Psychiatrike = Psychiatriki最新文献

{"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}

{"title":"Under pressure: A systematic review of the mental health impact of COVID-19 pandemic on mental health workers.","authors":"Antonis Tsionis, Pentagiotissa Stefanatou, George Konstantakopoulos","doi":"10.22365/jpsych.2024.025","DOIUrl":"10.22365/jpsych.2024.025","url":null,"abstract":"<p><p>The COVID-19 pandemic emerged suddenly, profoundly impacting the lives of us all, including mental health workers (MHW). This unprecedented crisis introduced significant challenges for MHW, exposing them to increased risks of psychological distress. This systematic review aims to evaluate the psychopathological effects of the COVID-19 pandemic on MHW. Additionally, it seeks to explore factors-social, regional, occupational, and others-influencing these effects. A systematic search was conducted across PubMed, PsycINFO, and Embase databases following PRISMA guidelines. A total of 2621 citations were screened, with 29 studies meeting the inclusion criteria for analysis. Our review focused exclusively on studies utilizing validated measurement tools to ensure reliability. Our findings revealed a high prevalence of anxiety, depression, stress, trauma-related disorders, and burnout among mental health nurses and other MHW during the COVID-19 pandemic, with significant variations based on regional, occupational, gender, and other demographic factors. Depressive symptoms ranged from 16.8% to 52.2%, and anxiety levels varied from 9.7% to 63% among MHW. Interestingly, MHW exhibited lower rates of depression and anxiety compared to other healthcare workers and the general population, possibly indicating higher resilience. Factors such as younger age, female gender, profession, work setting, fear of COVID-19, and workload were associated with increased psychological distress. Our review also underscores the need for more systematically accurate trauma research, particularly in how trauma is defined and assessed during global crises. While the consistency in study findings highlights the considerable effect of the pandemic, we observed differences that suggest the influence of multiple interacting factors. The lack of longitudinal studies and comparative data limits the ability to determine changes over time and differences with other groups. The COVID-19 pandemic significantly affected the mental health of those responsible for caring for the mental health of others, with considerable variations influenced by multiple interacting factors. Our findings highlight the critical need for protective protocols and psychological support systems to mitigate adverse effects on MHW during global crises. The variance in impact across different countries, in relation to local, political, cultural, and other factors, provides a foundation for future research.</p>","PeriodicalId":20741,"journal":{"name":"Psychiatrike = Psychiatriki","volume":" ","pages":"55-71"},"PeriodicalIF":0.0,"publicationDate":"2025-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142838926","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":"Βullying's anatomy: How it affects brain structure and function. A systematic review.","authors":"Christodoulos Komiotis, Ioannis Mavridis","doi":"10.22365/jpsych.2025.002","DOIUrl":"https://doi.org/10.22365/jpsych.2025.002","url":null,"abstract":"<p><p>Bullying victimization is a common problem among adolescents with many catastrophic sequelae, as it has been associated with psychiatric disorders such as anxiety and depression. Identifying the bullying print on the human brain could be useful in clinical practice, specifically in the secondary prevention of the disorders that are related to it. This review aims to explore the potential bullying-related changes of the human brain from a descriptive and functional anatomic perspective. A literature search was performed using the Pubmed/Medline database, and, following meticulous screening, 16 articles were finally used. Our review included magnetic resonance imaging (MRI) and functional MRI studies, which were focused on gray and white matter structures of the brain. Bullying affects the morphology and function of gray and white matter structures in both victims and perpetrators. Victims seem to have atrophic hyperactive orbitofrontal cortex, hypertrophic hypoactive amygdalae, and increased cortical activation in almost all brain lobes. Bullies, on the other hand, have hyperactive accumbens nuclei. Fundamental nuclei of the limbic system, namely the nucleus accumbens and amygdala, are affected in both victims and perpetrators. Bullying changes the human brain morphologically and functionally, primarily affecting structures of the limbic system. Identifying these changes early could mainly help in the prevention of the expression of psychopathology and thus improve the quality of life of victims and even help bullies to seek medical help.</p>","PeriodicalId":20741,"journal":{"name":"Psychiatrike = Psychiatriki","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143731164","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":"Link between the mechanism of mitophagy and schizophrenia: A narrative review","authors":"Nikolaos Statharakos","doi":"10.22365/jpsych.2025.008","DOIUrl":"10.22365/jpsych.2025.008","url":null,"abstract":"<p><p>Despite extensive research, the precise pathophysiology underlying schizophrenia remains unclear, but accumulating evidence suggests that mitochondrial dysfunction and oxidative stress play significant roles in its development. Mitophagy, the selective degradation of damaged or dysfunctional mitochondria, plays a critical role in maintaining cellular homeostasis and is increasingly recognized for its implications in various neuropsychiatric disorders, including schizophrenia. This review examines current knowledge regarding mitophagy and its association with schizophrenia. The literature was searched in PubMed- Medline and Scopus databases, and as a narrative review, the methodology focuses on the comprehensive coverage and synthesis of relevant studies. The hypothesis of the review claims that there is a link between mitophagy and schizophrenia. The terms used in the search query are \"mitophagy\", \"schizophrenia\" with the Boolean variable \"AND\". The relationship between mitophagy and schizophrenia is complex and multifaceted, involving mitochondrial dysfunction, neuroinflammation, and the integrity of oligodendrocytes and microglia. Schizophrenia is associated with dysfunctional mitophagy and elevated oxidative stress. These mechanisms may help to explain overlapping symptoms, particularly cognitive deficits. While the emerging data linking mitophagy and schizophrenia are promising, current research has limitations. Much of the evidence for mitophagy dysfunction in schizophrenia comes from animal models or postmortem studies, which may not fully capture the complexity of the disorder in humans. Moreover, mitophagy is challenging to study in vivo, particularly in the human brain, making it difficult to directly observe mitophagy processes in patients with schizophrenia. Mitophagy and its dysfunction may contribute to the pathophysiology of schizophrenia. Evidence suggests that impaired mitophagy can lead to energy dysregulation, oxidative stress, and neuroinflammation, all of which are implicated in schizophrenia. While more research is needed, the potential link between mitophagy and schizophrenia presents an interesting area for future studies and therapeutic development. Targeting mitophagy could offer new approaches for addressing cognitive and negative symptoms, providing hope for improved treatment outcomes.