Konstantinos Anargyros, Theodoros Mavrogiannidis, Eftychia Oikonomou, Eleana Karapournos, Sofia Dimou, Georgios I Moussas
{"title":"Psychiatric Hospital of Leros: a portrayal of the current situation.","authors":"Konstantinos Anargyros, Theodoros Mavrogiannidis, Eftychia Oikonomou, Eleana Karapournos, Sofia Dimou, Georgios I Moussas","doi":"10.22365/jpsych.2023.017","DOIUrl":"10.22365/jpsych.2023.017","url":null,"abstract":"<p><p>The purpose of this study was to describe the demographic and clinical features of the inpatients currently residing at the Psychiatric Hospital of Leros. The present systematic documentation and presentation aimed to demonstrate the standard of living and healthcare conditions provided today, after the implementation of the State's \"Psychargos\" program; this is the main Greek Psychiatric reform program, adhering to the principles of deinstitutionalization and community psychiatry, in accordance with the current international guidelines. In addition, we discussed the current relationship between the psychiatric departments of the hospital and the other departments and clinics in terms of providing healthcare services to chronic psychiatric inpatients in full compliance with the biopsychosocial model and its application to the unique case of Leros. The implemented patient profiles incorporated both subjective and objective factors, such as compliance with rules and treatment, self-injury, and harm to others. Furthermore, we quantified and categorized the level of care required for each patient in terms of personnel-reported activities. This parameter was assessed through the Greek version of Katz's Index of Independence in Activities of Daily Living. Simultaneously, the fundamental actions provided to inpatients by the social care and support services of the hospital were also depicted and categorized, in terms of connection to State social services, communication with the patient's families, and cooperation between the families and the hospital for the patient's healthcare needs. Furthermore, we analyzed and presented all statistically significant correlations found in our patients' characteristics. Briefly, the main results of our study show that the mean age of the 212 patients was 62.4 years old (with a standard deviation of ±13.6 years and the longest hospitalization of 62 consecutive years) including patients from the institution's asylum period. Since 1989, the year when the psychiatric reform began in our hospital, 87 new patients were admitted, 85.1% of whom were from the southern Aegean, thus following the principle of naiveness. Intellectual disabilities and psychotic spectrum disorders were the most common disorders among the total number of hospitalized patients, accounting for 40% in each category. Regarding the 87 patients hospitalized after 1989, psychotic spectrum disorders were diagnosed in the vast majority (58 patients, 66.7%) followed by organic mental disorders (10 patients, 11.5%). The rest were diagnosed with other disorders. Somatic comorbidity and the need for care and services, especially for patients with intellectual disabilities, demonstrate how the Institution now mainly offers psychogeriatric healthcare services. In conclusion, the purpose of this study was to highlight the Psychiatric Hospital of Leros as it stands today, in stark contrast to the long-established, stereotypical depiction of asylums in the sci","PeriodicalId":20741,"journal":{"name":"Psychiatrike = Psychiatriki","volume":" ","pages":"26-33"},"PeriodicalIF":0.0,"publicationDate":"2024-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9833834","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":"Brain health and value diversity: A new implementation field for values-based practice?","authors":"Panagiotis Alexopoulos, Alison Canty, Jayashree Dasgupta, Joyla A Furlano, Aline Nogueira Haas","doi":"10.22365/jpsych.2024.001","DOIUrl":"10.22365/jpsych.2024.001","url":null,"abstract":"<p><p>Brain health has recently emerged as an overarching concept encompassing cognitive, sensory, social-emotional, behavioural and motor aspects of brain functioning, enabling individuals to achieve their potential for both health and wellbeing over their life course, independent of the presence or absence of disease.1 It is contingent on a continuous, complex interplay between interconnected determinants related to physical health, healthy environments, safety and security, learning and social connection, and access to quality services. Even though responsibility for optimizing brain health can be taken at an individual level, brain health is in fact heavily influenced by determinants far beyond the control of individuals and their families. For instance, protection from abuse and maltreatment or equitable access to health services depend on interacting social, financial, and political factors that can often only be minimally influenced by individual or small group initiatives.2,3 In addition, the voice of many people, including the very young, the very old, the sick, the disadvantaged, and those who live in poverty, may