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Bakola M, Peritogiannis V, Kitsou KS, Gourzis P, Hyphantis T, Jelastopulu E. Length of hospital stay in involuntary admissions in Greece: a 10-year retrospective observational study. Soc Psychiatry Psychiatr Epidemiol 2024:10.1007/s00127-024-02653-x. [PMID: 38684516 DOI: 10.1007/s00127-024-02653-x] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2023] [Accepted: 03/07/2024] [Indexed: 05/02/2024]
Abstract
PURPOSE The treatment of mental disorders has shifted from inpatient wards to community-based settings in recent years, but some patients may still have to be admitted to inpatient wards, sometimes involuntarily. It is important to maintain the length of hospital stay (LoS) as short as possible while still providing adequate care. The present study aimed to explore the factors associated with the LoS in involuntarily admitted psychiatric patients. METHODS A ten-year retrospective chart review of 332 patients admitted involuntarily to the inpatient psychiatric ward of the General University Hospital of Ioannina, Northwestern Greece, between 2008 and 2017 was conducted. RESULTS The mean LoS was 23.8 (SD = 33.7) days and was relatively stable over the years. Longer-stay hospitalization was associated with schizophrenia-spectrum disorder diagnosis, previous hospitalizations and the use of mechanical restraint, whereas patients in residential care experienced significantly longer LoS (52.6 days) than those living with a caregiver (23.5 days) or alone (19.4 days). Older age at disease onset was associated with shorter LoS, whereas no statistically significant differences were observed with regard to gender. CONCLUSION While some of our findings were in line with recent findings from other countries, others could not be replicated. It seems that multiple factors influence LoS and the identification of these factors could help clinicians and policy makers to design more targeted and cost-effective interventions. The optimization of LoS in involuntary admissions could improve patients' outcomes and lead to more efficient use of resources.
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Affiliation(s)
- Maria Bakola
- Department of Public Health, Medical School, University of Patras, Rio, 26500, Patras, Greece
| | - Vaios Peritogiannis
- Mobile Mental Health Unit of the Prefectures of Ioannina and Thesprotia, Society for the Promotion of Mental Health in Epirus, Ioannina, Greece
| | | | - Philippos Gourzis
- Department of Psychiatry, Medical School, University of Patras, Patras, Greece
| | - Thomas Hyphantis
- Department of Psychiatry, Division of Medicine, School of Health Sciences, University of Ioannina, Ioannina, Greece
| | - Eleni Jelastopulu
- Department of Public Health, Medical School, University of Patras, Rio, 26500, Patras, Greece.
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Gkintoni E, Skokou M, Gourzis P. Integrating Clinical Neuropsychology and Psychotic Spectrum Disorders: A Systematic Analysis of Cognitive Dynamics, Interventions, and Underlying Mechanisms. Medicina (Kaunas) 2024; 60:645. [PMID: 38674291 PMCID: PMC11051923 DOI: 10.3390/medicina60040645] [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] [Subscribe] [Scholar Register] [Received: 03/07/2024] [Revised: 04/06/2024] [Accepted: 04/11/2024] [Indexed: 04/28/2024]
Abstract
Background and Objectives: The study aims to provide a comprehensive neuropsychological analysis of psychotic spectrum disorders, including schizophrenia, bipolar disorder, and depression. It focuses on the critical aspects of cognitive impairments, diagnostic tools, intervention efficacy, and the roles of genetic and environmental factors in these disorders. The paper emphasizes the diagnostic significance of neuropsychological tests in identifying cognitive deficiencies and their predictive value in the early management of psychosis. Materials and Methods: The study involved a systematic literature review following the PRISMA guidelines. The search was conducted in significant databases like Scopus, PsycINFO, PubMed, and Web of Science using keywords relevant to clinical neuropsychology and psychotic spectrum disorders. The inclusion criteria required articles to be in English, published between 2018 and 2023, and pertinent to clinical neuropsychology's application in these disorders. A total of 153 articles were identified, with 44 ultimately included for detailed analysis based on relevance and publication status after screening. Results: The review highlights several key findings, including the diagnostic and prognostic significance of mismatch negativity, neuroprogressive trajectories, cortical thinning in familial high-risk individuals, and distinct illness trajectories within psychosis subgroups. The studies evaluated underline the role of neuropsychological tests in diagnosing psychiatric disorders and emphasize early detection and the effectiveness of intervention strategies based on cognitive and neurobiological markers. Conclusions: The systematic review underscores the importance of investigating the neuropsychological components of psychotic spectrum disorders. It identifies significant cognitive impairments in attention, memory, and executive function, correlating with structural and functional brain abnormalities. The paper stresses the need for precise diagnoses and personalized treatment modalities, highlighting the complex interplay between genetic, environmental, and psychosocial factors. It calls for a deeper understanding of these neuropsychological processes to enhance diagnostic accuracy and therapeutic outcomes.
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Affiliation(s)
- Evgenia Gkintoni
- Department of Psychiatry, University General Hospital of Patras, 26504 Patras, Greece; (M.S.); (P.G.)
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Alexopoulos P, Skondra M, Charalampopoulou M, Georgiou EEZ, Demertzis AA, Aligianni SΙ, Gourzis P, Politis A, Εconomou P, Daoussis D. Low cognitive functioning and depressive symptoms in patients with rheumatoid arthritis and systemic sclerosis: a clinical study. BMC Psychiatry 2023; 23:513. [PMID: 37464342 DOI: 10.1186/s12888-023-04995-3] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/28/2023] [Accepted: 07/02/2023] [Indexed: 07/20/2023] Open
Abstract
BACKGROUND Recently, cognitive deficits occurring in rheumatic diseases have attracted scientific attention. Cognitive symptoms in patients with Rheumatoid Arthritis (RA) and Systemic Sclerosis (SSc) have not been thoroughly studied. This study aimed to assess cognitive function and its relationship with depressive symptoms in RA and SSc and compare it to mild neurocognitive disorder due to Alzheimer's disease (MiND) and to individuals without cognitive impairment. METHODS Cognitive function and depressive symptoms were tapped with the Cognitive Telephone Screening Instrument plus (COGTEL+), the Serial Seven Test (SST), the Mini-Mental State Examination (MMSE) and the Geriatric Depression scale-15 (GDS), respectively. Statistical analyses included between groups-, correlation- and regression analyses. Demographic characteristics were considered in the regression models. RESULTS The study included 30 individuals with RA, 24 with SSc, 26 adults without cognitive impairment and 33 individuals with MiND. Lower performance in verbal short-term memory, concentration/attention, verbal fluency and MMSE in patients with RA compared to individuals without cognitive impairment was detected. Of note, performance on verbal fluency, concentration/attention, inductive reasoning and MMSE was lower in RA compared to MiND. Individuals with SSc performed worse in verbal fluency and in MMSE in comparison to adults without cognitive deficits. Verbal fluency deficits in SSc exceeded that in MiND. Performance on MMSE, COGTEL+, prospective memory, working memory, verbal fluency and concentration/attention was related to GDS scores, which did not vary across the groups. CONCLUSIONS Patients with RA and SSc encountered cognitive dysfunction, which partially pertains to depressive symptoms. Of note, the severity of cognitive dysfunction in many cases exceeded that of MiND.
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Affiliation(s)
- Panagiotis Alexopoulos
- Mental Health Services, Department of Medicine, School of Health Sciences, Patras University Hospital, University of Patras, Rion 26504, Patras, Greece.
- Global Brain Health Institute, School of Medicine, Trinity College Dublin, University of Dublin, Dublin, Republic of Ireland.
- Department of Psychiatry and Psychotherapy, Klinikum rechts der Isar, Faculty of Medicine, Technical University of Munich, Munich, Germany.
| | - Maria Skondra
- Mental Health Services, Department of Medicine, School of Health Sciences, Patras University Hospital, University of Patras, Rion 26504, Patras, Greece
| | - Marina Charalampopoulou
- Mental Health Services, Department of Medicine, School of Health Sciences, Patras University Hospital, University of Patras, Rion 26504, Patras, Greece
| | - Eliza Eleni-Zacharoula Georgiou
- Mental Health Services, Department of Medicine, School of Health Sciences, Patras University Hospital, University of Patras, Rion 26504, Patras, Greece
| | - Antonios Alexandros Demertzis
- Mental Health Services, Department of Medicine, School of Health Sciences, Patras University Hospital, University of Patras, Rion 26504, Patras, Greece
| | - Suzana Ιoanna Aligianni
- Mental Health Services, Department of Medicine, School of Health Sciences, Patras University Hospital, University of Patras, Rion 26504, Patras, Greece
| | - Philippos Gourzis
- Mental Health Services, Department of Medicine, School of Health Sciences, Patras University Hospital, University of Patras, Rion 26504, Patras, Greece
| | - Antonios Politis
- First Department of Psychiatry, Eginition Hospital, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
- Department of Psychiatry, Division of Geriatric Psychiatry and Neuropsychiatry, Johns Hopkins Medical School, Baltimore, USA
| | - Polychronis Εconomou
- Department of Civil Engineering (Statistics), School of Engineering, University of Patras, Patras, Greece
| | - Dimitrios Daoussis
- Department of Rheumatology, University of Patras Medical School, Patras, Greece
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Vinni E, Karaivazoglou K, Tourkochristou E, Tsounis E, Kalogeropoulou M, Konstantopoulou G, Lourida T, Kafentzi T, Lampropoulou E, Rodi M, Aggeletopoulou I, Diamantopoulou G, Theocharis G, Thomopoulos K, Gourzis P, Mouzaki A, Triantos C. Alexithymic characteristics and interoceptive abilities are associated with disease severity and levels of C-reactive protein and cytokines in patients with inflammatory bowel disease. Ann Gastroenterol 2023; 36:412-422. [PMID: 37396003 PMCID: PMC10304527 DOI: 10.20524/aog.2023.0813] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2022] [Accepted: 05/12/2023] [Indexed: 07/04/2023] Open
Abstract
Background Alexithymia and atypical gut-brain signaling have been linked to the pathophysiology of inflammatory bowel disease (IBD). We herein assessed IBD patients' alexithymia levels and interoceptive abilities, and detected potential correlations with psychological distress, symptom severity and disease activity, and inflammation indices. Methods Adult IBD outpatients and healthy controls were recruited. Alexithymia was assessed using the Toronto Alexithymia Scale, interoceptive accuracy using the Heartbeat Counting Test (cardiac interoception) and the Water Load Test-II (gastric interoception), and interoceptive sensibility using the Multidimensional Assessment of Interoceptive Awareness (MAIA). Results Forty-one patients with Crohn's disease (CD), 16 with ulcerative colitis (UC), and 50 healthy controls were included. In CD patients, the level of externally oriented thinking and total alexithymia score were correlated with disease activity (P=0.027 and P=0.047, respectively), while in UC patients difficulties in identifying emotions were linked to disease activity (P=0.007). In CD patients, the Noticing, Not-Worrying and Emotional Awareness MAIA subscale score were correlated with C-reactive protein levels (P=0.005, P=0.048 and P=0.005), the Noticing subscale score with interleukin (IL)-1β levels (r=-0.350, P=0.039), the Not-Distracting subscale score with IL-6 levels (r=-0.402, P=0.017), and the Emotional Awareness subscale score with IL-1β (r=-0.367, P=0.030) and IL-6 (r=-0.379, P=0.025) levels. Finally, in UC patients, the Not-Worrying subscale score was significantly associated with IL-6 levels (r=-0.532, P=0.049), while difficulties in identifying emotions were linked to IL-8 levels (r=0.604, P=0.022). Conclusion Emotional and interoceptive processing is associated with IBD disease activity, suggesting a potential implication for IBD pathophysiology.
