Assessment of quality of life, job insecurity and work ability among nurses, working either under temporary or permanent terms.

OBJECTIVES: Aim of this study was to assess and compare health, quality of life, well-being, job satisfaction and job insecurity between nurses, in a tertiary hospital in Greece, working either under permanent or temporary contract. MATERIAL AND METHODS: In this cross-sectional study, consecutively recruited nurses answered a structured questionnaire, the WHO-5 Well-being Index (WHO-5), the Job Insecurity Index (JII), the Work Ability Index (WAI), and the Well-Being at Work Scale (WBWS). RESULTS: Included were 323 nurses (87.6% women, age M±SD 43.68±8.10 years). Tem- porary contract employees had worse quality of life (p = 0.009) and higher job insecurity: both in cognitive dimension (p = 0.013) and emotional dimension (p < 0.001). They also scored worse in the positive affect (p < 0.001), negative affect (p = 0.002) and fulfillment of expectations in work environment (p < 0.001) domains of the WBWS. Additionally, they reported less frequently occupational accidents and injuries (p = 0.001), muscu - loskeletal disorders of the spine or neck (p = 0.007), cardiovascular (p = 0.017), and gastrointestinal (p = 0.010) disorders, while they reported more frequently mental disorders (p < 0.001). Multivariate linear regression analysis showed that temporary work predicted high cognitive (p = 0.010) and emotional (p < 0.001) insecurity, low positive emotions and mood index (p = 0.007), low achievement-fulfillment index (p = 0.047) and high index of negative emotions (p = 0.006), regardless of gender and age. CONCLUSIONS: Temporary employment among nurses is associated with a lower sense of job security and well-being, and a higher prevalence of mental disorders, independently of age or gender without a significantly negative effect on their ability to work. Managers, as well as occupational physicians, should recognize the extent of nurses' job insecurity and assess their ability to work, to provide them with the necessary support and to stimulate the sense of occupational security and work capacity, so that they can thrive in their workplace and therefore be more productive and provide high quality healthcare. Int J Occup Med Environ Health. 2024;37(1):98-109.

Outcome of Involuntary Mental Health Assessment in a Psychiatric Department in Greece.

Despite their controversiality, involuntary admissions in psychiatric departments remain a central issue in mental health care. The present study aims to identify demographic and clinical factors possibly associated with emergency involuntary psychiatric assessment and its outcome in Greece. This study was carried out in the psychiatric department of the University General Hospital of Alexandroupolis (UGHA) from 1 March 2018 to 28 February 2019. The sample included 191 individuals who had been psychiatrically assessed without their consent following a prosecutorial order. The majority of the involuntary assessments resulted in hospitalization (71%), with 51% of them resulting in involuntary hospitalization. Almost all patients diagnosed with "F20-29 schizophrenia, schizotypal and delusional disorders" were subsequently admitted to the psychiatric department of the UGHA (77 of 81, 66 of them involuntarily). Higher admission rates were recorded among those who had been referred from the Prosecutor's Office of regions that are located far from the psychiatric department of UGHA (Fisher's exact test, p-value = 0.045). In multivariate logistic regression, prior contact with psychiatric services and having an "F20-29 schizophrenia, schizotypal and delusional disorders" diagnosis was statistically significant with admission to the hospital as an outcome variable. Our study suggests an increased risk of involuntary admission among patients with psychosis, patients who had visited a psychiatric service prior to their assessment as well as those living further away from the main psychiatric services of the hospital. Better organization of community psychiatric services in remote places from hospital central services may lead to fewer prosecutorial referrals and coercive measures.

Investigating the Role of Second Chance Schools and COVID-19 Pandemic on the Mental Health and Self-Image of Greek Adult Students.

COVID-19 has globally impacted both physical and mental health. This study aimed to explore the impact of Second Chance Schools (SCS) and the COVID-19 pandemic on the mental health and self-image of Greek SCS students. A total of 251 SCS students from two consecutive study cycles participated, completing the research instruments at the beginning and end of their studies. Participants' anxiety, depressive symptomatology, well-being, self-esteem and self-efficacy were evaluated by means of the GAD-7, PHQ-8, WHO-5 Well-being Index, Rosenberg Self-Esteem Scale and Generalized Self-Efficacy Scale, respectively. The research spanned three years, including a year of universal lockdown, a year with protective measures and a year without anti-COVID-19 measures. Factor analysis, regression analyses and two two-way repeated measures ANOVAs were applied to the collected data. All five psychological dimensions measured by the study's instruments were grouped into two factors, namely mental health and self-image. Well-being positively influenced mental health, while anxiety and depression had a negative impact. On the other hand, self-efficacy and self-esteem positively contributed to self-image. Mental health and self-image were moderately correlated. Pre-SCS values of mental health and self-image predicted a higher percentage of variance in post-SCS values compared to anxiety, depression, well-being, self-efficacy and self-esteem. Moreover, mental health improved after the completion of SCS, but only for participants after the lifting of anti-COVID-19 measures. Conversely, self-image improved for all participants regardless of the presence of anti-COVID-19 measures. Overall, the SCS had a considerable impact on the participants' mental health and self-image, although the effect was influenced by COVID-19.