not be sufficiently influential, even though the decision-making process crucially affects the brain health and quality of life for these individuals. The breadth of determinants of brain health makes brain health a terrain that is justifiably shaped by a plethora of stakeholders with highly diverse values and hence potentially conflicting interests and albeit different degrees of power. Consequently, decision-making in such contexts embodies a thorny process that may render the negligence of the values, viewpoints, and perspectives of those directly involved in a given decision, particularly when the individual capacity to advocate for oneself and the willingness of society and governments to act on behalf of their citizens, are low. Values-based practice (VBP) is a toolkit for balancing interests, wishes, and values in contexts characterized by diverse values, which may be valuable in decision-making related to brain health.4 The implementation of this toolkit in different fields of healthcare (e.g., occupational therapy, orthopedics, primary care, psychiatry, psychology, radiotherapy) has been proposed, and training materials for healthcare professionals have been developed.5 VBP aims to include the differences in values, viewpoints, and perspectives of those directly concerned with a given decision so that communication and shared decision-making are facilitated. Based on the legacy of the Popperian open society,5 VBP treats values in the same way that democracy treats ideas and human voices. Hence, this decision-making toolkit is neither restricted to ethical codes nor prioritizes one value over others. It also does not endorse certain values while excluding others, provided that the values in play are compatible with legal, regulatory, and bioethical frameworks. The emphasis of VBP is on good process rather than predeter","PeriodicalId":20741,"journal":{"name":"Psychiatrike = Psychiatriki","volume":" ","pages":"13-16"},"PeriodicalIF":0.0,"publicationDate":"2024-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139521308","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}
Helen Lempesi, Athina Katerinopoulou, Chara Tzavara, Anastasia Koumoula, Fragiskos Gonidakis
{"title":"Validation of the Greek version of the Accommodation and Enabling Scale for Eating Disorders (AESED).","authors":"Helen Lempesi, Athina Katerinopoulou, Chara Tzavara, Anastasia Koumoula, Fragiskos Gonidakis","doi":"10.22365/jpsych.2023.019","DOIUrl":"10.22365/jpsych.2023.019","url":null,"abstract":"<p><p>Eating disorders-related research has shown that families, in order to alleviate family conflict and stress, accommodate the symptoms of individuals with eating disorders. It has been argued that by tolerating or alleviating symptoms, the latter may gradually be reinforced or even fully accepted, as the family becomes increasingly \"trapped\" in specific eating patterns, weight control behaviors, and body shape worries. The Accommodation and Enabling Scale for Eating Disorders was created in 2009, aiming to assess family adaptability of individuals with eating disorders. The purpose of the present research was to test the psychometric properties of the Greek version of the scale in a sample of parents of individuals with eating disorders. The translation procedure was carried out based on the forward-backward method, while the study was conducted at the Eating Disorders Clinic of the First Psychiatric Clinic of Aiginiteion Hospital. The convenience sampling methods were used for the sample's recruitment. Respondents reported on their basic demographic characteristics, and completed the General Health Questionnaire-28, and the Accommodation and Enabling Scale for Eating Disorders. The final study's sample consisted of 125 parents of individuals with eating disorders (69.6% women), with a mean age of 55.2 years. Factor analysis revealed a five-factor model, similar to that of the original version of the scale, with the model explaining 63.3% of the total variance. Internal consistency was judged to be high, with Cronbach's coefficient a being 0.93 for the scale's total score, while Cronbach's α for the five subscales ranged from 0.78 to 0.90. Convergent validity was tested with the Spearman's coefficient rho, which revealed a statistically significant correlation of the weighted scale with the General Health Questionnaire (rho=0.33, p<0.5). The results showed that the Greek version of the Accommodation and Enabling Scale for Eating Disorders is a valid and reliable tool for assessing the adaptability of families of people suffering from eating disorders. Application of the tool to larger samples will validate its psychometric properties on a larger scale.