of Thessaloniki, Greece; Wolfram Kawohl, MD, Center for Social Psychiatry, Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, Zurich, Switzerland; Pavlos N. Theodorakis, MD, Mental Health Hospitals Trust of Attica 'Dafni & Dromokaiteio' and WHO National Counterpart for Mental Health, Athens, Greece; Ad J. F. M. Kerkhof, MD, Faculty of Psychology and Education, Department of Clinical Psychology, VU University Amsterdam, Amsterdam, The Netherlands; Alvydas Navickas, MD, PhD, Associate Professor, Psychiatric Clinic, Vilnius University Medical Faculty, Vilnius, Lithuania; Cyril Höschl, MD, Prague Psychiatric Center/NIMH, Czech Republic; Dusica Lecic-Tosevski, MD, Professor of Psychiatry, Belgrade University School of Medicine and Institute of Mental Health, WHO Collaborating Centre, Belgrade, Serbia; Eliot Sorel, MD, The George Washington University, School of Medicine & School of Public Health, Washington DC, USA; Elmars Rancans, MD, PhD, Chair of the Department of Psychiatry and Narcology, Riga Stradins University, Latvia; Eva Palova, MD, Department of Psychiatry, University Hospital, Slovakia; Georg Juckel, MD, PhD, Department of Psychiatry, Ruhr University Bochum, LWL-University Hospital, Bochum, Germany; Goran Isacsson, MD, Associate Professor, Department of Clinical Neuroscience, Karolinska Institutet, Sweden; Helena Korosec Jagodic, Psychiatric Hospital Vojnik, Vojnik, Slovenia; Ileana Botezat-Antonescu, MD, Associate Professor, National Mental Health Center and Anti-drug, Bucharest, Romania; Ingeborg Warnke, PhD, Center for Social Psychiatry, Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, Zurich, Switzerland; Janusz Rybakowski, Department of Adult Psychiatry, Poznan University of Medical Sciences, Poznan, Poland; Je
| | | | - Olivera Vukovic
- Konstantinos N. Fountoulakis, MD, Associate Professor of Psychiatry, 3rd Department of Psychiatry, School of Medicine, Aristotle University of Thessaloniki, Greece; Wolfram Kawohl, MD, Center for Social Psychiatry, Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, Zurich, Switzerland; Pavlos N. Theodorakis, MD, Mental Health Hospitals Trust of Attica 'Dafni & Dromokaiteio' and WHO National Counterpart for Mental Health, Athens, Greece; Ad J. F. M. Kerkhof, MD, Faculty of Psychology and Education, Department of Clinical Psychology, VU University Amsterdam, Amsterdam, The Netherlands; Alvydas Navickas, MD, PhD, Associate Professor, Psychiatric Clinic, Vilnius University Medical Faculty, Vilnius, Lithuania; Cyril Höschl, MD, Prague Psychiatric Center/NIMH, Czech Republic; Dusica Lecic-Tosevski, MD, Professor of Psychiatry, Belgrade University School of Medicine and Institute of Mental Health, WHO Collaborating Centre, Belgrade, Serbia; Eliot Sorel, MD, The George Washington University, School of Medicine & School of Public Health, Washington DC, USA; Elmars Rancans, MD, PhD, Chair of the Department of Psychiatry and Narcology, Riga Stradins University, Latvia; Eva Palova, MD, Department of Psychiatry, University Hospital, Slovakia; Georg Juckel, MD, PhD, Department of Psychiatry, Ruhr University Bochum, LWL-University Hospital, Bochum, Germany; Goran Isacsson, MD, Associate Professor, Department of Clinical Neuroscience, Karolinska Institutet, Sweden; Helena Korosec Jagodic, Psychiatric Hospital Vojnik, Vojnik, Slovenia; Ileana Botezat-Antonescu, MD, Associate Professor, National Mental Health Center and Anti-drug, Bucharest, Romania; Ingeborg Warnke, PhD, Center for Social Psychiatry, Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, Zurich, Switzerland; Janusz Rybakowski, Department of Adult Psychiatry, Poznan University of Medical Sciences, Poznan, Poland; Je
| | - Paraskevi Mavrogiorgou
- Konstantinos N. Fountoulakis, MD, Associate Professor of Psychiatry, 3rd Department of Psychiatry, School of Medicine, Aristotle University of Thessaloniki, Greece; Wolfram Kawohl, MD, Center for Social Psychiatry, Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, Zurich, Switzerland; Pavlos N. Theodorakis, MD, Mental Health Hospitals Trust of Attica 'Dafni & Dromokaiteio' and WHO National Counterpart for Mental Health, Athens, Greece; Ad J. F. M. Kerkhof, MD, Faculty of Psychology and Education, Department of Clinical Psychology, VU University Amsterdam, Amsterdam, The Netherlands; Alvydas Navickas, MD, PhD, Associate Professor, Psychiatric Clinic, Vilnius University Medical Faculty, Vilnius, Lithuania; Cyril Höschl, MD, Prague Psychiatric Center/NIMH, Czech Republic; Dusica Lecic-Tosevski, MD, Professor of Psychiatry, Belgrade University School of Medicine and Institute of Mental Health, WHO Collaborating Centre, Belgrade, Serbia; Eliot Sorel, MD, The George Washington University, School of Medicine & School of Public Health, Washington DC, USA; Elmars Rancans, MD, PhD, Chair of the Department of Psychiatry and Narcology, Riga Stradins University, Latvia; Eva Palova, MD, Department of Psychiatry, University Hospital, Slovakia; Georg Juckel, MD, PhD, Department of Psychiatry, Ruhr University Bochum, LWL-University Hospital, Bochum, Germany; Goran Isacsson, MD, Associate Professor, Department of Clinical Neuroscience, Karolinska Institutet, Sweden; Helena Korosec Jagodic, Psychiatric Hospital Vojnik, Vojnik, Slovenia; Ileana Botezat-Antonescu, MD, Associate Professor, National Mental Health Center and Anti-drug, Bucharest, Romania; Ingeborg Warnke, PhD, Center for Social Psychiatry, Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, Zurich, Switzerland; Janusz Rybakowski, Department of Adult Psychiatry, Poznan University of Medical Sciences, Poznan, Poland; Je
