Psychiatrike = Psychiatriki最新文献

{"title":"Validation of the Greek version of the Binge Eating Scale in a sample of binge eating disorder patients.","authors":"Maria Karapatsia, Maria Evangelia Antoniadou, Chara Tzavara, Ioannis Michopoulos, Fragiskos Gonidakis","doi":"10.22365/jpsych.2024.014","DOIUrl":"https://doi.org/10.22365/jpsych.2024.014","url":null,"abstract":"<p><p>Binge eating disorder (BED), the most prevalent eating disorder, carries significant physical and psychological consequences. Therefore, there is a continuous need to assess binge eating symptomatology and evaluate the effectiveness of various therapeutic interventions. The Binge Eating Scale (BES), which is a self-administered questionnaire, is widely used to assess binge eating in obese people. It examines the person' s experience of binge eating and the emotional, cognitive, and behavioural symptoms associated with it. The purpose of the present study was to translate and adapt BES in Greek, as well as to assess the factorial structure of BES and evaluate its psychometric properties. A sample of 160 participants (90% females) with a mean age of 40.7 years (SD=11.5 years) and a mean body mass index (BMI) 37.5kg/m2 (SD=9.2kg/m2) completed the BES and the Eating Disorder Examination Questionnaire (EDE-Q). An exploratory factor analysis (EFA) was carried out to assess the construct validity of the BES in a sample of patients with BED according to DSM-5 who came for therapy at the Eating Disorders Unit at Eginition Hospital and the day center \"Anasa\". The two-factor structure fits the data best. Regarding internal consistency, the results were acceptable, with Cronbach' s alpha equal to 0.78. The BES has high significant correlations with the Eating Concern, Weight Concern, and Shape Concern subscales and the Global Score of EDE-Q, but not with the Restrain subscale. Also, BES has correlations with the specific EDE-Q questions about the frequency of objective and subjective binge eating episodes. A high correlation was obtained with the measure of ΒΜΙ too. The Greek version of BES is a valid and reliable scale to evaluate binge eating in a clinical population diagnosed with BED.</p>","PeriodicalId":20741,"journal":{"name":"Psychiatrike = Psychiatriki","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142352613","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":"[Cerebellar cognitive affective syndrome and vertebrobasilar ischemia. From cerebello-cerebral diaschisis to \"dysmetria of thought\"].","authors":"Christos Ch Liapis","doi":"10.22365/jpsych.2024.012","DOIUrl":"https://doi.org/10.22365/jpsych.2024.012","url":null,"abstract":"<p><p>Cerebellum, along with it' s role in coordinating motor functions, exercises a significant regulatory influence in fields of cognitive and affective functions. Therefore, studying the effect of cerebrovascular atherosclerotic pathology on mood and cognition should not be limited to stenotic dysfunctions of carotid arteries, but also extend its methodological framework to the consideration of the integrity of vertebrobasilar system (VBS), cerebellar perfusion and posterior cerebral circulation in general, as it has not been yet sufficiently addressed whether VBS insufficiency is associated with deterioration of patients' mental and emotional status and quality of life (QoL). Vertebrobasilar circulatory dysfunction has been pointed out, since decades, as a cause of progressive memory impairment and dementia, due to multiple infarcts in cerebral areas which are topographically critical for mental and emotional functions. Indicative of the pathophysiological and anatomic-functional association of VBS with these neuro-psychiatric domains are cerebellar cognitive-affective syndrome (CCAS) and crossed cerebello-cerebral diaschisis (CCCD). Mental and psychiatric components of CCAS, along with ataxic motor disability, constitute the conceptual hypothesis of \"dysmetry of thought\", while diagnostic significance of mental dysfunctions and psychopathological manifestations, in terms of symptoms preceding motor impairments that ascribe cerebellar malfunction in the epicenter of their pathophysiology, such as cerebellar ataxias, in which, early recognition of CCAS may facilitate therapeutic interventions aimed at improving QoL, reveal that cerebellar pathology, either of degenerative etiology or vascular substrate on the ground of vertebrobasilar insufficiency (VBI) or other surgical conditions of the posterior fossa, is associated with deterioration of patients' QoL which is related to significant impairments in their cognitive functions with (co)manifested emotional disorders. Studies in animal models also support these conclusions. Since VBI is responsible for a wide range of psychiatric and neurological symptoms, new findings concurred with current indications advocating that, without consideration of VBS disorders, it is impossible to clarify the connection of cerebral perfusion dysfunctions to neurocognitive deficits. The inclusion of cerebellar perfusion disorders in scientific research and clinical approaches to cognitive and affective disorders that may occur in patients with cerebrovascular lesions constitutes a paradigm of best clinical practices implementation and interdisciplinary convergence of neurosciences and vascular medicine.