</p>","PeriodicalId":20741,"journal":{"name":"Psychiatrike = Psychiatriki","volume":" ","pages":"34-42"},"PeriodicalIF":0.0,"publicationDate":"2024-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10136582","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 between bullying and symptom presentation in first-episode psychosis.","authors":"Ioannis Kosteletos, Alexandros Hatzimanolis, Lida-Alkisti Xenaki, Irene Ralli, Stefanos Dimitrakopoulos, Ilias Vlahos, Mirijana Selakovic, Stefania Foteli, Rigas-Filippos Soldatos, Nikolaos Nianiakas, Konstantinos Kollias, Nikos Stefanis","doi":"10.22365/jpsych.2023.021","DOIUrl":"10.22365/jpsych.2023.021","url":null,"abstract":"<p><p>Multiple recent studies have indicated that adverse psycho-traumatic experiences are particularly significant, if not the most significant, among the environmental factors that participate in the aetiology of schizophrenic spectrum disorders. The prevalence of bullying in the adolescent population has increased dramatically compared to earlier reports. This may be related to the recent development of communication technology and the use of social media, which have expanded the means by which bullying can be practiced. The present study aims to investigate the association between bullying victimisation and psychotic symptoms in First-Episode Psychosis (FEP) patients, hypothesising that patients who have a bullying history may have increased psychotic symptoms and a more unfavourable early trajectory after treatment as usual compared to patients who do not have a bullying history. Research data were collected from a sample of men and women of the Greek general population aged between 16 and 45 (N=225) who experienced a FEP in the context of the Athens First-Episode Psychosis (FEP) Study. The assessment of bullying was performed using the Retrospective Bullying Questionnaire (RBQ). Assessment of positive and negative psychotic symptoms and general psychopathology was performed using the corresponding subscales of the Positive and Negative Syndrome Scale (PANSS) at baseline and after 4 weeks of treatment as usual. Clinical remission was assessed based on the baseline and follow-up values of the PANSS and on Andreasen's symptomatic criteria. Methodologically, Pearson's chi-square test was used to compare the history of bullying between men and women, while linear and logistic regression models were used to check the correlations between history of bullying and symptom severity at baseline and 4-week follow-up, as well as the correlation between history of bullying and remission. The prevalence of bullying history in our sample of patients (N:225) with a FEP was 51.4% (114/225). Bullying was recorded in our study participants with equal frequency in women and men. According to the analysis results, the patients who had experienced bullying did not present at baseline with significantly increased psychotic symptoms compared to the patients who did not have a history of bullying. In addition, bullying was not associated with reduced remission according to Andreasen's criteria. However, the patients who had experienced bullying were found to have significantly increased negative symptoms (B=1.66; SE=0.70; p=0.018) and increased PANSS total score (B=4.81; SE=2.34; p=0.041) at 4-week follow-up. Our results highlight the persistence of negative and overall symptoms as an impact of bullying on the development of the FEP and align with studies that support the consideration of a history of bullying during both the diagnostic and therapeutic processes.</p>","PeriodicalId":20741,"journal":{"name":"Psychiatrike = Psychiatriki","volume":" ","pages":"17-25"},"PeriodicalIF":0.0,"publicationDate":"2024-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41161498","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}
Michail Papantoniou, Georgia Panagou, Maria Gryllia
{"title":"Peduncular hallucinosis associated with pontine hemorrhage in an adult patient.","authors":"Michail Papantoniou, Georgia Panagou, Maria Gryllia","doi":"10.22365/jpsych.2023.026","DOIUrl":"10.22365/jpsych.2023.026","url":null,"abstract":"<p><p>Peduncular hallucinosis refers to a rare neurophychiatric disorder presenting with vivid visual hallucinations, disturbances of sleep, and oculomotor dysfunction. It is typically caused by mesencephalic lesions. Nonetheless, a few cases have also been reported, in which the same syndrome was associated with thalamic and pontine lesions. We report the case of a 63-year-old male patient presenting to the Emergency Department of our hospital with irritability, gait difficulty, and diplopia of sudden onset two hours ago. Neurological examination revealed dysarthria, right facial palsy, bilateral gaze palsy, dysmetria of his left extremities, left-sided hemihypaethesia and extensory plantar response on the left. Brain computerized tomography (CT) showed a hemorrhagic lesion on the right lateral side of the pons. During his hospitalization at the Department of Neurology, he developed visual hallucinations, confusion, disorientation, insomnia, and strong emotional response. An extensive laboratory screening was performed and showed no abnormal findings. Suspecting peduncular hallucinosis due to the brainstem lesion, treatment with quetiapine and melatonin was administered to the patient and symptoms resolved completely within days. Subsequently, gradual neurological clinical improvement was also noted and two weeks after his admission, a repeated