Validation of parental stress scale in a Greek sample of mothers with infants from 0 to 12 months.

Parenting an offspring is a rewarding, albeit challenging task, often accompanied by high levels of stress. It is important to accurately assess the stress associated with parenting, as severe forms of stress may affect the parent-child dyad and lead to poor child outcomes. The aim of this study was to translate and validate the Parental Stress Scale (PSS) in the Greek population. We implemented forward and back translation and conducted a pilot test. A total of 735 mothers (Mage  = 34.6) with infants aged 0-12 months completed the PSS, the Edinburgh Postnatal Depression Scale, and the Hospital Anxiety and Depression Scale. The Greek PSS-18 showed good internal consistency (Cronbach's α = .83) and adequate convergent validity. Results of exploratory and confirmatory factor analysis revealed two underlying factors: positive aspects of parenting and negative aspects of parenting. Our data confirm the validity of the Greek version of the PSS-18 in mothers with infants aged 0-12 months. The Greek version of the PSS-18 could be a useful tool for professionals and researchers who are interested in perinatal period and the aspects of parenthood.

Criar a un hijo es una tarea gratificante, aunque desafiante, a menudo acompañada por altos niveles de estrés. Es importante evaluar con certeza el estrés asociado con la crianza, ya que formas severas de estrés pudieran afectar la díada progenitor-niño y llevar a pobres resultados en el niño. El propósito de este estudio fue traducir y validar la Escala de Estrés del Progenitor (PSS) en la población griega. Implementamos la traducción hacia adelante y hacia atrás y llevamos a cabo una examinación experimental. Un total de 735 madres (Edad promedio = 34.6) con infantes de edad 0-12 meses completaron la PSS, la Escala de Edimburgo de Depresión Posnatal y la Escala de Ansiedad de Hospital y Depresión. La PSS griega-18 mostró una buena consistencia interna (de Cronbach α = .83) y una validez de convergencia adecuada. Los resultados de los análisis de factores exploratorios y confirmatorios revelaron dos factores subyacentes: aspectos positivos de crianza y aspectos negativos de crianza. Nuestros datos confirman la validez de la versión griega de PSS-18 en madres con infantes de edad 0-12 meses. La versión griega de PSS-18 pudiera ser una herramienta útil para profesionales e investigadores que están interesados en el período perinatal y los aspectos de la maternidad/paternidad.

Le parentage d'un enfant est une tâche gratifiante mais également un défi, souvent accompagnée de niveaux de stress élevés. Il est important d'évaluer avec précision le stress lié au parentage puisque les formes sévères de stress affectent la dyade parent-enfant et mènent à de piètres résultats pour l'enfant. Le but de cette étude était de traduire et de valider l'Echelle de Stress Parental (abrégé en anglais et ici par PSS) chez la population grecque. Nous avons procédé à la traduction et fait un test pilote. Un total de 735 mères (Mâge = 34,6) avec des bébés âgés de 0 à 12 mois ont rempli la PSS, l'Echelle de Dépression Postnatale d'Edinbourg, et l'Echelle d'Anxiété de l'Hôpital et de Dépression. La PSS-18 grecque a fait preuve de bonne cohérence interne (Cronbach's α = .83) et d'une validité convergente adéquate. Les résultats de l'analyse de facteur exploratoire et confirmative ont révélé deux facteurs sous-jacents: les aspects positifs du parentage et les aspects négatifs du parentage. Nos données confirment la validité de la version grecque de la PSS-19 chez des mères avec des bébés âgés de 0 à 12 mois. La version grecque de la PSS-18 pourrait être un outil utile pour les professionnels et les chercheurs qui s'intéressent à la période périnatale et aux aspects du parentage.

Mental Health Professionals' Attitudes to Severe Mental Illness and Its Correlates in Psychiatric Hospitals of Attica: The Role of Workers' Empathy.