| | - Peeter Varnik
- Konstantinos N. Fountoulakis, MD, Associate Professor of Psychiatry, 3rd Department of Psychiatry, School of Medicine, Aristotle University of Thessaloniki, Greece; Wolfram Kawohl, MD, Center for Social Psychiatry, Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, Zurich, Switzerland; Pavlos N. Theodorakis, MD, Mental Health Hospitals Trust of Attica 'Dafni & Dromokaiteio' and WHO National Counterpart for Mental Health, Athens, Greece; Ad J. F. M. Kerkhof, MD, Faculty of Psychology and Education, Department of Clinical Psychology, VU University Amsterdam, Amsterdam, The Netherlands; Alvydas Navickas, MD, PhD, Associate Professor, Psychiatric Clinic, Vilnius University Medical Faculty, Vilnius, Lithuania; Cyril Höschl, MD, Prague Psychiatric Center/NIMH, Czech Republic; Dusica Lecic-Tosevski, MD, Professor of Psychiatry, Belgrade University School of Medicine and Institute of Mental Health, WHO Collaborating Centre, Belgrade, Serbia; Eliot Sorel, MD, The George Washington University, School of Medicine & School of Public Health, Washington DC, USA; Elmars Rancans, MD, PhD, Chair of the Department of Psychiatry and Narcology, Riga Stradins University, Latvia; Eva Palova, MD, Department of Psychiatry, University Hospital, Slovakia; Georg Juckel, MD, PhD, Department of Psychiatry, Ruhr University Bochum, LWL-University Hospital, Bochum, Germany; Goran Isacsson, MD, Associate Professor, Department of Clinical Neuroscience, Karolinska Institutet, Sweden; Helena Korosec Jagodic, Psychiatric Hospital Vojnik, Vojnik, Slovenia; Ileana Botezat-Antonescu, MD, Associate Professor, National Mental Health Center and Anti-drug, Bucharest, Romania; Ingeborg Warnke, PhD, Center for Social Psychiatry, Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, Zurich, Switzerland; Janusz Rybakowski, Department of Adult Psychiatry, Poznan University of Medical Sciences, Poznan, Poland; Je
| | - Per Bech
- Konstantinos N. Fountoulakis, MD, Associate Professor of Psychiatry, 3rd Department of Psychiatry, School of Medicine, Aristotle University of Thessaloniki, Greece; Wolfram Kawohl, MD, Center for Social Psychiatry, Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, Zurich, Switzerland; Pavlos N. Theodorakis, MD, Mental Health Hospitals Trust of Attica 'Dafni & Dromokaiteio' and WHO National Counterpart for Mental Health, Athens, Greece; Ad J. F. M. Kerkhof, MD, Faculty of Psychology and Education, Department of Clinical Psychology, VU University Amsterdam, Amsterdam, The Netherlands; Alvydas Navickas, MD, PhD, Associate Professor, Psychiatric Clinic, Vilnius University Medical Faculty, Vilnius, Lithuania; Cyril Höschl, MD, Prague Psychiatric Center/NIMH, Czech Republic; Dusica Lecic-Tosevski, MD, Professor of Psychiatry, Belgrade University School of Medicine and Institute of Mental Health, WHO Collaborating Centre, Belgrade, Serbia; Eliot Sorel, MD, The George Washington University, School of Medicine & School of Public Health, Washington DC, USA; Elmars Rancans, MD, PhD, Chair of the Department of Psychiatry and Narcology, Riga Stradins University, Latvia; Eva Palova, MD, Department of Psychiatry, University Hospital, Slovakia; Georg Juckel, MD, PhD, Department of Psychiatry, Ruhr University Bochum, LWL-University Hospital, Bochum, Germany; Goran Isacsson, MD, Associate Professor, Department of Clinical Neuroscience, Karolinska Institutet, Sweden; Helena Korosec Jagodic, Psychiatric Hospital Vojnik, Vojnik, Slovenia; Ileana Botezat-Antonescu, MD, Associate Professor, National Mental Health Center and Anti-drug, Bucharest, Romania; Ingeborg Warnke, PhD, Center for Social Psychiatry, Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, Zurich, Switzerland; Janusz Rybakowski, Department of Adult Psychiatry, Poznan University of Medical Sciences, Poznan, Poland; Je
| | - Peter Dome
- Konstantinos N. Fountoulakis, MD, Associate Professor of Psychiatry, 3rd Department of Psychiatry, School of Medicine, Aristotle University of Thessaloniki, Greece; Wolfram Kawohl, MD, Center for Social Psychiatry, Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, Zurich, Switzerland; Pavlos N. Theodorakis, MD, Mental Health Hospitals Trust of Attica 'Dafni & Dromokaiteio' and WHO National Counterpart for Mental Health, Athens, Greece; Ad J. F. M. Kerkhof, MD, Faculty of Psychology and Education, Department of Clinical Psychology, VU University Amsterdam, Amsterdam, The Netherlands; Alvydas Navickas, MD, PhD, Associate Professor, Psychiatric Clinic, Vilnius University Medical Faculty, Vilnius, Lithuania; Cyril Höschl, MD, Prague Psychiatric Center/NIMH, Czech Republic; Dusica Lecic-Tosevski, MD, Professor of Psychiatry, Belgrade University School of Medicine and Institute of Mental Health, WHO Collaborating Centre, Belgrade, Serbia; Eliot Sorel, MD, The George Washington University, School of Medicine & School of Public Health, Washington DC, USA; Elmars Rancans, MD, PhD, Chair of the Department of Psychiatry and Narcology, Riga Stradins University, Latvia; Eva Palova, MD, Department of Psychiatry, University Hospital, Slovakia; Georg Juckel, MD, PhD, Department of Psychiatry, Ruhr University Bochum, LWL-University Hospital, Bochum, Germany; Goran Isacsson, MD, Associate Professor, Department of Clinical Neuroscience, Karolinska Institutet, Sweden; Helena Korosec Jagodic, Psychiatric Hospital Vojnik, Vojnik, Slovenia; Ileana Botezat-Antonescu, MD, Associate Professor, National Mental Health Center and Anti-drug, Bucharest, Romania; Ingeborg Warnke, PhD, Center for Social Psychiatry, Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, Zurich, Switzerland; Janusz Rybakowski, Department of Adult Psychiatry, Poznan University of Medical Sciences, Poznan, Poland; Je
