Psychiatrike = Psychiatriki最新文献

{"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":" ","pages":"142-155"},"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 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":" ","pages":"123-132"},"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":"<p><p>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":" ","pages":"165-166"},"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}

{"title":"[Mental health locus of control in refugees with clinically established psychopathology].","authors":"Antonis Tsionis, Dimitris Pantoglou, Yiannis Kasvikis","doi":"10.22365/jpsych.2022.094","DOIUrl":"10.22365/jpsych.2022.094","url":null,"abstract":"<p><p>The present study attempts to examine the mental health locus of control (LOC) of refugees with clinically diagnosed psychopathology and to examine the possible association of LOC with the presentation of the psychopathology. LOC refers to the degree to which a person attributes what happens in their life to themselves or to external factors. It draws its theoretical background from Rotter's theory of social learning. External LOC has been linked to psychopathology in anxiety disorders (AD), depression and post-traumatic stress disorder (PTSD), of which migrants are primarily at risk in comparison to the indigenous population. This is a descriptive cross-sectional study. The study involved 40 refugees who were referred to the psychiatric office, by the psychologists of a non-governmental organization, due to clinically established psychopathology. In the first session, the Patient Health Questionnaire-9 (PHQ-9) and the Harvard Trauma Questionnaire-5 (HTQ5) were administered, according to the score of which the psychologists' referral diagnoses were confirmed. To assess the LOC the Multidimensional Health Locus of Control Questionnaire (MHLC) was administered, which measures LOC in self, significant others, and luck. The questionnaires were administered in English, Farsi, and Lingala. We translated the MHLC questionnaire to Lingala for the needs of the present study and the validity of the translation was ensured using back-translation, from English to Lingala and from Lingala back to English by different translators to control the identification of the English texts. Refugees scored lower on self and higher on significant others and chance. Correlations between LOC and the presentation of psychopathology were sought. A negative correlation was found between the severity of depression and the score on self on the MHLC, a finding that has also been demonstrated in other studies. The intensity of depression was positively correlated with the score of MHLC on luck. There was also a positive correlation between the intensity of the symptoms of PTSD and the score of MHLC to luck, in our sample. The present study highlights the Multidimensional Health Locus of Control Questionnaire as a remarkable and useful tool in the assessment of refugees with psychopathology in Greece.</p>","PeriodicalId":20741,"journal":{"name":"Psychiatrike = Psychiatriki","volume":" ","pages":"103-111"},"PeriodicalIF":0.0,"publicationDate":"2024-06-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40707883","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 blind spots of psychiatric reform in Greece.","authors":"Stelios Stylianidis","doi":"10.22365/jpsych.2024.009","DOIUrl":"10.22365/jpsych.2024.009","url":null,"abstract":"<p><p>According to international experience, the conditions for the successful outcome of a psychiatric reform are the following: (a) Existence of political will (supporting a national plan with assessment, monitoring, and corrective intervention procedures for structural dysfunctions, etc.). (b) Strong mental health leadership (executive expertise and skills that advance the public health agenda). (c) Challenging the dominance of the biomedical model in therapeutic practice through the promotion of holistic care practices, evidence-based innovative actions, collaborative care, the promotion of recovery culture, and the and the use of innovative digital tools. (d) Ensuring necessary resources over time, so that resources from the transition of the asylum model to a model of sectorial community mental health services \"follow\" the patient. (e) Strengthening the participation of service recipients and their families in decision-making processes and evaluation of care quality. (f) Practices based on ethical principles (value-based practice) and not only on the always necessary documentation (evidence-based practice).1- 4 Convergent evidence from the \"ex post\" evaluation of the implementation of the national plan Psychargos 2000-20095 and from the recent rapid assessment of the psychiatric reform by the Ministry of Health and the WHO Athens office (SWOT analysis)6 indicates \"serious fragmentation of services, an uncoordinated system that often results in inappropriate service provision, a lack of epidemiological studies and studies concerning the local needs of specific populations, uneven development of services between different regions of the country, a large number of specialized professionals with significant deficits in community psychiatry expertise, a lack of personnel in supportive roles, significant gaps in specialized services (for individuals with autism spectrum disorders, intellectual disabilities, eating disorders, old and new addictions, and community forensic psychiatry services)\". We would also like to highlight lack of coordination and collaboration among different mental health service systems (public primary and secondary service providers, NGOs, municipal services, mental health services of the armed forces, private sector), complete absence of systematic evaluation and monitoring (lack of quality of care indicators, clinical outcomes, epidemiological profile of each service), lack of quality assurance mechanisms and clinical management systems, insufficient number of beds mainly for acute cases, unclear protocols for discharge issuance and ensuring continuity of care, deficient budget for Mental Health in relation to the overall