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Bozikas VP, Dardagani A, Parlapani E, Ntouros E, Lagoudis A, Tsotsi S. Improved facial affect recognition in patients with first-episode psychosis. Early Interv Psychiatry 2019; 13:977-983. [PMID: 30298549 DOI: 10.1111/eip.12738] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/07/2018] [Revised: 08/10/2018] [Accepted: 09/09/2018] [Indexed: 12/01/2022]
Abstract
AIM The present study aimed at assessing whether impaired facial affect recognition (FAR) in patients with first-episode psychosis (FEP) would improve after a brief intervention targeting FAR specifically. METHODS Thirty-five outpatients and 38 healthy controls were administered an intervention which involved training to recognize emotional information, conveyed by changes in facial features. Using a pre- and post-intervention design, two measurements of FAR were conducted using an experimental procedure with alternative sets of stimuli. RESULTS We found improved overall FAR performance in both participant groups with marked effects in recognizing anger, disgust and fear. Patients' post-intervention performance was comparable to healthy participants' baseline performance. CONCLUSIONS The present improvement in facial affects recognition in FEP patients, despite only somewhat impaired, emphasizes the importance of early targeted interventions for FAR in psychosis. Further research is needed to assess whether this improvement will generalize to global social functioning.
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Affiliation(s)
- Vasilios P Bozikas
- Second Department of Psychiatry, School of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Aikaterini Dardagani
- Second Department of Psychiatry, School of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Eleni Parlapani
- First Department of Psychiatry, School of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Evangelos Ntouros
- Second Department of Psychiatry, School of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Athanasios Lagoudis
- Second Department of Psychiatry, School of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Stella Tsotsi
- Centre for Research in Child Development, National Institute of Education, Nanyang Technological University, Singapore, Singapore
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Siddi S, Ochoa S, Laroi F, Cella M, Raballo A, Saldivia S, Quijada Y, Laloyaux J, Rocha NB, Lincoln TM, Schlier B, Ntouros E, Bozikas VP, Gawęda Ł, Machado S, Nardi AE, Rodante D, Deshpande SN, Haro JM, Preti A. A Cross-National Investigation of Hallucination-Like Experiences in 10 Countries: The E-CLECTIC Study. Schizophr Bull 2019; 45:S43-S55. [PMID: 30715543 PMCID: PMC6357978 DOI: 10.1093/schbul/sby156] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Hallucination-like experiences (HLEs) are typically defined as sensory perceptions in the absence of external stimuli. Multidimensional tools, able to assess different facets of HLEs, are helpful for a better characterization of hallucination proneness and to investigate the cross-national variation in the frequencies of HLEs. The current study set out to establish the validity, factor structure, and measurement invariance of the Launay-Slade Hallucinations Scale-Extended (LSHS-E), a tool to assess HLEs. A total of 4419 respondents from 10 countries were enrolled. Network analyses between the LSHS-E and the 3 dimensions of the Community Assessment of Psychic Experiences (CAPE) were performed to assess convergent and divergent validity of the LSHS-E. Confirmatory factor analysis was used to test its measurement invariance. The best fit was a 4-factor model, which proved invariant by country and clinical status, indicating cross-national stability of the hallucination-proneness construct. Among the different components of hallucination-proneness, auditory-visual HLEs had the strongest association with the positive dimension of the CAPE, compared with the depression and negative dimensions. Participants who reported a diagnosis of a mental disorder scored higher on the 4 LSHS-E factors. Small effect size differences by country were found in the scores of the 4 LSHS-E factors even after taking into account the role of socio-demographic and clinical variables. Due to its good psychometric properties, the LSHS-E is a strong candidate tool for large investigations of HLEs.