To describe mental health workers' attitudes to severe mental illness and to explore its socio-demographic and professional correlates, including the influence of empathy. A total of 127 mental health staff working on the psychiatric hospitals of Attica participated in the study. Stigma was assessed with the Attitudes to Severe Mental Illness scale (ASMI) and the Greek Social Distance scale; whilst Empathy with the Interpersonal Reactivity Index. Participants' unfavourable attitudes to severe mental illness were limited to pessimism about recovery, difficulty in viewing people with mental illness as similar to other people and desire to keep distance in intimate encounters. Professional group and personal experience with mental illness were found to predict stigma. Only perspective taking was associated with both stigma measures; while Fantasy was positively correlated with social distance. Anti-stigma interventions in mental healthcare should prioritize nurses and psychiatrists and aim at enhancing perspective taking.

Problem Gambling in Greece: Prevalence and Risk Factors During the Financial Crisis.

In Greece no study has ever been conducted on the prevalence of problem gambling. Therefore, a cross-sectional survey was carried out amid the recession aiming to (1) estimate past year prevalence of problem gambling, (2) explore socio-economic and demographic differences among gamblers and non gamblers, (3) explore socio-economic and demographic differences among gamblers who started gambling prior and during the downturn and (4) identify its risk factors with a special interest in the influence of the recession. To this end, data emanating from a telephone and patron survey were combined. A random and representative sample of 3.404 people participated in the telephone survey and 2.400 in the patron survey. The interview schedule was the same in both studies. The presence of problem gambling was assessed with the Canadian Problem Gambling Index. Information on participants' socio-economic and demographic characteristics as well as their ways of dealing financially with the crisis were collected. Findings indicated that 2.4% of respondents met criteria for problem gambling. Male gender, minority status, living with family of origin, low educational level and low to zero income were found to constitute the risk factors of the disorder. Moreover, having started gambling during the recession increased the odds of suffering from problem gambling; however this finding was gender-specific. Thus, people end up in problem gambling through various pathways, with these trajectories being different for men and women. Any intervention should address the complexity of the issue and be tailored by gender.

Adolescent gambling in greater Athens area: a cross-sectional study.

PURPOSE: Problem gambling in adolescents has recently emerged as a pressing public health concern. In this context and in light of the pervasive financial crisis in Greece, the present study aimed to explore adolescents' gambling involvement in Athens region to estimate the prevalence of its problematic form and to identify its risk/protective factors. METHODS: A total of 2141 students were recruited from a representative sample of 51 schools located in greater Athens area. The presence of problem gambling was assessed through the use of the DSM-IV-MR-J questionnaire. Data were collected in the form of a self-reported questionnaire during one school hour. RESULTS: Results indicate that 1-year prevalence of high severity problem gambling was found to be 5.6%. Regarding the risk factors for problem gambling; male gender, parental engagement with gambling activities, living without the parents, low grades at school, foreign nationality and the referent absence of availability of food in the household, increased the risk of suffering from the disorder. CONCLUSION: Gambling behavior among adolescents constitutes a problem in Greece and highlights the need for designing and implementing appropriate preventive interventions, especially amid the ongoing financial crisis.

Body mass index and plasma leptin in psychiatric suicide attempters.

OBJECTIVES: To evaluate body mass index (BMI) and its correlate plasma leptin levels that have been associated with psychiatric morbidity and suicidal behaviour, in relation to clinical features in psychiatric patients after a suicide attempt. METHODS: BMI and plasma leptin were assessed in 198 patients (66 males, age range of 21 to 80 years) who were admitted to the hospital after a suicide attempt, 98 with major depressive disorder, 28 with bipolar disorder, 30 with psychosis, and 42 with personality or adjustment disorder, compared to data of 134 healthy subjects, and evaluated in relation to gender, diagnosis, mode of attempt, and pharmacological treatment before attempt. The ratio leptin/BMI was used as a measure of adipocyte leptin secreting activity. RESULTS: Drugs taken for treatment before attempt, among them atypical neuroleptics, were not associated either to BMI or to plasma leptin. The positive correlation between BMI and leptin was significant in all groups. Compared to same gender controls, significant differences were found only for female patients, namely higher BMI for patients with psychosis and patients with bipolar disorder, while leptin/BMI ratio was higher only in females with bipolar disorder. CONCLUSION: BMI and plasma leptin in psychiatric suicide attempters are elevated in certain diagnostic groups in females, not related to previous pharmacologic treatment. The lack of a control group without a history of suicide attempts does not allow the attribution of enhanced leptin secreting activity found in female bipolar attempters specifically to suicidal behavior or to the disorder as a diagnostic entity.