</p>","PeriodicalId":20741,"journal":{"name":"Psychiatrike = Psychiatriki","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142352607","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":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-09-18","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":"[Posttraumatic stress disorder in refugees and therapeutic interventions based on cognitive behavioral approach: A systematic review].","authors":"Panagiota Karvela, Chrysovalantis Papathanasiou","doi":"10.22365/jpsych.2024.011","DOIUrl":"https://doi.org/10.22365/jpsych.2024.011","url":null,"abstract":"<p><p>Post-Traumatic Stress Disorder (PTSD) is connected with the experience of traumatic events and is significantly related to war and forced displacement. Refugee populations are characterized by a high degree of vulnerability for the development of PTSD, as they are confronted with stressors associated with all three distinct phases of migratory journey. The present article is an attempt to systematic review the therapeutic interventions based on the Cognitive Behavioral Approach and applied to refugees diagnosed with PTSD. For this reason, a review of the international literature was carried out through the electronic databases: Google Scholar, PubMed and Science Direct. Forty (40) studies were identified, of which 16 met the inclusion criteria. According to the results of the review, the most common interventions are Cognitive Behavioral Therapy (CBT), Narrative Exposure Therapy (NET) and Eye Movement Desensitization and Readaptation (EMDR). More specifically, CBT helps the individual to understand and reexamine the negative thoughts and feelings caused by the traumatic event, resulting in a reduction of symptoms and an improvement in quality of life. Following, NET supports that when a person talks about the traumatic events by placing them in a chronological continuity, they can gradually redefine the negative associations and responses related with the trauma. Finally, EMDR focuses on memory and how memories are stored in the brain. Its purpose is to reduce the intensity of the emotions associated with the traumatic event when it is recalled. All of those three approaches appear to have been studied and to yield reliable results. Other forms of therapeutic interventions are limited due to methodological issues as well as due to adopting standardized approaches that do not allow for an in depth understanding of trauma in refugee population. Further investigation of the long-term symptoms of trauma in refugees is suggested, in order to draw firm conclusions.</p>","PeriodicalId":20741,"journal":{"name":"Psychiatrike = Psychiatriki","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142352608","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 role of clinical, demographic and psychological characteristics of people with multiple sclerosis in their physical health related quality of life].","authors":"Anthi Amaslidou, Ioanna Ierodiakonou-Benou, Christos Bakirtzis, Ioannis Nikolaidis, Theano Tatsi, Nikolaos Grigoriadis, Ioannis Nimatoudis","doi":"10.22365/jpsych.2023.001","DOIUrl":"10.22365/jpsych.2023.001","url":null,"abstract":"<p><p>Multiple Sclerosis (MS) is a chronic demyelinating and neurodegenerative disease of the central nervous system, with a variety of symptoms and uncertain course. It affects multiple facets of everyday life and since it results to some degree of disability, MS may cause deterioration of quality of life, both in mental and physical health. In this study, we investigated the role of demographic, clinical and, mostly, personal and psychological factors related to physical health quality of life (PHQOL). Our sample consisted of 90 patients with definite MS and the instruments used were: MSQoL-54 for PHQOL, DSQ-88 and LSI for the assessment of defense styles and mechanisms, BDI-II for depression, STAI for anxiety, SOC-29 as a measure of sense of coherence and FES for family relations. Important personality factors affecting PHQOL were the maladaptive and the self-sacrificing defense styles, the defense mechanisms of displacement and reaction formation, sense of coherence, while from the family environment, conflict affected PHQOL negatively and expressiveness positively. However, in the regression analysis none of these factors were found to be important. Multiple regression analysis showed the major impact of depression in PHQOL (negative correlation. Moreover, the fact that a person receives disability allowance, the number of the children, disability status and the event of a relapse in the current year, were also important negative factors for PHQOL. After a step-wise analysis, in which BDI and employment status were excluded, the most important variables were EDSS, SOC and relapse during the past year. This study confirms the hypothesis that psychological parameters play an important role in PHQOL and highlights the importance of the assessment of every PwMS by mental health professionals, as a routine. Not only psychiatric symptoms but also psychological parameters should be searched out in order to determine in which way each individual adjusts to the illness, thus impacting his PHQOL. As a result, targeted interventions, in personal or group level, or even in the family may enhance their QOL.