| | - Petr Winkler
- Konstantinos N. Fountoulakis, MD, Associate Professor of Psychiatry, 3rd Department of Psychiatry, School of Medicine, Aristotle University of Thessaloniki, Greece; Wolfram Kawohl, MD, Center for Social Psychiatry, Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, Zurich, Switzerland; Pavlos N. Theodorakis, MD, Mental Health Hospitals Trust of Attica 'Dafni & Dromokaiteio' and WHO National Counterpart for Mental Health, Athens, Greece; Ad J. F. M. Kerkhof, MD, Faculty of Psychology and Education, Department of Clinical Psychology, VU University Amsterdam, Amsterdam, The Netherlands; Alvydas Navickas, MD, PhD, Associate Professor, Psychiatric Clinic, Vilnius University Medical Faculty, Vilnius, Lithuania; Cyril Höschl, MD, Prague Psychiatric Center/NIMH, Czech Republic; Dusica Lecic-Tosevski, MD, Professor of Psychiatry, Belgrade University School of Medicine and Institute of Mental Health, WHO Collaborating Centre, Belgrade, Serbia; Eliot Sorel, MD, The George Washington University, School of Medicine & School of Public Health, Washington DC, USA; Elmars Rancans, MD, PhD, Chair of the Department of Psychiatry and Narcology, Riga Stradins University, Latvia; Eva Palova, MD, Department of Psychiatry, University Hospital, Slovakia; Georg Juckel, MD, PhD, Department of Psychiatry, Ruhr University Bochum, LWL-University Hospital, Bochum, Germany; Goran Isacsson, MD, Associate Professor, Department of Clinical Neuroscience, Karolinska Institutet, Sweden; Helena Korosec Jagodic, Psychiatric Hospital Vojnik, Vojnik, Slovenia; Ileana Botezat-Antonescu, MD, Associate Professor, National Mental Health Center and Anti-drug, Bucharest, Romania; Ingeborg Warnke, PhD, Center for Social Psychiatry, Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, Zurich, Switzerland; Janusz Rybakowski, Department of Adult Psychiatry, Poznan University of Medical Sciences, Poznan, Poland; Je
| | - Raimo K R Salokangas
- Konstantinos N. Fountoulakis, MD, Associate Professor of Psychiatry, 3rd Department of Psychiatry, School of Medicine, Aristotle University of Thessaloniki, Greece; Wolfram Kawohl, MD, Center for Social Psychiatry, Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, Zurich, Switzerland; Pavlos N. Theodorakis, MD, Mental Health Hospitals Trust of Attica 'Dafni & Dromokaiteio' and WHO National Counterpart for Mental Health, Athens, Greece; Ad J. F. M. Kerkhof, MD, Faculty of Psychology and Education, Department of Clinical Psychology, VU University Amsterdam, Amsterdam, The Netherlands; Alvydas Navickas, MD, PhD, Associate Professor, Psychiatric Clinic, Vilnius University Medical Faculty, Vilnius, Lithuania; Cyril Höschl, MD, Prague Psychiatric Center/NIMH, Czech Republic; Dusica Lecic-Tosevski, MD, Professor of Psychiatry, Belgrade University School of Medicine and Institute of Mental Health, WHO Collaborating Centre, Belgrade, Serbia; Eliot Sorel, MD, The George Washington University, School of Medicine & School of Public Health, Washington DC, USA; Elmars Rancans, MD, PhD, Chair of the Department of Psychiatry and Narcology, Riga Stradins University, Latvia; Eva Palova, MD, Department of Psychiatry, University Hospital, Slovakia; Georg Juckel, MD, PhD, Department of Psychiatry, Ruhr University Bochum, LWL-University Hospital, Bochum, Germany; Goran Isacsson, MD, Associate Professor, Department of Clinical Neuroscience, Karolinska Institutet, Sweden; Helena Korosec Jagodic, Psychiatric Hospital Vojnik, Vojnik, Slovenia; Ileana Botezat-Antonescu, MD, Associate Professor, National Mental Health Center and Anti-drug, Bucharest, Romania; Ingeborg Warnke, PhD, Center for Social Psychiatry, Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, Zurich, Switzerland; Janusz Rybakowski, Department of Adult Psychiatry, Poznan University of Medical Sciences, Poznan, Poland; Je
| | - Tiina From
- Konstantinos N. Fountoulakis, MD, Associate Professor of Psychiatry, 3rd Department of Psychiatry, School of Medicine, Aristotle University of Thessaloniki, Greece; Wolfram Kawohl, MD, Center for Social Psychiatry, Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, Zurich, Switzerland; Pavlos N. Theodorakis, MD, Mental Health Hospitals Trust of Attica 'Dafni & Dromokaiteio' and WHO National Counterpart for Mental Health, Athens, Greece; Ad J. F. M. Kerkhof, MD, Faculty of Psychology and Education, Department of Clinical Psychology, VU University Amsterdam, Amsterdam, The Netherlands; Alvydas Navickas, MD, PhD, Associate Professor, Psychiatric Clinic, Vilnius University Medical Faculty, Vilnius, Lithuania; Cyril Höschl, MD, Prague Psychiatric Center/NIMH, Czech Republic; Dusica Lecic-Tosevski, MD, Professor of Psychiatry, Belgrade University School of Medicine and Institute of Mental Health, WHO Collaborating Centre, Belgrade, Serbia; Eliot Sorel, MD, The George Washington University, School of Medicine & School of Public Health, Washington DC, USA; Elmars Rancans, MD, PhD, Chair of the Department of Psychiatry and Narcology, Riga Stradins University, Latvia; Eva Palova, MD, Department of Psychiatry, University Hospital, Slovakia; Georg Juckel, MD, PhD, Department of Psychiatry, Ruhr University Bochum, LWL-University Hospital, Bochum, Germany; Goran Isacsson, MD, Associate Professor, Department of Clinical Neuroscience, Karolinska Institutet, Sweden; Helena Korosec Jagodic, Psychiatric Hospital Vojnik, Vojnik, Slovenia; Ileana Botezat-Antonescu, MD, Associate Professor, National Mental Health Center and Anti-drug, Bucharest, Romania; Ingeborg Warnke, PhD, Center for Social Psychiatry, Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, Zurich, Switzerland; Janusz Rybakowski, Department of Adult Psychiatry, Poznan University of Medical Sciences, Poznan, Poland; Je