brain CT and a brain magnetic resonance imaging (MRI) showed partial absorption of the brainstem hemorrhage. The patient underwent rehabilitation for two months, showing further clinical improvement, and treatment with quetiapine and melatonin was discontinued without any further episodes being noted. A repeated brain MRI was performed two months after his admission to our hospital and showed no hemorrhage, but a mixed signal intensity core and a hypointense hemosiderin rim at the location of the absorbed hemorrhagic lesion, compatible with pontine carvenoma. Peduncular hallucinosis is most commonly associated with ischemic lesions of the posterior brain blood circulation, but different lesions have been reported, like vasospasm, brain tumors, encephalitis, hemorrhage associated with vascular malformations, such as a carvenoma, as seen in our case, representing a very rare form of peduncular hallucinosis.</p>","PeriodicalId":20741,"journal":{"name":"Psychiatrike = Psychiatriki","volume":" ","pages":"78-82"},"PeriodicalIF":0.0,"publicationDate":"2024-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138047825","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":"Perceptions and attitudes of people with severe mental disorders towards smoking in Greece.","authors":"Georgia Papadosifaki, Vasiliki Psarra, Charalampos Touloumis, Chara Tzavara, Konstantinos Farsalinos, Evanthia Sakellari, Areti Lagiou, Anastasia Barbouni","doi":"10.22365/jpsych.2023.022","DOIUrl":"10.22365/jpsych.2023.022","url":null,"abstract":"<p><p>Despite its significant decline in the general population, smoking remains endemic and highly prevalent among people with mental disorders. The impact of smoking-attributable morbidity on life expectancy is significant since, in comparison to the general population, people with severe mental disorders have a 15-20-year reduction in life expectancy. A cross-sectional study was conducted among 1015 people with mental disorders through personal interviews. The questionnaire was designed to examine these patients' knowledge, perceptions, and attitudes towards smoking. Individuals were recruited from the mental health residential community services, the outpatient department, and the inpatient facilities of the Psychiatric Hospital of Attica. Statistical analysis was performed using SPSS 26.0. In the sample analyzed, the current-smoking prevalence stood at 68.4% (n=643), while 12.3% reported being former smokers. A staggering 86.3% smoked their first cigarette within 30 minutes of waking up, indicating a high level of dependence. Most of the former smokers (83.6%) reported that their main reason for quitting smoking was to improve their health, and the overwhelming majority (97.4%) had done so using no smoking cessation aid. Although slightly over half of the participants (53.7%) believed that health professionals adequately inform smokers about the harmful health effects of tobacco products, the information provided by health professionals on smoking cessation programs and tobacco harm reduction alternatives was considered sufficient by a mere 11.2%. Multiple logistic regression analysis demonstrated that outpatients tended to have a greater likelihood of being current smokers as compared to inpatients (OR=1.45), while users of mental health residential community services showed a significantly lower likelihood of being current smokers in comparison to inpatients (OR=0.49). Additionally, it was found that women had a lower likelihood of being current smokers compared to men (OR=0.51), while divorced/ widowed participants had a greater likelihood of being current smokers compared to single ones (OR=1.93). Finally, multiple regression analysis indicated that participants with psychotic disorders displayed a 2.39 times greater likelihood of being current smokers compared to those with mood disorders (OR=2.39). Understanding the knowledge, beliefs, and attitudes of people with mental disorders towards tobacco is an essential first step to confronting this neglected epidemic.</p>","PeriodicalId":20741,"journal":{"name":"Psychiatrike = Psychiatriki","volume":" ","pages":"43-53"},"PeriodicalIF":0.0,"publicationDate":"2024-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41144471","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}
Afroditi Stefani, Anna Mavridou, Stelios Chatziioannidis, Vasilios P Bozikas, Agorastos Agorastos
