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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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Fountoulakis KN, Alias NA, Bjedov S, Fountoulakis NK, Gonda X, Hilbig J, Jakovljević M, Kulig B, Mahale G, Manafis A, Mohammed M, Nadareishvili I, Navickas A, Patsali ME, Pavlichenko A, Pilaga SM, Razali S, Romanov D, Rossitza I, Salihu AS, Sinauridze A, Stoyanova M, Thosar K, Vorobjova J, Vrublevska J, Rancans E, Javed A, Theodorakis PN, Breda J, Smirnova D. Students' mental health during the pandemic: results of the observational cross-sectional COVID-19 MEntal health inTernational for university Students (COMET-S) study. Front Psychiatry 2024; 14:1320156. [PMID: 38293595 PMCID: PMC10825874 DOI: 10.3389/fpsyt.2023.1320156] [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] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/11/2023] [Accepted: 12/28/2023] [Indexed: 02/01/2024] Open
Abstract
Introduction The aim of the study was to search rates of depression and mental health in university students, during the COVID-19 pandemic. Materials and methods This is an observational cross-sectional study. A protocol gathering sociodemographic variables as well as depression, anxiety and suicidality and conspiracism was assembled, and data were collected anonymously and online from April 2020 through March 2021. The sample included 12,488 subjects from 11 countries, of whom 9,026 were females (72.2%; aged 21.11 ± 2.53), 3,329 males (26.65%; aged 21.61 ± 2.81) and 133 "non-binary gender" (1.06%; aged 21.02 ± 2.98). The analysis included chi-square tests, correlation analysis, ANCOVA, multiple forward stepwise linear regression analysis and Relative Risk ratios. Results Dysphoria was present in 15.66% and probable depression in 25.81% of the total study sample. More than half reported increase in anxiety and depression and 6.34% in suicidality, while lifestyle changes were significant. The model developed explained 18.4% of the development of depression. Believing in conspiracy theories manifested a complex effect. Close to 25% was believing that the vaccines include a chip and almost 40% suggested that facemask wearing could be a method of socio-political control. Conspiracism was related to current depression but not to history of mental disorders. Discussion The current study reports that students are at high risk for depression during the COVID-19 pandemic and identified specific risk factors. It also suggested a role of believing in conspiracy theories. Further research is important, as it is targeted intervention in students' groups that are vulnerable both concerning mental health and conspiracism.
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Affiliation(s)
- Konstantinos N. Fountoulakis
- 3rd Department of Psychiatry, School of Medicine, Aristotle University of Thessaloniki Greece, Thessaloniki, Greece
- WHO Collaboration Center for Quality in Mental Health, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Nor Aziah Alias
- Academic Affairs Division, Faculty of Education, Universiti Teknologi MARA, Sungai Buloh, Selangor, Malaysia
| | - Sarah Bjedov
- Department of Psychiatry and Psychological Medicine, University Hospital Centre Zagreb, Zagreb, Croatia
| | | | - Xenia Gonda
- Department of Psychiatry and Psychotherapy, Semmelweis University, Budapest, Hungary
| | - Jan Hilbig
- Clinic of Psychiatry, Medical Faculty, Institute of Clinical Medicine, Vilnius University, Vilnius, Lithuania
| | | | - Barbara Kulig
- Department of Psychiatry and Psychotherapy, Semmelweis University, Budapest, Hungary
- Department of Clinical Psychology, Semmelweis University, Budapest, Hungary
| | - Girija Mahale
- Symbiosis Centre for Emotional Wellbeing, Symbiosis International (Deemed) University, Pune, India
| | - Alexandros Manafis
- Faculty of Medicine, School of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Muftau Mohammed
- Department of Mental Health, University of Abuja Teaching Hospital, Abuja, Nigeria
| | | | - Alvydas Navickas
- Clinic of Psychiatry, Medical Faculty, Institute of Clinical Medicine, Vilnius University, Vilnius, Lithuania
| | - 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
| | | | - Salmi Razali
- Department of Psychiatry, Faculty of Medicine, Universiti Teknologi MARA, Sungai Buloh, Selangor, Malaysia
| | - Dmitry Romanov
- Department of Psychiatry, Samara State Medical University, Samara, Russia
| | - Iakimova Rossitza
- Second Psychiatric Clinic, University Hospital for Active Treatment in Neurology and Psychiatry “Saint Naum”, Sofia, Bulgaria
| | - Auwal Sani Salihu
- Department of Psychiatry, Bayero University, Kano, Nigeria
- Aminu Kano Teaching Hospital, Kano, Nigeria
| | - Ana Sinauridze
- Georgian Medical Students' Association, Tbilisi, Georgia
| | - Maria Stoyanova
- Second Psychiatric Clinic, University Hospital for Active Treatment in Neurology and Psychiatry “Saint Naum”, Sofia, Bulgaria
| | - Ketaki Thosar
- Symbiosis Centre for Emotional Wellbeing, Symbiosis International (Deemed) University, Pune, India
| | | | - Jelena Vrublevska
- Department of Psychiatry and Narcology, Riga Stradins University, Riga, Latvia
- Institute of Public Health, Riga Stradins University, Riga, Latvia
- Riga Centre of Psychiatry and Narcology, Riga, Latvia
| | - Elmars Rancans
- Department of Psychiatry and Narcology, Riga Stradins University, Riga, Latvia
- Riga Centre of Psychiatry and Narcology, Riga, Latvia
| | - Afzal Javed
- Institute of Applied Health Research, University of Birmingham, Birmingham, United Kingdom