| | - Vita Danileviciute
- Konstantinos N. Fountoulakis, MD, Associate Professor of Psychiatry, 3rd Department of Psychiatry, School of Medicine, Aristotle University of Thessaloniki, Greece; Wolfram Kawohl, MD, Center for Social Psychiatry, Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, Zurich, Switzerland; Pavlos N. Theodorakis, MD, Mental Health Hospitals Trust of Attica 'Dafni & Dromokaiteio' and WHO National Counterpart for Mental Health, Athens, Greece; Ad J. F. M. Kerkhof, MD, Faculty of Psychology and Education, Department of Clinical Psychology, VU University Amsterdam, Amsterdam, The Netherlands; Alvydas Navickas, MD, PhD, Associate Professor, Psychiatric Clinic, Vilnius University Medical Faculty, Vilnius, Lithuania; Cyril Höschl, MD, Prague Psychiatric Center/NIMH, Czech Republic; Dusica Lecic-Tosevski, MD, Professor of Psychiatry, Belgrade University School of Medicine and Institute of Mental Health, WHO Collaborating Centre, Belgrade, Serbia; Eliot Sorel, MD, The George Washington University, School of Medicine & School of Public Health, Washington DC, USA; Elmars Rancans, MD, PhD, Chair of the Department of Psychiatry and Narcology, Riga Stradins University, Latvia; Eva Palova, MD, Department of Psychiatry, University Hospital, Slovakia; Georg Juckel, MD, PhD, Department of Psychiatry, Ruhr University Bochum, LWL-University Hospital, Bochum, Germany; Goran Isacsson, MD, Associate Professor, Department of Clinical Neuroscience, Karolinska Institutet, Sweden; Helena Korosec Jagodic, Psychiatric Hospital Vojnik, Vojnik, Slovenia; Ileana Botezat-Antonescu, MD, Associate Professor, National Mental Health Center and Anti-drug, Bucharest, Romania; Ingeborg Warnke, PhD, Center for Social Psychiatry, Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, Zurich, Switzerland; Janusz Rybakowski, Department of Adult Psychiatry, Poznan University of Medical Sciences, Poznan, Poland; Je
| | - Xenia Gonda
- Konstantinos N. Fountoulakis, MD, Associate Professor of Psychiatry, 3rd Department of Psychiatry, School of Medicine, Aristotle University of Thessaloniki, Greece; Wolfram Kawohl, MD, Center for Social Psychiatry, Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, Zurich, Switzerland; Pavlos N. Theodorakis, MD, Mental Health Hospitals Trust of Attica 'Dafni & Dromokaiteio' and WHO National Counterpart for Mental Health, Athens, Greece; Ad J. F. M. Kerkhof, MD, Faculty of Psychology and Education, Department of Clinical Psychology, VU University Amsterdam, Amsterdam, The Netherlands; Alvydas Navickas, MD, PhD, Associate Professor, Psychiatric Clinic, Vilnius University Medical Faculty, Vilnius, Lithuania; Cyril Höschl, MD, Prague Psychiatric Center/NIMH, Czech Republic; Dusica Lecic-Tosevski, MD, Professor of Psychiatry, Belgrade University School of Medicine and Institute of Mental Health, WHO Collaborating Centre, Belgrade, Serbia; Eliot Sorel, MD, The George Washington University, School of Medicine & School of Public Health, Washington DC, USA; Elmars Rancans, MD, PhD, Chair of the Department of Psychiatry and Narcology, Riga Stradins University, Latvia; Eva Palova, MD, Department of Psychiatry, University Hospital, Slovakia; Georg Juckel, MD, PhD, Department of Psychiatry, Ruhr University Bochum, LWL-University Hospital, Bochum, Germany; Goran Isacsson, MD, Associate Professor, Department of Clinical Neuroscience, Karolinska Institutet, Sweden; Helena Korosec Jagodic, Psychiatric Hospital Vojnik, Vojnik, Slovenia; Ileana Botezat-Antonescu, MD, Associate Professor, National Mental Health Center and Anti-drug, Bucharest, Romania; Ingeborg Warnke, PhD, Center for Social Psychiatry, Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, Zurich, Switzerland; Janusz Rybakowski, Department of Adult Psychiatry, Poznan University of Medical Sciences, Poznan, Poland; Je
| | - Zoltan Rihmer
- Konstantinos N. Fountoulakis, MD, Associate Professor of Psychiatry, 3rd Department of Psychiatry, School of Medicine, Aristotle University of Thessaloniki, Greece; Wolfram Kawohl, MD, Center for Social Psychiatry, Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, Zurich, Switzerland; Pavlos N. Theodorakis, MD, Mental Health Hospitals Trust of Attica 'Dafni & Dromokaiteio' and WHO National Counterpart for Mental Health, Athens, Greece; Ad J. F. M. Kerkhof, MD, Faculty of Psychology and Education, Department of Clinical Psychology, VU University Amsterdam, Amsterdam, The Netherlands; Alvydas Navickas, MD, PhD, Associate Professor, Psychiatric Clinic, Vilnius University Medical Faculty, Vilnius, Lithuania; Cyril Höschl, MD, Prague Psychiatric Center/NIMH, Czech Republic; Dusica Lecic-Tosevski, MD, Professor of Psychiatry, Belgrade University School of Medicine and Institute of Mental Health, WHO Collaborating Centre, Belgrade, Serbia; Eliot Sorel, MD, The George Washington University, School of Medicine & School of Public