Comorbidity of Cognitive Impairment and Late-Life Depression Increase Mortality: Results From a Cohort of Community-Dwelling Elderly Individuals in Rural Greece.

OBJECTIVE: To investigate the association of cognitive impairment (COGI) and depression with all-cause mortality and cardiovascular-specific mortality among community-dwelling elderly individuals in rural Greece. METHODS: Cognition and depressive symptomatology of 676 Velestino town residents aged ≥60 years were assessed using Mini-Mental State Examination (MMSE) and Geriatric Depression Scale (GDS), respectively. Eight-year all-cause mortality and cardiovascular mortality were explored by multivariate Cox regression models controlling for major confounders. RESULTS: Two hundred and one patients died during follow-up. Cognitive impairment (MMSE ≤ 23) was independently associated with all-cause mortality (hazard ratio [HR]: 1.57, 95% confidence interval [CI]: 1.13-2.18) and cardiovascular mortality (HR: 1.57, 95%CI: 1.03-2.41). Moderate to severe depression (GDS > 10) was significantly associated only with a 51% increase in all-cause mortality. A male-specific association was noted for moderate to severe depression, whereas the effect of COGI was limited to females. Noteworthy, COGI and depression comorbidity, rather than their sole presence, increased all-cause mortality and cardiovascular mortality by 66% and 72%, respectively. The mortality effect of COGI was augmented among patients with depression and of depression among patients with COGI. CONCLUSION: COGI and depression, 2 entities often coexisting among elderly individuals, appear to increase all-cause mortality and cardiovascular mortality. Gender-specific modes may prevail but their comorbidity should be carefully assessed, as it seems to represent an independent index of increased frailty, which eventually shortens life expectancy.

Exploratory study of nocebo effect in senior medical students.

Background: Νocebo Effect is known to induce adverse symptoms after negative expectations which can be manifested on a physical and psychological level. As 6th year medical students often face a wide range of clinical challenges and may be prone to negative expectations or beliefs affecting their pre-clinical and clinical success, we want to investigate how they are affected by the Nocebo Effect. Objective: To investigate whether a nocebo effect can be induced when exposing final-year students to the clinical context of their training. Methods: We used verbal suggestions as a nocebo mechanism and by using three tools, the Illness Attitude Scales, the Symptom Checklist-90, and the State-Trait Anxiety Inventory, we examined the difference in scores on measures of psychometric parameters in 33 participants who were on their 6th year medical and attended three clinics for the first time during their education. The administrations were given before and after attending each clinic, and negative verbal suggestions were given prior to the first administration. We also measured whether the overall number of clinics, had an effect on psychometric parameters. Results: The results revealed a significant increase in second administration overall in the three clinics in specific psychometric parameters but no statistically significant difference was observed after attending consecutive clinics. Conclusion: Students reported the occurrence of adverse symptoms in the investigated psychometric parameters, which should be noted in order to avoid potential educational clinical failure.

[Epidemiological indicators and correlations of adolescent aggression in an urban student population].

