Psychiatrike = Psychiatriki最新文献

{"title":"Recent advances in the detection and management of motor dysfunction in Alzheimer's disease.","authors":"Chrysa Marogianni, Vasileios Siokas, Efthimios Dardiotis","doi":"10.22365/jpsych.2025.012","DOIUrl":"https://doi.org/10.22365/jpsych.2025.012","url":null,"abstract":"<p><p>Alzheimer's disease (AD) is a progressive neurodegenerative disorder primarily characterized by cognitive decline. However, there is growing recognition of the significant impact of motor dysfunction in individuals affected by AD. These motor impairments contribute substantially to functional decline, reduced quality of life, and increased caregiver burden in AD patients.1 Current research efforts are increasingly focused on identifying motor dysfunction as a potential early marker in the progression of AD. The temporal relationship between motor and cognitive decline is under intense investigation, with studies suggesting that subtle motor changes, such as gait and balance disturbances or slowed walking speed, may precede detectable cognitive impairment by several years.2 Specifically, research indicates that gait speed predicts a decline in processing speed and visuospatial abilities, and in ApoE4 carriers, it also predicts a memory decline.3 One study found that increased amyloid-beta (Aβ) deposition is associated with reduced gait speed, muscle strength, and balance in cognitively impaired older adults.4 Emerging evidence strongly supports the inclusion of motor function assessments, particularly gait analysis, in the early detection and risk stratification of AD. This could enable earlier interventions and potentially lead to improved disease management. Technological advancements provide increasingly sophisticated non-invasive methods for detecting motor impairments in AD, potentially enabling earlier and more accurate diagnoses. Digital tools and applications-including smartphone-based assessments and virtual reality platforms-are being explored for objective and quantitative evaluation of mobility. These digital measures offer the potential for longitudinal data collection and the detection of subtle changes in motor function over time.5 Digital biomarkers provide the advantage of frequent, objective monitoring in real-world settings, potentially capturing early motor changes that may be missed by traditional clinical evaluations.6 Nonetheless, challenges remain regarding validation, standardization, and the influence of variables such as demographics and disease stage. Wearable devices offer the potential for continuous, non-invasive monitoring of motor behavior, revealing subtle changes indicative of early AD. However, interpreting data from these devices requires careful consideration and further validation in larger studies. Additionally, recent applications of MRI, PET, and other neuroimaging techniques are being examined to detect brain changes related to motor dysfunction in AD. Advanced MRI techniques, such as diffusion tensor imaging (DTI), are used to assess white matter integrity along motor pathways, while molecular PET imaging can visualize amyloid and tau pathology in brain regions associated with motor control.7 Of note, tau pathology in higher motor regions has been significantly associated with cognitive decline. Ad","PeriodicalId":20741,"journal":{"name":"Psychiatrike = Psychiatriki","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144120689","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence of attention deficit hyperactivity disorder in individuals with psychoactive substance dependence.","authors":"Spyridoula Giatra, Venetsanos Mavreas","doi":"10.22365/jpsych.2025.010","DOIUrl":"https://doi.org/10.22365/jpsych.2025.010","url":null,"abstract":"<p><p>Attention Deficit Hyperactivity Disorder (ADHD) is the most common neurodevelopmental childhood disorder, which in most cases persists into adulthood, causing severe functional impairment. ADHD constitutes an important risk factor for the onset of use and the development of dependence on psychoactive substances. Impulse control disorders, anxiety, mood disorders, and substance abuse are the most common comorbid disorders. The present study aims to estimate the prevalence of ADHD in adult users of psychoactive substances who have attended a treatment program in a special detoxification unit for psychoactive substances. The study concerns the examination of one hundred eighteen psychoactive substance users using the following diagnostic tools: (a) Section 12 of the semi-structured interview SCAN 2.0, which assesses diagnostic criteria of psychoactive substance abuse and dependence. (b) The structured clinical interview CIS-R, which investigates the presence of