Health, Washington DC, USA; Elmars Rancans, MD, PhD, Chair of the Department of Psychiatry and Narcology, Riga Stradins University, Latvia; Eva Palova, MD, Department of Psychiatry, University Hospital, Slovakia; Georg Juckel, MD, PhD, Department of Psychiatry, Ruhr University Bochum, LWL-University Hospital, Bochum, Germany; Goran Isacsson, MD, Associate Professor, Department of Clinical Neuroscience, Karolinska Institutet, Sweden; Helena Korosec Jagodic, Psychiatric Hospital Vojnik, Vojnik, Slovenia; Ileana Botezat-Antonescu, MD, Associate Professor, National Mental Health Center and Anti-drug, Bucharest, Romania; Ingeborg Warnke, PhD, Center for Social Psychiatry, Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, Zurich, Switzerland; Janusz Rybakowski, Department of Adult Psychiatry, Poznan University of Medical Sciences, Poznan, Poland; Je
| | - Jonas Forsman Benhalima
- Konstantinos N. Fountoulakis, MD, Associate Professor of Psychiatry, 3rd Department of Psychiatry, School of Medicine, Aristotle University of Thessaloniki, Greece; Wolfram Kawohl, MD, Center for Social Psychiatry, Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, Zurich, Switzerland; Pavlos N. Theodorakis, MD, Mental Health Hospitals Trust of Attica 'Dafni & Dromokaiteio' and WHO National Counterpart for Mental Health, Athens, Greece; Ad J. F. M. Kerkhof, MD, Faculty of Psychology and Education, Department of Clinical Psychology, VU University Amsterdam, Amsterdam, The Netherlands; Alvydas Navickas, MD, PhD, Associate Professor, Psychiatric Clinic, Vilnius University Medical Faculty, Vilnius, Lithuania; Cyril Höschl, MD, Prague Psychiatric Center/NIMH, Czech Republic; Dusica Lecic-Tosevski, MD, Professor of Psychiatry, Belgrade University School of Medicine and Institute of Mental Health, WHO Collaborating Centre, Belgrade, Serbia; Eliot Sorel, MD, The George Washington University, School of Medicine & School of Public Health, Washington DC, USA; Elmars Rancans, MD, PhD, Chair of the Department of Psychiatry and Narcology, Riga Stradins University, Latvia; Eva Palova, MD, Department of Psychiatry, University Hospital, Slovakia; Georg Juckel, MD, PhD, Department of Psychiatry, Ruhr University Bochum, LWL-University Hospital, Bochum, Germany; Goran Isacsson, MD, Associate Professor, Department of Clinical Neuroscience, Karolinska Institutet, Sweden; Helena Korosec Jagodic, Psychiatric Hospital Vojnik, Vojnik, Slovenia; Ileana Botezat-Antonescu, MD, Associate Professor, National Mental Health Center and Anti-drug, Bucharest, Romania; Ingeborg Warnke, PhD, Center for Social Psychiatry, Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, Zurich, Switzerland; Janusz Rybakowski, Department of Adult Psychiatry, Poznan University of Medical Sciences, Poznan, Poland; Je
| | - Anne Grady
- Konstantinos N. Fountoulakis, MD, Associate Professor of Psychiatry, 3rd Department of Psychiatry, School of Medicine, Aristotle University of Thessaloniki, Greece; Wolfram Kawohl, MD, Center for Social Psychiatry, Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, Zurich, Switzerland; Pavlos N. Theodorakis, MD, Mental Health Hospitals Trust of Attica 'Dafni & Dromokaiteio' and WHO National Counterpart for Mental Health, Athens, Greece; Ad J. F. M. Kerkhof, MD, Faculty of Psychology and Education, Department of Clinical Psychology, VU University Amsterdam, Amsterdam, The Netherlands; Alvydas Navickas, MD, PhD, Associate Professor, Psychiatric Clinic, Vilnius University Medical Faculty, Vilnius, Lithuania; Cyril Höschl, MD, Prague Psychiatric Center/NIMH, Czech Republic; Dusica Lecic-Tosevski, MD, Professor of Psychiatry, Belgrade University School of Medicine and Institute of Mental Health, WHO Collaborating Centre, Belgrade, Serbia; Eliot Sorel, MD, The George Washington University, School of Medicine & School of Public Health, Washington DC, USA; Elmars Rancans, MD, PhD, Chair of the Department of Psychiatry and Narcology, Riga Stradins University, Latvia; Eva Palova, MD, Department of Psychiatry, University Hospital, Slovakia; Georg Juckel, MD, PhD, Department of Psychiatry, Ruhr University Bochum, LWL-University Hospital, Bochum, Germany; Goran Isacsson, MD, Associate Professor, Department of Clinical Neuroscience, Karolinska Institutet, Sweden; Helena Korosec Jagodic, Psychiatric Hospital Vojnik, Vojnik, Slovenia; Ileana Botezat-Antonescu, MD, Associate Professor, National Mental Health Center and Anti-drug, Bucharest, Romania; Ingeborg Warnke, PhD, Center for Social Psychiatry, Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, Zurich, Switzerland; Janusz Rybakowski, Department of Adult Psychiatry, Poznan University of Medical Sciences, Poznan, Poland; Je
| | - Anne Katrine Kloster Leadholm