Adolescent aggression has received a wide and longtime attention in scientific research, because of the extent of the phenomenon in this age group and of the negative consequences it inflicts on affected adolescents, and their human environments. The aim of this cross-sectional study was to determine the proportion (of high levels) of aggressive behaviors (physical, verbal, and direct aggression, anger, and hostility) in an urban sample of adolescent students, as well as to investigate associations between the occurrence of these behaviors, and adolescents' characteristics and mental health problems. The sample consisted of 2050 students attending the second grade of 49 random selected High Schools and Senior High Schools of the Regional Unit of the Central Sector of Attica and Piraeus. The Buss- Perry Aggression Questionnaire was administered to measure participants' aggression behaviors, while the Strength and Difficulties Questionnaire was also used to estimate their mental health and behavioral difficulties. Information about adolescents' individual, family, and school characteristics, was also collected. Results of the statistical analysis showed that the occurrence rates of high levels of participants' aggressive behaviors ranged between 2.2 (for total aggression) and 10.5% (for anger). Among individual characteristics, gender (with boys predominating in physical and direct aggression and girls in anger), (older) age, and sports activity (to direct aggression) were related to participants' aggressive behaviors. On the other hand, non-intact family structure and household insecurity food intake were positive correlated with specific aggressive behaviors, while pocket money allowance was positive associated with all of them. Concerning participants' mental health and behavioral issues, conduct problems and hyperactivity/ inattention were positive correlated with all investigated aggressive behaviors. In conclusion, the vast majority of the Central Sector of Attica and Piraeus adolescents did not seem to show high levels of aggressive behaviors (except anger). Nevertheless, considering this study outcomes (such as the "aggressive" burden of older adolescents, the role of family structure and pocket money allowance, as well as the co-occurrence with mental and behavioral problems), further longitudinal study is required to better understand the mechanisms that facilitate adolescent aggression.

[FiD: a smartphone application for anxiety assessment: two weeks study].

Anxiety disorders affect approximately one in six people, causing significant problems in their quality of life and that of their families with a significant percentage of mentally ill people not showing compliance with treatment or not receiving appropriate treatment. Research data therefore reveal the need to develop new and effective interventions that will improve the compliance and therapeutic management of the mentally ill. Because of the recent technological advancement, the field of electronic mental health applications (MHapps) offers unique opportunities which can contribute to self-management of mental health problems and patient compliance, as well as to development of preventive and therapeutic interventions. Mental health applications (MHapps) offer a unique opportunity for expanding availability and quality of treatment of mental health disorders, however few applications have been carefully assessed so far making their effectiveness questionable. The present study investigated the effect of MHapp FiD (Feel-Identity) on anxiety- an innovative electronic prototype application-in a sample of adults over a two-week period. Participants made daily use of the application, based on self-monitoring and self-recording in accordance with the Cognitive Behavioural Therapy protocol, with feedback interventions being fully automated. In order to investigate anxiety levels, the STAI questionnaire (State & Trait Anxiety Inventory) was administered over three different time periods: before the use of MHapp FiD, following the first week after its use, and following the second week after its use. The results between the 3 groups of application usage, showed a statistically significant decrease of the average TRAIT anxiety levels between the 1st and the 3rd administration, i.e., after two weeks of application usage, equal to -3.020 units (Mean Difference = -3.020, p-value = 0.006 <0.01), and a statistically significant drop of the average total anxiety levels, between the administration of the 2nd and the 3rd administration, i.e., over the second week of application usage, equal to -5.388 units (Mean Difference = -5.388, p-value = 0.029 <0.05). Τhere was no statistically significant difference as to the average STATE anxiety levels. The results showed a correlation between the daily use of the FiD application and the reduction of anxiety, providing a promising perspective for dissemination of the application in clinical populations with the addition of more functions and interventions.

Prevalence of Bullying and its Co-occurrence with Aggression and Mental Health Problems among Greek Adolescents Attending Urban Schools.