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Affiliation(s)
- Eleni Vinni
- Division of Gastroenterology, Department of Internal Medicine (Eleni Vinni, Evanthia Tourkochristou, Efthymios Tsounis, Theoni Lourida, Theodora Kafentzi, Efi Lampropoulou, Ioanna Aggeletopoulou, Georgia Diamantopoulou, Georgios Theocharis, Konstantinos Thomopoulos, Christos Triantos)
| | - Katerina Karaivazoglou
- Department of Psychiatry (Katerina Karaivazoglou, Maria Kalogeropoulou, Georgia Konstantopoulou, Philippos Gourzis)
| | - Evanthia Tourkochristou
- Division of Gastroenterology, Department of Internal Medicine (Eleni Vinni, Evanthia Tourkochristou, Efthymios Tsounis, Theoni Lourida, Theodora Kafentzi, Efi Lampropoulou, Ioanna Aggeletopoulou, Georgia Diamantopoulou, Georgios Theocharis, Konstantinos Thomopoulos, Christos Triantos)
| | - Efthymios Tsounis
- Division of Gastroenterology, Department of Internal Medicine (Eleni Vinni, Evanthia Tourkochristou, Efthymios Tsounis, Theoni Lourida, Theodora Kafentzi, Efi Lampropoulou, Ioanna Aggeletopoulou, Georgia Diamantopoulou, Georgios Theocharis, Konstantinos Thomopoulos, Christos Triantos)
| | - Maria Kalogeropoulou
- Department of Psychiatry (Katerina Karaivazoglou, Maria Kalogeropoulou, Georgia Konstantopoulou, Philippos Gourzis)
| | - Georgia Konstantopoulou
- Department of Psychiatry (Katerina Karaivazoglou, Maria Kalogeropoulou, Georgia Konstantopoulou, Philippos Gourzis)
| | - Theoni Lourida
- Division of Gastroenterology, Department of Internal Medicine (Eleni Vinni, Evanthia Tourkochristou, Efthymios Tsounis, Theoni Lourida, Theodora Kafentzi, Efi Lampropoulou, Ioanna Aggeletopoulou, Georgia Diamantopoulou, Georgios Theocharis, Konstantinos Thomopoulos, Christos Triantos)
| | - Theodora Kafentzi
- Division of Gastroenterology, Department of Internal Medicine (Eleni Vinni, Evanthia Tourkochristou, Efthymios Tsounis, Theoni Lourida, Theodora Kafentzi, Efi Lampropoulou, Ioanna Aggeletopoulou, Georgia Diamantopoulou, Georgios Theocharis, Konstantinos Thomopoulos, Christos Triantos)
| | - Efi Lampropoulou
- Division of Gastroenterology, Department of Internal Medicine (Eleni Vinni, Evanthia Tourkochristou, Efthymios Tsounis, Theoni Lourida, Theodora Kafentzi, Efi Lampropoulou, Ioanna Aggeletopoulou, Georgia Diamantopoulou, Georgios Theocharis, Konstantinos Thomopoulos, Christos Triantos)
| | - Maria Rodi
- Division of Hematology, Department of Internal Medicine, Medical School (Maria Rodi, Ioanna Aggeletopoulou, Athanasia Mouzaki), University of Patras, Greece
| | - Ioanna Aggeletopoulou
- Division of Gastroenterology, Department of Internal Medicine (Eleni Vinni, Evanthia Tourkochristou, Efthymios Tsounis, Theoni Lourida, Theodora Kafentzi, Efi Lampropoulou, Ioanna Aggeletopoulou, Georgia Diamantopoulou, Georgios Theocharis, Konstantinos Thomopoulos, Christos Triantos)
- Division of Hematology, Department of Internal Medicine, Medical School (Maria Rodi, Ioanna Aggeletopoulou, Athanasia Mouzaki), University of Patras, Greece
| | - Georgia Diamantopoulou
- Division of Gastroenterology, Department of Internal Medicine (Eleni Vinni, Evanthia Tourkochristou, Efthymios Tsounis, Theoni Lourida, Theodora Kafentzi, Efi Lampropoulou, Ioanna Aggeletopoulou, Georgia Diamantopoulou, Georgios Theocharis, Konstantinos Thomopoulos, Christos Triantos)
| | - Georgios Theocharis
- Division of Gastroenterology, Department of Internal Medicine (Eleni Vinni, Evanthia Tourkochristou, Efthymios Tsounis, Theoni Lourida, Theodora Kafentzi, Efi Lampropoulou, Ioanna Aggeletopoulou, Georgia Diamantopoulou, Georgios Theocharis, Konstantinos Thomopoulos, Christos Triantos)
| | - Konstantinos Thomopoulos
- Division of Gastroenterology, Department of Internal Medicine (Eleni Vinni, Evanthia Tourkochristou, Efthymios Tsounis, Theoni Lourida, Theodora Kafentzi, Efi Lampropoulou, Ioanna Aggeletopoulou, Georgia Diamantopoulou, Georgios Theocharis, Konstantinos Thomopoulos, Christos Triantos)
| | - Philippos Gourzis
- Department of Psychiatry (Katerina Karaivazoglou, Maria Kalogeropoulou, Georgia Konstantopoulou, Philippos Gourzis)
| | - Athanasia Mouzaki
- Division of Hematology, Department of Internal Medicine, Medical School (Maria Rodi, Ioanna Aggeletopoulou, Athanasia Mouzaki), University of Patras, Greece
| | - Christos Triantos
- Division of Gastroenterology, Department of Internal Medicine (Eleni Vinni, Evanthia Tourkochristou, Efthymios Tsounis, Theoni Lourida, Theodora Kafentzi, Efi Lampropoulou, Ioanna Aggeletopoulou, Georgia Diamantopoulou, Georgios Theocharis, Konstantinos Thomopoulos, Christos Triantos)
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Kouznetsov R, Angelopoulos P, Moulinos S, Dimakos I, Gourzis P, Jelastopulu E. Epidemiological Study of Autism Spectrum Disorders in Greece for 2021: Nationwide Prevalence in 2–17-Year-Old Children and Regional Disparities. J Clin Med 2023; 12:jcm12072510. [PMID: 37048594 PMCID: PMC10095433 DOI: 10.3390/jcm12072510] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2023] [Revised: 03/16/2023] [Accepted: 03/23/2023] [Indexed: 03/29/2023] Open
Abstract
This study estimated the crude prevalence of autism spectrum disorders (ASD) in Greece in 2021. A retrospective study was conducted for 2021 using data provided for research purposes for the first time by the Greek National Health Service Organization for Healthcare Services Provision (EOPYY) related to the ICD-10 diagnosis codes F84.0–F84.9 (ASD). Treatments were categorized by gender, age, and location. Statistical analysis was performed using the open-source software R. In total, 15,706 children aged 2–17 years were registered with ASD: 12,380 boys and 3326 girls. In total, 6,117,910 therapies were prescribed: 4,844,173 for boys and 1,273,737 for girls. Boys are estimated to be diagnosed 3.5 times more often than girls. On average, approximately 390 treatments are prescribed per person per year for both sexes. The annual prevalence is estimated at 0.94%, ranging from 0.42% to 1.44% depending on geographic region. Our findings provide evidence-based data for the planning of policies regarding health, education, and employment for people with ASD. The number of children and treatments makes ASD a public health concern to support children and their families and ensure equal participation in all aspects of society.
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Affiliation(s)
- Raissa Kouznetsov
- Department of Public Health, School of Medicine, University of Patras, 26504 Patras, Greece
| | | | - Spyridon Moulinos
- Department of Digital Media and Communication, Ionian University, 49100 Kerkira, Greece
| | - Ioannis Dimakos
- Department of Educational Sciences and Social Work, University of Patras, 26504 Patras, Greece
| | - Philippos Gourzis
- Department of Psychiatry, School of Medicine, University of Patras, 26504 Patras, Greece
| | - Eleni Jelastopulu
- Department of Public Health, School of Medicine, University of Patras, 26504 Patras, Greece
- Correspondence:
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Bakola M, Peritogiannis V, Stuckler D, Kitsou KS, Gourzis P, Hyphantis T, Jelastopulu E. Who is coercively admitted to psychiatric wards? Epidemiological analysis of inpatient records of involuntary psychiatric admissions to a University General Hospital in Greece for the years 2008-2017. Int J Soc Psychiatry 2023; 69:267-276. [PMID: 35232289 DOI: 10.1177/00207640221081793] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [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: 11/15/2022]
Abstract
BACKGROUND Involuntary psychiatric admissions are a widely used practice despite ethical concerns about coercion. There are particular concerns that vulnerable groups, such as single, unemployed or racial minorities, may be more subjected to such practices. AIM We aimed to investigate the social patterns of involuntary psychiatric admissions from 2008 to 2017 at University General Hospital in Ioannina, Greece. METHOD We retrospectively assessed inpatient records from 2008 to 2017 of patients admitted to the Department of Psychiatry of the Ioannina University General Hospital, Northwestern Greece. Alternative patients of alternative years were selected for inclusion; this yielded 332 patients involuntarily admitted, corresponding to 28.5% of total involuntary psychiatric admissions. RESULTS Over the 10-year period, the overall numbers of annual involuntary psychiatric admissions remained relatively stable, as did the length of hospital stay (mean = 23.8 days). The most common disorder upon admission was schizophrenia spectrum disorders, accounting for approximately two-thirds of all admissions, followed by mood disorders (about 20%). There was evidence that people who lacked social support or experienced financial hardship were more greatly represented among those admitted: 70.2% of admitted patients were single and 64.8% were unemployed. Most patients had been admitted to the psychiatric ward in the past (64.2%). CONCLUSION Our study indicates potentially worrisome evidence that patients who are in vulnerable positions are at elevated likelihood of being involuntarily admitted to psychiatric wards. Future research is needed to evaluate the socio-demographic patterning of involuntary admissions in other European countries.
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Affiliation(s)
- Maria Bakola
- Postgraduate Program of Public Health, Medical School, University of Patras, Greece
| | - Vaios Peritogiannis
- Mobile Mental Health Unit of the Prefectures of Ioannina and Thesprotia, Society for the Promotion of Mental Health in Epirus, Ioannina, Greece
| | - David Stuckler
- Department of Social and Political Sciences, University of Bocconi, Milan, Italy
| | | | - Philippos Gourzis
- Department of Psychiatry, Medical School, University of Patras, Greece
| | - Thomas Hyphantis
- Department of Psychiatry, Division of Medicine, School of Health Sciences, University of Ioannina, Greece
| | - Eleni Jelastopulu
- Department of Public Health, Medical School, University of Patras, Greece
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Skokou M, Messinis L, Nasios G, Gourzis P, Dardiotis E. Cognitive Rehabilitation for Patients with Schizophrenia: A Narrative Review of Moderating Factors, Strategies, and Outcomes. Adv Exp Med Biol 2023; 1423:193-199. [PMID: 37525044 DOI: 10.1007/978-3-031-31978-5_17] [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] [Subscribe] [Scholar Register] [Indexed: 08/02/2023]
Abstract
OBJECTIVE Antipsychotic drugs constitute the basis of schizophrenia therapy; however, available pharmaceutical agents lack efficacy for treating the cognitive deficits caused by the illness. The aim of the present work is to present current data regarding cognitive rehabilitation of schizophrenia, providing information and guidance to health professionals. METHOD A literature search was conducted in the PubMed and Google Scholar Databases from inception up to 1/9/2022. Relevant articles were explored for factors affecting cognitive function, including genetics, psychopathology, time in the course of the illness, and drug therapy. Characteristics and outcome of cognitive rehabilitation programs are briefly presented. RESULTS A total of 562 relevant articles were retrieved, 39 of which were selected for the review. Factors contributing to a favorable outcome are young age, early phase of disease, symptomatic control of hostility and conceptual disorganization, lack of negative symptoms, management of drug side effects, and cognitive and cortical reserve. Some evidence for a procognitive effect seems to exist for atypical antipsychotics, clozapine, aripiprazole, memantine, modafinil, d-serine, and cycloserine. The Val/Val polymorphism of the COMT gene seems to be associated with worse outcome. Specific remediation strategies include programs such as Cognitive Enhancement Therapy (CET), Cognitive Adaptation Training (CAT), and RehaCom Cognitive Therapy Software, among others, all employing a range of techniques, from paper-and-pencil to computer-assisted, bottom-up, or top-down approaches, and varying neurocognitive targets. CONCLUSION Cognitive symptoms, closely related to functional impairment, still remain a therapeutic challenge. Cognitive rehabilitation strategies are as yet the only treatment modality offering cognitive improvement to patients who struggle to recover.
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Affiliation(s)
- Maria Skokou
- Department of Psychiatry, General University Hospital of Patras, University of Patras, Patras, Greece
| | - Lambros Messinis
- Lab of Cognitive Neuroscience, School of Psychology, Aristotle University of Thessaloniki, Thessaloniki, Greece.
| | - Grigorios Nasios
- Department of Speech and Language Therapy, School of Health Sciences, University of Ioannina, Ioannina, Greece
| | - Philippos Gourzis
- Department of Psychiatry, General University Hospital of Patras, University of Patras, Patras, Greece
| | - Euthymios Dardiotis
- University of Thessaly, Department of Neurology, Laboratory of Neurogenetics, Larissa, Greece
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Savvopoulou N, Assimakopoulos K, Gourzis P, Jelastopulu E. Eating habits during quarantine: Investigating the role of emotions and loneliness in a sample of adults in Greece. Eur Psychiatry 2022. [PMCID: PMC9566874 DOI: 10.1192/j.eurpsy.2022.1364] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Introduction
Imposing quarantine as a measure to manage the coronavirus pandemic is a stressful event that is often associated with negative psychological effects. Eating habits seemed to be significantly affected during the quarantine, while strong negative emotions were triggered as the feeling of loneliness increased at the same time.
Objectives
This study aims to investigate the eating habits of individuals during quarantine and the role of positive and negative emotions and loneliness in shaping these habits.
Methods
An online cross-sectional study was performed using 3 validated scales, EAT-26 (3 subscales: Dieting, Bulimia and Food Preoccupation, Oral Control), Modified Differential Emotions Scale and UCLA Loneliness Scale. Data was collected between April and May 2021 mainly from social media platforms. Statistical analyses included linear regression and mediation analyses.
Results
Abnormal eating habits were detected in 25% of the participants (N= 450, ages 18-74) while the majority reported medium rates of negative/positive emotions and loneliness. Female sex is associated with abnormal eating habits (p=0.010) and mainly dietary behaviors (p=0.029). Negative emotions (p=0.032) and loneliness (p=0.001) seem to be predictive factors of eating habits in general and bulimic behaviors. Negative emotions correlate directly with eating habits. However, we found a significant mediation of loneliness (p=0.032). Furthermore, the observed association between negative emotions and bulimia is partly mediated by loneliness (p=0.018).
Conclusions
Negative emotions and loneliness seemed to play an important role in shaping eating habits during quarantine. Multilevel public health interventions are needed to address the negative effects of quarantine and pandemic in general.
Disclosure
No significant relationships.
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Giourou E, Theodoropoulou A, Yfantis S, Prodromaki O, Georgila E, Gourzis P. Affective disorder associated with post-traumatic epilepsy, misdiagnosis and under treatment: A case report. Eur Psychiatry 2022. [PMCID: PMC9567767 DOI: 10.1192/j.eurpsy.2022.1147] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Introduction A history of traumatic brain injury (TBI) is often associated with acquired epilepsy, which is associated with psychiatric co-morbidity, that when undetected might lead to misdiagnosis and mistreatment. Objectives The objective is to present the case of a 47-years-old male with a history of TBI and undetected acquired epilepsy, with a subsequent treatment resident mood disorder that was lead to a full clinical remission once epileptic activity was controlled using anti-seizure monotherapy. Methods After compulsory admittion to our inpatient psychiatric unit because of suicidal ideation and persistent aggressive behavior with volatile mood swings, the patient was fully evaluated and his psychiatric and medical histories were recorded. A brain CT scan and EEG were performed. Laboratory tests excluded other medical co-morbidity. Results The patient had a previous history of TBI and subsequent multiple episodes of mood disorders that failed to reach full remission even if treated with antidepressives and antipsychotics for adequate time and dosage according to current quidelines. EEG was positive for epileptiform activity with sporadic slow theta waves and right frontotemporal epileptic-like features while the patient was free of clinical seizures. Carbamazepine was initiated and titrated up to 1200mg daily leading to the full remission of the initial clinical symptoms along with the EEG findings’ improvement. The patient remained stable with his functionality at its utmost recovery during the two-years follow-up evaluations. Conclusions TBI induced epilepsy might be under-diagnosed in the absence of clinical seizures leading to the mistreatment of the associated psychiatric disorders that could be the only clinical presentation of the underlying pathology. Disclosure No significant relationships.
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Giourou E, Theodoropoulou A, Batzikosta P, Prodromaki O, Georgila E, Gourzis P. A case report of eosinophilia associated with risperidone withdrawl in a patient with schizophrenia. Eur Psychiatry 2022. [PMCID: PMC9567693 DOI: 10.1192/j.eurpsy.2022.1837] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Introduction Risperidone, a second generation antipsychotic, shows high affinity with serotoninergic and dopaminergic D2 receptors, but also adrenergic and H1 histaminergic receptors. Previous studies have shown an increase in eosinophile count associated with the second-generation antipsychotics through the histaminergic path. Objectives The presentation of a case in which eosinophilia was associated with risperidone withdrawl which has not been described so far. Methods A 46-year-old woman with schizophrenia diagnosed at the age of 22 was admitted in our inpatient psychiatric clinic with psychotic symptoms relapse after she voluntarily discontinued risperidone. The patient was fully evaluated with full laboratory tests, a brain CT scan, EEG and her medical and psychiatric histories were recorded. Results Risperidone was reinitiated but due to the persistence of symptoms it was switched to clozapine which lead to full remission. It was observed though, that while gradually decreasing risperidone dosage (Figure 1.), eosinophile count was raising and it was normalized after complete discontinuation. Eosinophilia was also present in other instances that the patient discontinued taking risperidone according to her personal history. Other causes of eosinophilia (allergic, inflammatory) were fully excluded. ![]()
Conclusions Risperidone discontinuation could lead to an elevated eosinophile count. There is limited research in this topic and it is yet to be clarified whether the elevation is due to stopping one antipsychotic or switching between two different antipsychotics. It is important to run laboratory tests regularly with every treatment modification. Disclosure No significant relationships.