- Konstantinos N. Fountoulakis, MD, Associate Professor of Psychiatry, 3rd Department of Psychiatry, School of Medicine, Aristotle University of Thessaloniki, Greece; Wolfram Kawohl, MD, Center for Social Psychiatry, Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, Zurich, Switzerland; Pavlos N. Theodorakis, MD, Mental Health Hospitals Trust of Attica 'Dafni & Dromokaiteio' and WHO National Counterpart for Mental Health, Athens, Greece; Ad J. F. M. Kerkhof, MD, Faculty of Psychology and Education, Department of Clinical Psychology, VU University Amsterdam, Amsterdam, The Netherlands; Alvydas Navickas, MD, PhD, Associate Professor, Psychiatric Clinic, Vilnius University Medical Faculty, Vilnius, Lithuania; Cyril Höschl, MD, Prague Psychiatric Center/NIMH, Czech Republic; Dusica Lecic-Tosevski, MD, Professor of Psychiatry, Belgrade University School of Medicine and Institute of Mental Health, WHO Collaborating Centre, Belgrade, Serbia; Eliot Sorel, MD, The George Washington University, School of Medicine & School of Public Health, Washington DC, USA; Elmars Rancans, MD, PhD, Chair of the Department of Psychiatry and Narcology, Riga Stradins University, Latvia; Eva Palova, MD, Department of Psychiatry, University Hospital, Slovakia; Georg Juckel, MD, PhD, Department of Psychiatry, Ruhr University Bochum, LWL-University Hospital, Bochum, Germany; Goran Isacsson, MD, Associate Professor, Department of Clinical Neuroscience, Karolinska Institutet, Sweden; Helena Korosec Jagodic, Psychiatric Hospital Vojnik, Vojnik, Slovenia; Ileana Botezat-Antonescu, MD, Associate Professor, National Mental Health Center and Anti-drug, Bucharest, Romania; Ingeborg Warnke, PhD, Center for Social Psychiatry, Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, Zurich, Switzerland; Janusz Rybakowski, Department of Adult Psychiatry, Poznan University of Medical Sciences, Poznan, Poland; Je
| | - Susan Soendergaard
- Konstantinos N. Fountoulakis, MD, Associate Professor of Psychiatry, 3rd Department of Psychiatry, School of Medicine, Aristotle University of Thessaloniki, Greece; Wolfram Kawohl, MD, Center for Social Psychiatry, Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, Zurich, Switzerland; Pavlos N. Theodorakis, MD, Mental Health Hospitals Trust of Attica 'Dafni & Dromokaiteio' and WHO National Counterpart for Mental Health, Athens, Greece; Ad J. F. M. Kerkhof, MD, Faculty of Psychology and Education, Department of Clinical Psychology, VU University Amsterdam, Amsterdam, The Netherlands; Alvydas Navickas, MD, PhD, Associate Professor, Psychiatric Clinic, Vilnius University Medical Faculty, Vilnius, Lithuania; Cyril Höschl, MD, Prague Psychiatric Center/NIMH, Czech Republic; Dusica Lecic-Tosevski, MD, Professor of Psychiatry, Belgrade University School of Medicine and Institute of Mental Health, WHO Collaborating Centre, Belgrade, Serbia; Eliot Sorel, MD, The George Washington University, School of Medicine & School of Public Health, Washington DC, USA; Elmars Rancans, MD, PhD, Chair of the Department of Psychiatry and Narcology, Riga Stradins University, Latvia; Eva Palova, MD, Department of Psychiatry, University Hospital, Slovakia; Georg Juckel, MD, PhD, Department of Psychiatry, Ruhr University Bochum, LWL-University Hospital, Bochum, Germany; Goran Isacsson, MD, Associate Professor, Department of Clinical Neuroscience, Karolinska Institutet, Sweden; Helena Korosec Jagodic, Psychiatric Hospital Vojnik, Vojnik, Slovenia; Ileana Botezat-Antonescu, MD, Associate Professor, National Mental Health Center and Anti-drug, Bucharest, Romania; Ingeborg Warnke, PhD, Center for Social Psychiatry, Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, Zurich, Switzerland; Janusz Rybakowski, Department of Adult Psychiatry, Poznan University of Medical Sciences, Poznan, Poland; Je
| | - Carlos Nordt
- Konstantinos N. Fountoulakis, MD, Associate Professor of Psychiatry, 3rd Department of Psychiatry, School of Medicine, Aristotle University of Thessaloniki, Greece; Wolfram Kawohl, MD, Center for Social Psychiatry, Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, Zurich, Switzerland; Pavlos N. Theodorakis, MD, Mental Health Hospitals Trust of Attica 'Dafni & Dromokaiteio' and WHO National Counterpart for Mental Health, Athens, Greece; Ad J. F. M. Kerkhof, MD, Faculty of Psychology and Education, Department of Clinical Psychology, VU University Amsterdam, Amsterdam, The Netherlands; Alvydas Navickas, MD, PhD, Associate Professor, Psychiatric Clinic, Vilnius University Medical Faculty, Vilnius, Lithuania; Cyril Höschl, MD, Prague Psychiatric Center/NIMH, Czech Republic; Dusica Lecic-Tosevski, MD, Professor of Psychiatry, Belgrade University School of Medicine and Institute of Mental Health, WHO Collaborating Centre, Belgrade, Serbia; Eliot Sorel, MD, The George Washington University, School of Medicine & School of Public Health, Washington DC, USA; Elmars Rancans, MD, PhD, Chair of the Department of Psychiatry and Narcology, Riga Stradins University, Latvia; Eva Palova, MD, Department of Psychiatry, University Hospital, Slovakia; Georg Juckel, MD, PhD, Department of Psychiatry, Ruhr University Bochum, LWL-University Hospital, Bochum, Germany; Goran Isacsson, MD, Associate Professor, Department of Clinical Neuroscience, Karolinska Institutet, Sweden; Helena Korosec Jagodic, Psychiatric Hospital Vojnik, Vojnik, Slovenia; Ileana Botezat-Antonescu, MD, Associate Professor, National Mental Health Center and Anti-drug, Bucharest, Romania; Ingeborg Warnke, PhD, Center for Social Psychiatry, Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, Zurich, Switzerland; Janusz Rybakowski, Department of Adult Psychiatry, Poznan University of Medical Sciences, Poznan, Poland; Je
| | - Juan Lopez-Ibor