- Warwick Medical School, University of Warwick, Coventry, United Kingdom
- Pakistan Psychiatric Research Centre, Fountain House, Lahore, Pakistan
| | | | - Joao Breda
- WHO Athens Quality of Care Office, WHO Regional Office for Europe, Copenhagen, Denmark
| | - Daria Smirnova
- International Centre for Education and Research in Neuropsychiatry, 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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Fountoulakis KN, Fountoulakis NK, Theodorakis PN. Correlation of temperament and character to adherence with mandatory facemask use in the general population during the COVID-19 lockdown: A hypothesis based on data. J Affect Disord 2022; 316:118-119. [PMID: 35932941 PMCID: PMC9382402 DOI: 10.1016/j.jad.2022.07.074] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2022] [Accepted: 07/30/2022] [Indexed: 11/29/2022]
Affiliation(s)
- Konstantinos N. Fountoulakis
- 3rd Department of Psychiatry, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki Greece, Greece
| | - Nikolaos K. Fountoulakis
- Faculty of Medicine, Medical University of Sofia, Bulgaria,Corresponding author at: 6, Odysseos str (1st Parodos Ampelonon str.), 55535 Pylaia, Thessaloniki, Greece
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6
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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, Fountoulakis NK, Theodorakis PN, Souliotis K. Overall mortality trends in Greece during the first period of austerity and the economic crisis (2009-2015). Hippokratia 2022; 26:98-104. [PMID: 37324039 PMCID: PMC10266329] [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] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/17/2023]
Abstract
OBJECTIVES The economic crisis and the resulting austerity in Greece led to a drastic reduction in healthcare spending, which has been assumed to have impacted people's health. This paper discusses official standardized mortality rates in Greece between 2000 and 2015. METHODS This study was designed to analyze population-level data and collected data from the World Bank, the Organisation for Economic Co-operation and Development, Eurostat, and the Hellenic Statistics Authority. Separate linear regression models were developed for the periods before and after the crisis and were compared. RESULTS Standardized mortality rates do not support a previously reported assumption of a specific and direct negative effect of austerity on global mortality. Standardized rates continued to decrease linearly, and their correlation to economic variables changed after 2009. Total infant mortality rates show an overall rising trend since 2009, but the interpretation is unclear because of the reduction in the absolute number of deliveries. CONCLUSIONS The mortality data from the first six years of the financial crisis in Greece and the decade that preceded do not support the assumption that budget cuts in health are related to the dramatic worsening of the overall health of the Greek people. Still, data suggest an increase in specific causes of death and the burden on a dysfunctional and unprepared health system that is working in an overstretched manner trying to meet needs. The dramatic acceleration of the aging of the population constitutes a specific challenge for the health system. HIPPOKRATIA 2022, 26 (3):98-104.
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Affiliation(s)
- K N Fountoulakis
- 3rd Department of Psychiatry, School of Medicine, Aristotle University of Thessaloniki, Greece
| | | | | | - K Souliotis
- Faculty of Social and Political Sciences, University of Peloponnese, Greece
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Fountoulakis KN, Breda J, Arletou MP, Charalampakis AI, Karypidou MG, Kotorli KS, Koutsoudi CG, Ladia ES, Mitkani CA, Mpouri VN, Samara AC, Stravoravdi AS, Tsiamis IG, Tzortzi A, Vamvaka MA, Zacharopoulou CN, Prezerakos PE, Koupidis SA, K Fountoulakis N, Tsapakis EM, Konsta A, Theodorakis PN. Adherence to facemask use in public places during the autumn-winter 2020 COVID-19 lockdown in Greece: observational data. Ann Gen Psychiatry 2022; 21:9. [PMID: 35264198 PMCID: PMC8905561 DOI: 10.1186/s12991-022-00386-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [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: 12/19/2021] [Accepted: 02/22/2022] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Wearing facemasks is of proven efficacy as a public health protective measure against COVID-19. Currently there are no observational data concerning the wearing of facemasks and the adherence to guidelines concerning their handling. METHODS Registration of the way passers-by were wearing facemasks at 26 different locations of five major cities in Greece. The results were correlated with the rate of COVID-19 deaths in the region. RESULTS In total, 119,433 passers-by were registered, 57,043 females (47.8%) and 62,390 males (52.2%). From the total sample, 81.1% were wearing the mask properly, 10.8% had their nose out, 6.2% were wearing it under the jaw, and 1.9% had no mask at all . There was a significant difference between males and females concerning any use of mask. Inappropriate use of was correlated with COVID-19 death rate in the studied region. CONCLUSION Our findings suggest that under conditions of mandatory wearing and in central locations of major cities, during walking, proper use of masks is suboptimal, but still contributes with some protection. Fear and risk perception seem to be strong factors contributing to adherence to proper mask wearing.