</p>","PeriodicalId":20741,"journal":{"name":"Psychiatrike = Psychiatriki","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143731156","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":"Barriers to the use of telepsychiatry for the treatment of eating disorders: A systematic review and thematic synthesis.","authors":"Melpomeni Eleni Sapouna, Andreas Lappas, Myrto Samara, Vasilios P Bozikas, Nikos Christodoulou","doi":"10.22365/jpsych.2025.007","DOIUrl":"https://doi.org/10.22365/jpsych.2025.007","url":null,"abstract":"<p><p>Eating disorders are mental disorders characterized by disturbed body image and excessive fear of weight gain, leading to disordered eating and weight control behavior. Studies show that early treatment is one of the most important factors in improving the prognosis of these diseases. Nevertheless, a large percentage of patients with eating disorders do not receive treatment or seek treatment until their disorder has progressed. Telepsychiatry promises to expedite treatment times by resolving geographical and cost barriers. However, there are various shortcomings in using telepsychiatry in eating disorders, including its effectiveness in treating patients with eating disorders, difficulty establishing a strong therapeutic relationship, privacy concerns, and security and technological limitations, among others. The purpose of this paper is to review the barriers that limit the usefulness of telepsychiatry in eating disorders. Ultimately, it aims to improve the use of telepsychiatry to better and more safely serve the particular needs of patients with eating disorders. We conducted a systematic review and thematic synthesis using a mixed PRISMA/ ENTREQ methodology, focusing on research that directly or indirectly investigated barriers to the use of telepsychiatry in the treatment of patients with EDs. Fifty-two studies were included, revealing multifaceted challenges in implementing telepsychiatry for patients with EDs. Specific barriers identified include poor therapeutic relationship and poor treatment adherence, clinical limitations (poor therapeutic effect, illness severity, comorbidity, certain eating disorder types are barriers themselves, impersonal care), and technical limitations (program design issues, privacy concerns), as well as negative patient experience. Telepsychiatry shows promise for treating EDs, but it is important to address these barriers in order to reach its full potential. Clinical adaptations, technological improvements, and a person-centered approach are essential to fully realize its potential. Online or hybrid treatment models must be highly personalized and multifaceted and have active therapist involvement, particularly for patients with clinical complexity.</p>","PeriodicalId":20741,"journal":{"name":"Psychiatrike = Psychiatriki","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143731474","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":"Factor analysis and reliability of the Illness Attitude Scales in senior medical students.","authors":"Charalampos Pischos, Antonios Politis, Petros Sfikakis, Charalampos Papageorgiou","doi":"10.22365/jpsych.2025.004","DOIUrl":"https://doi.org/10.22365/jpsych.2025.004","url":null,"abstract":"<p><p>Illness behavior is influenced by subjective, social, and cultural factors and can vary from one person to another and even internally within the same individual depending on the situation and the type of illness he or she needs to deal with. The Illness Attitude Scales (IAS) were designed by Robert Kellner to assess fears, negative beliefs, and attitudes related to hypochondriasis and abnormal behavior in relation to illness, and it is a reliable tool for detecting them as it does not contain items related to symptoms that are characteristic of other psychiatric symptoms. Although the IAS are commonly used, only a few studies have investigated their factor structure, but no common factor solution has been found. The results of these studies differ, ranging from 2 to 5 factor solutions, as well as which items are assigned to the factors. Since factor analysis for the Greek translation has not been previously researched, we analyzed the factor structure in a Greek sample using exploratory factor analysis to reflect cultural nuances in health perceptions and illness behaviors and to enable meaningful comparisons with other populations. A mixed sample of senior medical students of the Athens Medical School (N = 163) completed the psychometric tool before attending the educational clinics. Α percentage of 60.98% were women and 39.02% were men, and the average age of the sample was 23.84 years (SD = 1.67). Data were subjected to Maximum Likelihood Estimation and oblique rotation, which revealed a solution of seven factors: i) Worry about Illness after Pain Sensation, ii) Health Habits, iii) Effects of Symptoms, iv) Hypochondriac Beliefs, v) Thanatophobia, vi) Treatment Experiences, vii) Disease Phobia. The internal consistency of the factors, measured by Cronbach's alpha coefficient, achieved good to acceptable reliability: 0.86, 0.88, 0.68, 0.76, 0.73, 0.65, and 0.81, respectively. The results of the current study, although they cannot be generalized to the general population, provide information on medical students' attitudes towards illness and may pave the way for educational strategies and programs in medical school to improve the detection of negative beliefs and attitudes towards illness in medical students during clinical practice.</p>","PeriodicalId":20741,"journal":{"name":"Psychiatrike = Psychiatriki","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143731138","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}