- Konstantinos N. Fountoulakis, MD, Associate Professor of Psychiatry, 3rd Department of Psychiatry, School of Medicine, Aristotle University of Thessaloniki, Greece; Wolfram Kawohl, MD, Center for Social Psychiatry, Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, Zurich, Switzerland; Pavlos N. Theodorakis, MD, Mental Health Hospitals Trust of Attica 'Dafni & Dromokaiteio' and WHO National Counterpart for Mental Health, Athens, Greece; Ad J. F. M. Kerkhof, MD, Faculty of Psychology and Education, Department of Clinical Psychology, VU University Amsterdam, Amsterdam, The Netherlands; Alvydas Navickas, MD, PhD, Associate Professor, Psychiatric Clinic, Vilnius University Medical Faculty, Vilnius, Lithuania; Cyril Höschl, MD, Prague Psychiatric Center/NIMH, Czech Republic; Dusica Lecic-Tosevski, MD, Professor of Psychiatry, Belgrade University School of Medicine and Institute of Mental Health, WHO Collaborating Centre, Belgrade, Serbia; Eliot Sorel, MD, The George Washington University, School of Medicine & School of Public Health, Washington DC, USA; Elmars Rancans, MD, PhD, Chair of the Department of Psychiatry and Narcology, Riga Stradins University, Latvia; Eva Palova, MD, Department of Psychiatry, University Hospital, Slovakia; Georg Juckel, MD, PhD, Department of Psychiatry, Ruhr University Bochum, LWL-University Hospital, Bochum, Germany; Goran Isacsson, MD, Associate Professor, Department of Clinical Neuroscience, Karolinska Institutet, Sweden; Helena Korosec Jagodic, Psychiatric Hospital Vojnik, Vojnik, Slovenia; Ileana Botezat-Antonescu, MD, Associate Professor, National Mental Health Center and Anti-drug, Bucharest, Romania; Ingeborg Warnke, PhD, Center for Social Psychiatry, Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, Zurich, Switzerland; Janusz Rybakowski, Department of Adult Psychiatry, Poznan University of Medical Sciences, Poznan, Poland; Je
| | - Juan Lopez-Ibor
- Konstantinos N. Fountoulakis, MD, Associate Professor of Psychiatry, 3rd Department of Psychiatry, School of Medicine, Aristotle University of Thessaloniki, Greece; Wolfram Kawohl, MD, Center for Social Psychiatry, Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, Zurich, Switzerland; Pavlos N. Theodorakis, MD, Mental Health Hospitals Trust of Attica 'Dafni & Dromokaiteio' and WHO National Counterpart for Mental Health, Athens, Greece; Ad J. F. M. Kerkhof, MD, Faculty of Psychology and Education, Department of Clinical Psychology, VU University Amsterdam, Amsterdam, The Netherlands; Alvydas Navickas, MD, PhD, Associate Professor, Psychiatric Clinic, Vilnius University Medical Faculty, Vilnius, Lithuania; Cyril Höschl, MD, Prague Psychiatric Center/NIMH, Czech Republic; Dusica Lecic-Tosevski, MD, Professor of Psychiatry, Belgrade University School of Medicine and Institute of Mental Health, WHO Collaborating Centre, Belgrade, Serbia; Eliot Sorel, MD, The George Washington University, School of Medicine & School of Public Health, Washington DC, USA; Elmars Rancans, MD, PhD, Chair of the Department of Psychiatry and Narcology, Riga Stradins University, Latvia; Eva Palova, MD, Department of Psychiatry, University Hospital, Slovakia; Georg Juckel, MD, PhD, Department of Psychiatry, Ruhr University Bochum, LWL-University Hospital, Bochum, Germany; Goran Isacsson, MD, Associate Professor, Department of Clinical Neuroscience, Karolinska Institutet, Sweden; Helena Korosec Jagodic, Psychiatric Hospital Vojnik, Vojnik, Slovenia; Ileana Botezat-Antonescu, MD, Associate Professor, National Mental Health Center and Anti-drug, Bucharest, Romania; Ingeborg Warnke, PhD, Center for Social Psychiatry, Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, Zurich, Switzerland; Janusz Rybakowski, Department of Adult Psychiatry, Poznan University of Medical Sciences, Poznan, Poland; Je
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Vukovic O, Tosevski DL, Jasovic-Gasic M, Damjanovic A, Zebic M, Britvic D, Stepanovic J, Djordjevic-Dikic A, Beleslin B, Ostojic M. Type D personality in patients with coronary artery disease. Psychiatr Danub 2014; 26:46-51. [PMID: 24608156] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
BACKGROUND During the past decade studies have shown that Type D personality is associated with increased risk of cardiac events, mortality and poor quality of life. Some authors suggested that depression and Type D personality have substantial phenomenological overlap. SUBJECTS AND METHODS The sample consisted of non-consecutive case series of seventy nine patients with clinically stable and angiographically confirmed coronary artery disease (CAD), who had been admitted to the Clinic of Cardiology, University Clinical Centre, from May 2006 to September 2008. The patients were assessed by the Type-D scale (DS14), The Beck Depression Inventory (BDI), and provided demographic information. Risk factors for CAD were obtained from cardiologists. RESULTS The findings of our study have shown that 34.2% patients with CAD could be classified as Type D personality. The univariate analysis has shown that the prevalence of Type D personality was significantly higher in individuals with unstable angina pectoris and myocardial infarction (MI) diagnoses (p=0.02). Furthermore, some components of metabolic syndrome were more prevalent in patients with Type D personality: hypercholesterolemia (p=0.00), hypertriglyceridemia (p=0.00) and hypertension (p=0.01). Additionally, the distribution of depression in patients with a Type D personality and a non-Type D personality were statistically significantly different (p=0.00). CONCLUSION To our knowledge, this study is the first one to describe the prevalence and clinical characteristics of the Type D personality in patients with CAD in this region of Europe. We have found that the prevalence of Type D personality in patients with CAD is in concordance with the other studies. We also have found that Type D personality and depression are two distinctly different categories of psychological distress.