</p>","PeriodicalId":20741,"journal":{"name":"Psychiatrike = Psychiatriki","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-06-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9304303","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 profile of reading and cognitive skills of children with a history of specific developmental language disorder].","authors":"Sophia Giannopoulou, Ioanna Giannopoulou, Vasiliki Efstathiou, Apostolos Maidonis, Despoina Tsourti, Evangelia Koukoula, Gerasimos Kolaitis","doi":"10.22365/jpsych.2022.089","DOIUrl":"10.22365/jpsych.2022.089","url":null,"abstract":"<p><p>The present study aimed to investigate the profile of reading and cognitive skills of primary school' students with a history of specific developmental language disorder during preschool years. The sample comprised 247 children referred for assessment of their reading difficulties to the University Child Psychiatry Department, at the \"Aghia Sophia\" Children's Hospital, Athens, Greece. The study was retrospective utilizing medical records from where the following information was drawn: demographic data, presence of a diagnosis of a specific developmental language disorder, results of Reading Test-A and WISC-III. Among the 247 children with normal intelligence IQ>80 (mean age: 10.5 years, 61.5% boys) included in the study, 226 (92.5%) were identified as having significant reading difficulties in at least one of the four subtests of the Reading-A Test (≤ 30 percentile); 72% performed poorly in reading fluency, 67.1% in decoding familiar and pseudowords, 52.8% in reading comprehension and 49.8% in morphosyntax subtest. When comparing children with severe reading difficulties (≤ 10 percentile on the Reading Test A) with a history of specific developmental language disorder (N=110) and no relevant history (N=116), the findings indicated that a significantly higher proportion of children with a history of specific language disorder had severe difficulty in morphosyntax (χ2=21.94, p<0.001) and reading comprehension subtests (χ2=8.89, p <0,001) than those with no history. In terms of the cognitive profile of children with severe reading difficulties, the results showed that a significantly higher proportion of children with a history of developmental language disorder than those with no history had low performance (<7TB) on all WISC-III subtests, however the difference between the two groups was found to be statistically significant on three subtests: \"Vocabulary\" (p=0.014), Arithmetic (p=0.006), and \"Information\" (p=0.005). Multiple linear stepwise regression analysis showed that lower levels of the verbal IQ (β=-0.121, p=0.042) and positive history of developmental language disorder during preschool years (β=0.537, p<0.001) were independently related to the severity of reading disability. In conclusion, the findings of the present study highlight the importance of early detection of language deficits during the preschool years and timely speech and language therapy intervention.</p>","PeriodicalId":20741,"journal":{"name":"Psychiatrike = Psychiatriki","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-06-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40331051","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 human circadian system: physiology, pathophysiology and interactions with sleep and stress reactivity].","authors":"Agorastos Agorastos, Miltiadis Vasiliadis, George P Chrousos","doi":"10.22365/jpsych.2023.016","DOIUrl":"10.22365/jpsych.2023.016","url":null,"abstract":"<p><p>The dramatic fluctuations in the energy demands of living organisms by the rhythmic succession of night and day on our planet has prompted a geophysical evolutionary need for a biological temporal organization necessary for maintenance of homeostasis and adaptation to environmental changes across phylogeny. The intrinsic circadian system (CS) represents a highly conserved and complex internal biological \"clock\", adjusted to the 24-hour rotation of the earth about itself. This system creates and maintains cellular and organismal rhythmicity and enables a nyctohemeral coordination of multi-level physiologic processes, ranging from gene expression to behaviour. The suprachiasmatic nucleus (SCN) of the hypothalamus is the primary pacemaker of the circadian system of the organism, while a ubiquitous peripheral oscillating network of cellular molecular clocks participates in a complex circadian hierarchy. A critical loss of this harmoniously timed circadian order at different organizational levels is defined as \"chronodisruption\", a condition that may alter the fundamental properties of basic homeostatic systems at molecular, cellular and organismal levels, and lead to a breakdown of biobehavioral adaptive mechanisms, resulting in maladaptive stress regulation and increased sensitivity and vulnerability to stress. Chronodisruption has been linked to neuroendocrine, immune, cardiometabolic and autonomic dysregulation, with blunted diurnal rhythms, specific sleep pattern pathologies and cognitive deficits, as well as with altered circadian gene expression. This condition may, thus, play a central role in the development of mental and somatic disease. Nevertheless, circadian and sleep disturbances are often clinically considered as \"secondary\" manifestations in most disorders, neglecting the potentially important pathophysiological role of CS. Understanding the pathophysiologic mechanisms of circadian dysregulation and their role in stress-related, systemic disease could provide new insights into disease mechanisms and could help advance chronobiological treatment possibilities and preventive strategies in populations at risk.