psychopathological symptoms of \"common mental disorders\". (c) The WURS scale retrospectively probes into ADHD symptoms up to the age of 7. The prevalence of ADHD in the sample of individuals with psychoactive substance use disorders was found to be 38.1%. Analyses were also performed concerning age and the comorbidity of common psychiatric disorders and ADHD. Findings are consistent with the results of other studies. The drug users of psychoactive substances, regardless of the ADHD comorbidity, had an increased prevalence of common psychiatric disorders. The most common comorbidities were other psychoactive substance disorders, anxiety, and depressive disorders. The small number of participants, the exclusive use of one substance by the participants, and the type of unit where the present study was conducted restrict the generalizability of its results.</p>","PeriodicalId":20741,"journal":{"name":"Psychiatrike = Psychiatriki","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144120688","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Post-traumatic stress disorder and outcome in train passengers of the Tempi accident in Greece: Data from the Trauma and Stress Disorders Unit of the 3rd Department of Psychiatry, A.U.Th., University Hospital AHEPA].","authors":"Konstantinos N Fountoulakis, Konstantina Tsiggeni, Gregory Karakatsoulis","doi":"10.22365/jpsych.2025.009","DOIUrl":"https://doi.org/10.22365/jpsych.2025.009","url":null,"abstract":"<p><p>The aim of this study is to present the data from the psychiatric evaluation and treatment of passengers of the passenger train of the accident of Tempi in central Greece (28/2/2023) who were assessed and treated at the Trauma and Stress Disorders Unit of the Outpatient Clinic of the 3rd Department of Psychiatry, Aristotle University of Thessaloniki, at the University Hospital AHEPA. The material included two populations. The first was the total population of passengers on the passenger train (N=352). The second population was a subset of the first and consisted of those passengers who presented for diagnosis and follow-up (N=41). Frequency and percentage tables were generated, the Risk Ratio (RR) was calculated, and t-test and chi-square tests were used. Concerning the total of passengers on the train, it was estimated that 20-59 people would develop PTSD. The Trauma and Stress Disorders Unit of the 3rd Department of Psychiatry assessed and followed a total of 41 passengers, 18 males (43.90% aged 28.83±10.83 years) and 23 females (56.10% aged 32.87±14.16 years) with 34 (82.92%) of them developing PTSD, representing 2/3 of the expected PTSD cases after the accident. There was no significant effect of gender, physical injury or general psychiatric history on help-seeking, but there was an effect of proximity to the impact (wagon) and history of psychosis. The treatment included antidepressants (63.14%) and group psychotherapy (48.78%), with 58.54% showing significant improvement, and 7.32% deterioration. Males showed an overall increased likelihood of showing improvement (RR=1.53). Physical injury increased the likelihood of females not showing improvement (RR=2.44) while it did not affect men at all (RR=1.02). The findings of the present study are generally in agreement with the literature in terms of incidence and response to treatment, as well as concerning the role of gender, physical injury, and proximity to the event. An important finding was that males responded more to treatment and that physical injury adversely affected the outcome of females but not males, and this point should be considered as a novel contribution of the present study to the literature.</p>","PeriodicalId":20741,"journal":{"name":"Psychiatrike = Psychiatriki","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144120625","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Picture description impairment and neurocognition in schizophrenia: A pilot study.","authors":"Evagelia P Koutra, Sofia Athanasiou, Efstathia Karakosta, Nikitas Arnaoutoglou, Eva-Maria Tsapakis, Konstantinos N Fountoulakis","doi":"10.22365/jpsych.2025.011","DOIUrl":"https://doi.org/10.22365/jpsych.2025.011","url":null,"abstract":"<p><p>Schizophrenia is also manifested in a pattern of impaired speech traditionally considered to reflect thought disorder. This pilot study aimed to investigate the relationship between language impairment and other neurocognitive impairments and psychopathology. The study included 10 patients with schizophrenia (5 males), aged 45.5±12.48 years. They were assessed with the PANSS, scales of disability, and a neuropsychological battery. The experimental condition included four pictures with concrete everyday life content. The statistical