Quality of life in dementia patients in Athens, Greece: predictive factors and the role of caregiver-related factors.

BACKGROUND: Quality of life (QOL) is increasingly recognized as the main target of currently available dementia care. Its assessment has grown exponentially in the dementia field, but few studies have examined predictive factors for QOL taking caregiver variables into account. We examined patient and caregiver factors related to the QOL of dementia patients. METHODS: The study design was cross-sectional. 161 couples of community residing dementia patients and their primary caregivers were interviewed. QOL was measured by the ADRQL, a proxy-rated, dementia-specific QOL instrument. Demographic factors were collected and clinical characteristics assessed using validated scales. RESULTS: In univariate analyses several patient and caregiver characteristics appeared associated with patient QOL. In multivariate analyses, independent predictors of worse patient QOL were behavioral and depressive symptoms of dementia patients, dependency in basic activities of daily living, poorer cognitive function, use of antipsychotic medication, caregiver burden, and caregiver not being an adult child. The adjusted R2 of the final, seven-factor model was 0.598. CONCLUSIONS: QOL for a person with dementia is a complex issue that is associated with several patient and caregiver factors. Efforts to improve patients' QOL should be addressed for both patients and caregivers. The measurement of QOL should be included, when possible, as a standard measurement tool, in everyday dementia clinical practice.

Defense mechanisms in inflammatory bowel disease.

BACKGROUND: Although psychiatric disturbances and personality features are possibly involved in inflammatory bowel disease, little attention has been given to the potential role of defense mechanisms in the formation, course, or prognosis of the disease. The purpose of the present study was to determine whether certain defense styles and ego mechanisms of defense are associated with inflammatory bowel disease, including both ulcerative colitis and Crohn's disease. METHODS: Seventy-six consecutive unselected outpatients participated in the study. The sample consisted of 39 patients with Crohn's disease, 33 with ulcerative colitis, and 4 with an intermediate form of inflammatory bowel disease. The Symptom Distress Checklist (SCL-90-R), Defense Style Questionnaire (DSQ), and Hostility and Direction of Hostility Questionnaire (HDHQ) were used. RESULTS: Crohn's disease patients presented a more immature defensive profile than ulcerative colitis patients, using a "maladaptive action" style, as well as "consumption" and "pseudo-altruism" defense mechanisms more often. These differences were statistically significant and they were independent of age, sex, educational level, disease extension, and pharmacologic treatment. A significant positive correlation was also found between disease activity and defensive profiles in both ulcerative colitis and Crohn's disease patients. In contrast, there was no statistically significant difference between ulcerative colitis and Crohn's disease patients in terms of psychiatric symptoms. CONCLUSIONS: Crohn's disease patients presented a different and more immature defensive profile than patients with ulcerative colitis. In addition, the more psychologically mature inflammatory bowel disease patients had lower rates of relapses and surgical operations, providing evidence that these aspects of personality are likely to influence the patients' adaptation to the disease.

Mental distress and sociodemographic variables: a study of Greek warship personnel.

BACKGROUND: Mental disorders have been found to be the main cause of maladjustment and early discharge of the personnel in the Hellenic Navy and the armed forces in general. This study investigates the mental health status of a warship's military personnel by use of a widely used self-administered scale. METHODS: The 28-item Greek version of the General Health Questionnaire was administered to 281 men aboard a Greek warship to determine their mental health status and to examine possible associations with sociodemographic variables (rank, educational level, marital status). RESULTS: A high prevalence of General Health questionnaire cases (48.8%) was found which indicated conscripts as the group with the greater tendency for problems of adjustment and performance among the personnel of the warship. A negative association was found between educational level and psychological distress, whereas married subjects were found to have better levels of psychological well-being as defined by lower General Health questionnaire scores, compared with unmarried subjects. CONCLUSIONS: Although a further methodological and more sophisticated inquiry is necessary, the findings of the present study could be useful for the design of mental health interventions in the naval and the military setting.