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Affiliation(s)
- Konstantinos N Fountoulakis
- Department of Psychiatry, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, 6, Odysseos str, 55535, Thessaloniki, Greece
| | - Joao Breda
- WHO Athens Quality of Care Office, WHO Regional Office for Europe, Athens, Greece
| | - Marianna P Arletou
- School of Medicine, Faculty of Health Sciences, Clinical Mental Health, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Anastasios I Charalampakis
- School of Medicine, Faculty of Health Sciences, Clinical Mental Health, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Maria G Karypidou
- School of Medicine, Faculty of Health Sciences, Clinical Mental Health, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Konstantina S Kotorli
- School of Medicine, Faculty of Health Sciences, Clinical Mental Health, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Christina G Koutsoudi
- School of Medicine, Faculty of Health Sciences, Clinical Mental Health, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Eleftheria S Ladia
- School of Medicine, Faculty of Health Sciences, Clinical Mental Health, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Calypso A Mitkani
- School of Medicine, Faculty of Health Sciences, Clinical Mental Health, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Vasiliki N Mpouri
- School of Medicine, Faculty of Health Sciences, Clinical Mental Health, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Anastasia C Samara
- School of Medicine, Faculty of Health Sciences, Clinical Mental Health, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Aikaterini S Stravoravdi
- School of Medicine, Faculty of Health Sciences, Clinical Mental Health, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Ioannis G Tsiamis
- School of Medicine, Faculty of Health Sciences, Clinical Mental Health, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Aphrodite Tzortzi
- School of Medicine, Faculty of Health Sciences, Clinical Mental Health, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Maria A Vamvaka
- School of Medicine, Faculty of Health Sciences, Clinical Mental Health, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Charikleia N Zacharopoulou
- School of Medicine, Faculty of Health Sciences, Clinical Mental Health, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Panagiotis E Prezerakos
- Department of Nursing, Laboratory of Integrated Health Care, University of Peloponnese, Tripoli, Greece
| | - Sotirios A Koupidis
- Occupational & Environmental Health Sector, Public Health Policy Department, School of Public Health, University of West Attica, Athens, Greece
| | | | | | - Anastasia Konsta
- Department of Psychiatry, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, 6, Odysseos str, 55535, Thessaloniki, Greece
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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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Kluge H, Kelley E, Swaminathan S, Yamamoto N, Fisseha S, Theodorakis PN, Kristensen S, Anderson M, Mossialos E. After Astana: building the economic case for increased investment in primary health care. Lancet 2018; 392:2147-2152. [PMID: 30420124 DOI: 10.1016/s0140-6736(18)32859-9] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/03/2018] [Accepted: 11/07/2018] [Indexed: 02/04/2023]
Affiliation(s)
- Hans Kluge
- Division of Health Systems and Public Health, Regional Office for Europe, World Health Organization, Copenhagen, Denmark
| | - Ed Kelley
- Department of Service Delivery and Safety, World Health Organization, Geneva, Switzerland
| | - Soumya Swaminathan
- Office of the Deputy Director-General for Programmes, World Health Organization, Geneva, Switzerland
| | - Naoko Yamamoto
- Universal Health Coverage and Health Systems, World Health Organization, Geneva, Switzerland
| | - Senait Fisseha
- International Programs, Susan Thompson Buffett Foundation, Omaha, NE, USA; Obstetrics and Gynecology, University of Michigan Medical School, Ann Arbor, MI, USA
| | - Pavlos N Theodorakis
- Department of Service Delivery and Safety, World Health Organization, Geneva, Switzerland
| | - Søren Kristensen
- Institute of Global Health Innovation, Imperial College London, London, UK
| | - Michael Anderson
- Department of Health Policy, London School of Economics and Political Science, London WC2A 2AE, UK
| | - Elias Mossialos
- Institute of Global Health Innovation, Imperial College London, London, UK; Department of Health Policy, London School of Economics and Political Science, London WC2A 2AE, UK.
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11
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Kluge H, Kelley E, Barkley S, Theodorakis PN, Yamamoto N, Tsoy A, Aiypkhanova A, Ganesh V, Hipgrave DB, Peterson SS, Valderas JM, Mossialos E. How primary health care can make universal health coverage a reality, ensure healthy lives, and promote wellbeing for all. Lancet 2018; 392:1372-1374. [PMID: 30343844 DOI: 10.1016/s0140-6736(18)32482-6] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/27/2018] [Accepted: 10/03/2018] [Indexed: 11/24/2022]
Affiliation(s)
- Hans Kluge
- Division of Health Systems and Public Health, Regional Office for Europe, World Health Organization, Copenhagen, Denmark
| | - Ed Kelley
- Department of Service Delivery and Safety, World Health Organization, Geneva 1202, Switzerland.