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Affiliation(s)
- Olivera Vukovic
- Institute of Mental Health, 37 Palmotićeva Street, 11000 Belgrade, Serbia,
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Pavlovic Z, Delic D, Maric Bojovic N, Vukovic O, Jasovic-Gasic M. P-519 - Risk factors for depressive symptoms in patients with hepatitis c treated with pegylated interferon alpha therapy. Eur Psychiatry 2012. [DOI: 10.1016/s0924-9338(12)74686-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/28/2022] Open
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Lecic-Tosevski D, Vukovic O, Stepanovic J. Stress and personality. Psychiatriki 2011; 22:290-297. [PMID: 22271841] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
Stress is an adaptation reaction of living organisms in response to internal or external threats to homeostasis. It is considered as a complex defence mechanism representing the final endpoint of numerous dynamic and interconnected factors of biological, psychological and social nature. Stress is not a simple, stimulus-response reaction, but the interaction between an individual and the environment, involving subjective perception and assessment of stressors, thus constituting a highly personalized process. Specific inherited characteristics, early experience in life, and particular, learned cognitive predispositions make individuals more or less susceptible to the effects of stressors. Resilience and vulnerability to stressors as well as intensity of stress response are greatly dependable on age, gender, intelligence, and numerous characteristics of personality, such as hardiness,locus of control, self-efficacy, self-esteem, optimism, hostility (component of type A personality)and type D traits (negative affectivity and social inhibition). To understand the relation between personality and stress, it is essential to recognize the impact of individual differences in the following four aspects: (1) choice or avoidance of environments that are associated with specific stressors, challenges or benefits, (2) way of interpreting a stressful situation and evaluating one's own abilities and capacities for proactive behaviour so as to confront or avoid it, (3) intensity of response to a stressor,and (4) coping strategies employed by the individual facing a stressful situation. Studies have recorded considerable consistency in coping strategies employed to confront stressful situations, independentlyof situational factors and in connection with permanent personality and temperamental traits,such as neuroticism, extraversion, sense of humour, persistence, fatalism, conscientiousness, andopenness to experience. Positive affect has been associated with positive reappraisal (reframing) ofstressful situations, goal-directed problem-focused coping, using spiritual or religious beliefs to seekcomfort, and infusion of meaning into the ordinary events of daily life in order to gain a psychologicaltime-out from distress. Characteristics of a resilient personality are: ability to cope in stressful situations,continuing engagement in activities, flexibility to unexpected changes in life, ability to seeksocial support, perceiving stress as a challenge - a chance for growth and development rather than athreat to life, taking care of one's body, living in harmony with nature, optimism and sense of humour,work and love, developing spiritualism and seeking true sense. The tolerance threshold is individual.However, even persons with mature and integrated personalities exposed to prolonged stress mayexperience failure of their adaptive capacities and psychological or somatic decompensation. Duringthe last years, Life Skills Education has become the focus of particular attention. Educational programsaim at developing the capacities for critical thinking, analyzing and problem-solving, buildingof self-confidence, confronting various negative pressures imposed by the environment, improvingself-assessment, developing communication and social adjustment skills, and gaining control overstressors and one's own affective and behavioral response. Finally, special programs for individualvulnerable population groups (teenagers, elderly persons, patients with AIDS, addictions, etc.) havebeen introduced so as to strengthen their ability to handle specific stressful situations.
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Affiliation(s)
- D Lecic-Tosevski
- Psychiatric Department, Belgrade University, School of Medicine, Belgrade, Serbia
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Stevovic L, Raznatovic A, Perunovic Jovanovic T, Tadic N, Vukovic O. P03-312 - Risk factors for suicides in montenegro during 2005-2008 period. Eur Psychiatry 2010. [DOI: 10.1016/s0924-9338(10)71366-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
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Injac L, Bakovic T, Vukovic O. P01.147 Analysis of suicides committed in podgorica during 1995–1999 period. Eur Psychiatry 2000. [DOI: 10.1016/s0924-9338(00)94554-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
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Caran N, Kastratovic Z, Injac L, Vukovic O. The application of the existing etiopathological concepts on an OCD case. Eur Psychiatry 1996. [DOI: 10.1016/0924-9338(96)89160-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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