analysis included the calculation of Spearman's rho correlation coefficient. Picture description was significantly correlated with the PANSS G. Non-significant but high correlations included the PANSS N, ratings of disability, and the Graphic Sequence test, the Rey figure, and the Stroop test, but there was a lack of correlation with verbal fluency, abstract thinking, and executive function Despite the small study sample, it could be said that the impaired performance in picture description in patients with schizophrenia is not a consequence of disordered thought alone, but also of the existence of a dysfunctional processing of visual information and a problematic translation of it into meaningful mental images.</p>","PeriodicalId":20741,"journal":{"name":"Psychiatrike = Psychiatriki","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144120681","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sleep quality and associated factors in teachers.","authors":"Igor Monteiro Lima Martins, Nayra Suze Souza E Silva, Rose Elizabeth Cabral Barbosa, Amanda Mota Lacerda, Cristina Andrade Sampaio, Alfredo Maurício Batista de Paula, Desiree Sant'ana Haikal","doi":"10.22365/jpsych.2025.003","DOIUrl":"10.22365/jpsych.2025.003","url":null,"abstract":"<p><p>Sleep is an essential part of life, accounting for about one third of an individual's life expectancy and plays an important role in quality of life and professional performance. This study focuses specifically on primary school teachers, a group that often faces high levels of stress. Restorative sleep is vital for dealing with this stress, and when its quality is unsatisfactory, it can contribute to the development of burnout. The aim of the study was to assess the prevalence of poor sleep quality among state schoolteachers in Minas Gerais and to identify the factors associated with this condition. The cross-sectional study included 1,907 teachers who took part in a web survey. It included sociodemographic variables, work characteristics, lifestyle, and health conditions. The data was collected between October and December 2021, using validated instruments such as the Pittsburgh Sleep Quality Index (PSQI) to assess sleep quality. The results showed that 39.1% of teachers reported poor or very poor sleep quality. The main variables associated with poor sleep quality included working more than 40 hours a week (OR = 1.618), low control over work (OR = 1.235), professional dissatisfaction (OR = 2.234), poor diet (OR = 3.240), smartphone dependence (OR = 2.265) and high fear of COVID-19 (OR =1.532). It was noted that mental health problems, such as anxiety (OR = 1.728), were also significantly related to sleep quality. In addition, although sleep quality varied with age, older teachers had fewer sleep problems. The study suggests that working conditions and psychosocial factors play a crucial role in sleep quality, highlighting the importance of interventions that consider the specific needs of teachers. The recommendations include carrying out regular psychological assessments and applying sleep hygiene practices in order to mitigate these problems and improve the quality of life of this group.</p>","PeriodicalId":20741,"journal":{"name":"Psychiatrike = Psychiatriki","volume":" ","pages":"17-29"},"PeriodicalIF":0.0,"publicationDate":"2025-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143731159","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A systematic review of depressive and anxiety symptoms in caregivers of dementia patients.","authors":"Despοina Deli, George Tsouvelas, Dimitrios Roukas, Manolis Mentis","doi":"10.22365/jpsych.2024.023","DOIUrl":"10.22365/jpsych.2024.023","url":null,"abstract":"<p><p>The current number of dementia cases in Europe stands at 7.7 million, a figure projected to double by 2050. Caregivers of individuals with dementia experience a heightened burden compared to those caring for other chronically ill individuals, increasing the risk of depression and stress disorders. This systematic literature review, following PRISMA guidelines, explores the prevalence of anxiety and depressive symptoms in dementia caregivers. Searches in academic databases, restricted to studies from the last 15 years, identified 85 articles with 16 meeting the inclusion criteria. Results indicate significant caregiver burden, diminished self-reported quality of life, and a propensity for clinical depression. Depression and anxiety symptoms were more pronounced among female caregivers. Caregiver depression correlated with increased emergency department utilization by dementia patients, with a surge in depressive symptoms reported during the COVID-19 pandemic. Caregiving for dementia patients was associated with