healthcare expenditure (currently 3.3%), and finally, one of the highest rates of involuntary hospitalizations in Europe, which is linked to serious issues concerning the protection of the rights of service users. After the pandemic and the emergence of the silent but expected mental health pandemic, WHO","PeriodicalId":20741,"journal":{"name":"Psychiatrike = Psychiatriki","volume":" ","pages":"99-102"},"PeriodicalIF":0.0,"publicationDate":"2024-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141175499","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 structure and reliability of the Greek version of Attitudes Towards Mentally Ill Offenders (ΑΤΜΙΟ) Scale in a general population sample.","authors":"Sophia Martinaki, Kimon Athanasiadis, Chara Tzavara, Veatriki Ntelidaki","doi":"10.22365/jpsych.2023.025","DOIUrl":"10.22365/jpsych.2023.025","url":null,"abstract":"<p><p>Mentally ill offenders constitute a group with a unique set of characteristics since they are doubly stigmatized by both their mental illness and the offence they have committed. The coexistence of these two circumstances significantly heightens negative public attitudes towards these people. The group of mentally ill offenders has been shown to elicit more stigmatic attitudes than offenders without a mental health condition. Nevertheless, research on stigma towards mentally ill offenders is rather limited, while the number of psychometric tools used to measure this stigma is even smaller compared to the number of relevant tools assessing mental illness stigma. The purpose of this study was to explore the attitudes towards mentally ill offenders in a Greek sample in terms of demographic characteristics, and at the same time to assess the psychometric properties of a specialized tool on stigma towards this patient group, namely the Attitudes Towards Mentally Ill Offenders (ΑΤΜΙΟ) scale in Greek. The study included 1031 participants from the general population who completed an online questionnaire on sociodemographic data as well as the ATMIO scale. The scale's structural validity was tested on the basis of the exploratory factor analysis after Quartimax rotation, and the internal relevance of its factors recorded a Cronbach's alpha value of more than 0.7, both for the whole scale and its individual factors. It was shown that more negative stereotypes towards mentally ill offenders were correlated with less compassion and less desire for their rehabilitation, with stronger belief and conviction that they represent a danger to the community, with less diminished responsibility, and a lot fewer positive attitudes in general. Women, older people, individuals with a lower education level and participants with children were found to hold more negative attitudes. The ATMIO scale translated in Greek is the first tool to measure attitudes towards mentally ill offenders in the country and shows satisfactory internal consistency and interpretation of its four-factor structure. It is a comprehensible and easy-to-complete scale, which can become a reliable tool to record attitudes towards mentally ill offenders also in our country.</p>","PeriodicalId":20741,"journal":{"name":"Psychiatrike = Psychiatriki","volume":" ","pages":"66-77"},"PeriodicalIF":0.0,"publicationDate":"2024-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138047824","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":"Efficacy of a conservative physical treatment regimen on psychological status and quality of life in Greek patients with chronic low back pain.","authors":"Matthaios Petrelis, Konstantinos Soultanis, Ioannis Michopoulos, Vasileios Nikolaou","doi":"10.22365/jpsych.2023.027","DOIUrl":"10.22365/jpsych.2023.027","url":null,"abstract":"<p><p>Chronic Low Back Pain (CLBP) is a very common health problem that has a great negative impact on the quality of life and the psychological well-being of backache patients. Literature findings have shown that a conventional physiotherapeutic approach is a beneficial choice for CLBP management. The aim of this study was to examine the short-term effects of a conservative physical treatment on depression, anxiety, somatic symptom disorders (SSD), quality of life, pain and disability in Greek individuals suffering from CLBP. Seventy-five CLBP patients were recruited using random systematic sampling. All subjects received ultrasound, low-level laser, massage, transcutaneous electrical nerve stimulation (ΤENS) and alongside an exercise program (sum of 10 sessions, 5 times per week). The intervention was assessed by comparing pre and post outcome measurements based on the Hospital Anxiety and Depression Scale (HADS), Somatic Symptom Scale-8 (SSS-8), EuroQol 5-dimension 5-level (EQ-5D-5L), Roland-Morris Disability Questionnaire (RMDQ) and Pain Numerical Rating Scale (PNRS) instruments. The mean age of the sample was 60.8 years (±14.4) and nearly one out of four (25.3%) was obese. After the end of the treatment, there were improvements in EQ-5D-5L indices and decreases in HADS, SSS-8, RMDQ and PNRS scores, which were found to be statistically significant. Greater effect size was found in PNRS (d=0.75), followed by EQ-5D-5L index value scale (d=0.42), SSS-8 (d=0.38), EQ-5D-5L VAS (d=0.36), RMDQ (d=0.29), HADS-A (d=0.16) and HADS-D (d=0.14). Men and women had similar changes in all under-study scales after the treatment, while besides pain scale, the pre-intervention scores as well as the degree of change in all scores were similar across all Body Mass Index (BMI) levels. In conclusion, convectional physical treatment was found to be an effective option in improving considerably the psychological status and quality of life, while also decreasing functional disability and pain in CLBP patients in the short run.</p>","PeriodicalId":20741,"journal":{"name":"Psychiatrike = Psychiatriki","volume":" ","pages":"54-65"},"PeriodicalIF":0.0,"publicationDate":"2024-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138047823","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":"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}

{"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}