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Affiliation(s)
- Sara Siddi
- Parc Sanitari Sant Joan de Déu, Fundació Sant Joan de Déu, Institut de Recerca Sant Joan de Déu, Sant Boi de Llobregat, Spain,Universitat de Barcelona, Barcelona, Spain,Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain,Department of Education, Psychology, Philosophy, University of Cagliari, Cagliari, Italy,To whom correspondence should be addressed; Teaching, Research & Innovation Unit, Parc Sanitari Sant Joan de Déu, Dr. Antoni Pujadas, 42, 08830 - Sant Boi de Llobregat, Barcelona, Spain; tel: +34-93-640-63-50 Ext: (1) 2385, fax: +34-93-556-96-74, e-mail:
| | - Susana Ochoa
- Parc Sanitari Sant Joan de Déu, Fundació Sant Joan de Déu, Institut de Recerca Sant Joan de Déu, Sant Boi de Llobregat, Spain,Universitat de Barcelona, Barcelona, Spain,Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain
| | - Frank Laroi
- Department of Biological and Medical Psychology, University of Bergen, Bergen, Norway,NORMENT – Norwegian Center of Excellence for Mental Disorders, Research, University of Oslo, Oslo, Norway,Psychology and Neuroscience of Cognition Research Unit, University of Liège, Liège, Belgium
| | - Matteo Cella
- Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
| | - Andrea Raballo
- Department of Medicine, Section of Psychiatry, University of Perugia, Perugia, Italy,Department of Psychology, Psychopathology and Development Research, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
| | - Sandra Saldivia
- Department of Psychiatry and Mental Health, Faculty of Medicine, University of Concepcion, Concepcion, Chile
| | - Yanet Quijada
- Facultad de Psicologia, Universidad San Sebastian, Concepcion, Chile
| | - Julien Laloyaux
- Department of Biological and Medical Psychology, University of Bergen, Bergen, Norway,NORMENT – Norwegian Center of Excellence for Mental Disorders, Research, University of Oslo, Oslo, Norway,Psychology and Neuroscience of Cognition Research Unit, University of Liège, Liège, Belgium
| | - Nuno Barbosa Rocha
- Center for Rehabilitation Research, School of Health, P.Porto, Porto, Portugal
| | - Tania M Lincoln
- Clinical Psychology and Psychotherapy, Institute of Psychology and Movement Sciences, Universitat Hamburg, Hamburg, Germany
| | - Björn Schlier
- Clinical Psychology and Psychotherapy, Institute of Psychology and Movement Sciences, Universitat Hamburg, Hamburg, Germany
| | - Evangelos Ntouros
- Psychiatric Department, 424 General Military Hospital of Thessaloniki, Thessaloniki, Greece,1st Department of Psychiatry, Aristotle University of Thessaloniki, General Hospital “Papageorgiou”, Thessaloniki, Greece
| | - Vasileios P Bozikas
- 1st Department of Psychiatry, Aristotle University of Thessaloniki, General Hospital “Papageorgiou”, Thessaloniki, Greece
| | - Łukasz Gawęda
- II Department of Psychiatry, The Medical University of Warsaw, Warsaw, Poland
| | - Sergio Machado
- Laboratory of Panic and Respiration, Institute of Psychiatry (IPUB), Federal University of Rio de Janeiro (UFRJ), Rio de Janeiro, Brazil,Laboratory of Physical Activity Neuroscience, Salgado de Oliveira University, Niteroi, Brazil
| | - Antonio E Nardi
- Laboratory of Panic and Respiration, Institute of Psychiatry (IPUB), Federal University of Rio de Janeiro (UFRJ), Rio de Janeiro, Brazil
| | - Demián Rodante
- Institute of Pharmacology, School of Medicine, University of Buenos Aires, Argentina; “Dr. Braulio A. Moyano” Neuropsychiatric Hospital, Ciudad de Buenos Aires, Argentina
| | - Smita N Deshpande
- Department of Psychiatry, & Centre of Excellence in Mental Health, PGIMER-Dr. Ram Manohar Lohia Hospital, Bangabandhu Sheikh Mujib Road, New Delhi, India
| | - Josep Maria Haro
- Parc Sanitari Sant Joan de Déu, Fundació Sant Joan de Déu, Institut de Recerca Sant Joan de Déu, Sant Boi de Llobregat, Spain,Universitat de Barcelona, Barcelona, Spain,Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain
| | - Antonio Preti
- Department of Education, Psychology, Philosophy, University of Cagliari, Cagliari, Italy,Center of Liaison Psychiatry and Psychosomatics, University Hospital, University of Cagliari, Cagliari, Italy
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Ntouros E, Karanikas E, Floros G, Andreou C, Tsoura A, Garyfallos G, Bozikas VP. Social cognition in the course of psychosis and its correlation with biomarkers in a male cohort. Cogn Neuropsychiatry 2018; 23:103-115. [PMID: 29447074 DOI: 10.1080/13546805.2018.1440201] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
INTRODUCTION Patients diagnosed with schizophrenia display deficits in Theory of Mind (ToM) and Emotion Perception (EP) even before the appearance of full-blown symptomatology. METHODS We evaluated ToM and EP in a male cohort consisting of 25 First Episode Psychosis (FEP) and 16 relapsed schizophrenic patients (CHRON) compared to 12 subjects in Ultra-high Risk (UHR) and 23 healthy controls (CTR). Furthermore, we measured the levels of Cortisol, Insulin like Growth Factor (IGF-1), TNF-a, TNF-b and several interleukins as potential biomarkers. RESULTS Deficits in EP and ToM were found in FEP, CHRON patients and UHR subjects compared to CTR. The impairments in these two domains seem to follow different patterns in the course of psychosis. EP was more impaired in subjects with a longer history of symptomatology whereas there was no statistically significant difference regarding ToM. On the other hand IL-4 was the only biomarker correlated to ToM and EP scores in two different samples of our study. CONCLUSION Social Cognition (SC) domains are impaired in patients with psychosis as well as in UHR subjects compared to healthy controls. There are differences in the progress of ToM and EP deficits in the course of psychosis. Interleukins as IL-4 could correlate to SC.