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Alexopoulos P, Roukas D, Efkarpidis A, Konstantopoulou G, Soldatos R, Karaivazoglou K, Kontogianni E, Assimakopoulos K, Iliou T, Εconomou P, Gourzis P, Politis A. Hospital workforce mental reaction to the pandemic in a low COVID-19 burden setting: a cross-sectional clinical study. Eur Arch Psychiatry Clin Neurosci 2022; 272:95-105. [PMID: 33904979 PMCID: PMC8078092 DOI: 10.1007/s00406-021-01262-y] [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] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/31/2020] [Accepted: 04/20/2021] [Indexed: 11/26/2022]
Abstract
Τhe COVID-19 pandemic has mental health implications for both healthcare workforces and general population, particularly in regions heavily hit by the crisis. Τhe study aimed (i) to investigate anxiety- and depression severity differences between staff of a COVID-19 treatment unit (N = 84) and a hospital without such a unit (N = 55) in comparison to participants of a convenience general population online survey (N = 240) and (ii) to explore relations between such symptoms and hospital staff reaction to COVID-19 in a low COVID-19 burden setting. Anxiety was studied with the Generalized Anxiety Disorder 7-Item in hospital workforces and with the Hospital Anxiety Depression Scale (HADS) in online survey participants. Depression symptoms were assessed with the Patient Health Questionnaire-9 in hospital employees and the HADS in the online survey sample. Symptoms were classified as absent/minimal, borderline abnormal or indicating clinical caseness. Staff reaction to COVID-19 was tapped with a 9-item-questionnaire and the 22-item Impact of Event Scale-revised (IES-R). Proper tests for differences and stepwise ordered logistic regression models were employed. Anxiety- and depression severity was higher in hospital workforces than in online survey participants (P < 0.05). Anxiety was more severe in frontline- compared to backstage employees (P < 0.001) was inversely correlated with age (P = 0.011) and positively with avoidance (P = 0.028). Both anxiety and depression symptoms related to intrusion symptoms (P < 0.001). Regarding the relatively long data collection period, an inverse association between crisis duration and depression symptoms was detected (P = 0.025). These observations point to the urgent need for distress-mitigating interventions for hospital workforces even in low COVID-19 burden settings.
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Affiliation(s)
- Panagiotis Alexopoulos
- Department of Psychiatry, Faculty of Medicine, School of Health Sciences, Patras University General Hospital, University of Patras, Patras, Greece.
- Department of Psychiatry and Psychotherapy, Klinikum Rechts Der Isar, Faculty of Medicine, Technische Universität München, Munich, Germany.
| | - Dimitrios Roukas
- Department of Psychiatry, 417 Army Equity Fund Hospital (NIMTS) Hospital, Athens, Greece
| | - Apostolos Efkarpidis
- Nursing Services Department, General Hospital of Syros "Vardakeio and Proio", Ermoupolis, Greece
| | - Georgia Konstantopoulou
- Special Office for Health Consulting Services and Faculty of Education and Social Work, School of Humanities and Social Sciences, University of Patras, Patras, Greece
| | - Rigas Soldatos
- First Department of Psychiatry, School of Medicine, Eginition Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Katerina Karaivazoglou
- Department of Psychiatry, Faculty of Medicine, School of Health Sciences, Patras University General Hospital, University of Patras, Patras, Greece
| | - Evagellia Kontogianni
- First Department of Psychiatry, School of Medicine, Eginition Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Konstantinos Assimakopoulos
- Department of Psychiatry, Faculty of Medicine, School of Health Sciences, Patras University General Hospital, University of Patras, Patras, Greece
| | - Theodoros Iliou
- Medical Informatics Laboratory, Faculty of Medicine, School of Health Sciences, Democritus University of Thrace, Alexandroupolis, Greece
| | - Polychronis Εconomou
- Department of Civil Engineering (Statistics), University of Patras, Patras, Greece
| | - Philippos Gourzis
- Department of Psychiatry, Faculty of Medicine, School of Health Sciences, Patras University General Hospital, University of Patras, Patras, Greece
| | - Antonios Politis
- First Department of Psychiatry, School of Medicine, Eginition Hospital, National and Kapodistrian University of Athens, Athens, Greece
- Division of Geriatric Psychiatry and Neuropsychiatry, Department of Psychiatry, Johns Hopkins Medical School, Baltimore, MD, USA
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Goula P, Iconomou G, Gourzis P, Kalofonos HP, Georgila E, Maria A, Assimakopoulos K. Prospective assessment of psychopathological symptoms and their relation to demographic factors in primary caregivers of cancer patients throughout chemotherapy. Support Care Cancer 2021; 30:2467-2475. [PMID: 34779919 DOI: 10.1007/s00520-021-06662-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2021] [Accepted: 10/27/2021] [Indexed: 11/24/2022]
Abstract
PURPOSE The present study aims to investigate the course of psychological symptoms through chemotherapy in a sample of primary caregivers of patients with cancer and to examine all possible correlations between psychological distress and demographic characteristics. METHODS In this prospective study, 112 primary family caregivers of cancer patients were evaluated. Symptom checklist 90 revised (SCL-90-R) was administered to assess their pathological symptoms, the Hospital Anxiety and Depression Scale (HADS) to assess depression and anxiety. There was an evaluation at the beginning of chemotherapy and a second at the end of the patients' intravenous chemotherapy treatment (EOT). RESULTS A total of 112 primary caregivers were initially enrolled in the study, and 99 (88.4%) completed it. Caregivers' psychopathology was low to moderate at both points of time (baseline and EOT). However, a considerable decrease in the Global Severity Index (GSI) emerged over time. CONCLUSIONS At EOT, participants reported statistically significant decreases in five aspects of SCL 90, namely Depression, phobic anxiety, obsessive-compulsive symptoms, somatization, and psychoticism. A notable finding was that female caregivers were significantly more distressed, especially when providing care to a male recipient.
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Affiliation(s)
- Panagiota Goula
- Psychiatric Clinic, School of Health Sciences, Department of Medicine, University of Patras, Rion, 265 04, Patras, Greece.
| | - Gregoris Iconomou
- Division of Oncology, School of Health Sciences, Department of Medicine, University of Patras Medical School, Rion, Patras, Greece
| | - Philippos Gourzis
- Psychiatric Clinic, School of Health Sciences, Department of Medicine, University of Patras, Rion, 265 04, Patras, Greece
| | - Haralabos P Kalofonos
- Division of Oncology, School of Health Sciences, Department of Medicine, University of Patras Medical School, Rion, Patras, Greece
| | - Eleni Georgila
- Division of Oncology, School of Health Sciences, Department of Medicine, University of Patras Medical School, Rion, Patras, Greece
| | - Adraskela Maria
- Psychiatric Clinic, School of Health Sciences, Department of Medicine, University of Patras, Rion, 265 04, Patras, Greece
| | - Konstantinos Assimakopoulos
- Psychiatric Clinic, School of Health Sciences, Department of Medicine, University of Patras, Rion, 265 04, Patras, Greece
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Alexopoulos P, Skondra M, Kontogianni E, Vratsista A, Frounta M, Konstantopoulou G, Aligianni SI, Charalampopoulou M, Lentzari I, Gourzis P, Kliegel M, Economou P, Politis A. Validation of the Cognitive Telephone Screening Instruments COGTEL and COGTEL+ in Identifying Clinically Diagnosed Neurocognitive Disorder Due to Alzheimer's Disease in a Naturalistic Clinical Setting. J Alzheimers Dis 2021; 83:259-268. [PMID: 34275904 PMCID: PMC8461705 DOI: 10.3233/jad-210477] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Background: Telephone-based neurocognitive instruments embody valuable tools in identifying cognitive impairment in research settings and lately also in clinical contexts due to the pandemic crisis. The accuracy of the Cognitive Telephone Screening Instrument (COGTEL) in detecting mild- (MiND) and major (MaND) neurocognitive disorder has not been studied yet. Objective: Comparison of the utility of COGTEL and COGTEL+, which is enriched with orientation items, with the modified Mini-Mental State Examination (3MS) in detecting MiND and MaND due to Alzheimer’s disease (AD) and assessment of the impact of COGTEL face-to-face-versus telephone administration on individual performance. Methods: The study included 197 cognitively intact individuals (CI), being at least 45 years old, 95 and 65 patients with MiND and MaND due to AD, respectively. In 20 individuals COGTEL was administered both in face-to-face and telephone sessions. Statistical analyses included proportional odds logistic regression models, stratified repeated random subsampling used to recursive partitioning to training and validation set (70/30 ratio), and an appropriate F-test. Results: All studied instruments were significant predictors of diagnostic outcome, but COGTEL+ and 3MS explained more variance relative to the original COGTEL. Except for the validation regression models including COGTEL in which the average misclassification error slightly exceeded 15%, in all other cases the average misclassification errors (%) were lower than 15%. COGTEL administration modality was not related to systematic over- or underestimation of performance on COGTEL. Conclusion: COGTEL+ is a valuable instrument in detecting MiND and MaND and can be administered in face-to-face or telephone sessions.
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Affiliation(s)
- Panagiotis Alexopoulos
- Department of Psychiatry, Patras University Hospital, Faculty of Medicine, School of Health Sciences, University of Patras, Patras, Greece.,Department of Psychiatry and Psychotherapy, Klinikum rechts der Isar, Faculty of Medicine, Technical University of Munich, Munich, Germany.,Psychogeriatric Unit for Neurocognitive Assessment and Caregiver Counselling, Patras Office of The Hellenic Red Cross, Patras, Greece.,Patras Dementia Day Care Center, Corporation for Succor and Care of Elderly and Disabled -FRODIZO, Patras, Greece
| | - Maria Skondra
- Department of Psychiatry, Patras University Hospital, Faculty of Medicine, School of Health Sciences, University of Patras, Patras, Greece.,Psychogeriatric Unit for Neurocognitive Assessment and Caregiver Counselling, Patras Office of The Hellenic Red Cross, Patras, Greece
| | - Evagellia Kontogianni
- First Department of Psychiatry, Eginition Hospital, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | | | - Maria Frounta
- Patras Dementia Day Care Center, Corporation for Succor and Care of Elderly and Disabled -FRODIZO, Patras, Greece
| | - Georgia Konstantopoulou
- Special Office for Health Consulting Services and Faculty of Education and Social Work, School of Humanities and Social Sciences, University of Patras, Patras, Greece
| | - Suzana Ioanna Aligianni
- Department of Psychiatry, Patras University Hospital, Faculty of Medicine, School of Health Sciences, University of Patras, Patras, Greece
| | - Marina Charalampopoulou
- Department of Psychiatry, Patras University Hospital, Faculty of Medicine, School of Health Sciences, University of Patras, Patras, Greece
| | - Iliana Lentzari
- Department of Psychiatry, Patras University Hospital, Faculty of Medicine, School of Health Sciences, University of Patras, Patras, Greece
| | - Philippos Gourzis
- Department of Psychiatry, Patras University Hospital, Faculty of Medicine, School of Health Sciences, University of Patras, Patras, Greece
| | - Matthias Kliegel
- Laboratory of Cognitive Aging, University of Geneva, Geneva, Switzerland
| | - Polychronis Economou
- Department of Civil Engineering (Statistics), School of Engineering, University of Patras, Patras, Greece
| | - Antonios Politis
- First Department of Psychiatry, Eginition Hospital, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece.,Department of Psychiatry, Division of Geriatric Psychiatry and Neuropsychiatry, Johns Hopkins Medical School, Baltimore, MD, USA
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Skokou M, Asimakopoulou R, Andreopoulou O, Kolettis G, Perrou S, Gourzis P, Daskalaki S. Reliability, validity and psychometric properties of the Greek version of the Altman self rating mania scale. Compr Psychiatry 2021; 109:152243. [PMID: 34271257 DOI: 10.1016/j.comppsych.2021.152243] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/19/2020] [Revised: 03/17/2021] [Accepted: 04/14/2021] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Although self-rating mania scales have been developed, a lack of such instruments validated for the Greek population is noted. This study aims to examine the validity, reliability and psychometric properties of the Altman Self Rating Mania Scale (ASRM) adapted in Greek (G-ASRM). METHODS A sample of 86 consecutive inpatient and outpatient bipolar patients diagnosed by the DSM-5 criteria and 37 healthy controls were assessed by using the Young Mania Rating Scale (YMRS) and the Montgomery Asberg Depression Rating Scale (MADRS), and self-administered the G-ASRM. Factor analysis, test-retest analysis, measurement invariance tests, mean differences, Pearson's Correlation analysis and ROC analysis were used to confirm the validity of G-ASRM as a scale, test its reliability, study its psychometric properties in different subgroups and establish a cut-off value for indicating the presence of (hypo)mania in BD patients. Also, regression models were built to expose dependencies between YMRS and G-ASRM items. RESULTS Monofactoriality of the scale was verified, based on Exploratory Factor Analysis (EFA). Cronbach's alpha was 0.895. G-ASRM is highly correlated with YMRS (r = 0.856, p < 0.0005) and uncorrelated with MADRS (r = -0.051, p = 0.623). Test- retest r-coefficient was calculated at 0.85. The optimal cut-off score, set at ≥6 for (hypo)mania assessment, is in agreement with the results reported for the original version. Limitations of the study are that the scale was not normed on diagnostic groups other than bipolar, nor was it administered longitudinally, so as to assess its sensitivity to symptom changes overtime. CONCLUSION The G-ASRM can be validly and reliably used in the Greek population for the assessment of (hypo)mania in bipolar patients.
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Affiliation(s)
- Maria Skokou
- Department of Psychiatry, University Hospital of Patras, Patras, Greece.
| | - Rafailia Asimakopoulou
- Department of Electrical and Computer Engineering, School of Engineering, University of Patras, Greece
| | - Ourania Andreopoulou
- Department of Psychiatry, University Hospital of Patras, School of Medicine, University of Patras, Greece.
| | | | - Sofia Perrou
- School of Medicine, University of Patras, Greece
| | - Philippos Gourzis
- Department of Psychiatry, University Hospital of Patras, School of Medicine, University of Patras, Greece.
| | - Sophia Daskalaki
- Department of Electrical and Computer Engineering, School of Engineering, University of Patras, Greece.