| | - Shannon Barkley
- Department of Service Delivery and Safety, World Health Organization, Geneva 1202, Switzerland
| | - Pavlos N Theodorakis
- Division of Health Systems and Public Health, Regional Office for Europe, World Health Organization, Copenhagen, Denmark
| | - Naoko Yamamoto
- Universal Health Coverage and Health Systems, World Health Organization, Geneva 1202, Switzerland
| | - Alexey Tsoy
- Ministry of Healthcare, Government of Kazakhstan, Astana, Kazakhstan
| | - Ainur Aiypkhanova
- Ministry of Healthcare, Government of Kazakhstan, Astana, Kazakhstan
| | | | | | | | - Jose M Valderas
- University of Health Services and Policy Research Group, APEx Collaboration for Academic Primary Care, University of Exeter, Exeter, UK
| | - Elias Mossialos
- Department of Health Policy, London School of Economics and Political Science, London, UK
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12
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Branas CC, Kastanaki AE, Michalodimitrakis M, Tzougas J, Kranioti EF, Theodorakis PN, Carr BG, Wiebe DJ. 67 Impact of economic austerity and prosperity events on suicide in greece: a 30-year interrupted time-series analysis. Inj Prev 2016. [DOI: 10.1136/injuryprev-2016-042156.67] [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] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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13
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Branas CC, Kastanaki AE, Michalodimitrakis M, Tzougas J, Kranioti EF, Theodorakis PN, Carr BG, Wiebe DJ. The impact of economic austerity and prosperity events on suicide in Greece: a 30-year interrupted time-series analysis. BMJ Open 2015; 5:e005619. [PMID: 25643700 PMCID: PMC4316557 DOI: 10.1136/bmjopen-2014-005619] [Citation(s) in RCA: 64] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/06/2014] [Revised: 09/16/2014] [Accepted: 10/13/2014] [Indexed: 12/17/2022] Open
Abstract
OBJECTIVES To complete a 30-year interrupted time-series analysis of the impact of austerity-related and prosperity-related events on the occurrence of suicide across Greece. SETTING Greece from 1 January 1983 to 31 December 2012. PARTICIPANTS A total of 11 505 suicides, 9079 by men and 2426 by women, occurring in Greece over the study period. PRIMARY AND SECONDARY OUTCOMES National data from the Hellenic Statistical Authority assembled as 360 monthly counts of: all suicides, male suicides, female suicides and all suicides plus potentially misclassified suicides. RESULTS In 30 years, the highest months of suicide in Greece occurred in 2012. The passage of new austerity measures in June 2011 marked the beginning of significant, abrupt and sustained increases in total suicides (+35.7%, p<0.001) and male suicides (+18.5%, p<0.01). Sensitivity analyses that figured in undercounting of suicides also found a significant, abrupt and sustained increase in June 2011 (+20.5%, p<0.001). Suicides by men in Greece also underwent a significant, abrupt and sustained increase in October 2008 when the Greek recession began (+13.1%, p<0.01), and an abrupt but temporary increase in April 2012 following a public suicide committed in response to austerity conditions (+29.7%, p<0.05). Suicides by women in Greece also underwent an abrupt and sustained increase in May 2011 following austerity-related events (+35.8%, p<0.05). One prosperity-related event, the January 2002 launch of the Euro in Greece, marked an abrupt but temporary decrease in male suicides (-27.1%, p<0.05). CONCLUSIONS This is the first multidecade, national analysis of suicide in Greece using monthly data. Select austerity-related events in Greece corresponded to statistically significant increases for suicides overall, as well as for suicides among men and women. The consideration of future austerity measures should give greater weight to the unintended mental health consequences that may follow and the public messaging of these policies and related events.
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Affiliation(s)
| | | | | | | | - Elena F Kranioti
- Edinburgh Unit for Forensic Anthropology, SHCA, University of Edinburgh, UK
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14
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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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Mystakidou K, Parpa E, Tsilika E, Panagiotou I, Theodorakis PN, Galanos A, Gouliamos A. Self-Efficacy and Its Relationship to Posttraumatic Stress Symptoms and Posttraumatic Growth in Cancer Patients. Journal of Loss and Trauma 2014. [DOI: 10.1080/15325024.2013.838892] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Affiliation(s)
- Konstantinos N Fountoulakis
- Third Department of Psychiatry, School of Medicine, Aristotle University of Thessaloniki, 54636 Thessaloniki, Greece.
| | - Pavlos N Theodorakis
- Mental Health Hospitals Trust of Attica Dafni & Dromokaiteio, Athens, Greece; WHO National Counterpart for Mental Health, Athens, Greece
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Fountoulakis KN, Gonda X, Dome P, Theodorakis PN, Rihmer Z. Possible delayed effect of unemployment on suicidal rates: the case of Hungary. Ann Gen Psychiatry 2014; 13:12. [PMID: 24803949 PMCID: PMC4011839 DOI: 10.1186/1744-859x-13-12] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [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: 02/11/2014] [Accepted: 04/09/2014] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND During the last few years, many countries in Europe suffered from a severe economic crisis which resulted in high unemployment rates. In this frame, the possible relationship between unemployment rate and suicidal rates at the level of the general population has been debated recently. MATERIAL AND METHODS The official data concerning completed suicides and unemployment rates from the Hungarian Central Statistical Office for the years 2000-2011 were used. The percentage of changes from the previous year in the unemployment rate and the suicidal rates concerning both the general and the unemployed populations was calculated. Pearson correlation coefficient between the change in suicidal rates and change in unemployment rates was calculated both for the same year as well as after 1-6 years. RESULTS The correlations between the unemployment rate and suicide rates were strongly negative both for the general and for the unemployed populations (-0.65 and -0.55, respectively). The correlation of unemployment change with suicidality change after 1-6 years gave a peak strong positive correlation at 5 years for the general population (0.78). At 4 years after the index year, there is a peak correlation with a moderate value for the unemployed population (0.47) and a similar moderate value for the general population (0.46). DISCUSSION The current findings from Hungary suggest that unemployment might be associated with suicidality in the general population only after 3-5 years. It is possible that the distressing environment of the economic crisis increases suicidality in the general population rather than specifically in unemployed people.