BACKGROUND: Bullying is one widespread violence type that threatens adolescent's well-being in family, school, and neighborhood. This study aimed to estimate the percentages of the last 12 months bullying behaviors- types among Greek adolescents, and to identify the associations between these behaviors and adolescents' aggression and mental health- behavioral problems. STUDY DESIGN: A cross-sectional study. METHODS: The sample consisted of 1934 adolescents, attending the second grade of 45 randomly selected public and private high schools and senior high schools, of the Greater Athens Metropolitan Area. Bullying involvement was examined by four questions, evaluating the occurrence and type of bullying. The Buss and Perry Questionnaire and Strength and Difficulties Questionnaire were administrated in order to estimate adolescents' aggression and mental health-behavioral problems, respectively. Information about adolescents' individual and family characteristics was also collected. RESULTS: Overall, 18.4% of participants reported bullying involvement at school, as a victim (11.0%), a bully (5.0%), or both (2.4%), while verbal bullying was the most common type. Compared to uninvolved participants, victims were significantly more likely to report emotional symptoms and peer problems, bullies were more likely to report physical aggression, and bully-victims physical aggression, hostility, and lower prosocial behavior. CONCLUSIONS: Approximately one out of five adolescents were involved in bullying in the past year at school, reporting aggressive behaviors, emotional problems, and/or social difficulties. Further longitudinal research would increase understanding of the mechanisms of bullying involvement and may lead to preventative interventions promoting positive peer interactions in schools.

COVID-19 psychological impact, knowledge and perceptions of healthcare professionals in Greece: Α nationwide cross-sectional study.

The impact of the COVID-19 pandemic on the mental health of healthcare professionals is currently under research and prevalence of mental health symptoms across the world vary a lot. Moreover, knowledge and perceptions of healthcare professionals towards the new coronavirus is yet to be explored since very few data have been published to date. Thus, we decided to conduct a cross-sectional, web-based survey to measure the levels of depressive, anxiety and stress symptoms using the Depression, Anxiety and Stress Scale-21. The knowledge and perceptions of healthcare professionals towards the new coronavirus were also examined with a self-constructed questionnaire. Data were collected between April 19th and May 31st 2020. In total, 1484 professionals participated in the survey and 1064 completed it in full; 60.8% were females, 66.5% were physicians and 24.3% were first-line healthcare workers. The prevalence of at least moderate symptoms was 13% for depression, 11.9% for anxiety, and 11.3% for stress. Women, younger participants, residents in urban areas, having lower income and worse self-reported health status had higher scores in all outcomes. First-line healthcare workers also indicated higher anxiety scores compared to those who were not first responders. Regarding knowledge and perceptions, most participants agreed with the asymptomatic nature of the virus and its heightened danger for older individuals and those with underlying health conditions. Different views were expressed regarding the possibility of airborne transmission, its similarity to common flu, and the statements that the new coronavirus is manufactured and serves a specific purpose and that it is out of control. In conclusion, the results of our study suggest that the prevalence of depressive, anxiety and stress symptoms in Greek healthcare professionals is placed in the lower end of the range reported from various recent studies across the world. Nevertheless, professionals at risk should be monitored closely and supported when needed.airborne transmission, its similarity to common flu, and the statements that the new coronavirus is manufactured and serves a specific purpose and that it is out of control. In conclusion, the results of our study suggest that the prevalence of depressive, anxiety and stress symptoms in Greek healthcare professionals is placed in the lower end of the range reported from various recent studies across the world. Nevertheless, professionals at risk should be monitored closely and supported when needed.

Salivary cortisol and alpha-amylase daily profiles and stress responses to an academic performance test and a moral cognition task in children with neurodevelopmental disorders.