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15
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Argyropoulos K, Krikonis K, Alexopoulos P, Avramidis D, Gourzis P, Jelastopulu E. COVID-19 lockdown and its impact on mental health in various population groups in Greece: A cross-sectional study. Eur Psychiatry 2021. [PMCID: PMC9480293 DOI: 10.1192/j.eurpsy.2021.1768] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
Introduction COVID-19 pandemic and lockdown has brought a serious impact on physical and mental health. Objectives The purpose of the present study was to estimate the impact of the first lockdown in Greece, on both quality of life and anxiety levels in different occupational groups. Methods A cross-sectional on- line survey was conducted from 20th of April to 4th of May 2020. A 24-item anonymous questionnaire was administered to collect basic demographic and socioeconomic data. The 5-item WHO Well-Being Index (WHO-5, 0-100%, cut-off 52%) and the Generalized Anxiety Disorder Assessment (GAD-7) tools were used to assess well-being and anxiety, respectively. Statistical analysis was performed with SPSS for Windows v.24.0 Statistical Package. Results A total of 575 participated in the study, 62.8% females, 48.5% aged between 40 to 59 years. 32.5% were employed in education sector, 32.5% in health sector and 20.3% as season workers in tourism sector. Males showed slightly higher levels of wellbeing (52.1 vs. 47.3, p=0.023) and lower levels of anxiety (7.1 vs. 8.2, p=0.023) compared to females. Factors associated with higher wellbeing and lower anxiety were higher education and income level, optimism, taking less protection measures, and being seasonal worker. Furthermore, participants with comorbidities and symptoms like headache, musculoskeletal pain, as well as feeling depressed or stressed revealed lower wellbeing and higher anxiety scores. Conclusions Our study revealed an overall poor wellbeing and mild to moderate levels of anxiety during the lockdown. Actions should be taken to address and to prevent its serious impact on mental health. Disclosure No significant relationships.
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Sazakli E, Leotsinidis M, Bakola M, Kitsou K, Argyropoulos K, Konstantopoulou A, Katsifara A, Gourzis P, Jelastopulu E. Anxiety and depression among students in a greek university amidst COVID-19 pandemic. Eur Psychiatry 2021. [PMCID: PMC9528447 DOI: 10.1192/j.eurpsy.2021.756] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
Introduction The coronavirus pandemic has challenged the world with an unprecedented situation. Social distancing, self or quarantine isolation, personal hand hygiene, self-protection, and the fear of becoming infected with the virus, come with a psychological fallout. The COVID-19 pandemic has affected students around the world, in terms of their education and lifestyle. Objectives To investigate the impact of COVID-19 pandemic on the students’ mental health and well-being at the University of Patras, in Western Greece. Methods An online questionnaire was prepared to collect responses from students during April 2020. Socio-demographic data, academic status, opinions about distance learning, changes in daily routine during the lockdown and anxiety and depression scores, according to the Greek version of the Hospital Anxiety and Depression Scale (HADS), were gathered. Results The total number of responders was 2009, of which 67.3% women. During lockdown, the 68% of the students returned to their family home. Anxiety and depression scores were higher in students with a low income, poor self-rated health, not informed about COVID-19, not satisfied with distance learning and being annoyed at staying home. Prevalence of anxiety and depression was found to be 35.8% and 51.2%, ranging from 26.7% to 48.2% for anxiety and from 36.3% to 60.5% for depression in Health Sciences and Humanities and Social Sciences, respectively. Conclusions Depression rates among university students in Greece were alarmingly high, denoting the impact of lockdown and changes in students’ life, due to the COVID-19 pandemic.
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Kallianezos P, Bakola M, Kitsou K, Petropoulos C, Sinopidis X, Gourzis P, Jelastopulu E. Prevalence of post traumatic stress disorder in children with mild traumatic brain injury. Eur Psychiatry 2021. [PMCID: PMC9476107 DOI: 10.1192/j.eurpsy.2021.1205] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
IntroductionChildren with traumatic brain injury (TBI) are at risk for post-traumatic stress disorder (PTSD). The vast majority of TBI are of mild severity (MTBI), however, they may develop persistent neurophysiological symptoms.ObjectivesThe purpose of this study was to investigate the incidence of PTSD in children with MTBI in Western Greece.MethodsA one-year prospective study was conducted at the Children Hospital of Patras. A total of 175 children aged 6-14 years screened for risk of PTSD at one-week and one-month post-injury, completing the Child Trauma Screening Questionnaire (CTSQ). The Children’s Revised Impact of Event Scale (CRIES 13) was administered to the parents, to inquire their assessment of PTSD in the children. Statistical analysis was performed with IBM SPSS v.22.0ResultsThere were 59 (33.7%) children (27.2% boys, 45.9% girls) whose screen result was at risk. At the rescreening one-month postinjury, 9.9% were still at risk. Parents assessed presence of PTSD in 19% of their children at one-week and in 3.9% at one-month post-injury. There was a positive correlation between parenting and child reporting on symptoms of PTSD in children. However, 23.4% mistakenly estimated their children did not experience stress while in fact they did and 24.2% mistakenly estimated the contrary.ConclusionsThe findings revealed the risk of PTSD even in mild TBI, justifying thus the screening to identify these children for intervention strategies. On the other hand, the rescreening demonstrated that not all at-risk children required intervention, since a natural remission in PTSD symptoms was observed one-month post-injury.
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Papanastasiou P, Gourzis P, Nimatoudis I, Ginis A. Evaluation of depression and anxiety control in greek patients with major depressive disorder with/without generalized anxiety disorder and cardiovascular disease–pronoi study. Eur Psychiatry 2021. [PMCID: PMC9470870 DOI: 10.1192/j.eurpsy.2021.266] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Introduction Patients with depression are likely to eventually develop Cardiovascular disease(CVD) and have a higher mortality rate than general population. In addition, anxiety disorders, especially Generalized Anxiety Disorder (GAD), may be associated with mortality and other adverse cardiac outcomes. Objectives Evaluation of depression and anxiety control in Greek patients with Major Depressive Disorder (MDD) with/without GAD and CVD, under 6 months of treatment with citalopram, and/or quetiapine, and/or pregabalin. Methods 565 patients with MDD with/without GAD, enrolled in this observational, study (NCT03317262). The subgroup of 133(24%) patients had CVD. Severity of MDD and GAD symptoms was evaluated using the HAM-D and HAM-A Scores at baseline (V1) and after 6 months (V3) respectively. Results Mean HAM-D score in patients with CVD without GAD, at V1 and V3 was 23.94±7.51 and 8.14±4.65 respectively (p<0.0001). Similar results were observed in patients without CVD without GAD (HAM-D score 26.67±8.79 at V1 and 7.44±4.40 at V3). Mean HAM-A score in patients with CVD and GAD at V1 and V3 was 25.64±6.38 and 8.98±3.93, respectively (p<0.0001). Same magnitude reduction in HAM-A score was observed in patients without CVD and GAD, 26.27±8.16 at V1 and 9.28±6.48 at V3 (p<0.0001). Patients’ depression symptoms with/without CVD and GAD showed also a significant reduction between V1 and V3. Conclusions MDD patients with CVD without GAD, had a marginally lower baseline HAM-D score versus patients with GAD. After 6 months of treatment with citalopram, and/or quetiapine, and/or pregabalin the improvement of depressive and anxiety symptoms was almost equal between MDD patients with/without GAD regardless of the presence of coexisting CVD. Disclosure Employee of ELPEN Pharmaceutical Co. Inc.
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Karaivazoglou K, Konstantopoulou G, Kalogeropoulou M, Iliou T, Vorvolakos T, Assimakopoulos K, Gourzis P, Alexopoulos P. Psychological distress in the Greek general population during the first COVID-19 lockdown. BJPsych Open 2021; 7:e59. [PMID: 33622422 PMCID: PMC7925978 DOI: 10.1192/bjo.2021.17] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND SARS-CoV-2 has rapidly spread worldwide, threatening public health and financial and social life. AIMS The current study's aim was to determine the prevalence of psychological distress and post-traumatic stress symptoms in the Greek population during the first COVID-19 lockdown, and to detect potential correlates. METHOD An anonymous online survey was conducted between 10 April and 4 May 2020, to collect information regarding people's psychological functioning and COVID-19-related perceptions. RESULTS A total of 1443 individuals completed the survey; 293 (20%) reported clinically significant anxiety symptoms, 188 (12.9%) reported clinically significant depressive symptoms and 506 (36.4%) suffered from definite post-traumatic stress disorder. Anxiety symptoms were independently associated with female gender (β = 1.281, 95% CI 0.808-1.755, P < 0.001), educational level (β = -1.570, 95% CI -2.546 to -0.595, P = 0.002), perceived severity (β = -1.745, 95% CI -3.146 to -0.344, P = 0.015) and COVID-19-related worry (β = 7.633, 95% CI 6.206-9.060, P < 0.001). Depressive symptoms were strongly correlated with educational level (β = -1.298, 95% CI -2.220 to -0.377, P = 0.006), perceived severity (β = -1.331, 95% CI -2.579 to -0.082, P = 0.037) and COVID-19-related worry (β = 4.102, 95% CI 2.769-5.436, P < 0.001). Finally, post-traumatic stress symptoms were linked to female gender (β = 6.451, 95% CI 4.602-8.299, P < 0.001), educational level (β = -5.737, 95% CI -9.479 to -1.996, P = 0.003), psychiatric history (β = -4.028, 95% CI -6.274 to -1.782, P < 0.001) and COVID-19-related worry (β = 23.865, 95% CI 18.201-29.530, P < 0.001). CONCLUSIONS A significant percentage of the population reported clinically important anxiety, depressive and post-traumatic stress symptoms. Women, less-educated individuals and people with a psychiatric history appeared more vulnerable to the pandemic's psychological impact.
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Affiliation(s)
| | - Georgia Konstantopoulou
- Special Office for Health Consulting Services and Faculty of Education and Social Work, School of Humanities and Social Sciences, University of Patras, Greece
| | | | - Theodoros Iliou
- Department of Psychiatry, University General Hospital of Alexandroupolis, Greece; and Faculty of Medicine, School of Health Sciences, Democritus University of Thrace, Greece
| | - Theofanis Vorvolakos
- Department of Psychiatry and Psychotherapy, Klinikum rechts der Isar, Faculty of Medicine, Technical University of Munich, Germany
| | | | | | - Panagiotis Alexopoulos
- Department of Psychiatry, University Hospital of Patras, Greece; and Klinikum rechts der Isar, Faculty of Medicine, Department of Psychiatry and Psychotherapy, Technical University of Munich, Germany
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Alexopoulos P, Papanastasiou AD, Εconomou P, Beis P, Niforas M, Dassios TG, Kormpaki A, Zarkadis IK, Reichel M, Kornhuber J, Perneczky R, Gourzis P. Associations between APOE-, COMT Val108/158Met- and BDNF Val66Met polymorphisms and variations in depressive and anxiety symptoms, sense of coherence and vital exhaustion in the real-life setting of mandatory basic military training. J Neural Transm (Vienna) 2021; 128:105-114. [PMID: 33394176 DOI: 10.1007/s00702-020-02280-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2020] [Accepted: 11/14/2020] [Indexed: 01/21/2023]
Abstract
Apolipoprotein E (APOE) ε, catechol-O-methytranferase (COMT) Val108/158Met and brain-derived neurotrophic factor (BDNF) Val66Met single nucleotide polymorphisms (SNPs) were shown to affect stress perception and response. The present study explored possible associations between these SNPs and changes in subclinical anxiety- and depressive symptoms, sense of coherence (SOC) and vital exhaustion (VE) during compulsory basic military training. The study encompassed 179 conscripts of a training base in Greece. The neuropsychiatric assessment was based on the Beck Depression Inventory, the State-Trait Anxiety Inventory, the Antonovsky SOC scale and the Maastricht Questionnaire. It was conducted at three time points of the 19-day basic military training: on day one (baseline), day six (follow-up I) and day 13 (follow-up II). Statistical analyses included Mann-Whitney test, Chi-square test and cross-sectional time series regression models based on the Skillings-Mack statistic. APOE ε4 non-carriers encountered significant changes in anxiety- and depressive symptoms and SOC (in all cases P < 0.001) over the observation period, whilst ε4 carriers did not. The changes in anxiety, depressive symptoms and SOC attained statistical significance in both BDNF Met66 carriers (in all cases P < 0.001) and non-carriers (P = 0.036; < 0.001; < 0.001, respectively) as well as in COMT Met108/158 carriers (P = 0.004; < 0.001; < 0.001, respectively) and non-carriers (P = 0.02; 0.01; 0.021, respectively. Changes over time in VE were not significant (P > 0.05). The observed resistance of APOE ε4 carriers vs non-carriers to changes in anxiety- and depressive symptoms and SOC when exposed to a stressful environment may point to superior coping capacities of healthy young men carrying the ε4 allele.
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Affiliation(s)
- Panagiotis Alexopoulos
- Department of Psychiatry, Faculty of Medicine, School of Health Sciences, University of Patras, University Hospital of Patras, 26504, Rion Patras, Greece.