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Affiliation(s)
- Evangelos Ntouros
- a Psychiatric Department , 424 General Military Hospital of Thessaloniki , Thessaloniki , Greece
| | - Evangelos Karanikas
- a Psychiatric Department , 424 General Military Hospital of Thessaloniki , Thessaloniki , Greece.,e The University of Queensland, Rural Clinical School, School of Medicine , Toowoomba , Australia
| | - Georgios Floros
- b 2nd Department of Psychiatry , Aristotle University of Thessaloniki, Psychiatric Hospital of Thessaloniki , Thessaloniki , Greece
| | - Christina Andreou
- c University Psychiatric Clinics, University of Basel , Basel , Switzerland
| | - Aikaterini Tsoura
- b 2nd Department of Psychiatry , Aristotle University of Thessaloniki, Psychiatric Hospital of Thessaloniki , Thessaloniki , Greece
| | - Georgios Garyfallos
- b 2nd Department of Psychiatry , Aristotle University of Thessaloniki, Psychiatric Hospital of Thessaloniki , Thessaloniki , Greece
| | - Vasilios P Bozikas
- d 1st Department of Psychiatry , Aristotle University of Thessaloniki, General Hospital "Papageorgiou" , Thessaloniki , Greece
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Karanikas E, Ntouros E, Oikonomou D, Floros G, Griveas I, Garyfallos G. Evidence for Hypothalamus-Pituitary-Adrenal Axis and Immune Alterations at Prodrome of Psychosis in Males. Psychiatry Investig 2017; 14:703-707. [PMID: 29042899 PMCID: PMC5639142 DOI: 10.4306/pi.2017.14.5.703] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/15/2016] [Revised: 09/11/2016] [Accepted: 10/13/2016] [Indexed: 12/12/2022] Open
Abstract
We aimed to investigate the inflammatory substrate in psychosis by evaluating both the Hypothalamus-Pituitary-Adrenal axis function and immune state at prodrome. This involved the recruitment of Ultra High Risk (UHR) of Psychosis subjects, Healthy Controls (HC) and patients with established Schizophrenia (CHRON). Serum cortisol at 3 different times throughout the day was measured. The Dexamethasone Suppression Test was performed plus 12 circulating cytokines were measured. The UHR subjects presented increased IL-4 levels compared with both the HC and CHRON patients. In contrast the UHR differed only from the CHRON group regarding the endocrine parameters. In conclusion, IL-4 appears to play a key role at prodrome.