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Affiliation(s)
- Konstantinos N Fountoulakis
- 3rd Department of Psychiatry, School of Medicine, Aristotle University of Thessaloniki, 6, Odysseos Str. (1st Parodos Ampelonon Str.), Pylaia, Thessaloniki 55535, Greece
| | - Xenia Gonda
- Department of Clinical and Theoretical Mental Health, Faculty of Medicine, Semmelweis University, Budapest 1089, Hungary ; Laboratory for Suicide Research and Prevention, National Institute of Psychiatry and Addictions, Budapest H-1135, Hungary ; Department of Pharmacodynamics, Semmelweis University, Budapest H-1089, Hungary ; MTA-SE Neuropsychopharmacology and Neurochemistry Research Group, Hungarian Academy of Sciences, Semmelweis University, Budapest 1089, Hungary
| | - Peter Dome
- Department of Clinical and Theoretical Mental Health, Faculty of Medicine, Semmelweis University, Budapest 1089, Hungary ; Laboratory for Suicide Research and Prevention, National Institute of Psychiatry and Addictions, Budapest H-1135, Hungary
| | - Pavlos N Theodorakis
- Mental Health Hospitals Trust of Attica "Dafni & Dromokaiteio", Athens 12462, Greece ; WHO National Counterpart for Mental Health, Athens 12462, Greece
| | - Zoltan Rihmer
- Department of Clinical and Theoretical Mental Health, Faculty of Medicine, Semmelweis University, Budapest 1089, Hungary ; Laboratory for Suicide Research and Prevention, National Institute of Psychiatry and Addictions, Budapest H-1135, Hungary
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Skapinakis P, Bellos S, Koupidis S, Grammatikopoulos I, Theodorakis PN, Mavreas V. Prevalence and sociodemographic associations of common mental disorders in a nationally representative sample of the general population of Greece. BMC Psychiatry 2013; 13:163. [PMID: 23734578 PMCID: PMC3686601 DOI: 10.1186/1471-244x-13-163] [Citation(s) in RCA: 82] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/06/2013] [Accepted: 05/25/2013] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND No study in Greece has assessed so far the full range of common mental disorders using a representative sample of the population from both mainland and insular regions of the country. The aim of the present paper was to present the results of the first such study. METHODS The study was carried out between 2009-2010 in a nationally representative sample of 4894 individuals living in private households in Greece. Common mental disorders in the past week were assessed with the revised Clinical Interview Schedule (CIS-R). We also assessed alcohol use disorders (using AUDIT), smoking and cannabis use. RESULTS 14% of the population (Male: 11%, Female: 17%) was found to have clinically significant psychiatric morbidity according to the scores on the CIS-R. The prevalence (past seven days) of specific common mental disorders was as follows: Generalized Anxiety Disorder: 4.10% (95% CI: 3.54, 4.65); Depression: 2.90% (2.43, 3.37); Panic Disorder: 1.88% (1.50, 2.26); Obsessive-Compulsive Disorder: 1.69% (1.33, 2.05); All Phobias: 2.79% (2.33, 3.26); Mixed anxiety-depression: 2.67% (2.22, 3.12). Harmful alcohol use was reported by 12.69% of the population (11.75, 13.62). Regular smoking was reported by 39.60% of the population (38.22, 40.97) while cannabis use (at least once during the past month) by 2.06% (1.66, 2.46). Clinically significant psychiatric morbidity was positively associated with the following variables: female gender, divorced or widowed family status, low educational status and unemployment. Use of all substances was more common in men compared to women. Common mental disorders were often comorbid, undertreated, and associated with a lower quality of life. CONCLUSIONS The findings of the present study can help in the better planning and development of mental health services in Greece, especially in a time of mental health budget restrictions.
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Affiliation(s)
- Petros Skapinakis
- Department of Psychiatry, University of Ioannina, School of Medicine, Ioannina 45110, Greece
| | - Stefanos Bellos
- Department of Psychiatry, University of Ioannina, School of Medicine, Ioannina 45110, Greece
| | - Sotirios Koupidis
- Department of Psychiatry, University of Ioannina, School of Medicine, Ioannina 45110, Greece
| | - Ilias Grammatikopoulos
- Department of Psychiatry, University of Ioannina, School of Medicine, Ioannina 45110, Greece
| | - Pavlos N Theodorakis
- Department of Psychiatry, University of Ioannina, School of Medicine, Ioannina 45110, Greece
| | - Venetsanos Mavreas
- Department of Psychiatry, University of Ioannina, School of Medicine, Ioannina 45110, Greece
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Fountoulakis KN, Siamouli M, Grammatikopoulos IA, Koupidis SA, Siapera M, Theodorakis PN. Economic crisis-related increased suicidality in Greece and Italy: a premature overinterpretation. J Epidemiol Community Health 2012; 67:379-80. [PMID: 23213113 DOI: 10.1136/jech-2012-201902] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
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Karavitakis M, Komninos C, Theodorakis PN, Politis V, Lefakis G, Mitsios K, Koritsiadis S, Doumanis G. Evaluation of Sexual Function in Hypertensive Men Receiving Treatment: A Review of Current Guidelines Recommendation. J Sex Med 2011; 8:2405-14. [DOI: 10.1111/j.1743-6109.2011.02342.x] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Kastanaki AE, Kranioti EF, Papavdi A, Theodorakis PN, Michalodimitrakis M. Suicide by firearms on the island of Crete: a 9-year record. Crisis 2011; 31:43-52. [PMID: 20197257 DOI: 10.1027/0227-5910/a000006] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
BACKGROUND Whereas firearm suicide mortality has been a longstanding public concern worldwide, in Greece no systematic analysis has been reported so far despite the recent evidence of a rising rate of gun ownership. AIMS To estimate the proportion of firearm suicides on the island of Crete, Southern Greece, well-known for its widespread gun ownership; to describe the victims' sociodemographic profile and firearm-related suicide variables; and to assess the severity of suicidal intention in the group. METHODS Records of suicides between 1999 and 2007 were reviewed and information was extracted into a computerized database. A rating of the circumstances section of the Beck's Suicide Intent Scale (SIS) for each case was also performed. RESULTS The firearm suicide rate was 1.3 per 100,000, with males constituting the vast majority. These men were more likely to be less than 55 years of age, to have lived in the western part of the island, to have some degree of planning prior to the suicidal act, and to have used a shotgun, but less likely to have left a note. CONCLUSIONS As an important first step toward implementing preventive initiatives the authors stress the need for a thorough look at the sociocultural factors associated with firearms in the region.