- Department of Psychiatry and Psychotherapy, Faculty of Medicine, Technical University of Munich, Klinikum Rechts Der Isar, Ismaninger Strasse 22, 81675, Munich, Germany.
| | - Anastasios D Papanastasiou
- Deparment of Biomedical Sciences, University of West Attica, Ag. Spyridonos Street, 12243, Egaleo, Greece
| | - Polychronis Εconomou
- Department of Civil Engineering (Statistics), School of Engineering, University of Patras, 26504, Rion Patras, Greece
| | - Pavlos Beis
- Department of Psychiatry, Faculty of Medicine, School of Health Sciences, University of Patras, University Hospital of Patras, 26504, Rion Patras, Greece
| | - Michail Niforas
- Health Unit, Training Center of Technical Corps of the Hellenic Army, Maragkopoulou Str. 2, 26331, Patras, Greece
- Department of Orthopaedic and Accident Surgery, Center for Foot and Endoprothetic Joint Surgery, Malteser Clinics Rhein-Ruhr Duisburg, St. Johannesstift, Johannisstr. 21, 47198, Duisburg-Homberg, Germany
| | - Theodore G Dassios
- Health Unit, Training Center of Technical Corps of the Hellenic Army, Maragkopoulou Str. 2, 26331, Patras, Greece
- Department of Women and Children's Health, School of Life Course Sciences, Faculty of Life Sciences and Medicine, King's College London, St Thomas' Hospital, Westminster Bridge Road, London, SE1 7EH, UK
| | - Aggeliki Kormpaki
- Health Unit, Training Center of Technical Corps of the Hellenic Army, Maragkopoulou Str. 2, 26331, Patras, Greece
| | - Ioannis K Zarkadis
- Laboratory of General Biology, Faculty of Medicine, School of Health Sciences, University of Patras, 26504, Rion Patras, Greece
| | - Martin Reichel
- Department of Psychiatry and Psychotherapy, Friedrich-Alexander-University of Erlangen-Nuremberg, Schwabachanlage 6, 91054, Erlangen, Germany
- Department of Nephrology and Medical Intensive Care, Charité-Universitätsmedizin Berlin, Charitéplatz 1, 10117, Berlin, Germany
| | - Johannes Kornhuber
- Department of Psychiatry and Psychotherapy, Friedrich-Alexander-University of Erlangen-Nuremberg, Schwabachanlage 6, 91054, Erlangen, Germany
| | - Robert Perneczky
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich Nussbaumstraße 7, 80336, Munich, Germany
- Ageing Epidemiology (AGE) Research Unit, Faculty of Medicine, School of Public Health, The Imperial College of Science, Technology and Medicine, London, SW7 2AZ, UK
- Munich Cluster for Systems Neurology (SyNergy), Feodor-Lynen-Str. 17, 81377, Munich, Germany
- German Center for Neurodegenerative Diseases (DZNE) Munich, Feodor-Lynen-Strasse 17, 81377, Munich, Germany
| | - Philippos Gourzis
- Department of Psychiatry, Faculty of Medicine, School of Health Sciences, University of Patras, University Hospital of Patras, 26504, Rion Patras, Greece
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Tsermpini EE, Skokou M, Ferentinos P, Georgila E, Gourzis P, Assimakopoulos K, Patrinos GP. Clinical implementation of preemptive pharmacogenomics in psychiatry: Τhe "PREPARE" study. Psychiatriki 2020; 31:341-351. [PMID: 33361064 DOI: 10.22365/jpsych.2020.314.341] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
PREemptive Pharmacogenomic testing for Preventing Adverse drug REactions (PREPARE) is the first prospective, pre-emptive pharmacogenomic study conducted in Europe, within the frame of the Horizon 2020 program. It aims to determine whether implementing pre-emptive pharmacogenomics (PGx) testing of clinically relevant biomarkers, so as the dose and drug selection to be guided, will result in an overall reduction of both the occurrence and the severity of drug-genotype-associated adverse drug reactions (ADRs). To achieve that, two groups of patients will be recruited; one that will receive treatment according to standard clinical practice and one other that will receive pharmacogenomic-guided treatment. The Laboratory of Pharmacogenomics and Individualized Treatment of the University of Patras, which coordinates and represents Greece in this study, in collaboration with the Department of Psychiatry of the General University Hospital of Patras, the Department of Psychiatry of the Hospital "Attikon" and the Departments of Psychiatry of the Psychiatric Hospital of Athens "Dafni" is going to recruit 1500 psychiatric patients that are going to receive antidepressant or antipsychotic treatment. Our scientific hypothesis is that patients who receive pharmacogenomic guided drug and dose selection will experience 30% less ADRs than patients following standard care. Eligible drugs for inclusion in the PREPARE study, are those for which the clinical decision regarding drug and dose choice can be guided according to the Dutch Pharmacogenomics Working Group Guidelines (DPWG). Overall, 7 antidepressants (citalopram, escitalopram, sertraline, paroxetine, venlafaxine, clomipramine, amitriptyline) and 3 antipsychotics (haloperidol, zuclopenthixol, aripiprazole) related to 17 genetic variations in 2 genes (CYP2D6, CYP2C19) will be examined. Occurrence, severity and causality of adverse drug events (ADEs) will be assessed during monitoring, at month 1 and 3 after starting the index-drug, and at the end of each arm, by using the Common Toxicity Criteria for Adverse Events Scale (CTCAE) and the Liverpool Causality Assessment Tool (LCAT), respectively. The results of our study are expected to significantly contribute to the improvement of psychiatric patients' quality of life, by helping to provide the right drug, to the right dose in terms of efficacy, safety and cost-effectiveness.
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Affiliation(s)
- E E Tsermpini
- Laboratory of Pharmacogenomics and Personalized Treatment, Department of Pharmacy, University of Patras
| | - M Skokou
- Department of Psychiatry, General University Hospital of Patras, University of Patras, Patra
| | - P Ferentinos
- Second Department of Psychiatry, General University Hospital "Attikon", National and Kapodistrian University of Athens, Athens, Greece
| | - E Georgila
- Department of Psychiatry, General University Hospital of Patras, University of Patras, Patra
| | - P Gourzis
- Department of Psychiatry, General University Hospital of Patras, University of Patras, Patra
| | - K Assimakopoulos
- Department of Psychiatry, General University Hospital of Patras, University of Patras, Patra
| | - G P Patrinos
- Laboratory of Pharmacogenomics and Personalized Treatment, Department of Pharmacy, University of Patras.,U-PGx Group in Greece
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22
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Giamarelou A, Polychronopoulos P, Skokou M, Messinis L, Gourzis P. Frontotemporal dementia misdiagnosed as schizophrenia or other psychotic disorder. Eur Psychiatry 2020. [DOI: 10.1016/j.eurpsy.2017.01.1575] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
IntroductionFrontotemporal dementia (FTD) encompasses a group of clinical features that include personality and behavior changes (disinhibition, social isolation, antisocial behavior, compulsion) and executive dysfunction (poor planning, loss of judgment and loss of insight). These features may lead to an incorrect diagnosis of a primary psychiatric disorder.ObjectivesTo emphasize the difficulties in making a clinical distinction between early frontotemporal dementia and other psychiatric diseases.MethodsWe describe 11 patients who suffered from FTD, while initially had diagnosed with primary psychiatric disorders. The correct diagnosis was achieved by psychiatric and neuropsychological evaluations (WAIS SCALE, ACE-R, MMSE), neuroimaging studies (MRI 7/11, SPECT 8/11) and applying the international consensus criteria for FTD.ResultsAll patients (5 males and 6 females) were initially diagnosed with psychiatric disorders: schizophrenia (2/11), bipolar disorders (4/11), depression (5/11), schizoaffective disorder (1/11), somatization disorder (1/11), personality disorders (2/11), malingering (1/11), alcohol dependence (1/11), while 5 patients had more than one diagnosis. The age of onset varied from 19 to 53 years old. Final diagnosis of FTD was delayed on average 6,5 years from the onset of symptoms.ConclusionClinicians should be familiar with the clinical entity of FTD and its difficult distinction from other psychiatric disorders. A possible hospitalization of a patient with FTD in a psychiatric department and the social impact that it brings may be avoided. On the other hand, the proper care of FTD patients (pharmacological and psychosocial) improves the quality of life of patients and their caregivers.Disclosure of interestThe authors have not supplied their declaration of competing interest.
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Messinis L, Kosmidis MH, Nasios G, Konitsiotis S, Ntoskou A, Bakirtzis C, Grigoriadis N, Patrikelis P, Panagiotopoulos E, Gourzis P, Malefaki S, Papathanasopoulos P. Do Secondary Progressive Multiple Sclerosis patients benefit from Computer- based cognitive neurorehabilitation? A randomized sham controlled trial. Mult Scler Relat Disord 2020; 39:101932. [PMID: 31927200 DOI: 10.1016/j.msard.2020.101932] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2019] [Revised: 12/21/2019] [Accepted: 01/02/2020] [Indexed: 02/08/2023]
Abstract
BACKGROUND Cognitive impairment is common in multiple sclerosis (MS), but deficits tend to be more pronounced in progressive MS, negatively impacting daily functional capacity. Despite this, most cognitive rehabilitation (CR) interventions to date have focused on relapsing-remitting MS (RRMS). Moreover, information on the efficacy of CR in progressive MS is limited and controversial. The present study investigated the efficacy of a home based, computer assisted cognitive rehabilitation (HBCACR) intervention (RehaComTM software) exclusively in a Secondary Progressive Multiple Sclerosis (SPMS) sample. METHODS This was a randomized, multi site, sham controlled trial. Thirty six (36) individuals with SPMS, naïve to the RehaCom software, with cognitive deficits were randomized to the treatment (IG; n= 19) or control group condition (CG; n=17). Treatment with the RehaCom modules consisted of 24 domain and task specific, 45 minute session's over an 8-week period, three sessions per week, applied by each patient at home. The CG completed non specific computer based activities at home with the same frequency and duration. Primary cognitive outcome measures included the Brief International Cognitive Assessment for Multiple Sclerosis (BICAMS) battery, and secondary outcome measures for depression (BDI-FS), fatigue (MFIS), and quality of life (EuroQol EQ-5D) visual analogue scale (VAS). RESULTS The two groups were well matched on demographic and clinical characteristics, cognitive reserve and severity of cognitive deficits at baseline assessment. At post treatment assessment the IG group showed significant improvements with large effect sizes; in verbal learning [z = -4.759, p <.0005, g = 2.898], visuospatial memory [z = -3.940, p <.0005, g = 1.699] and information processing speed [z= -4.792, p <.0005, g = 2.980], compared with the sham control group. We also found significant between group differences on physical [z=-3.308, p = .001, g= -.604], cognitive [z = -4.011, p <.0005, g = -1.654], psychosocial [z= 3.308, p = .010, g = -.940], and general fatigue impact [z= -2.623, p = .008, g = -.519], depression severity [z = -2.730, p = .006, g = -.519], and quality of life [z= -4.239, p <.0005, g = -1.885] in favor of the treated group. CONCLUSION These data provide the first evidence supporting the efficacy of computer based restorative cognitive rehabilitation applied at home exclusively in SPMS patients, suggesting that adaptive neuroplasticity may occur after functional cognitive training in progressive MS. Improved cognitive functioning in combination with mood augmentation appear to have ameliorated fatigue, which impacted daily functioning activity and culminated in improved health related quality of life.
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Affiliation(s)
- Lambros Messinis
- Neuropsychology Section, Departments of Neurology and Psychiatry, University Hospital of Patras and University of Patras Medical School.
| | - Mary H Kosmidis
- Lab of Cognitive Neuroscience, School of Psychology, Aristotle University of Thessaloniki, Greece
| | - Grigorios Nasios
- Department of Speech and Language Therapy, School of Health Sciences, University of Ioannina
| | | | - Aikaterini Ntoskou
- Rehabilitation Unit for patients with Spinal Cord Injury, "Demetrios and Vera Sfikas" Department of Medicine, University of Patras Medical School
| | - Christos Bakirtzis
- B'Department of Neurology and the MS Center, AHEPA University Hospital, Central Macedonia, Thessaloniki, Greece
| | - Nikolaos Grigoriadis
- B'Department of Neurology and the MS Center, AHEPA University Hospital, Central Macedonia, Thessaloniki, Greece
| | - Panayiotis Patrikelis
- First Department of Neurosurgery, Medical School, National and Kapodistrian University of Athens, Greece
| | - Elias Panagiotopoulos
- Rehabilitation Unit for patients with Spinal Cord Injury, "Demetrios and Vera Sfikas" Department of Medicine, University of Patras Medical School
| | | | - Sonia Malefaki
- Department of Mechanical Engineering & Aeronautics, University of Patras (statistics)
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Skokou M, Sakellaropoulos G, Zairi NA, Gourzis P, Andreopoulou O. An Exploratory Study of Trait Emotional Intelligence and Mental Health in Freshmen Greek Medical Students. Curr Psychol 2019. [DOI: 10.1007/s12144-019-00535-z] [Citation(s) in RCA: 4] [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: 11/28/2022]
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25
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Pisanu C, Tsermpini EE, Skokou M, Kordou Z, Gourzis P, Assimakopoulos K, Congiu D, Meloni A, Balasopoulos D, Patrinos GP, Squassina A. Leukocyte telomere length is reduced in patients with major depressive disorder. Drug Dev Res 2019; 81:268-273. [DOI: 10.1002/ddr.21612] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2019] [Revised: 09/30/2019] [Accepted: 10/01/2019] [Indexed: 12/12/2022]
Affiliation(s)
- Claudia Pisanu
- Department of Biomedical Sciences, Section of Neuroscience and Clinical PharmacologyUniversity of Cagliari Cagliari Italy
| | | | - Maria Skokou
- Psychiatric Clinic, Patras General Hospital Patras Greece
| | - Zoe Kordou
- Department of PharmacyUniversity of Patras School of Health Sciences Patras Greece
| | - Philippos Gourzis
- Department of MedicineUniversity of Patras School of Health Sciences Patras Greece
| | | | - Donatella Congiu
- Department of Biomedical Sciences, Section of Neuroscience and Clinical PharmacologyUniversity of Cagliari Cagliari Italy
| | - Anna Meloni
- Department of Biomedical Sciences, Section of Neuroscience and Clinical PharmacologyUniversity of Cagliari Cagliari Italy
| | | | - George P. Patrinos
- Department of PharmacyUniversity of Patras School of Health Sciences Patras Greece
- Department of PathologyUnited Arab Emirates University, College of Medicine and Health Sciences Al‐Ain UAE
- Zayed Center of Health SciencesUnited Arab Emirates University Al‐Ain UAE
| | - Alessio Squassina
- Department of Biomedical Sciences, Section of Neuroscience and Clinical PharmacologyUniversity of Cagliari Cagliari Italy
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26
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Gogos A, Skokou M, Ferentinou E, Gourzis P. Nicotine consumption during the prodromal phase of schizophrenia - a review of the literature. Neuropsychiatr Dis Treat 2019; 15:2943-2958. [PMID: 31802874 PMCID: PMC6801495 DOI: 10.2147/ndt.s210199] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/28/2019] [Accepted: 07/11/2019] [Indexed: 12/12/2022] Open
Abstract
Recent research has fueled a debate concerning the role of nicotine in the emergence of schizophrenia. The three main hypotheses are: (a) the self-medication effect, (b) the causal relationship hypothesis, or (c) the shared diathesis hypothesis. To explore this role, the study of nicotine consumption during the initial prodromal phase of schizophrenia offers important opportunities. In the present work, 10 relevant studies are reviewed, out of 727 retrieved citations, in order to address questions regarding the prevalence of smoking in the prodromal period, the time of smoking initiation, existing patterns of tobacco use in relation with the escalation of prodromal symptoms into first psychotic episode, and potential differences in symptomatology between smokers and nonsmokers. Even though there was considerable heterogeneity among studies, relevant findings are discussed. Prevalence of nicotine use during the prodromal period was reported to be 16.6-46%. Tobacco use was found to be taken up most often before or during the prodromal period of schizophrenia. Even though a protective role of smoking has been reported by one study, other studies report an increased risk for psychosis, with hazard ratios 2.77 (95% CI: 2.34-3.43) and 2.21 (95% CI: 1.11-4.42) for female and male heavy smokers (11-20 and >20 cigarettes/day), respectively. In a different study, the risk of onset was associated with the progressive use of cannabis and tobacco prior to onset, particularly with rapid escalation to the highest levels of use. Also, nicotine use in ultra high risk (UHR) for developing psychosis subjects is associated with elevated cognitive performance, namely better processing speed, visual learning, and spatial working memory. As a conclusion, it appears that evidence accumulates supporting a possible etiologic role of smoking, in the emergence of schizophrenia along with diverse effects on patients' symptomatology, already demonstrable at the prodromal phase. Future research employing better-defined criteria should further explore the patterns of use and effects of nicotine during the schizophrenia prodrome.