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Affiliation(s)
- Evangelos Karanikas
- School of Medicine, Rural Clinical School, The University of Queensland, Toowoomab, Australia
- Psychiatric Department, General Military Hospital of Thessaloniki, Thessaloniki, Greece
| | - Evangelos Ntouros
- Psychiatric Department, General Military Hospital of Thessaloniki, Thessaloniki, Greece
| | - Dimitrios Oikonomou
- Psychiatric Department, General Military Hospital of Thessaloniki, Thessaloniki, Greece
| | - Georgios Floros
- 2nd Psychiatric Department, Aristotle University of Thessaloniki, Psychiatric Hospital of Thessaloniki, Thessaloniki, Greece
| | | | - Georgios Garyfallos
- 2nd Psychiatric Department, Aristotle University of Thessaloniki, Psychiatric Hospital of Thessaloniki, Thessaloniki, Greece
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Karanikas E, Manganaris S, Ntouros E, Floros G, Antoniadis D, Garyfallos G. Cytokines, cortisol and IGF-1 in first episode psychosis and ultra high risk males. Evidence for TNF-α, IFN-γ, ΤNF-β, IL-4 deviation. Asian J Psychiatr 2017; 26:99-103. [PMID: 28483103 DOI: 10.1016/j.ajp.2017.01.026] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [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: 11/09/2016] [Revised: 01/21/2017] [Accepted: 01/22/2017] [Indexed: 01/01/2023]
Abstract
The aim of the study was to determine circulating cytokines, cortisol and Insulin-like Growth Factor (IGF)-1, known for their involvement in inflammation, in male patients with First Episode Psychosis (FEP) and subjects at Ultra High Risk (UHR) for Psychosis. The FEP group presented increased pro-inflammatory cytokines (TNF-α, IFN-γ, ΤNF-β) as well as increased anti-inflammatory cytokine (IL-4) compared with Healthy Controls (HC). The UHR group showed increased IL-4 against HC. In contrast, none of the groups did show deviation from normality in either cortisol or IGF-1 levels. These preliminary findings support the cytokines' role in the inflammatory hypothesis in psychosis.
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Affiliation(s)
- Evangelos Karanikas
- The University of Queensland, Rural Clinical School, School of Medicine, 152, West St., Toowoomba, QLD 4350, Australia; 424 General Military Hospital of Thessaloniki, Psychiatric Department, Thessaloniki Ring Road, 56429 Efkarpia, Thessaloniki, Greece.
| | - Stefanos Manganaris
- International Business Machines Corporation, New Orchard Road, Armonk, New York 10504 USA
| | - Evangelos Ntouros
- 424 General Military Hospital of Thessaloniki, Psychiatric Department, Thessaloniki Ring Road, 56429 Efkarpia, Thessaloniki, Greece
| | - Georgios Floros
- 2nd Psychiatric Department, Aristotle University of Thessaloniki, 196 Lagkadast, Stavroupoli 564 29, Thessaloniki, Greece
| | - Diomidis Antoniadis
- 2nd Psychiatric Department, Aristotle University of Thessaloniki, 196 Lagkadast, Stavroupoli 564 29, Thessaloniki, Greece
| | - Georgios Garyfallos
- 2nd Psychiatric Department, Aristotle University of Thessaloniki, 196 Lagkadast, Stavroupoli 564 29, Thessaloniki, Greece
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Dardagani A, Athanasis P, Lagoudis A, Ramnalis A, Ntouros E, Bozikas V. A longitudinal evaluation of cognitive deficits in patients with first episode of psychosis. Eur Psychiatry 2017. [DOI: 10.1016/j.eurpsy.2017.01.2117] [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: 11/15/2022] Open
Abstract
It has been well documented in many studies till now that patients in their first episode of psychosis demonstrate cognitive deficits. However, it is yet to be made clear how these deficits progress. Deterioration, stability or even amelioration in some domains has been noted from researchers. The aim of this study was to examine the longitudinal course of cognitive deficits over time. We administered a comprehensive battery of neuropsychological test to a group of first psychotic episode patients at the acute phase, 6 months and 1 year later. The sample comprised of 25 patients (13 male) in the first episode of psychosis. Specific tests of the Cambridge Neuropsychological Test Automated Battery (CANTAB) were used. The cognitive domains of attention, memory, working memory, visuospatial ability and planning, mental flexibility/shifting were examined. Repeated measures ANOVA was used in order to detect changes in the patients’ performance over time. According to our data, there was an improvement from baseline to 6 months in attention, planning and visual working memory. There was no change in performance in these cognitive domains from 6 months to 1 year from baseline. Memory, mental flexibility/shifting and visuospatial memory remained stable over time. Our data suggest variability concerning neuropsychological performance in specific tests examining different domains. Evaluation of cognitive function in the first episode of psychosis needs more thorough and comprehensive research, in relation to its course over time.Disclosure of interestThe authors have not supplied their declaration of competing interest.