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Affiliation(s)
- Anastasia E Kastanaki
- State Mental Health Hospital of Chania, Crete, Greece Department of Forensic Sciences, Faculty of Medicine, University of Crete, Greece.
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Vivilaki VG, Dafermos V, Daglas M, Antoniou E, Tsopelas ND, Theodorakis PN, Brown JB, Lionis C. Identifying intimate partner violence (IPV) during the postpartum period in a Greek sample. Arch Womens Ment Health 2010; 13:467-76. [PMID: 20306211 DOI: 10.1007/s00737-010-0155-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [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] [Received: 11/02/2009] [Accepted: 02/07/2010] [Indexed: 11/26/2022]
Abstract
Research has highlighted the wide impact of intimate partner violence (IPV) and the public health role of community health professionals in detection of victimized women. The purpose of this study was to identify postpartum emotional and physical abuse and to validate the Greek version of the Women Abuse Screening Tool (WAST) along with its sensitivity and specificity. Five hundred seventy-nine mothers within 12 weeks postpartum were recruited from the perinatal care registers of the Maternity Departments of two public hospitals in Athens, Greece. Participants were randomly selected by clinic or shift. The WAST and the Partner Violence Screen (PVS) surveys were administered in random order to the mothers from September 2007 to January 2008. The WAST was compared with the PVS as a criterion standard. Agreement between the screening instruments was examined. The psychometric measurements that were performed included: two independent sample t tests, reliability coefficients, explanatory factor analysis using a Varimax rotation, and Principal Components Method. Confirmatory analysis-also called structural equation modeling-of principal components was conducted by Linear Structural Relations. A receiver operating characteristic (ROC) analysis was carried out to evaluate the global functioning of the scale. Two hundred four (35.6%) of the mothers screened were identified as experiencing IPV. Scores on the WAST correlated well with those on the PVS; the internal consistency of the WAST Greek version-tested using Cronbach's alpha coefficient-was found to be 0.926 and that of Guttman's split-half coefficient was 0.924. Our findings confirm the multidimensionality of the WAST, demonstrating a two-factor structure. The area under ROC curve (AUC) was found to be 0.824, and the logistic estimate for the threshold score of 0/1 fitted the model sensitivity at 99.7% and model specificity at 64.4%. Our data confirm the validity of the Greek version of the WAST in identifying IPV. The validated Greek WAST scale could be used for screening purposes in both clinical practice and research.
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Affiliation(s)
- Victoria G Vivilaki
- Clinic of Social and Family Medicine, Faculty of Medicine, University of Crete, Heraklion, Greece.
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Abstract
Background: The role of pesticides in suicidal acts has not yet received adequate attention in Greece despite an evident rise of 39% in pesticide use over the period 1990–1992 to 2002–2004. Aims: To investigate the epidemiology of pesticide suicide on the Greek island of Crete, a largely rural agricultural area, and by further exploring the victim profiles, as well as patterns and trends of pesticide ingestion, to suggest probable preventive measures. Methods: Self-poisoning suicides between 1999 and 2007 were reviewed and information gathered was entered into a computerized database. Results: The overall incidence of intentional pesticide poisoning was 1.7 per 100,000, representing the second most frequently used suicide method after hanging. The victim profile was composed of the following features: middle aged male, rural habitant, who carried out a suicidal act by consuming primarily methomyl or paraquat (WHO toxicity class Ib and class II, respectively). As to the place of death, the vast majority was found dead in the place of intoxication. Conclusions: Pesticide self-poisoning accounts for a quarter of the suicides in Crete. More detailed research is required to identify aspects of these deaths amenable to prevention, but measures such as bans on the most toxic pesticides and changes in storage practice would appear to be sensible initial approaches.
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Affiliation(s)
- Anastasia E. Kastanaki
- State Mental Health Hospital of Chania, Crete, Greece
- Department of Forensic Sciences, Faculty of Medicine, University of Crete, Greece
| | | | - Elena F. Kranioti
- Department of Forensic Sciences, Faculty of Medicine, University of Crete, Greece
- Department of Archaeology, University of Edinburgh, UK
| | - Despoina Nathena
- Department of Forensic Sciences, Faculty of Medicine, University of Crete, Greece
| | - Pavlos N. Theodorakis
- Department of Forensic Sciences, Faculty of Medicine, University of Crete, Greece
- Organization for Health and Social Solidarity, City of Athens, Greece
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Kastanaki AE, Kranioti EF, Theodorakis PN, Michalodimitrakis M. An Unusual Suicide Inside a Grave with Two Gunshot Wounds to the Head-The Psychological Approach. J Forensic Sci 2009; 54:404-7. [DOI: 10.1111/j.1556-4029.2008.00983.x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Anastasiou F, Antonakis N, Chaireti G, Theodorakis PN, Lionis C. Identifying dyspepsia in the Greek population: translation and validation of a questionnaire. BMC Public Health 2006; 6:56. [PMID: 16515708 PMCID: PMC1420284 DOI: 10.1186/1471-2458-6-56] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2005] [Accepted: 03/04/2006] [Indexed: 11/24/2022] Open
Abstract
Background Studies on clinical issues, including diagnostic strategies, are considered to be the core content of general practice research. The use of standardised instruments is regarded as an important component for the development of Primary Health Care research capacity. Demand for epidemiological cross-cultural comparisons in the international setting and the use of common instruments and definitions valid to each culture is bigger than ever. Dyspepsia is a common complaint in primary practice but little is known with respect to its incidence in Greece. There are some references about the Helicobacter Pylori infection in patients with functional dyspepsia or gastric ulcer in Greece but there is no specific instrument for the identification of dyspepsia. This paper reports on the validation and translation into Greek, of an English questionnaire for the identification of dyspepsia in the general population and discusses several possibilities of its use in the Greek primary care. Methods The selected English postal questionnaire for the identification of people with dyspepsia in the general population consists of 30 items and was developed in 1995. The translation and cultural adaptation of the questionnaire has been performed according to international standards. For the validation of the instrument the internal consistency of the items was established using the alpha coefficient of Chronbach, the reproducibility (test – retest reliability) was measured by kappa correlation coefficient and the criterion validity was calculated against the diagnosis of the patients' records using also kappa correlation coefficient. Results The final Greek version of the postal questionnaire for the identification of dyspepsia in the general population was reliably translated. The internal consistency of the questionnaire was good, Chronbach's alpha was found to be 0.88 (95% CI: 0.81–0.93), suggesting that all items were appropriate to measure. Kappa coefficient for reproducibility (test – retest reliability) was found 0.66 (95% CI: 0.62–0.71), whereas the kappa analysis for criterion validity was 0.63 (95% CI: 0.36–0.89). Conclusion This study indicates that the Greek translation is comparable with the English-language version in terms of validity and reliability, and is suitable for epidemiological research within the Greek primary health care setting.