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Affiliation(s)
| | - Maria Skokou
- Department of Psychiatry, University Hospital of Patras, Rion, Patras, Greece
| | | | - Philippos Gourzis
- Department of Psychiatry, University Hospital of Patras, Rion, Patras, Greece
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27
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Alexopoulos P, Thierjung N, Economou P, Werle L, Buhl F, Kagerbauer S, Papanastasiou AD, Grimmer T, Gourzis P, Berthele A, Hemmer B, Kübler H, Martin J, Politis A, Perneczky R. Plasma Levels of Soluble AβPPβ as a Biomarker for Alzheimer's Disease with Dementia. J Alzheimers Dis 2019; 69:83-90. [PMID: 30909232 DOI: 10.3233/jad-181088] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Cost- and time-effective markers of Alzheimer's disease (AD), reliable and feasible at the population level are urgently needed. Soluble amyloid-β protein precursor β (sAβPPβ) in plasma has attracted scientific attention as a potential AD biomarker candidate. Here we report that plasma sAβPPβ levels in patients with AD dementia and typical for AD cerebrospinal fluid (CSF) biomarker profiles (N = 33) are significantly lower (p < 0.01) than those of cognitively healthy elderly individuals without AD (N = 39), while CSF sAβPPβ levels did not differ between the studied groups. This provides further evidence for the potential of sAβPPβ in plasma as an AD biomarker candidate.
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Affiliation(s)
- Panagiotis Alexopoulos
- Department of Psychiatry and Psychotherapy, Klinikum rechts der Isar, Technische Universität München, Munich, Germany.,Department of Psychiatry, University Hospital of Rion, University of Patras, Patras, Greece
| | - Nathalie Thierjung
- Department of Psychiatry and Psychotherapy, Klinikum rechts der Isar, Technische Universität München, Munich, Germany
| | - Polychronis Economou
- Department of Civil Engineering (Statistics), University of Patras, Patras, Greece
| | - Lukas Werle
- Department of Psychiatry and Psychotherapy, Klinikum rechts der Isar, Technische Universität München, Munich, Germany.,Max Planck Institute of Psychiatry, Munich, Germany
| | - Felix Buhl
- Department of Psychiatry and Psychotherapy, Klinikum rechts der Isar, Technische Universität München, Munich, Germany
| | - Simone Kagerbauer
- Department of Anaesthesiology, Klinikum rechts der Isar, Technische Universität München, Munich, Germany
| | - Anastasios D Papanastasiou
- Molecular Oncology Laboratory, Division of Oncology, University Hospital of Patras, University of Patras, Patras, Greece
| | - Timo Grimmer
- Department of Psychiatry and Psychotherapy, Klinikum rechts der Isar, Technische Universität München, Munich, Germany
| | - Philippos Gourzis
- Department of Psychiatry, University Hospital of Rion, University of Patras, Patras, Greece
| | - Achim Berthele
- Department of Neurology, Klinikum rechts der Isar, Technische Universität München, Munich, Germany
| | - Bernhard Hemmer
- Department of Neurology, Klinikum rechts der Isar, Technische Universität München, Munich, Germany.,Munich Cluster for Systems Neurology (SyNergy), Munich, Germany
| | - Hubert Kübler
- Department of Urology, Klinikum rechts der Isar, Technische Universität München, Munich, Germany
| | - Jan Martin
- Department of Anaesthesiology, Klinikum rechts der Isar, Technische Universität München, Munich, Germany
| | - Antonios Politis
- First Department of Psychiatry, Eginition Hospital, National and Kapodistrian University of Athens, Athens, Greece.,Department of Psychiatry, Division of Geriatric Psychiatry and Neuropsychiatry, Johns Hopkins Medical School, Baltimore, USA
| | - Robert Perneczky
- Munich Cluster for Systems Neurology (SyNergy), Munich, Germany.,Department of Psychiatry and Psychotherapy, Ludwig-Maximilians-Universität München, Munich, Germany.,Ageing Epidemiology (AGE) Research Unit, School of Public Health, Faculty of Medicine, The Imperial College of Science, Technology and Medicine, London, UK.,German Center for Neurodegenerative Diseases (DZNE) Munich, Munich, Germany
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28
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Alexopoulos P, Thierjung N, Grimmer T, Ortner M, Economou P, Assimakopoulos K, Gourzis P, Politis A, Perneczky R. Cerebrospinal Fluid BACE1 Activity and sAβPPβ as Biomarker Candidates of Alzheimer's Disease. Dement Geriatr Cogn Disord 2018; 45:152-161. [PMID: 29788013 DOI: 10.1159/000488481] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/08/2018] [Accepted: 03/11/2018] [Indexed: 01/03/2023] Open
Abstract
BACKGROUND/AIMS The utility of β-site amyloid-β precursor protein (AβPP) cleaving enzyme 1 (BACE1) activity and soluble AβPP β (sAβPPβ) levels in cerebrospinal fluid (CSF) in detecting Alzheimer's disease (AD) is still elusive. METHODS BACE1 activity and sAβPPβ concentration were measured in patients with AD dementia (n = 56) and mild cognitive impairment (MCI) due to AD (n = 76) with abnormal routine AD CSF markers, in patients with MCI with normal CSF markers (n = 39), and in controls without preclinical AD (n = 48). In a subsample with available 18F-fluorodeoxyglucose positron emission tomography (FDG PET) data, ordinal regression models were employed to compare the contribution of BACE1 and sAβPPβ to correct diagnostic classification to that of FDG PET. RESULTS BACE1 activity was significantly higher in patients with MCI due to AD compared to both controls and patients with MCI with normal CSF markers. sAβPPβ did not differ between any of the studied groups. Interestingly, BACE1 activity was not found to be inferior to FDG PET as predictive covariate in differentiating between the diagnostic groups. CONCLUSIONS Further studies using biomarker-underpinned diagnoses are warranted to shed more light on the potential diagnostic utility of BACE1 activity as AD biomarker candidate in MCI.
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Affiliation(s)
- Panagiotis Alexopoulos
- Department of Psychiatry, University Hospital of Rion, University of Patras, Patras, Greece.,Department of Psychiatry and Psychotherapy, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
| | - Nathalie Thierjung
- Department of Psychiatry and Psychotherapy, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
| | - Timo Grimmer
- Department of Psychiatry and Psychotherapy, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
| | - Marion Ortner
- Department of Psychiatry and Psychotherapy, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
| | - Polychronis Economou
- Department of Civil Engineering (Statistics), University of Patras, Patras, Greece
| | | | - Philippos Gourzis
- Department of Psychiatry, University Hospital of Rion, University of Patras, Patras, Greece
| | - Antonios Politis
- First Department of Psychiatry, Eginition Hospital, National and Kapodistrian University of Athens, Athens, Greece.,Department of Psychiatry, Division of Geriatric Psychiatry and Neuropsychiatry, John's Hopkins Medical School, Baltimore, Maryland, USA
| | - Robert Perneczky
- Department of Psychiatry and Psychotherapy, Ludwig-Maximilians-Universität München, Munich, Germany.,Neuroepidemiology and Ageing Research Unit, School of Public Health, Faculty of Medicine, The Imperial College of Science, Technology and Medicine, London, United Kingdom.,West London Mental Health NHS Trust, London, United Kingdom.,German Center for Neurodegenerative Diseases (DZNE) Munich, Munich, Germany
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29
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Alexopoulos P, Gleixner LS, Werle L, Buhl F, Thierjung N, Giourou E, Kagerbauer SM, Gourzis P, Kübler H, Grimmer T, Yakushev I, Martin J, Kurz A, Perneczky R. Plasma levels of soluble amyloid precursor protein β in symptomatic Alzheimer's disease. Eur Arch Psychiatry Clin Neurosci 2018; 268:519-524. [PMID: 28602012 DOI: 10.1007/s00406-017-0815-9] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/07/2016] [Accepted: 06/06/2017] [Indexed: 11/29/2022]
Abstract
The established biomarkers of Alzheimer's disease (AD) require invasive endeavours or presuppose sophisticated technical equipment. Consequently, new biomarkers are needed. Here, we report that plasma levels of soluble amyloid precursor protein β (sAPPβ), a protein of the initial phase of the amyloid cascade, were significantly lower in patients with symptomatic AD (21 with mild cognitive impairment due to AD and 44 with AD dementia) with AD-typical cerebral hypometabolic pattern compared with 27 cognitively healthy elderly individuals without preclinical AD. These findings yield further evidence for the potential of sAPPβ in plasma as an AD biomarker candidate.
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Affiliation(s)
- Panagiotis Alexopoulos
- Department of Psychiatry and Psychotherapy, Klinikum Rechts der Isar, Technical University of Munich, Munich, Germany. .,Department of Psychiatry, University Hospital of Rion, University of Patras, 26500, Patras, Greece.
| | - Lena-Sophie Gleixner
- Department of Psychiatry and Psychotherapy, Klinikum Rechts der Isar, Technical University of Munich, Munich, Germany
| | - Lukas Werle
- Department of Psychiatry and Psychotherapy, Klinikum Rechts der Isar, Technical University of Munich, Munich, Germany.,Max Planck Institute of Psychiatry, Munich, Germany
| | - Felix Buhl
- Department of Psychiatry and Psychotherapy, Klinikum Rechts der Isar, Technical University of Munich, Munich, Germany
| | - Nathalie Thierjung
- Department of Psychiatry and Psychotherapy, Klinikum Rechts der Isar, Technical University of Munich, Munich, Germany
| | - Evangelia Giourou
- Department of Psychiatry, University Hospital of Rion, University of Patras, 26500, Patras, Greece
| | - Simone M Kagerbauer
- Department of Anaesthesiology, Klinikum Rechts der Isar, Technical University of Munich, Munich, Germany
| | - Philippos Gourzis
- Department of Psychiatry, University Hospital of Rion, University of Patras, 26500, Patras, Greece
| | - Hubert Kübler
- Department of Urology, Klinikum Rechts der Isar, Technical University of Munich, Munich, Germany
| | - Timo Grimmer
- Department of Psychiatry and Psychotherapy, Klinikum Rechts der Isar, Technical University of Munich, Munich, Germany
| | - Igor Yakushev
- Department of Nuclear Medicine, Klinikum Rechts der Isar, Technical University of Munich, Munich, Germany
| | - Jan Martin
- Department of Anaesthesiology, Klinikum Rechts der Isar, Technical University of Munich, Munich, Germany
| | - Alexander Kurz
- Department of Psychiatry and Psychotherapy, Klinikum Rechts der Isar, Technical University of Munich, Munich, Germany
| | - Robert Perneczky
- Department of Psychiatry and Psychotherapy, Ludwig-Maximilians-Universität München, Munich, Germany.,Neuroepidemiology and Ageing Research Unit, Faculty of Medicine, School of Public Health, The Imperial College of Science, Technology and Medicine, London, UK.,West London Mental Health NHS Trust, London, UK.,German Center for Neurodegenerative Diseases (DZNE) Munich, Munich, Germany
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Abstract
Compulsory admissions represent a significant proportion of psychiatric hospitalizations. A wide variation seems to exist internationally regarding legal frameworks, administrative procedures, detention rates and clinical practice. The aim of the present study is to describe qualitative and quantitative features of compulsory admissions in a large administrative area in southwest Greece, in order to identify targets for future research and possible remediation. Involuntary assessments and admissions in the Department of Psychiatry of the University Hospital of Patras were retrospectively assessed, during a 12-month period, for demographic features and data regarding legal procedures. Diagnoses following compulsory first assessment and at discharge were recorded for the patients who were admitted in our department. During the period of observation, 218 compulsory assessments were made, corresponding to 190 patients and resulting in 183 compulsory admissions. Thirty five cases (16.1%) were assessed as not justifying hospitalization and corresponded mainly to the diagnoses of alcohol and/or substance abuse or dependence. Involuntary hospitalizations represented 44.9% of all psychiatric admissions in our department. Diagnosis at first assessment was most frequently psychosis (68.4%). Diagnoses at discharge were most often schizophrenia (52.8%) and bipolar disorder (21.3%). A history of multiple hospitalizations (>5) was observed in 17 (15.8%) patients, whereas 46 patients (42.6%) were hospitalized for the first time, and 13 (11.7%) exhibited their first psychotic episode. Of the 108 patients who were admitted in our department, 88 (81.5%) declared that they did not wish to attend the court hearing, 7 (6.5%) were not able to attend due to severe health condition, and only 13 (12.0%) actually presented in court. Concluding, current situation regarding legal procedures, involuntary admissions and mental health care in Greece is rather far from satisfying. Future directions should include the systematic recording of mental health care parameters, such as compulsory hospitalizations, as well as efforts to improve these parameters and the existing legal framework and procedures.
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Affiliation(s)
- M Skokou
- Department of Psychiatry, General University Hospital of Patras, School of Medicine, University of Patras, Rio, Patra
| | - P Gouma
- Department of Child and Adolescent Psychiatry, General Children's Hospital "Agia Sophia", National and Kapodistrian University of Athens, Athens, Greece
| | - P Gourzis
- Department of Psychiatry, General University Hospital of Patras, School of Medicine, University of Patras, Rio, Patra
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Giourou E, Skokou M, Andrew SP, Alexopoulou K, Gourzis P, Jelastopulu E. Complex posttraumatic stress disorder: The need to consolidate a distinct clinical syndrome or to reevaluate features of psychiatric disorders following interpersonal trauma? World J Psychiatry 2018; 8:12-19. [PMID: 29568727 PMCID: PMC5862650 DOI: 10.5498/wjp.v8.i1.12] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/13/2017] [Revised: 12/29/2017] [Accepted: 02/05/2018] [Indexed: 02/05/2023] Open
Abstract
Complex posttraumatic stress disorder (Complex PTSD) has been recently proposed as a distinct clinical entity in the WHO International Classification of Diseases, 11th version, due to be published, two decades after its first initiation. It is described as an enhanced version of the current definition of PTSD, with clinical features of PTSD plus three additional clusters of symptoms namely emotional dysregulation, negative self-cognitions and interpersonal hardship, thus resembling the clinical features commonly encountered in borderline personality disorder (BPD). Complex PTSD is related to complex trauma which is defined by its threatening and entrapping context, generally interpersonal in nature. In this manuscript, we review the current findings related to traumatic events predisposing the above-mentioned disorders as well as the biological correlates surrounding them, along with their clinical features. Furthermore, we suggest that besides the present distinct clinical diagnoses (PTSD; Complex PTSD; BPD), there is a cluster of these comorbid disorders, that follow a continuum of trauma and biological severity on a spectrum of common or similar clinical features and should be treated as such. More studies are needed to confirm or reject this hypothesis, particularly in clinical terms and how they correlate to clinical entities’ biological background, endorsing a shift from the phenomenologically only classification of psychiatric disorders towards a more biologically validated classification.