{"title":"Childhood Trauma Questionnaire (CTQ): Greek translation and psychometric validation in general and clinical population.","authors":"Afroditi Stefani, Anna Mavridou, Stelios Chatziioannidis, Vasilios P Bozikas, Agorastos Agorastos","doi":"10.22365/jpsych.2024.005","DOIUrl":"https://doi.org/10.22365/jpsych.2024.005","url":null,"abstract":"<p><p>Exposure to childhood trauma experiences shows a high prevalence worldwide, with approximately two-thirds of the general population reporting traumatic experiences during childhood. The valid psychometric assessment of childhood trauma experience represents, however, a significant challenge in clinical research and practice. The Childhood Trauma Questionnaire - Short Form (CTQ-SF) embodies the most valid and internationally widely used tool for the retrospective assessment of traumatic experiences during childhood to date. The purpose of this study was the Greek translation of the questionnaire and its validation in both a general and clinical population. Participants completed electronically the Greek translation of the CTQ-SF, the Early Trauma Questionnaire (ETI-SR-SF), the Trauma Symptom Checklist (TSC-40), the Positive and Negative Affect Scale (PANAS- SF), the Well-Being Index (WHO-5) and the Patient Health Questionnaire (PHQ-4) to examine psychometric properties of the questionnaire (e.g., internal consistency, concurrent, convergent and divergent validity), but also to investigate the relationship between childhood trauma exposure and psychological well-being and symptoms of anxiety and depression. The total study sample (TS) consisted of 722 adults (606 women), of which 155 declared the existence of a psychiatric diagnosis (PD) and 567 constituted the general population (GP) sample. The most common trauma types reported were emotional abuse (29.1%), emotional neglect (23.7%), and physical abuse (24.6%). The CTQ-SF questionnaire showed high levels of internal consistency based on the Cronbach α coefficient (TS = 0.92, PD = 0.92, GP = 0.92), high concurrent and convergent validity and satisfactory convergent validity. In addition, self-reported childhood trauma was highly positively correlated to negative affect and anxiety and depression symptoms, as well as negatively to psychological well-being. Our results confirm that the Greek Version of Childhood Trauma Questionnaire (CTQ-SF) is a reliable and valid tool that can be used for the retrospective assessment of traumatic childhood experiences both in the general and in the clinical adult Greek population.</p>","PeriodicalId":20741,"journal":{"name":"Psychiatrike = Psychiatriki","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140028820","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}
Christina Boteli, Stavroula Bargiota, Anna Papakonstantinou, Agorastos Agorastos
{"title":"[Comparative study of stress and psychological well-being in parents of children with and without special education needs during the COVID-19 pandemic].","authors":"Christina Boteli, Stavroula Bargiota, Anna Papakonstantinou, Agorastos Agorastos","doi":"10.22365/jpsych.2024.002","DOIUrl":"https://doi.org/10.22365/jpsych.2024.002","url":null,"abstract":"<p><p>The COVID-19 pandemic, which rapidly spread worldwide in early 2020, has affected the daily lives of parents and their children in various ways. This study assessed the overall mental health status and stress experienced by parents during the COVID-19 pandemic and the differences between parents of children with special educational needs and parents of typically developing children. Additionally, we explored potential demographic factors that may influence these experiences. In this cross-sectional study, data were collected through questionnaires completed by a sample of 205 parents (103 of children with typical development attending regular mainstream schools and 102 of children with special educational needs attending special education schools) from February to April 2021. Participants completed the Perceived Stress Scale (PSS-10), the short form of the Profile of Mood States (POMS-S), and a demographic questionnaire. Our findings confirmed that parents of children attending special education schools reported higher levels of anxiety, reduced coping abilities, and poorer overall emotional well-being during the pandemic compared to parents of children attending regular schools. The type of educational setting that children attended was identified through multivariate analyses as the only factor consistently influencing all psychometric outcomes. Factors influencing anxiety levels included gender, older age, and family status, while family status and unemployment negatively impacted coping abilities. Taken together, the pandemic appears to have had a greater impact on the mental health of parents of children with special education needs compared to parents of children attending regular schools, highlighting the need for increased psychosocial support within this population group.</p>","PeriodicalId":20741,"journal":{"name":"Psychiatrike = Psychiatriki","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140028818","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":"Investigating predictors of well-being in type 2 diabetes mellitus patients: the role of undiagnosed depression.","authors":"Anastasia Antoniou, Alexios Sotiropoulos, Efstathios Skliros, Athanasios Raptis, Rossetos Gournellis, Emmanouil Rizos, Nikolaos Smyrnis, Panagiotis Ferentinos","doi":"10.22365/jpsych.2022.093","DOIUrl":"10.22365/jpsych.2022.093","url":null,"abstract":"<p><p>Type 2 diabetes mellitus (T2DM) is a common metabolic disorder with various medical and psychological adverse effects. Well-being in patients with T2DM is often compromised. The aim of the present study was to