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Affiliation(s)
- Foteini Anastasiou
- Clinic of Social and Family Medicine, Department of Social Medicine, Faculty of Medicine, University of Crete, Greece, P.O. Box: 2208, 71003, Heraklion, Crete, Greece
| | | | - Georgia Chaireti
- Health Centre of Agia Barbara, 70003, Agia Barbara, Crete, Greece
| | - Pavlos N Theodorakis
- Clinic of Social and Family Medicine, Department of Social Medicine, Faculty of Medicine, University of Crete, Greece, P.O. Box: 2208, 71003, Heraklion, Crete, Greece
| | - Christos Lionis
- Clinic of Social and Family Medicine, Department of Social Medicine, Faculty of Medicine, University of Crete, Greece, P.O. Box: 2208, 71003, Heraklion, Crete, Greece
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Theodorakis PN, Mantzavinis GD, Rrumbullaku L, Lionis C, Trell E. Measuring health inequalities in Albania: a focus on the distribution of general practitioners. Hum Resour Health 2006; 4:5. [PMID: 16504028 PMCID: PMC1395320 DOI: 10.1186/1478-4491-4-5] [Citation(s) in RCA: 49] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/20/2005] [Accepted: 02/21/2006] [Indexed: 05/04/2023]
Abstract
BACKGROUND The health workforce has a dynamically changing nature and the regular documentation of the distribution of health professionals is a persistent policy concern. The aim of the present study was to examine available human medical resources in primary care and identify possible inequalities regarding the distribution of general practitioners in Albania between 2000 and 2004. METHODS With census data, we investigated the degree of inequality by calculating relative inequality indices. We plotted the Lorenz curves and calculated the Gini, Atkinson and Robin Hood indices and decile ratios, both before and after adjusting for mortality and consultation rates. RESULTS The Gini index for the distribution of general practitioners in 2000 was 0.154. After adjusting for mortality it was 0.126, while after adjusting for consultation rates it was 0.288. The Robin Hood index for 2000 was 11.2%, which corresponds to 173 general practitioners who should be relocated in order to achieve equality. The corresponding figure after adjusting for mortality was 9.2% (142 general practitioners), while after adjusting for consultation rates the number was 20.6% (315). These figures changed to 6.3% (100), 6.3% (115) and 19.8% (315) in 2004. CONCLUSION There was a declining trend in the inequality of distribution of general practitioners in Albania between 2000 and 2004. The trend in inequality was apparent irrespective of the relative inequality indicator used. The level of inequality varied depending on the adjustment method used. Reallocation strategies for general practitioners in Albania could be the key in alleviating the inequalities in primary care workforce distribution.