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Affiliation(s)
- Evangelia Giourou
- Department of Psychiatry, School of Medicine, University of Patras, Rio Patras 26500, Greece
- Department of Public Health, School of Medicine, University of Patras, Rio Patras 26500, Greece
| | - Maria Skokou
- Department of Psychiatry, School of Medicine, University of Patras, Rio Patras 26500, Greece
| | - Stuart P Andrew
- Specialist Care Team Limited, Lancashire LA4 4AY, United Kingdom
| | | | - Philippos Gourzis
- Department of Psychiatry, School of Medicine, University of Patras, Rio Patras 26500, Greece
| | - Eleni Jelastopulu
- Department of Public Health, School of Medicine, University of Patras, Rio Patras 26500, Greece
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Giourou E, Skokou M, Andrew SP, Gourzis P. Physiological Basis of the Couvade Syndrome and Peripartum Onset of Bipolar Disorder in a Man: A Case Report and a Brief Review of the Literature. Front Psychiatry 2018; 9:509. [PMID: 30405452 PMCID: PMC6200967 DOI: 10.3389/fpsyt.2018.00509] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2018] [Accepted: 09/26/2018] [Indexed: 01/09/2023] Open
Abstract
Rapid hormonal changes during pregnancy as well as psycho-social stressors accompanying parenthood have often been associated with peripartum mood episodes in women with bipolar disorder or with not yet clinically expressed bipolar diathesis. Yet, little is known about the correlation of peripartum onset of bipolar disorder in men. We present the case of a man with bipolar disorder with peripartum onset and subsequent episodes following the peripartum initiation of the disease, as well as the association of the couvade syndrome, as a pathological response to a man due to hormonal shifts observed in males cohabiting with a pregnant female. The patient had his first depressive episode during the peripartum period of his spouse, followed by two mixed episodes with psychotic features that leaded to his compulsory psychiatric evaluation and subsequent hospitalization and the diagnosis of Bipolar Disorder I. There is a well-known correlation between the peripartum period and mood disturbances to the point of inducing full blown episodes, suggesting of a bipolar disorder initiation or mood episodes relapsing in female patients already diagnosed with bipolar disorder. Due to the patient's psychological disturbances and the phenomenology of his symptoms, mainly concerning the psychotic features accompanying his episodes, we discuss the possible underlying biological correlates as a triggering mechanism, that might overlap the manifestation of the Couvade Syndrome as well as the initiation or relapse of Bipolar Disorder in males. It seems that males are not less influenced by hormonal and psycho-social factors posed upon them during the peripartum period of their cohabiting female spouse.
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Affiliation(s)
- Evangelia Giourou
- Department of Psychiatry, School of Medicine, University of Patras, Patras, Greece
| | - Maria Skokou
- Department of Psychiatry, School of Medicine, University of Patras, Patras, Greece
| | | | - Philippos Gourzis
- Department of Psychiatry, School of Medicine, University of Patras, Patras, Greece
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Alexopoulos P, Roesler J, Werle L, Thierjung N, Lentzari I, Ortner M, Grimmer T, Laskaris N, Politis A, Gourzis P, Kurz A, Perneczky R. Fluid biomarker agreement and interrelation in dementia due to Alzheimer’s disease. J Neural Transm (Vienna) 2017; 125:193-201. [DOI: 10.1007/s00702-017-1810-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2017] [Accepted: 11/07/2017] [Indexed: 11/30/2022]
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Argyropoulos K, Andreou G, Avramidis D, Gourzis P, Charalambous G, Jelastopulu E. Postpartum Depression in a Public Hospital in Cyprus. Prevalence, Risk Factors. Eur Psychiatry 2017. [DOI: 10.1016/j.eurpsy.2017.01.2018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
Abstract
IntroductionPostpartum depression (PPD) is a serious mental health condition. Untreated PPD places the mother and infant at risk and is associated with significant long-term effects on child development and behavior.ObjectivesAppropriate screening for and prompt recognition and treatment of depression after the birth of a child are essential for maternal and child well-being.AimsThe purpose of the present study was to estimate the prevalence of PPD in the first 5 days after the birth of a neonate and to investigate associations with several risk factors.MethodsA cross-sectional study was conducted among 150 mothers, in a public obstetric hospital in Nicosia, Cyprus. A questionnaire was administered including socio-demographic characteristics. The Greek version of the Edinburgh postnatal depression scale (EPDS), a 10–item questionnaire to identifying women who are at risk of PPD, was used to estimate depression among the participants.ResultsAccording to EPDS, 42% of the mothers screened positive for risk of developing PPD. Higher risk was observed in very young mothers (<20 years) (66.6% vs 15%), in women with history of psychological disorders (86.95% vs 33.85%), in single mothers (71.69% vs 22.8%), in women with serious problems during the pregnancy (74% vs 23.95%) and in mothers with not healthy neonate (75.7% vs 32.4%).ConclusionThe study reveals a high prevalence of PPD and identifies various risk factors associated with developing PPD. The use of maternal depression screening programs such as the EPDS may help to recognize an elevated risk of postpartum depression and to ensure a healthier mother-child relationship.
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Alexopoulos P, Werle L, Roesler J, Thierjung N, Gleixner LS, Yakushev I, Laskaris N, Wagenpfeil S, Gourzis P, Kurz A, Perneczky R. Conflicting cerebrospinal fluid biomarkers and progression to dementia due to Alzheimer's disease. Alzheimers Res Ther 2016; 8:51. [PMID: 27931251 PMCID: PMC5146856 DOI: 10.1186/s13195-016-0220-z] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/08/2015] [Accepted: 10/28/2016] [Indexed: 01/12/2023]
Abstract
BACKGROUND According to new diagnostic guidelines for Alzheimer's disease (AD), biomarkers enable estimation of the individual likelihood of underlying AD pathophysiology and the associated risk of progression to AD dementia for patients with mild cognitive impairment (MCI). Nonetheless, how conflicting biomarker constellations affect the progression risk is still elusive. The present study explored the impact of different cerebrospinal fluid (CSF) biomarker constellations on the progression risk of MCI patients. METHODS A multicentre cohort of 469 patients with MCI and available CSF biomarker results and clinical follow-up data was considered. Biomarker values were categorized as positive for AD, negative or borderline. Progression risk differences between patients with different constellations of total Tau (t-Tau), phosphorylated Tau at threonine 181 (p-Tau) and amyloid-beta 1-42 (Aβ42) were studied. Group comparison analyses and Cox regression models were employed. RESULTS Patients with all biomarkers positive for AD (N = 145) had the highest hazard for progression to dementia due to AD, whilst patients with no positive biomarkers (N = 111) had the lowest. The risk of patients with only abnormal p-Tau and/or t-Tau (N = 49) or with positive Aβ42 in combination with positive t-Tau or p-Tau (N = 119) is significantly lower than that of patients with all biomarkers positive. CONCLUSIONS The risk of progression to dementia due to AD differs between patients with different CSF biomarker constellations.
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Affiliation(s)
- Panagiotis Alexopoulos
- Department of Psychiatry, University Hospital of Rion, University of Patras, 26504, Rio, Patras, Greece. .,Department of Psychiatry and Psychotherapy, Klinikum rechts der Isar, Technische Universität München, Ismaninger Straße 22, 81675, München, Germany. .,Department of Psychiatry, University Hospital of Patras, University of Patras, 26504, Rion, Patras, Greece.
| | - Lukas Werle
- Max Planck Institute of Psychiatry, Kraepelinstr. 2-10, 80804, München, Germany
| | - Jennifer Roesler
- Department of Psychiatry and Psychotherapy, Klinikum rechts der Isar, Technische Universität München, Ismaninger Straße 22, 81675, München, Germany
| | - Nathalie Thierjung
- Department of Psychiatry and Psychotherapy, Klinikum rechts der Isar, Technische Universität München, Ismaninger Straße 22, 81675, München, Germany
| | - Lena Sophie Gleixner
- Department of Psychiatry and Psychotherapy, Klinikum rechts der Isar, Technische Universität München, Ismaninger Straße 22, 81675, München, Germany
| | - Igor Yakushev
- Department of Nuclear Medicine, Klinikum rechts der Isar, Technische Universität München, Ismaninger Straße 22, 81675, München, Germany
| | - Nikolaos Laskaris
- Department of Informatics, Aristotle University of Thessaloniki, 54124, Thessaloniki, Greece
| | - Stefan Wagenpfeil
- Institute of Medical Biometrics, Epidemiology, and Medical Informatics (IMBEI), University of the Saarland, 66421, Homburg/Saar, Germany
| | - Philippos Gourzis
- Department of Psychiatry, University Hospital of Rion, University of Patras, 26504, Rio, Patras, Greece
| | - Alexander Kurz
- Department of Psychiatry and Psychotherapy, Klinikum rechts der Isar, Technische Universität München, Ismaninger Straße 22, 81675, München, Germany
| | - Robert Perneczky
- Department of Psychiatry and Psychotherapy, Klinikum rechts der Isar, Technische Universität München, Ismaninger Straße 22, 81675, München, Germany.,Neuroepidemiology and Ageing Research Unit, School of Public Health, Faculty of Medicine, The Imperial College of Science, Technology and Medicine, London, W6 8RP, UK.,Department of Psychiatry and Psychotherapy, Ludwig-Maximilans-Universität München, Nußbaumstraße 7, München, 80336, Germany
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Argyropoulos K, Gourzis P, Jelastopulu E. Depression among older adults in Greece: an undetected disorder? Psychogeriatrics 2016; 16:334-5. [PMID: 26550761 DOI: 10.1111/psyg.12169] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- Konstantinos Argyropoulos
- Department of Public Health, Medical School, University of Patras, Patras, Greece.,Psychiatric Hospital of Tripolis, Tripolis, Greece
| | - Philippos Gourzis
- Department of Psychiatry, University Hospital of Patras, Patras, Greece
| | - Eleni Jelastopulu
- Department of Public Health, Medical School, University of Patras, Patras, Greece. ,
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Skokou M, Assimakopoulos K, Gourzis P. The birth of Athena – Psychodynamic formulation and case report. Eur Psychiatry 2016. [DOI: 10.1016/j.eurpsy.2016.01.2082] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
Abstract
IntroductionAthena possesses a special place among the Greek Gods, as she was born from her father, according to an extreme patriarchal model with a marked depreciation of the maternal role. Zeus had swallowed and absorbed the mother of Athena, Mites, because of an oracle that if Mites gave birth to a boy, the boy would take his throne. When the time comes, Zeus commands Hephaestus to cleave his forehead with an axe, and then Athena leaps fully armed and shouting her cry of war, in front of the astonished Gods. The next moment she puts her weapons down, as a token of obedience and devotion. The exceptionally close bond between father and daughter is evident through their uniquely confidential relationship. The ancient myth is paralleled, from a psychodynamic aspect, with the case of a narcissistic patient receiving psychodynamic psychotherapy.MethodsCase report.ResultsA case of a woman with narcissistic personality features and depressive symptoms is described, presenting with the complaints of withdrawal, self-depreciation, passivity, and agoraphobia. Psychodynamic factors defining her pathology are her narcissistic and sexualized relationship with her father, whereas the relationship with her mother has been depreciated. The patient experiences an intrapsychic conflict of reciprocal idealization, against her anger and fear for her father, resulting in the symptoms of agoraphobia and passivity.ConclusionLike Athena, who puts her weapons down, the patient resigns from her will for autonomy and moves to a passive position, as a result of her entrapment in her idealized relationship with the father.Disclosure of interestThe authors have not supplied their declaration of competing interest.
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Papathanasiou A, Messinis L, Zampakis P, Panagiotakis G, Gourzis P, Georgiou V, Papathanasopoulos P. Thalamic atrophy predicts cognitive impairment in relapsing remitting multiple sclerosis. Effect on instrumental activities of daily living and employment status. J Neurol Sci 2015; 358:236-42. [DOI: 10.1016/j.jns.2015.09.001] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2015] [Revised: 08/31/2015] [Accepted: 09/01/2015] [Indexed: 11/30/2022]
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Efthymiou V, Hyphantis T, Karaivazoglou K, Gourzis P, Alexandrides TK, Kalfarentzos F, Assimakopoulos K. The effect of bariatric surgery on patient HRQOL and sexual health during a 1-year postoperative period. Obes Surg 2015; 25:310-8. [PMID: 25085222 DOI: 10.1007/s11695-014-1384-x] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
BACKGROUND Negative consequences of the obesity epidemic include decreased physical, psychological, and sexual health. Bariatric surgery is a well-tolerated and effective treatment for morbid obesity. This study aimed to determine the effect of bariatric surgery on health-related quality of life (HRQOL) and sexual functioning and to identify potential predictors of this effect. METHODS Eighty morbidly obese patients (50 women) completed the study. HRQOL was measured using the Short Form 36 questionnaire (SF-36). Sexual functioning was assessed using the Female Sexual Functioning Index (FSFI) and the International Index of Erectile Function (IIEF). All participants were evaluated four times as follows: presurgery (T1), 1 month (T2), 6 months (T3), and 1 year (T4) after surgery. RESULTS Body mass index (BMI) significantly decreased over time (p < 0.001). Apart from male orgasm, all sexual functioning components as well as all SF-36 sub-scales improved between T1 and T4. The maximum improvement was observed between T2 and T3. Baseline HRQOL scores correlated with postoperative improvement in all HRQOL components. BMI improvement was correlated with improvement in role physical, bodily pain, and mental health scores. Baseline total sexual satisfaction score independently predicted total satisfaction improvement in both genders. CONCLUSIONS The present findings indicate that bariatric surgery represents an effective obesity treatment, leading to significant BMI reduction and improvement in HRQOL and sexual functioning, especially in the first 6 months postoperatively.