There is evidence that children with neurodevelopmental disorders may exhibit atypical responses to stress and alterations in concentrations and diurnal secretion of stress hormones. We assessed diurnal profiles and stress responses of salivary cortisol and alpha-amylase (sAA) in children with attention-deficit hyperactivity disorder (ADHD), autism spectrum disorder (ASD) and specific learning disorder (SLD) compared to typically developing children (TD). A total of 157 children of both sexes, aged between 6 and 12 years old, took part in the study distributed into four groups: ADHD (N = 34), ASD (N = 56), SLD (N = 43) and TD (N = 24). Salivary samples were collected at three time points during a day, as well as before and 5 min after an academic performance test and a moral cognition task. ADHD children had lower evening and diurnal sAA levels, adjusted for age. Also, ASD children showed lower diurnal sAA secretion, adjusted for age. The mean percentage change for salivary cortisol and sAA after both tests did not differ between the groups. In conclusion, we demonstrated alterations in diurnal autonomic functioning in children with ADHD and ASD, while hypothalamic-pituitary-adrenal axis functioning did not differ between the clinical and the comparison groups.

Gambling in adolescents during the financial crisis in Greece.

Problem gambling emerges as a serious and ever growing problem of modern societies, largely affecting adolescents as well. The etiology of gambling disorder is complex and multifaceted as it is governed by multiple and interrelated factors. In this context and in light of the pervasive financial crisis in Greece, we conducted a study in order to explore adolescents' gambling involvement in Athens region and also to identify the socio-economic characteristics of adolescents who have engaged into gambling activities. Students were recruited from a sample of schools in Athens area. For the assessment of gambling involvement in adolescents, the Diagnostic and Statistical Manual of Mental Disorders-IV Multiple Response Adapted for Juveniles Questionnaire (DSM-IV-MR-J) was administered. Additional self-constructed questions enquired about students' socio-demographic and economic characteristics. Our results indicate that adolescents that had problem with gambling or had at least one pathological item on DSM were more likely to be boys and to have been born in a country other than Greece. Additionally, the proportion of those having at least one pathological item on DSM was greater in those with low school grades. Τhe lack of food in the household due to inability of providing food during the last month was significantly associated with both having problem with gambling and having at least one pathological item on DSM. Furthermore, having been worried that there would not be enough food during the last month and having been fed with a restrained variety of food due to lack of recourses were associated with at least one pathological item on DSM. These findings are congruent with the literature suggesting that youth living under poverty often resort to gambling. In conclusion, our results point out the adverse effects of the financial crisis on the development of problem gambling in adolescents within the Greek society. Problem gambling may have developed in response to the ubiquitous insecurity characterizing the Greek society during this rough time period. Interventions should prioritize endowing adolescents with the necessary coping skills for dealing with daily obstacles or life adversities productively and without losing their self-control.

[New patients' access to psychiatric treatment services: Improving the quality indicators of mental health services].

Accessibility of patients to the health system as well as the system's rapid and effective response to patients' needs constitute basic quality indices of health services. Major parameter of accessibility is the required waiting time for a new patient to enter the health system. We present the results of the use of an organized system for the management of new requests for psychiatric treatment, which is based on the triage and evaluation of priorities. While taking into consideration the administrative distribution of the health services, our system intervenes in the waiting time by evaluating the requests in terms of medical and moral criteria, via gradual prioritization. Principal aim is waiting time reduction as well as the optimal response of our service to the needs of our patients. This perspective study was based on the new requests. The 1839 (100%) requests for first psychiatric evaluation at the outpatient clinic of Eginition University Hospital in 2019 were studied in relation to different parameters, as well as the efficacy of the system in terms of waiting-time management. Mean age of the petitioners was 45.8 (± 16.8), with statistically significant rate of women over men (N=1062, 59.1%, p˂0.05). The initial communication with the petitioners and the evaluation of the requests rendered the correct management feasible via immediate referrals to special psychiatric services depending on the nature of the cases, as well as redirection to their local psychiatric services for 1057 (57,5%) of the requests, where needed. The remaining 595 (33,4%) requests, after their assortment into three categories of graded prioritization, were placed in outpatient psychiatric clinics after waiting time of 25 days, 50 days and 76 days, respectively. In conclusion, the results of the study show that the systematic management of psychiatric treatment requests, when scientifically and ethically substantiated, may provide mental health services with manifold benefits.Accessibility of patients to the health system as well as the system's rapid and effective response to patients' needs constitute basic quality indices of health services. Major parameter of accessibility is the required waiting time for a new patient to enter the health system. We present the results of the use of an organized system for the management of new requests for psychiatric treatment, which is based on the triage and evaluation of priorities. While taking into consideration the administrative distribution of the health services, our system intervenes in the waiting time by evaluating the requests in terms of medical and moral criteria, via gradual prioritization. Principal aim is waiting time reduction as well as the optimal response of our service to the needs of our patients. This perspective study was based on the new requests. The 1839 (100%) requests for first psychiatric evaluation at the outpatient clinic of Eginition University Hospital in 2019 were studied in relation to different parameters, as well as the efficacy of the system in terms of waiting-time management. Mean age of the petitioners was 45.8 (± 16.8), with statistically significant rate of women over men (N=1062, 59.1%, p<0.05). The initial communication with the petitioners and the evaluation of the requests rendered the correct management feasible via immediate referrals to special psychiatric services depending on the nature of the cases, as well as redirection to their local psychiatric services for 1057 (57,5%) of the requests, where needed. The remaining 595 (33,4%) requests, after their assortment into three categories of graded prioritization, were placed in outpatient psychiatric clinics after waiting time of 25 days, 50 days and 76 days, respectively. In conclusion, the results of the study show that the systematic management of psychiatric treatment requests, when scientifically and ethically substantiated, may provide mental health services with manifold benefits.

