Psychiatrike = Psychiatriki最新文献

{"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":"[Hypnosis: An ancient therapeutic practice revived in modern science].","authors":"Dimitrios Sakellion, Shokhrukh Sultanov, Dilmurad Irgashev, Ulugbeg Alimov, Vagioula Tsoutsi, Dimitris Dikeos","doi":"10.22365/jpsych.2025.006","DOIUrl":"https://doi.org/10.22365/jpsych.2025.006","url":null,"abstract":"<p><p>Hypnosis is an externally induced alteration in consciousness as a result of suggestion. Hypnotherapy, also called clinical hypnosis, is the use of hypnosis as psychological treatment, either brief or long-term psychotherapy, for alleviating pain, inducing habit modification, and treating a range of physical and mental health problems, such as psychosomatic diseases, mood and anxiety disorders, and personality or behavior disorders. In the present article, the method for therapeutic hypnosis is presented, mainly based on the first author's experience. The method involves muscle relaxation, suggestion, and sensory deprivation, which lead the hypnotized individual to become detached from the environment, allowing them to establish a connection (\"rapport\"), meaning they have direct contact only with the hypnologist and receive instructions without any external influences. The method used by the first author is that of \"rapid\" induction of catalepsy, which starts with instructions to remain still with closed eyes. The hypnologist then takes hold of the person's limbs and moves them, stimulating the kinesthetic system responsible for the proprioceptive sense of position in space, thus leading to entering the hypnotic state. Personal characteristics that are associated with the degree of hypnotizability are also presented, as well as the levels of hypnotic state depth, potential complications of hypnosis, and its contraindications, which mainly include psychosis, especially schizophrenia with delusions of influence, and the presence of prominent histrionic personality characteristics. Use of alcohol or illegal substances is not a contraindication; it is, however, noted that, in their presence, the therapeutic effect of hypnosis is uncertain in the absence of other appropriate measures and suitable therapeutic interventions. The effects of hypnosis on the electroencephalogram (EEG) are indicative that the hypnotic state is distinct both from sleep and from full wakefulness. During hypnotic catalepsy, the EEG is characterized (compared to baseline) by an increase in delta rhythm power and an increase in the amplitude and index of theta rhythm, mainly in the temporal leads of both hemispheres. Additionally, there is significant asymmetry between the right and left hemispheres. It must be noted that hypnosis is just the tool through which hypnotherapy is applied. The latter should be only performed by clinicians, psychiatrists, or psychologists trained in psychotherapy, ensuring, thus, the therapeutic value of advice that is given to patients during the period of hypnotic suggestion.</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":"143731471","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}

{"title":"Vaccination coverage of persons using hospital outpatient mental health services at Heraklion, Crete, Greece: A cross-sectional study during pandemic.","authors":"Epameinondas Evangelos Kantidakis, Emmanouil K Symvoulakis, Maria Basta, Evgenia Chourdaki, Helen Dimitriou","doi":"10.22365/jpsych.2024.019","DOIUrl":"10.22365/jpsych.2024.019","url":null,"abstract":"<p><p>Persons with mental health disorders are vulnerable, with demanding care needs. This cross-sectional study aimed to report on their vaccination coverage against COVID-19 and common vaccine-preventable diseases. The study was conducted from September to November 2022 at the psychiatric outpatient settings of Venizeleion General Hospital of Heraklion, Crete, Greece, and the Mental Health Center of Heraklion. Information was collected via personal medical interview and prescription data. The study population included 361 participants, with a mean age of 49.8±14.3 years, 59.0% women. The most common diagnoses were recurrent depressive disorder (24.1%), schizophrenia (22.7%), anxiety disorder (21.3%), and bipolar disorder (15.7%). Vaccination coverage against seasonal influenza for 2020, 2021, and 2022 was 43.2%, 39.8%, and 40.7%, respectively. Pneumococcal vaccination included the conjugate (28.8%) and polysaccharide (7.7%) vaccines. Vaccination against Tetanus, Diphtheria, Pertussis (TDP) accounted for 11.0%, Hepatitis B for 5.8%, and Herpes Zoster for 27.1%. COVID-19 vaccination, with at least one booster dose, reached a high 73.6%. Patients with severe mental illness, 139 out of 361, were less likely to have contracted COVID-19 (50/139, 35.9%) than those without (108/222, 46.6%), (p=0.018). Coverage with polysaccharide vaccine, TDP, and Hepatitis B, was very low. Patients annually vaccinated for influenza in the last three consecutive years were most likely to be fully vaccinated for pneumococcal disease and for COVID-19 (with at least one booster dose). Future research and clinical practice should focus on identifying patients at risk of not receiving preventive services, such as vaccines.