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Affiliation(s)
- Pavlos N Theodorakis
- Clinic of Social and Family Medicine, School of Medicine, University of Crete, Heraklion, Crete, Greece
- State Mental Health Hospital of Chania, Chania, Crete, Greece
- Department of General Practice and Primary Health Care, Faculty of Health Sciences, University of Linköping, Linköping, Sweden
- Research Unit, Cretan Mental Health Services Coordination Centre, Chania, Crete, Greece
| | - Georgios D Mantzavinis
- Department of General Practice and Primary Health Care, Faculty of Health Sciences, University of Linköping, Linköping, Sweden
- Research Unit, Cretan Mental Health Services Coordination Centre, Chania, Crete, Greece
| | - Llukan Rrumbullaku
- Department of Family Medicine, Faculty of Medicine, University of Tirana, Tirana, Albania
| | - Christos Lionis
- Clinic of Social and Family Medicine, School of Medicine, University of Crete, Heraklion, Crete, Greece
| | - Erik Trell
- Department of General Practice and Primary Health Care, Faculty of Health Sciences, University of Linköping, Linköping, Sweden
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Theodorakis PN, Mantzavinis GD. Inequalities in the distribution of rural primary care physicians in two remote neighboring prefectures of Greece and Albania. Rural Remote Health 2005; 5:457. [PMID: 16134954] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/04/2023] Open
Abstract
INTRODUCTION Inequalities in the distribution of primary care physicians are of great importance in the provision of health care. This becomes more apparent mainly in the rural and remote areas of each country. The objective of the present study was to evaluate and compare the degree of inequality in the provision of primary care physicians in two rural and remote prefectures of neighboring countries. We studied the cases of Ioannina, Greece and Gjirokaster, Albania during 2001. METHODS In both prefectures, for all calculations made, we used the total number of physicians providing primary care in rural areas. This includes GPs, internal medicine specialists, non-specialised graduate physicians. All other physician specialties (eg. microbiologists) were excluded from the calculations of the present study. We calculated the population per physician ratio (PPR) for each health center in each prefecture. For the comparison of the inequality we used two relative inequality measures. We plotted the Lorenz curves and calculated the Gini coefficients for the distribution of physicians' workforce adjusted by population in the two districts. Finally, we calculated the difference in the inequalities in these distributions. The p values were two tailed and calculated for 95% confidence levels. RESULTS The PPR for the whole prefecture of Ioannina, Greece was 1222. The lowest PPR, which corresponds to higher supply of human resources, was 205, while the highest (worst) was 8166. In the case of Gjirokaster the PPR was 2376 for the whole prefecture. The lowest PPR was 1323, while the highest was 4546 inhabitants per physician. Because the two curves do not intersect we can assume with certainty that primary care physicians in the prefecture of Ioannina were more unevenly distributed than those in the prefecture of Gjirokaster. The Gini coefficient for the distribution of primary care physicians in Ioannina was 0.489 (SD = 0.045), while that of the Gjirokaster district was 0.186 (SD = 0.034). The difference between the two Gini indices was 0.303 (p < 0.001). CONCLUSIONS Primary care physicians in both prefectures were unevenly distributed. The inequality in the distribution of primary care physicians was significantly higher in the prefecture of Ioannina, Greece compared with that of the prefecture of Gjirokaster, Albania. Further investigations could be made using a need adjusted index instead of PPR. For this purpose, the number of physicians could be adjusted for mortality, morbidity of chronic diseases or limiting longstanding illness. Studying the inequality patterns in districts could be aided by the use of other disciplines, such as geographical information systems, giving a clearer picture of the situation of primary care provision in these districts. The results of the present study could be considered by health policy researchers. It seems that human resources' density and inequality in the distribution of health manpower are both needed as indicators for a more thorough investigation of health services, especially in the case of rural and remote areas. Furthermore, health policy makers should focus on the redistribution of the health manpower towards a more equitable situation, based on the results of similar studies. Finally, the documentation of inter-country differences would prove helpful in terms of international cooperation and sharing of knowledge by policy makers when the objective is the equality and quality of health services provision.
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Mantzavinis G, Theodorakis PN, Lionis C, Trell E. [Geographical inequalities in the distribution of general practitioners in Sweden]. Lakartidningen 2003; 100:4294-7. [PMID: 14756094] [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: 04/28/2023]
Abstract
AIM To estimate trends in the inequalities in the distribution of general practitioners in Sweden during the past fifteen years. METHODS Relative inequality indicators. We plotted the Lorenz curves and calculated the Gini coefficients for the entire country during 1986, 1991, 1996 and 2001. RESULTS During the past 15 years in all a declining trend was noted in the inequalities in the geographical distribution of general practitioners in Sweden, with the lowest level in 1996. CONCLUSIONS The degree of inequality in the geographical distribution of general practitioners appeared rather stable during the period, although with some increase in the final year studied. Since equality is part of quality, policy makers in all levels--national, regional and local--should pay attention as to how human resources are distributed.
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Affiliation(s)
- Georgios Mantzavinis
- Kretas universitet, hösten 2001 forskarstipendiat vid avdelningen för allmänmedicin, Hälsouniversitetet, Linköping
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Abstract
In the Balkan context education in general practice varies greatly and it is in different stages of reorganisation and curriculum development. The postgraduate training in family medicine in Albania started in January 1997 with the goal of providing future family doctors with the proper knowledge, skills, attitudes, and professional values that will enable them to address the medical problems in the community. This paper describes the structure and content of the training programme and discusses some of its key elements.
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Affiliation(s)
- L Rrumbullaku
- Department of Family Medicine, Faculty of Medicine, University of Tirana, Albania
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Rrumbullaku L, Theodorakis PN, Caca P, Lionis C, Trell E. Medical education in Albania: current situation and perspective, with reference to primary care. Croat Med J 2002; 43:50-3. [PMID: 11828560] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/23/2023] Open
Abstract
A radical primary health care-oriented reform of the medical services in Albania is now under way, calling for adequate revision in medical education. The reform has started in 1994. In January 1997, the Department of Family Medicine at the Faculty of Medicine, University of Tirana, was established for the development of general practice and family medicine, and with it a new era in medical education in Albania has begun. Mutual agreements for international collaborations are being realized, modern medical textbooks are being published, and the importance of continuous medical education is gaining a deserved appreciation. Here we describe medical education in Albania, including undergraduate education, vocational training, and continuing professional development. The emphasis is given on primary care, with some suggestions for concrete actions that would improve the current situation. A brief descriptive account is given of the ongoing Albanian medical education reform, primarily in the field of primary health care, which assumes its most interesting global aspects and at the same time reflects the unique demands of the country.
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Affiliation(s)
- Llukan Rrumbullaku
- Department of Family Medicine, Tirana University Faculty of Medicine, Dibres str., Tirana, Albania.
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Theodorakis PN, Rrumbullaku L, Glaros D, Lionis C, Trell E. ["Green islands" for primary health care in the Balkan?]. Lakartidningen 2001; 98:2747. [PMID: 11430237] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/20/2023]
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