investigate clinicodemographic predictors of well-being in patients with T2DM with no known psychiatric history and explore the mediatory role of undiagnosed anxiety and depression. We recruited 175 outpatients with T2DM (54.3% males, aged 34-79 (mean 59.9) years) followed-up at the Diabetes Center of the General Hospital of Nikaia-Peiraeus in Athens. Patients included had no severe diabetes-related complications or known psychiatric history. Well-being was measured with the Mental Health Continuum Short-Form (MHC-SF), a novel 14-item tool measuring the emotional (EWB), social (SWB) and psychological (PWB) dimensions of well-being, as well as a total score of well-being (WBT). Hospital Anxiety and Depression Scale (HADS) was used for screening for undiagnosed anxiety (HADS-A) and depression (HADS-D). Patients' demographics, Body Mass Index (BMI), glycemic control (HbA1c), T2DM duration, comorbid hypertension or dyslipidemia and type of antidiabetic medication were investigated as predictors of well-being or its dimensions in stepwise linear regression models, also including or excluding HADS-A and HADS-D. Mediational effects of HADS-A and HADS-D were explored in structural equation models through path analyses. Results showed that 21.1% of participants had comorbid depression (HADS-D≥11) and 5.1% comorbid anxiety disorder (HADS-A≥11). In the models without HADS, higher WBT as well as EWB and PWB were significantly predicted by lower HbA1c (all p=0.001) and lower BMI (p=0.015, 0.019 and 0.030, respectively). After being included in the model, HADS-A and HADS-D significantly predicted WBT and every dimension of well-being, but the effects of HbA1c and BMI were no longer statistically significant. In path analyses, the indirect effects of HbA1c and BMI on well-being via HADS-D were statistically significant, while the direct and indirect effects via HADS-A were not. Therefore, the effects of HbA1c and BMI on EWB, PWB and WBT were completely mediated by HADS-D. Concludingly, this is the first study using MHC-SF to measure well-being in patients with T2DM. High levels of undiagnosed depression were recorded, in agreement with other studies. Depression was predicted by HbA1c and BMI and finally predicted well-being. Undiagnosed depression fully explained the effects of HbA1c and BMI on well-being. The interplay of glycemic control and positive mental health should be further investigated.</p>","PeriodicalId":20741,"journal":{"name":"Psychiatrike = Psychiatriki","volume":" ","pages":"269-278"},"PeriodicalIF":0.0,"publicationDate":"2023-12-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40707882","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 Τype 1 Diabetes Stigma Assessment Scale (DSAS-1-Gr).","authors":"Emmanouil S Benioudakis, Argyroula Kalaitzaki, Eleni Karlafti, Maria-Alexandra Kalpou, Christos Savopoulos, Triantafyllos Didangelos","doi":"10.22365/jpsych.2022.097","DOIUrl":"10.22365/jpsych.2022.097","url":null,"abstract":"<p><p>Type 1 Diabetes Mellitus (T1D) is one of the most common chronic diseases affecting children and adolescents. The daily management of T1D requires continuous insulin therapy, as well as the inevitable adjustment of daily activities according to glycaemic control, both of which may result in experiencing T1D related stigma. A significant proportion of people with T1D have been shown to experience social discrimination and stigma, which can lead to emotional distress and act as a barrier to help-seeking behavior. This study presents the psychometric properties of the Greek translation of the Diabetes Stigma Assessment Scale-1 (DSAS-1), which assesses self-perceived stigma in people with T1D. A sample of 105 adults with T1D, mostly females (70.5%), with a mean age of 34.3 years (±11.1), and mean disease duration of 19.4 years (±10.5), completed the translated in Greek DSAS-1 (DSAS-1-Gr). Exploratory and confirmatory factor analyses were used to investigate the construct validity of the scale. In line with the original version, the results of the present study supported the three-factor model of the scale 'identity concerns', 'different treatment', 'blame and judgment'. The internal consistency indices (Cronbach alpha) of the three subscales were above α=.80 and .88 for the whole scale. Moderate correlations were found between the DSAS-1-Gr and the Diabetes Distress scale for type 1 Diabetes (T1-DDS), the Rosenberg self-esteem scale, and the DASS-21 subscales (depression, anxiety, and stress), which is indicative of convergent validity. DSAS-1-Gr correlated negatively with the diabetes duration (in years), which was indicative of discriminant validity. Finally, females presented higher total DSAS-1-Gr score than males. DSAS-1-Gr is a valid and reliable tool to be used in clinical practice to assess stigma in Greek people with T1D.</p>","PeriodicalId":20741,"journal":{"name":"Psychiatrike = Psychiatriki","volume":" ","pages":"279-288"},"PeriodicalIF":0.0,"publicationDate":"2023-12-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40707828","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}