burnout, adversely impacting caregiver quality of life. Depression and anxiety symptoms in caregivers correlated with substance use. Sociodemographic variables, including low socioeconomic status, high urbanization levels, and older age, were associated with caregiver depression. Caregivers of individuals with Alzheimer's disease reported higher anxiety, burden, and depression scores compared to those assisting individuals with other dementias, particularly when neuropsychiatric symptoms were evident. The identification of the factors that are linked to the mental burden of caregivers allows mental health professionals to enhance symptom detection and provide tailored support, ultimately alleviating caregiver burden and improving dementia care quality. Systematic professional assistance and training opportunities through health policies can effectively alleviate caregiver burden.</p>","PeriodicalId":20741,"journal":{"name":"Psychiatrike = Psychiatriki","volume":" ","pages":"72-80"},"PeriodicalIF":0.0,"publicationDate":"2025-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142838980","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clozapine/norclozapine plasma concentrations and their ratio in treatment resistant, early psychosis patients.","authors":"Andreas Karampas, Dimitra Florou, Giorgos Markozannes, Alexandros Asimakopoulos, Giorgos Georgiou, Marios Plakoutsis, Thomas Hyphantis, Vasiliki Boumba, Petros Petrikis","doi":"10.22365/jpsych.2025.001","DOIUrl":"10.22365/jpsych.2025.001","url":null,"abstract":"<p><p>Treatment-resistant schizophrenia affects approximately 30% of schizophrenia patients, and clozapine is the antipsychotic of choice for their treatment. Despite its effectiveness, clozapine is considerably under-prescribed for the aforementioned patients' group, probably due to its severe side effects. Measurement of plasma concentrations of clozapine and its active metabolite, norclozapine, in plasma could help clinicians to monitor compliance to treatment and reduce the possibility of severe side effects. Such measurements are currently not included in routine clinical practice, although clozapine plasma concentrations seem to be influenced by many different factors and do not usually reflect the prescribed dose. The aim of the present study was to measure clozapine and norclozapine plasma concentrations and their ratio in a group of early psychosis, treatment-resistant, schizophrenia patients and to investigate possible associations among the prescribed clozapine daily dose and socio- demographic variables. Thirty-eight patients were included in the study, and 342 blood samples were collected. Clozapine and norclozapine plasma concentration measurements were performed by UHPLC-MS/MS. Mixed-effects linear regression models were performed to associate blood clozapine and norclozapine levels and their ratio to clozapine dose. The median clozapine dose, clozapine, norclozapine plasma concentrations, and their ratio at first and last measurement were as follows: 400mg/day (IQR = 350mg/day to 500mg/day) and 425mg/day (IQR = 350mg/day to 600mg/day), 335 ng/ml (IQR = 191 ng/ml to 427 ng/ml) and 389 ng/ml (IQR = 276 ng/ml to 523 ng/ml), 129 ng/ml (IQR = 62 ng/ml to 218 ng/ml) and 135 ng/ml (IQR = 82 ng/ml to 209 ng/ml), 2.5 (IQR = 1.6 to 4.8) and 2.9 (IQR = 1.7 to 4.4). An increase of clozapine dose by 50mg/day was associated with higher blood clozapine and norclozapine levels but with lower clozapine/norclozapine ratio. Clozapine dose was positively associated with blood clozapine and norclozapine levels and negatively with the clozapine/norclozapine ratio.</p>","PeriodicalId":20741,"journal":{"name":"Psychiatrike = Psychiatriki","volume":" ","pages":"42-54"},"PeriodicalIF":0.0,"publicationDate":"2025-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143730614","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"On the sectorization of psychiatric services.","authors":"Dimitris Ploumpidis, George Konstantakopoulos","doi":"10.22365/jpsych.2025.005","DOIUrl":"10.22365/jpsych.2025.005","url":null,"abstract":"&lt;p&gt;&lt;p&gt;Sectorization, the organizational principle of dividing the population into geographic sectors and developing all necessary public hospital and outpatient services within each sector, emerged as part of the broader movement to reform psychiatric services in Europe as early as the 1950s. In France, sectorization began in the 1960s through the joint management of hospitals and new outpatient services and was institutionalized by 1985 laws establishing sectors for 75,000 residents for adults and 150,000 for children and adolescents, today numbering 830 across the country.1 Another form of sectorization evolved concurrently in