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Affiliation(s)
- Vasileios Efthymiou
- Department of Endocrinology, University of Patras, Medical School, Rion, Patras, Greece
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Argyropoulos K, Bartsokas C, Argyropoulou A, Gourzis P, Jelastopulu E. Depressive symptoms in late life in urban and semi-urban areas of South-West Greece: An undetected disorder? Indian J Psychiatry 2015; 57:295-300. [PMID: 26600585 PMCID: PMC4623650 DOI: 10.4103/0019-5545.166617] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
OBJECTIVE The objective of this study was to estimate the prevalence and probable under-diagnosis of depressive symptoms in elderly of an urban and semi-urban area in Greece. MATERIALS AND METHODS A cross-sectional study was conducted among the members of 4 days care centers for older people (KAPI), three in the municipality of Patras, West-Greece, and in one in Tripolis, Peloponnese, Greece. A total of 378 individuals took part in the study, aged >60 years. A questionnaire was developed to collect basic demographic data, including three questions from the European Health Interview Survey, regarding self-reported or by a physician-diagnosed depression. Moreover, to all participants the Greek validated version of the Geriatric Depression Scale-15 (GDS-15) was applied, to screen for depressive symptoms. RESULTS According to GDS-15, 48.1% of the studied population screened positive for depressive symptoms (38.6% moderate, 9.5% severe), whereas having ever been affected with chronic depression reported 19.0% by themselves. In 162 members of KAPI of Patras and in 106 of Tripolis, who never reported have been affected by depression and depressive symptoms were observed in 27.7% and 44.7%, respectively. In 28 individuals from Patras, who reported not to know if they have depression and in 10 from Tripolis, depressive symptoms were observed in 60.7% and 90%, respectively, applying the GDS-15. CONCLUSION Except the high prevalence, the present study reveals a remarkable under-detection of depressive symptoms in older adults. Various interventions in primary care are necessary so as to increase detection rates of depression among the elderly.
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Affiliation(s)
- Konstantinos Argyropoulos
- Department of Public Health, School of Medicine, University of Patras, Greece ; Department of Psychiatry, Panarcadian General Hospital of Tripolis, Greece
| | - Christos Bartsokas
- Department of Public Health, School of Medicine, University of Patras, Greece
| | | | | | - Eleni Jelastopulu
- Department of Public Health, School of Medicine, University of Patras, Greece
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Argryopoulos K, Bartsokas C, Argyropoulou A, Gourzis P, Jelastopulu E. Depression in Late Life in Urban and Semi Urban Areas of South-west Greece. Eur Psychiatry 2015. [DOI: 10.1016/s0924-9338(15)30233-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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Skokou M, Gourzis P. Demographic features and premorbid personality disorder traits in relation to age of onset and sex in paranoid schizophrenia. Psychiatry Res 2014; 215:554-9. [PMID: 24495576 DOI: 10.1016/j.psychres.2014.01.018] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/09/2013] [Revised: 01/08/2014] [Accepted: 01/11/2014] [Indexed: 11/25/2022]
Abstract
Personality disorders in the premorbid period of schizophrenia and particularly in relation to age of onset and sex, seem to be a rather under-researched area. In the present study, 88 patients with paranoid schizophrenia were examined, regarding demographic characteristics and premorbid personality disorder traits, in order to investigate for differences in the premorbid period of the disease, in relation to age of onset and sex. Age cutoff points were set at <30 years and ≥35 years of age for young and late onset groups, respectively. The Structured Clinical Interview for DSM-IV-Patient Edition for Axis I disorders (SCID-P) was used prospectively for diagnoses. Premorbid personality disorder traits were retrospectively assessed by using the Structured Clinical Interview for DSM-IV-Patient Edition for Axis II disorders (SCID-II). Comparisons were performed by applying the two-tailed Wilcoxon rank-sum and the χ(2) statistical tests. Young onset patients were characterized by significantly higher proportion of urban birth, single status, more avoidant premorbid personality disorder traits, and less passive-aggressive premorbid personality disorder traits, than late onset counterparts. Differences were more prominently shown in men. Earlier age of onset seems to be associated to increased social inhibition and worse psychosocial adaptation in the premorbid period of paranoid schizophrenia.
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Affiliation(s)
- Maria Skokou
- Department of Psychiatry, University Hospital of Patras, School of Medicine, University of Patras, University Campus, 26504 Rio, Patras, Greece.
| | - Philippos Gourzis
- Department of Psychiatry, University Hospital of Patras, School of Medicine, University of Patras, University Campus, 26504 Rio, Patras, Greece.
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Argyropoulos K, Bartsokas C, Argyropoulou A, Gourzis P, Jelastopulu E. EPA-0173 – Sleep disorders and association with depression in members of a day care center for elderly in tripolis, greece. Eur Psychiatry 2014. [DOI: 10.1016/s0924-9338(14)77631-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
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Skokou M, Gourzis P. 1824 – Menstrually related cyclothymia: a case report. Eur Psychiatry 2013. [DOI: 10.1016/s0924-9338(13)76789-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
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45
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Skokou M, Soubasi E, Gourzis P. Depression in multiple sclerosis: a review of assessment and treatment approaches in adult and pediatric populations. ISRN Neurol 2012; 2012:427102. [PMID: 23097716 PMCID: PMC3477767 DOI: 10.5402/2012/427102] [Citation(s) in RCA: 47] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/26/2012] [Accepted: 09/17/2012] [Indexed: 12/18/2022]
Abstract
Multiple sclerosis is a chronic demyelinating disease affecting one million people worldwide, with a significant burden of psychiatric comorbidity. Depression is the commonest psychiatric manifestation but still remains largely underdiagnosed and undertreated. The present work reviews current knowledge on diagnosis, assessment, and somatic and psychotherapeutic treatment interventions for depression in adult and pediatric populations of patients with multiple sclerosis.
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Affiliation(s)
- Maria Skokou
- Department of Psychiatry, School of Medicine and University Hospital of Patras, University of Patras, Rio, 26504 Patras, Greece
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Skokou M, Katrivanou A, Andriopoulos I, Gourzis P. [Active and prodromal phase symptomatology of young-onset and late-onset paranoid schizophrenia]. Rev Psiquiatr Salud Ment 2012; 5:150-9. [PMID: 22854609 DOI: 10.1016/j.rpsm.2012.03.002] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/23/2011] [Revised: 02/21/2012] [Accepted: 03/05/2012] [Indexed: 11/15/2022]
Abstract
INTRODUCTION Young and late onset patients with paranoid schizophrenia were compared, regarding the initial prodromal and active phases of the disorder, in order to examine the influence of age of onset on the prodromal and active phase symptomatology of the disease. MATERIALS AND METHODS We examined 88 consecutively hospitalized patients with paranoid schizophrenia. Age cutoff points were set at <30 years of age for the young, and ≥35 years of age for the late onset group. Diagnoses were made prospectively, using the Structured Clinical Interview for DSM-IV-Patient Edition for Axis I disorders (SCID-P). Type and severity of psychopathology in the active phase were assessed by applying the Structured Clinical Interview for Positive and Negative Syndrome Scale (PANSS). Patients were retrospectively examined regarding their initial prodromal symptoms by applying the Structured Clinical Interview for DSM-III-R Patient Edition and clinical interviewing for additional symptoms. Comparisons were performed by applying the two-tailed Wilcoxon rank-sum and the chi-square statistical tests. RESULTS The young onset group was characterized by significantly more negative prodromal symptoms, and heavier negative symptomatology in the active phase, than the late onset group. Differences were more prominently shown in male patients. CONCLUSIONS Older age of onset of paranoid schizophrenia appears to be related to a less severe form of the disease, characterized by less severity of negative symptomatology, already demonstrated in the prodromal phase of the disorder.
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Affiliation(s)
- Maria Skokou
- Department of Psychiatry, School of Medicine, University Hospital of Patras, Patras, Grecia
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Argyropoulos K, Gourzis P, Jelastopulu E. [Prevalence of depression among the elderly]. Psychiatriki 2012; 23:39-45. [PMID: 22549039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
Depression is the most common mental health problem among older people, posing a critical impact on their well-being and the quality of life. The objective of the present study was to estimate the prevalence of depression in elderly population of an urban area and to investigate the association with various aggravating or protective factors. The sample consisted of 239 subjects, aged >60 years, members of "daycare centers for older people" (KAPI) in the municipality of Patras, W-Greece. A questionnaire was developed to collect basic demographic and socioeconomic data, including three questions from the "European Health Interview Survey" (EHIS), regarding self-reported and/or by a physician diagnosed depression. Moreover, to all participants the Greek validated version of the Geriatric Depression Scale (GDS-15) was applied, to screen the elderly for depressive symptoms. The scores of the GDS were a) compared to the corresponding answers of the EHIS questions and b) associated to the various recorded basic parameters. Statistical analyses were performed using the SPSS v. 17.0. The results of the GDS indicated 45% of the studied population having depressive symptoms (36% moderate, 9% severe), while having ever been affected with chronic depression reported 49 (20.5%) and out of them 34 (66.8%) stated to have been diagnosed by a medical doctor. In detail, out of the 162 (67.8%) subjects reporting never have been affected by a depression, 37 (22.8%) and 8 (4.9%) screened positive for moderate and severe depressive symptoms, respectively. In 27 individuals who reported not to know if they have depression, 16 revealed depressive symptoms using the GDS. Depressive symptoms were more frequent in women (54.6% vs 37.4%, p=0.027), in not married, including divorced and widowed, compared to married (55.6% vs 38.9%, p=0.038) and in subjects living alone at home (62% vs 38.1%, p=0.003). Depressive symptoms were more frequent in elderly with chronic diseases compared to elderly without comorbidity (50.8% vs 27.5%, p=0.02). High prevalence of depressive symptoms in elderly population is evident, but rarely recognized. The systematic use of short GDS versions in Primary Care may increase detection rates of depression among the elderly.
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Affiliation(s)
- K Argyropoulos
- Department of Public Health, Medical School, University of Patras, Patra - Psychiatric Hospital of Tripoli, Tripoli
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Argyropoulos K, Gourzis P, Jelastopulu E. P-721 - Depression in older people: prevalence and underdiagnosis in members of day care centers in patras. Eur Psychiatry 2012. [DOI: 10.1016/s0924-9338(12)74888-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Alexopoulos P, Ebert A, Richter-Schmidinger T, Schöll E, Natale B, Aguilar CA, Gourzis P, Weih M, Perneczky R, Diehl-Schmid J, Kneib T, Förstl H, Kurz A, Danek A, Kornhuber J. Validation of the German revised Addenbrooke's cognitive examination for detecting mild cognitive impairment, mild dementia in alzheimer's disease and frontotemporal lobar degeneration. Dement Geriatr Cogn Disord 2010; 29:448-56. [PMID: 20502019 DOI: 10.1159/000312685] [Citation(s) in RCA: 44] [Impact Index Per Article: 3.1] [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] [Accepted: 03/30/2010] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND/AIMS The diagnostic accuracy of the German version of the revised Addenbrooke's Cognitive Examination (ACE-R) in identifying mild cognitive impairment (MCI), mild dementia in Alzheimer's disease (AD) and mild dementia in frontotemporal lobar degeneration (FTLD) in comparison with the conventional Mini Mental State Examination (MMSE) was assessed. METHODS The study encompasses 76 cognitively healthy elderly individuals, 75 patients with MCI, 56 with AD and 22 with FTLD. ACE-R and MMSE were validated against an expert diagnosis based on a comprehensive diagnostic procedure. Statistical analysis was performed using the receiver operating characteristic method and regression analyses. RESULTS The optimal cut-off score for the ACE-R for detecting MCI, AD, and FTLD was 86/87, 82/83 and 83/84, respectively. ACE-R was superior to MMSE only in the detection of patients with FTLD [area under the curve (AUC): 0.97 vs. 0.92], whilst the accuracy of the two instruments did not differ in identifying MCI and AD. The ratio of the scores of the memory ACE-R subtest to verbal fluency subtest contributed significantly to the discrimination between AD and FTLD (optimal cut-off score: 2.30/2.31, AUC: 0.77), whereas the MMSE and ACE-R total scores did not. CONCLUSION The German ACE-R is superior to the most commonly employed MMSE in detecting mild dementia in FTLD and in the differential diagnosis between AD and FTLD. Thus it might serve as a valuable instrument as part of a comprehensive diagnostic workup in specialist centres/clinics contributing to the diagnosis and differential diagnosis of the cause of dementia.
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Affiliation(s)
- P Alexopoulos
- Department of Psychiatry and Psychotherapy, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany. panos.alexopoulos @ lrz.tu-muenchen.de
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Moukas G, Gourzis P, Beratis IN, Beratis S. Sex differences in prepsychotic "prodromal" symptomatology and its association with Positive and Negative Syndrome Scale active phase psychopathology in male and female patients. Compr Psychiatry 2010; 51:546-51. [PMID: 20728014 DOI: 10.1016/j.comppsych.2009.11.003] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [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] [Received: 03/18/2009] [Revised: 08/27/2009] [Accepted: 11/12/2009] [Indexed: 12/01/2022] Open
Abstract
BACKGROUND A wide spectrum of prodromal symptoms has been reported, but their association with the severity of the active phase psychopathology in relationship to sex is unknown. METHOD Seventy-three (47 male) Diganostic and Statistical Manual (DSM) schizophrenia patients were subjected to the structured clinical interview for Positive and Negative Syndrome Scale (PANSS). Prodromal symptoms were recorded retrospectively after psychotic phase had subsided. RESULTS Thirty-eight prodromal symptoms were identified. All symptoms appeared in both sexes. However, there was a significantly greater frequency of 3 symptoms (odd beliefs/magical thinking, over elaborate speech, hyperacusia) in female patients and of 2 symptoms (marked peculiar behavior, aggressiveness) in male patients. In the female patients, 9 symptoms were associated with an increased risk for severe total and components of the PANSS psychopathology in the psychotic phase; 2 symptoms were associated with a mild negative subscale psychopathology. In the male patients, 6 symptoms were associated with the severity of the PANSS psychopathology; 5 carried an increase risk for severe and 1 was associated with mild psychopathology. Also, the risk for severe PANSS positive, general, and total psychopathology increased with the increasing number of total and less specific symptoms in the female but not in the male patients. CONCLUSIONS Sex differences in schizophrenia are extended into the prepsychotic stage. Also, the presence of certain prodromal symptoms, different in men and women, and the number of symptoms in female patients are associated with the severity of the psychotic phase psychopathology. Evaluation of early therapeutic interventions in prodromal phase should consider sex and spectrum of prodromal symptoms.
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Affiliation(s)
- George Moukas
- Department of Psychiatry, General University Hospital, University of Patras, Medical School, 265 04 Rion, Patras Greece
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