</p>","PeriodicalId":20741,"journal":{"name":"Psychiatrike = Psychiatriki","volume":" ","pages":"282-292"},"PeriodicalIF":0.0,"publicationDate":"2024-12-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142786640","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":"The impact of the COVID-19 pandemic on hospital admissions in a psychiatric ward in a general hospital in Greece.","authors":"Ioanna-Athina Botsari, Anastasios Papatsoris, Petros Argitis, Nicholas-Tiberio Economou, Vaios Peritogiannis","doi":"10.22365/jpsych.2024.018","DOIUrl":"10.22365/jpsych.2024.018","url":null,"abstract":"<p><p>The negative consequences of the COVID-19 pandemic and the subsequent restrictive measures on the mental health and well-being of the population and psychiatric patients have been widely recognized. Patients' treatment attendance and engagement with mental health services had been negatively affected by the pandemic, whereas patients were less likely to receive timely outpatient care. The pandemic also impacted the use of inpatient services. The aim of the present study was to explore the variability of attendance and admissions to a general hospital psychiatric ward over a 12-month interval after the onset of the pandemic (March 2020), compared to the respective 12-month pre-pandemic interval. A retrospective, observational pre/post study was performed, involving a general hospital psychiatric ward in Corfu, Northwest Greece, which serves an insular catchment area of approximately 100,000 inhabitants. For data analysis, c- and u-charts of statistical process control charts were employed, using monthly data (March 2019 to February 2021). Overall, a significant decline in attendance rates was observed, mostly accounted for by a 26.5% reduction in voluntary attendance rates (1516 patients prior vs. 1114 patients after the onset of the pandemic). The involuntary commitment of patients did not differ between the two periods (106 prior vs. 100 after the onset of the pandemic). Admission rates did not change significantly between the two periods. Diagnoses that exhibited significant variance in examinations between the two study periods were mood disorders and personality disorders, whereas there was no significant variation in the number of admissions across different diagnoses. Length of hospital stay increased significantly by 13.2% over the first year of the pandemic, from 25.57 days (Md= 13, IQR= 22) during the pre-COVID-19 period to 28.95 days (Md= 22, IQR= 28) during the COVID-19 period. Patients with schizophrenia and related disorders (Mean= 34.25 days, SD= 43.19) and mood disorders (Mean= 26.26, SD= 33.48) had prolonged hospital stays compared to other diagnoses. These findings highlight significant shifts in psychiatric care delivery during the pandemic and underscore the need for targeted interventions to address the evolving demands on mental health services during public health crises.</p>","PeriodicalId":20741,"journal":{"name":"Psychiatrike = Psychiatriki","volume":" ","pages":"269-281"},"PeriodicalIF":0.0,"publicationDate":"2024-12-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142786715","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":"Dimensionality and psychometric properties of the Greek version of the Diabetes Impact and Device Satisfaction (DIDS) scale.","authors":"Emmanouil S Benioudakis, Argyroula Kalaitzaki, Eleni Karlafti, Oxana Ahanov, Elisavet Kapageridou, Christos Savopoulos, Triantafyllos Didangelos","doi":"10.22365/jpsych.2024.017","DOIUrl":"10.22365/jpsych.2024.017","url":null,"abstract":"<p><p>Type 1 diabetes mellitus (T1D) is a chronic condition with rising prevalence. The only treatment for individuals with T1D to prevent diabetes-related complications is exogenous insulin administration. Diabetes-related technology has significantly contributed to the management of T1D by reducing the burden of living with diabetes and providing greater flexibility in insulin management during daily activities. This study presents the psychometric properties of the Greek translation of the Diabetes Impact and Device Satisfaction (DIDS) Scale, which assesses satisfaction with the use of an insulin delivery device and the impact of diabetes management on individuals with T1D. A sample of 101 adults with T1D, mostly females (71.3%), with a mean age of 38.4 years (± 11.7), completed the translated Greek version of DIDS (DIDS-Gr). Exploratory factor analysis revealed three factors: 'Device Satisfaction', 'Diabetes Management Impact', and (new factor) 'Device Usability'. The internal consistency indices (Cronbach's alpha) for the subscales were 0.86, 0.71, and 0.60, respectively. Furthermore, convergent validity was demonstrated with moderate to high positive correlations between the DIDS-Grand the Diabetes Quality of Life Brief Clinical Inventory (DQoL-BCI) and its subscales, while divergent validity was also confirmed with weaker correlations with the depression subscale of the Hospital Anxiety and Depression Scale (HADS). Additionally, test-retest reliability and differential validity were present in our study. Therefore, DIDS-Gr is a valid and reliable measure for assessing the impact of diabetes on individuals with T1D and the satisfaction with the use of an insulin delivery device in Greece.</p>","PeriodicalId":20741,"journal":{"name":"Psychiatrike = Psychiatriki","volume":" ","pages":"314-323"},"PeriodicalIF":0.0,"publicationDate":"2024-12-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142352611","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":"Disaster Psychiatry: An urgent field in psychiatry posing a pertinent question.","authors":"Nikos Christodoulou","doi":"10.22365/jpsych.2024.022","DOIUrl":"10.22365/jpsych.2024.022","url":null,"abstract":"&lt;p&gt;&lt;p&gt;Disasters, both natural and man-made, impose a significant burden on the mental health of individuals, communities, and societies. The frequency and intensity of disasters are increasing; 3–4fold compared to the last century, with 400–500 significant disasters/year, affecting &gt;1.5 billion people worldwide and costing 250–400 billion dollars/year. Most natural disasters are directly or indirectly linked to climate change, itself a natural disaster of human origin. Armed conflict is another human self-infliction; 59 state-based conflicts are currently active, the highest since WW2 (Uppsala Conflict Data Program-UCDP1).\u0000\u0000The mental health impact of disasters is multifaceted, influencing both immediate and long-term mental health outcomes. Acute stress, anxiety, depression, and post-traumatic stress disorder (PTSD) represent just the direct impact of disasters on mental health. Forced displacement, economic hardship, and societal matrix disturbance can predispose survivors – especially the most vulnerable – to longer-term and indirect mental health morbidity. In some cases, there may be persistent, even transgenerational morbidity.2,3\u0000\u0000Disasters also have important systemic effects, especially in less well-developed systems, where disasters cause acuteon-chronic failures. The ethical handicap is that pressured systems fail exactly where the most vulnerable need them intact. Indeed, in disasters, mental health services are likely to fail early.2–4\u0000\u0000Disaster Psychiatry is a branch dedicated to preventing, preparing for, and responding to the mental health consequences of disasters. It relies on a range of evidence-based interventions designed to address the acute response to disasters, but more importantly, to address future disasters by prevention and preparedness. Acute disaster response refers to supporting individuals and the wider system at times of crisis. It is well covered by guidelines by the WHO/IASC, the Sphere, RCPsych, APA, and the World Psychiatric Association, Section on Disaster Psychiatry.5 Beyond practical support and good clinical care, several well-supported interventions deal with the clinical sequelae of disasters. A key intervention is Psychological First Aid (PFA), which focuses on providing immediate and practical support to individuals following a disaster. Among others, effective therapeutic interventions include Eye Movement Desensitization and Reprocessing (EMDR), Cognitive-behavioral therapy (CBT), which has emerged as a gold standard for treating PTSD in meta-research, and Exposure Therapy (ET) which has lately been enhanced by XR and AI integration.\u0000\u0000To minimize the escalation of disaster-related psychopathology, early intervention, social support, and good access to mental health services are critical. Supporting the wider system before, during, and after disasters includes psychoeducation and support for front-line responders, advising decision-makers, facilitating coordination and effective communication between","PeriodicalId":20741,"journal":{"name":"Psychiatrike = Psychiatriki","volume":" ","pages":"265-268"},"PeriodicalIF":0.0,"publicationDate":"2024-12-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142838924","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}