</p>","PeriodicalId":20741,"journal":{"name":"Psychiatrike = Psychiatriki","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-06-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10136579","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 relationship of carotid artery disease with mental and neurocognitive disorders].","authors":"Christos Ch Liapis","doi":"10.22365/jpsych.2022.083","DOIUrl":"10.22365/jpsych.2022.083","url":null,"abstract":"<p><p>Carotid stenosis constitutes a common vascular disease that significantly affects cerebral blood flow and thus is associated with patients' cognitive functions. Carotid revascularization techniques [carotid endarterectomy (CEA) and carotid artery stenting (CAS)] may benefit cognition, though there are opposing findings, reporting an apparent decrement in cognitive function, no effect, or an apparent improvement after revascularization. A great number of studies are trying to evaluate the effect of carotid revascularization (CEA, CAS) on patients' cognitive functions, as well as on their psychological condition and quality of life through a baseline and follow-up neuropsychological examination. Recent reviews refer only to the narrow limits of cognitive deficits that may be attributed to carotid stenosis, rather than elucidating the outfit of all aspects of mental and cognitive correlations. Most of those findings depict controversy in current literature as far as the neuropsychological effects of carotid revascularization techniques are concerned, while clinical entities of \"vascular dementia\" and \"vascular depression\", as well as intercurrent vascular risk factors are also addressed. This might be taken into consideration, when determining the optimal therapeutic strategy for tackling carotid artery occlusive disease, while best practice clinical decisions should be still focused on stroke prevention and symptoms alleviation, until further research on the field of neuroangiology presents undisputable conclusions regarding the underlying effects of revascularization on mood and cognition. Τhe neurovascular interface, as far as mental and neurocognitive impact of carotid stenosis is concerned, also, comprises, the conceptual pathophysiological entity of \"atheroinflammation\", underscoring the association of vascular lesions with cognitive impairment, major depressive disorder and bipolar disorder. Chronic recurrent ischemia and chronic low perfusion are also addressed from neurocognitive aspect, regarding therapeutic strategies that might be preferred so as to reduce the burden of chronic cerebrovascular disease in both symptomatic and asymptomatic patients, given the fact that inflammatory processes of vascular complexion underlie both neuroinflammation and atherosclerosis, affecting cerebral perfusion as well as cortical blood flow.</p>","PeriodicalId":20741,"journal":{"name":"Psychiatrike = Psychiatriki","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-06-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72772953","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 effects of carotid revascularization on mood symptoms and quality of life in patients with high - grade carotid stenosis].","authors":"Christos C Liapis, Despina Perrea, Maria Ginieri-Coccossis, Foteini Christidis, Ioannis Zalonis, Christos D Liapis","doi":"10.22365/jpsych.2023.003","DOIUrl":"10.22365/jpsych.2023.003","url":null,"abstract":"<p><p>Carotid occlusive disease has been related to ischaemic strokes and cerebral hypoperfusion, thus affecting patients' quality of life, mainly because of cognitive decline and depressive symptoms. Carotid revascularization techniques [carotid endarterectomy (CEA) and carotid artery stenting (CAS)] may, postoperatively, have a positive impact on patients' quality of life and mental condition, though there have been also presented elusive findings and controversial results. The aim of the present study is to evaluate the effect of carotid revascularization (CEA, CAS) on patients' psychological condition and quality of life through a baseline and follow-up examination. We present data of a group of 35 patients (age range:60-80 years, ΜA=70,26-SD=9,05) with severe, left or right, carotid artery stenosis (>75%), presented with or without symptoms, who underwent surgical treatment with CEA or CAS. Baseline and follow-up (6 months post-surgery) evaluation was conducted in order to assess patients' depressive