Problem gambling and concurrent emotional/behavioral problems among Greek adolescents.

AIM: Problem gambling in adolescents constitutes a major health problem. Very few studies have investigated the relationship of adolescent gambling with emotional/behavioral problems. The aim of this study was to examine the association between adolescent problem gambling and emotional/behavioral problems using data from a school survey in the greater Athens area. MATERIAL AND METHODS: The total sample consisted of 2159 high school students (45.4% males and 54.6% females) from a random and representative sample of public and private schools in the greater Athens area. Data were collected in the form of self-reported questionnaires during one school hour. To access problem gambling the Diagnostic and Statistical Manual of Mental Disorders-IV Multiple Response Adapted for Juveniles questionnaire was administered to the study population. The presence of emotional/behavioral problems was assessed via the Strengths and Difficulties Questionnaire. Full data from 2141 participants were analyzed. Eighteen questionnaire with incomplete data were excluded. RESULTS: Problem gambling in adolescence is in line with the presence of emotional/behavioral problems. All Strengths and Difficulties Questionnaire subscales were significantly associated with problem gambling. Specifically, emotional symptoms, conduct problems, attention/hyperactivity, and social dysfunction were all significantly and independently associated with adolescent pathologic gambling. The prosocial scale had lower scores in problem gamblers. CONCLUSION: This article aims to highlight and discuss the coexistence of adolescent problem gambling with other symptoms. The significant association of emotional/behavioral problems among adolescents with problem gambling indicates a need to screen for these symptoms and for their subsequent treatment among adolescents with problem gambling.

Early psychosis intervention outpatient service of the 1st Psychiatric University Clinic in Athens: 3 Years of experience.

To present the 3-year experience of the early intervention in psychosis (EIP) service implementation of the 1st Psychiatric University Clinic in Athens. An overview of: (1) the purpose of our service, (2) the referral network, (3) the selection criteria, (4) the diagnostic procedures, (5) the therapeutic interventions and (6) the research activities. The service was established in 2012 and developed gradually aiming to provide information, early detection, treatment and support to people aged 15 to 40 years with psychotic manifestations, who are either at increased risk of developing psychosis (at-risk mental state [ARMS]) or with first episode psychosis (FEP). In order to assess individuals with ARMS, we used the comprehensive assessment of at-risk mental states interview and the Social and Occupational Functioning Assessment Scale The duration of untreated psychosis was estimated by using the Nottingham Onset Schedule. So far we have had 65 referrals, of which 26 were ARMS and 17 FEP. Based on the individual needs, they were offered psychotherapeutic and/or pharmacological treatment. After 3 years, the rate of transition to psychosis was 19.2% and the rate of psychosis relapse was 11.7%. The implementation of our service has had positive results, enabling young people with early psychosis to receive prompt and effective care. The rates of transition to psychosis are the first to be published from a Greek EIP service. Further development of our referral network and inter-hospital collaboration will allow us to address the needs of a wider part of the population.