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Karanikas E, Griveas I, Ntouros E, Floros G, Garyfallos G. Evidence for increased immune mobilization in First Episode Psychosis compared with the prodromal stage in males. Psychiatry Res 2016; 244:333-8. [PMID: 27517343 DOI: 10.1016/j.psychres.2016.07.059] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2016] [Revised: 07/12/2016] [Accepted: 07/31/2016] [Indexed: 10/21/2022]
Abstract
The aim of the study was to gauge both the immune and neuroendocrine function in Ultra High Risk for psychosis (UHR) subjects and compare them with a cohort presenting with First Episode Psychosis (FEP). We recruited two groups, the first group consisted of 12 UHR males and the second of 25 males with FEP. We measured serum cortisol levels at 08:00, 12:00, 18:00 with their Area Under Curve with respect to the ground (AUCg) and the increase (AUCi) and we measured serum cytokines levels, Interleukin-1a, IL-1a, IL-2, IL-4,IL-5,IL-6,IL-8, IL-10,IL-12, IL-17a, Tumor Necrosis Factor-a (TNF-a), Interferon-γ (IFN-γ). Dexamethasone Suppression Test (DST) was also performed . The results suggest higher levels of both pro-inflammatory (TNF-a, IL-2, IL-12, IFN-γ) and anti-inflammatory (IL-10) cytokines in the FEP group compared with the UHR counterparts. Regarding the HPA axis function, the prodromal subjects showed a trend for higher AUCg and AUCi change/decrease cortisol levels. On the contrary, the DST results did not differ between the groups. No significant associations were demonstrated within each group among cytokines, cortisol and psychopathology. The findings favor a hypothesis of a relatively increased mobilization of both the pro- and anti-inflammatory cytokine networks, in FEP compared with that of UHR subjects.
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Affiliation(s)
- Evangelos Karanikas
- The University of Queensland, Rural Clinical School, School of Medicine, 152 West St, Toowoomba, QLD 4350, Australia; 424 General Military Hospital of Thessaloniki, Psychiatric Department, Thessaloniki Ring Road, 56429 Efkarpia, Thessaloniki, Greece.
| | - Ioannis Griveas
- 401 General Military Hospital of Athens, P Kanelopoulou 1 st, 11525 Goudi, Athens, Greece
| | - Evangelos Ntouros
- 424 General Military Hospital of Thessaloniki, Psychiatric Department, Thessaloniki Ring Road, 56429 Efkarpia, Thessaloniki, Greece
| | - Georgios Floros
- 2nd Psychiatric Department, Aristotle University of Thessaloniki, Psychiatric Hospital of Thessaloniki, 196 Lagkada St, Stavroupoli 564 29, Greece
| | - George Garyfallos
- 2nd Psychiatric Department, Aristotle University of Thessaloniki, Psychiatric Hospital of Thessaloniki, 196 Lagkada St, Stavroupoli 564 29, Greece
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Bozikas VP, Ntouros E, Andreou C, Nazlidou EI, Floros G, Tsoura E, Garyfallos G. The role of obsessive-compulsive symptoms in the perception of insincere speech in first-episode psychosis. J Clin Exp Neuropsychol 2016; 37:842-52. [PMID: 26313514 DOI: 10.1080/13803395.2015.1064863] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
OBJECTIVES The aim of the present study was to investigate the effects of comorbid obsessive-compulsive symptoms (OCS) on the perception of insincere speech (e.g., sarcasm and white lies) in patients with first-episode psychosis. DESIGN AND METHOD Participants were 65 patients with nonaffective first-episode psychosis (FEP) and 47 healthy controls. The patient group was divided into two subgroups, those with (FEP+; n= 38) and those without OCS (FEP-; n = 27). The ability to process sarcasm and lie was assessed with the Perception of Social Inference Test (PESIT). Severity of psychotic symptoms and OCS was assessed with the Positive and Negative Syndrome Scale (PANSS) and the Yale-Brown Obsessive Compulsive Scale (Y-BOCS), respectively. RESULTS Deficits in the perception of sarcasm and lie were confirmed in patients with nonaffective first-episode psychosis compared to healthy controls. In patients, comorbidity with OCS was associated with worse performance on certain aspects of insincere speech (i.e., lie) compared to FEP- patients. Y-BOCS scores correlated significantly with the perception of lying. The cognitive factor of the PANSS predicted accuracy on the perception of sincere speech, paradoxical sarcasm, and white lies, while the presence of OCS predicted accuracy on the perception of sincere speech and white lies. CONCLUSIONS Our finding of impaired counterfactual information processing in patients with first-episode psychosis suggests that these deficits are already present at illness onset. Presence of OCS appears to have additional deleterious effects on the successful interpretation of intentional lying, further supporting that these patients are characterized by more extensive cognitive impairment.