the United Kingdom through the development of community psychiatry and later the establishment of mental health trusts.2 Since then, sectorization has been adopted in most European countries,3 while in some, like Belgium, community psychiatry has been linked to primary healthcare services.4 Sectorization aims to facilitate service accessibility and continuity of care, contributing to the reduction of hospitalizations and readmissions. International experience indeed shows that the implementation of sectorization has been associated with many achievements of community psychiatry3 and that it has significant long-term positive outcomes for the users of mental health services in terms of functioning and met needs.5 In all countries, as expected, there was a gradual transition from the development of units with specific catchment areas to the full establishment of a sectorized system with administrative, managerial, and operational efficiency. In some countries, despite earlier declarations, its implementation progressed only in recent years, as in Portugal6 and Greece.7 Additionally, in recent decades, the expansion of community-based interventions has brought about complex problems in the liaison of various service units and the issues caused by the widening gap between growing needs and cuts in public funding. In Greece, Law 2071/1992 and Framework Law 2716/1999 designated sectorization as the organizational principle of public psychiatric care, while Law 2716/1999 also introduced community mental health as a core principle. However, deinstitutionalization remained the central axis of the reform for a long time, rather than the development of community mental health units, and thus the implementation of sectorization lacked adequate support in practice.7 Ιn 2019, 38 adult sectors (11 in Attica) and 17 child and adolescent sectors (4 in Attica) were registered, accommodating populations of 250-300,000.8 However, only a few sectors provide an adequate range of services. The deficiencies lead to bypassing sectorization, especially regarding hospitalizations, and widespread use of private services. This situation undermines continuity of care and contributes to relapses and high rates of involuntary hospitalizations, especially in Athens. Mental health sectors in Greece include public hospitals and outpatient services as well ","PeriodicalId":20741,"journal":{"name":"Psychiatrike = Psychiatriki","volume":" ","pages":"13-16"},"PeriodicalIF":0.0,"publicationDate":"2025-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143731143","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Death anxiety, life's meaninglessness, and mental resilience among women with symptoms of behavioral addictions and alcohol use disorder: Using the existential approach.","authors":"Chrysoula Vatikioti, Kalliopi Triantafyllou, Chara Tzavara, Thomas Paparrigopoulos","doi":"10.22365/jpsych.2024.026","DOIUrl":"10.22365/jpsych.2024.026","url":null,"abstract":"<p><p>In recent decades, a growing body of research has emphasized the unique nature of substance abuse among women, necessitating a gender-specific approach and thus individualized therapeutic interventions.The purpose of this study, based on the existential approach, was to examine whether symptoms of several behavioral addictions (shopping, sex, gambling and betting, eating) and alcohol use disorder correlate with death anxiety, lack of meaning in life, and levels of mental resilience in a convenience sample of women. A total of 3,176 women participated in this online study and completed a demographic characteristics questionnaire, the Shorter PROMIS Questionnaire (SPQ), the Meaning in Life Questionnaire (MLQ), the Connor-Davidson Resilience Scale (CD-RISC), and the Death Anxiety Scale (DAS).The results showed a significant negative correlation between the \"Presence of meaning in life\" subscale and all addiction symptoms subscales (shopping, p<0.001; sex, p<0.001; gambling and betting, p=0.006; food, p<0.001, and alcohol use, p<0.001). Conversely, the \"Search for meaning in life\" subscale showed a significant positive correlation with all addiction symptoms subscales (shopping, sex, gambling and betting, food, and alcohol use, p<0.001). Resilience emerged as a protective factor, showing significant negative correlations with symptoms of sex addiction (p<0.001), alcohol use disorder (p<0.001), shopping addiction (p<0.001), and food addiction (p<0.001) addiction, although the correlation coefficients were small (ranging from -0.07 to -0.21), indicating a weak or no correlation. Participants with higher death anxiety also showed more symptoms of gambling and betting addiction (p<0.001), shopping addiction (p<0.001), and food addiction (p<0.001). Women who were married and had a university degree showed fewer symptoms of sex addiction (â = - 0.079; p = 0.004 / â = - 0.118; p = 0.001), alcohol use disorder (â = -0.105; p = 0.011 / â = -0.158; p = 0.004), and gambling addiction (â = -0.055; p < 0.001 / â = -0.091; p < 0.001), while women aged 18-25 displayed significantly lower symptoms of shopping and food addiction. Marriage and higher levels of education emerged as protective factors against certain types of addictive behaviors. In conclusion, this research showed a meaningful relationship between the lack of meaning in life and death anxiety with the manifestation of behavioral addiction symptoms and alcohol use. Also, the presence of mental resilience may act as a protective factor against gambling and betting addiction, shopping addiction, and food addiction, but not against sex addiction and alcohol use disorder.</p>","PeriodicalId":20741,"journal":{"name":"Psychiatrike = Psychiatriki","volume":" ","pages":"30-41"},"PeriodicalIF":0.0,"publicationDate":"2025-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142838981","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"New guidelines for the effectiveness of exercise in the prevention of dementia: Implications for psychiatry.","authors":"Nikos Christodoulou, Andreas Lappas, Olga Karpenko, Rodrigo Ramalho, Myrto Samara, Marco Solmi, Paolo Fusar-Poli, Nicola Veronese","doi":"10.22365/jpsych.2024.015","DOIUrl":"10.22365/jpsych.2024.015","url":null,"abstract":"<p><p>To the Editors, We recently published evidence-based guidelines for the role of exercise in the prevention of dementia.1 The guidelines combined an umbrella review and expert consensus, and has important implications for psychiatry. Evidence from published studies was evaluated using the GRADE assessment. We found scarce and relatively low-quality evidence in the literature, particularly for the primary prevention of dementia. Our GRADE-informed evidence synthesis yielded the following conclusions: For Primary prevention of dementia: Physical activity may be considered for the primary prevention of dementia. In people without dementia or MCI, exercise may be no better than health education for the primary prevention of dementia and MCI.</p><p><strong>Quality of evidence: </strong>Very low for physical activity; very low for exercise. For Secondary prevention of dementia: In people with MCI there is continued uncertainty about the role of physical activity and exercise in slowing the conversion to dementia.</p><p><strong>Quality of evidence: </strong>Very low for physical activity; very low for exercise. For Tertiary prevention of dementia: In people with moderate dementia, physical activity/exercise could be considered for maintaining cognition and exercise could be considered for stabilizing disability compared to usual care.</p><p><strong>Quality of evidence: </strong>Exercise: very low for cognitive outcomes; low for disability. Following a consensus process, we recommended physical activity/exercise for all three purposes, namely primary, secondary, and tertiary prevention (improve cognition and reduce disability) of dementia. The recommendation of exercise was largely contingent on its positive effects on mental health,2,3 in conjunction with the extensive body of evidence linking mental disorder with dementia.4 The guidelines highlight the need for further research on multidisciplinary interventions for both the primary and secondary prevention of dementia. A question remains whether the positive effect of physical activity on mood/behaviour applies to the MCI group, as it does to the dementia group. More research is required in people with established dementia and in less common forms of dementia. The guidelines also make an implicit research recommendation in support of heurism, in the sense that they integrate the evidence-based expectation that exercise is likely to be beneficial both for mental and physical health. Indeed, employing heurism may be inherently necessary in prevention research.5 Overall, these guidelines offer an evidence-based insight into the effectiveness of physical activity/exercise for the prevention (primary, secondary, and tertiary) of dementia. Importantly, they necessitate the inclusion of mental health in a multi-component approach. In doing so, they emphasize the necessity of mental health promotion and mental illness prevention in the prevention and management of dementia.</p>","PeriodicalId":20741,"journal":{"name":"Psychiatrike = Psychiatriki","volume":" ","pages":"81-82"},"PeriodicalIF":0.0,"publicationDate":"2025-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142352612","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}