Comparative study of aggression - Dangerousness on patients with paranoid schizophrenia: Focus on demographic data, PANSS, drug use and aggressiveness.

This cross sectional study aimed to compare the differences in psychopathology of Greek homicide and homicide attempters, patients with schizophrenia, with non violent individuals, suffering from schizophrenia. The study compared three Groups of 220 men, diagnosed with schizophrenia: (a) Group Α (Schizophrenia - No violence, (b) Group Β (Schizophrenia - with violence or violent crime), (c) Group C (Schizophrenia - not guilty by reason of insanity - violent crime). Several psychometric tools were used, such as M.I.N·I (Mini-International Neuropsychiatric Interview), PANSS scale (Positive and Negative Symptoms Scale). Most subjects suffered from paranoid schizophrenia. On factors such as demographic characteristics (i.e. current occupational status, living status), statistically significant findings were shown for Groups B and C vs Group A. Predisposing psychosocial factors, such as family conflicts and aggressiveness against family, were found to be statistically significant in differentiating violent versus nonviolent individuals with psychosis. They differed significantly in factors like history of juvenile delinquency, but also in the type of aggressiveness in general. These differences were confirmed on PANSS scale. In conclusion, the longer the history of aggressiveness is presented, the greater the chances are of individuals falling into Group C and it is possible to spend several years from the onset of the disease until the moment of crime.

Blood Pressure and All-Cause Mortality by Level of Cognitive Function in the Elderly: Results From a Population-Based Study in Rural Greece.

This study aimed to investigate whether the effect of blood pressure (BP) on mortality differs by levels of cognitive function. The associations of brachial systolic BP, diastolic BP, mean arterial pressure (MAP), and pulse pressure with all-cause mortality were prospectively explored (follow-up 7.0±2.2 years) in 660 community-dwelling individuals (≥60 years) using adjusted Cox models, stratified by cognitive impairment (Mini-Mental State Examination [MMSE] <24). No association between brachial BP variables and mortality was shown for the total sample in quartiles analysis; however, MAP in the highest quartile, compared with the second, was associated with mortality (hazard ratio, 1.85; 95% confidence intervals, 1.09-3.12) among cognitively impaired individuals. The fractional-polynomials approach for BP confirmed this finding and further showed, solely in the MMSE <24 subcohort, U-shaped trends of MAP and systolic BP, with increased mortality risk in extremely low or high values; no such pattern was evident for patients with MMSE ≥24. Elderly individuals with cognitive impairment might be more susceptible to the detrimental effects of low and elevated MAP and systolic BP.

Acute Necrotizing Pancreatitis Following Olanzapine Treatment and 759C/T Polymorphism of HTR2C Gene: A Case Report.

Acute pancreatitis can be attributed to numerous potential causes, such as alcohol abuse, chololithiasis, infection, lesions, tumors, hypercalcemia, hyperlipidemia, and medications. Among psychotropic medications, the use of some atypical antipsychotics, such as clozapine, olanzapine, quetiapine and risperidone, has been implicated in the development of acute pancreatitis, although the underlying mechanism has not been clarified. We describe the case of a young man with no other major medical problems, alcohol abuse or predisposing factors, who developed acute necrotizing pancreatitis following olanzapine administration, possibly through severe elevation of serum triglycerides. A pharmacogenomic analysis revealed the presence of the 5-hydroxytryptamine (serotonin) receptor 2C, G protein-coupled (HTR2C) -759C genotype which is related to increased risk for metabolic syndrome.