symptoms and quality of life, through completion of the Beck Depression Inventory and WHOQOL-BREF Inventory, respectively. No statistically significant (p < 0,05) effect of the revascularization process on mood or quality of life assessment could be documented for our patients, regardless of the applied technique (CAS or CEA). Our study supports existing evidence that all of the traditional vascular risk factors represent active participants in the inflammatory process, which has also been implicated in the pathophysiology of depression as well as in pathogenesis of atherosclerotic processes. Thus we have to illuminate new links between the two nosological entities, in the crossroads of psychiatry, neurology and angiology, through the pathways of inflammatory reactions and endothelium dysfunctions. Even though the effects of carotid revascularization on patient's mood and quality of life, are often characterized by opposing results, pathophysiological processes of \"vascular depression\" and \"post stroke depression\" remain a promising interdisciplinary medical domain, sharing both scientific and clinical interests between the fields of neurosciences and vascular medicine. Our results, regarding the bilateral connection of depression and carotid artery disease, advocate a most probable causality link between atherosclerotic process and depressive symptoms, rather than justifying a direct association between depressive disorders and carotid stenosis and inferred cerebral blood flow reduction per se.</p>","PeriodicalId":20741,"journal":{"name":"Psychiatrike = Psychiatriki","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-06-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9304305","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":"Depression and driving.","authors":"Vagioula Tsoutsi, Maria Papadakaki, Dimitris Dikeos","doi":"10.22365/jpsych.2023.014","DOIUrl":"10.22365/jpsych.2023.014","url":null,"abstract":"&lt;p&gt;&lt;p&gt;We have recently published an article in the International Journal of Environmental Research and Public Health presenting the results of our study on the driving behaviour of patients with depression.1 This is the first study conducted on the Greek population assessing the fitness-to-drive of patients with psychiatric disorders through the use of questionnaires and driving simulator. Similar studies in Greece have only been performed among patients with neurological conditions such as Parkinson's disease and mild cognitive impairment.2,3 The aim of the present communication is to discuss our findings in the light of the Greek law and regulations on driving licensure and on the evaluation of driving ability. The main findings of our study add evidence in this discussion by indicating that patients with depression (N=39) do not differ from controls (N=30) regarding their scores on the self-report questionnaires Driver Stress Inventory and Driver Behaviour Questionnaire. The DSI assesses the propensity to develop stress reactions while driving and consists of subscales for driving aggression, dislike of driving, hazard monitoring, thrill seeking, and proneness to fatigue. The DBQ assesses driving behaviour by the subscales of driving errors, traffic violations, and attention lapses. Driving simulator results showed very few differences between patients and controls in terms of their performance on the three selected driving scenarios. The sole difference found between patients and controls was that the former exhibited lower ability to maintain a stable track of the vehicle (measured as the standard deviation of lateral position) only in the rural road scenario. On the other hand, safety distance from the preceding vehicle was found to be higher in patients than in controls, indicating that patients, possibly aware of their somewhat impaired driving ability, tend to drive more carefully.1 These findings provide a plausible explanation for existing conflicting study results, which do not clearly show depression to be associated with susceptibility to traffic accidents and increased crash risk .4-6 International guidelines do not suggest a blanket restriction on the driving licensure of individuals with psychiatric disorders. Instead, there are recommendations for an approach based on the severity of the disorder, insight, adherence to treatment, level of cognitive impairment, and period of stability.7,8 Regulations in Greece are more restrictive, guided by laws 148/08.08.2016 and 5703/09.12.2021, which define the minimum requirements for licensure in certain medical conditions. A psychiatric examination is requested by internists, upon suspicion of a mental health issue and the psychiatric diagnosis assigns a competence level to the patient (\"competent\" or \"non-competent\"). The condition can be re-evaluated upon the patient's request after the lapse of one year from the initial examination; in certain conditions, renewal of driving licensure is","PeriodicalId":20741,"journal":{"name":"Psychiatrike = Psychiatriki","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-06-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9869506","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}