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Affiliation(s)
- Vasilis P Bozikas
- a First Department of Psychiatry , Aristotle University of Thessaloniki , Thessaloniki , Greece
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Nasioudis D, Palaiodimos L, Dagiasis M, Katsarou A, Ntouros E. Depression in military medicine cadets: a cross-sectional study. Mil Med Res 2015; 2:28. [PMID: 26557991 PMCID: PMC4640107 DOI: 10.1186/s40779-015-0058-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [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: 03/23/2015] [Accepted: 10/20/2015] [Indexed: 12/01/2022] Open
Abstract
BACKGROUND Military medicine cadets undergo strenuous military training alongside demanding medical studies. This stressful and complex educational environment can lead to the emergence of depressive symptoms. We investigated the prevalence of depressive symptoms in a cohort of military medicine cadets. METHODS We conducted a descriptive questionnaire-based cross-sectional study among Greek military medicine cadets in the undergraduate program of the Hellenic Military School of Combat Support Officers. The Greek translation of the Zung self-rating depression scale questionnaire was used to screen for the presence of depressive symptoms. In addition, demographic, academic and dietary information was collected. The Shapiro-Wilk test of normality, Pearson correlation test, Chi-square test, t-test and Mann Whitney U test were employed for statistical analysis. RESULTS We enrolled 55 female and 91 male military medicine cadets with a mean age of 19.84 years (SD = 0.99). The mean Zung crude score was 43.32 (SD = 4.55): 42.8 (SD = 4.43) for female cadets and 43.64 (SD = 4.6) for male cadets. Cadets were further subdivided into low and high risk groups for the presence of depressive symptoms. We identified 57 (39 %) cadets with a total Zung crude score of 45 or above: 21 females and 36 males. Statistical analysis did not reveal any significant differences between the two groups based on gender, year of training, academic performance, alcohol consumption, smoking status, vitamin supplementation, dietary habits or BMI. CONCLUSIONS We report a high prevalence of depressive symptoms in a cohort of military medicine cadets that underscores the need for effective screening and appropriate and timely interventions. We did not identify any related risk factors. Military medicine cadets are exposed to a challenging military and medical training environment, and thus represent a group at risk for development of depression.
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Affiliation(s)
| | - Leonidas Palaiodimos
- Department of Medicine, Jacobi Medical Center/Albert Einstein College of Medicine, New York, USA
| | | | | | - Evangelos Ntouros
- Hellenic Military School of Combat Support Officers (SSAS), Thessaloniki, Greece
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Abstract
Koro syndrome is a psychiatric disorder characterised, in its typical form, by acute and intense anxiety, with complaints in men of a shrinking penis or fear of its retraction into the abdomen and resultant death. Initially, this syndrome was described as a culture specific disorder. Sporadic cases referred to as the koro-like syndrome have been observed in western countries recently. They are more likely to appear in the context of a psychiatric or neurological disorder. The clinical course of culture bound koro syndrome is usually self limited, but in some cases it can be transient or take on a chronic or recurrent form, lasting from days to weeks, months or even years. We present two cases, one of a middle aged man whose koro-like symptoms have persisted for over 18 years in a relapse mode that is rarely observed, and one of a young schizophrenic, who also exhibits koro-like symptoms.
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Affiliation(s)
- Evangelos Ntouros
- Aristotle University of Thessaloniki, 2nd Psychiatric Department, Dodekanisou 2, Polichni, 56533, Greece
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Floros G, Grammatikopoulos I, Girouki M, Amanatiadis V, Ntouros E, Pahumis G, Nikolaidis N, Garyfallos G, Giouzepas I. P03-329 - Impact of transition to atypical antipsychotics in the course and outcome of first-time admittances in a psychiatric clinic. Eur Psychiatry 2010. [DOI: 10.1016/s0924-9338(10)70935-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
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