Clinical determinants of involuntary psychiatric hospitalization: A clinical profile approach.

OBJECTIVES: The study examines the clinical determinants of involuntary psychiatric hospitalization. Specifically, it investigates whether distinct clinical profiles of hospitalized patients can be discerned, what other characteristics they are linked with, and which profiles predict involuntary admission. METHODS: In this cross-sectional multicentre population study, data were collected for 1067 consecutive admissions in all public psychiatric clinics of Thessaloniki, Greece, during 12 months. Through Latent Class Analysis distinct patient clinical profiles were established based on Health of the Nation Outcome Scales ratings. The profiles were then correlated with sociodemographic, other clinical, and treatment-related factors as covariates and admission status as a distal outcome. RESULTS: Three profiles emerged. The "Disorganized Psychotic Symptoms" profile, combining positive psychotic symptomatology and disorganization, included mainly men, with previous involuntary hospitalizations and poor contact with mental health services and adherence to medication, indicating a deteriorating condition and chronic course. Τhe "Active Psychotic Symptoms" profile included younger persons with positive psychotic symptomatology in the context of normal functioning. The "Depressive Symptoms" profile, characterized by depressed mood coupled with nonaccidental self-injury, included mainly older women in regular contact with mental health professionals and treatment. The first two profiles were associated with involuntary admission and the third with voluntary admission. CONCLUSIONS: Identifying patient profiles allows the examination of the combined effect of clinical, sociodemographic, and treatment-related characteristics as risk factors for involuntary hospitalization, moving beyond the variable-centered approach mainly adopted to date. The identification of two profiles associated with involuntary admission necessitates the development of interventions tailored to chronic patients and younger persons suffering from psychosis respectively.

Involuntary psychiatric hospitalizations in Greece: Contemporary research and policy implications.

Involuntary psychiatric hospitalization is a contested issue in mental health care provision. Despite indications of very high rates of involuntary hospitalizations in Greece, no valid national statistical data has been collected. After reviewing current research on involuntary hospitalizations in Greece, the paper introduces the Study of Involuntary Hospitalizations in Greece (MANE), a multi-centre national study of the rates, process, determinants and outcome of involuntary hospitalizations, conducted in the regions of Attica, Thessaloniki and Alexandroupolis, from 2017 to 2020, and presents some preliminary comparative findings regarding the rates and process of involuntary hospitalizations. There is a major difference in the rates of involuntary hospitalizations between Alexandroupolis (around 25%) and Athens and Thessaloniki (over 50%), that is possibly related to the sectorized organization of mental health services in Alexandroupolis and to the benefits of not covering a metropolitan urban area. There is a significantly larger percentage of involuntary admissions that end in involuntary hospitalization in Attica and Thessaloniki compared to Alexandroupolis. Reversely, of those accessing the emergency departments voluntarily, almost everyone is admitted in Athens, while large percentages are not admitted in Thessaloniki and in Alexandroupolis. A significantly higher percentage of patients were formally referred upon discharge in Alexandroupolis compared to Athens and Thessaloniki. This may be due to increased continuity of care in Alexandroupolis and that might explain the low rates of involuntary hospitalization there. Finally, re-hospitalization rates were very high in all the study centers, demonstrating the revolving-door phenomenon, especially for voluntary hospitalizations. The MANE project came to address the gap in national recording of involuntary hospitalizations, by implementing, for the first time, a coordinated monitoring of involuntary hospitalizations in three regions of the country with different characteristics, so that a picture of involuntary hospitalizations can be drawn at national level. The project contributes to raising awareness of this issue at the level of national health policy and to formulating strategic goals to address the problem of violation of human rights and to promote mental health democracy in Greece.

High Expressed Emotion and Warmth among Families of Patients with Schizophrenia in Greece.

Expressed emotion (EE) is an established prognostic factor for relapse in schizophrenia. Through critical comments (CC), hostility (H) and emotional overinvolvement (EOI), a relative can be rated as high or low EE, but the role of warmth should also be evaluated in order to consider the influence of a positive affect within the family context. In this study, EE was assessed in a sample of 48 relatives of patients with schizophrenia using the Camberwell Family Interview (CFI). Questionnaires assessing coping (brief-COPE), their wellbeing (World Health Organization Well-Being Index WHO-5) and the socio-demographic variables were also administered. Relatives who expressed a higher level of warmth were found to make fewer CC (5.2 ± 4.6 vs. 8.4 ± 4.6, p = 0.009) and have, on average, higher EOI scores (3.2 ± 1.0 vs. 1.9 ± 1.1, p = 0.002) than those who expressed no or very little warmth. High EE was found to be associated with having fewer family members (p = 0.035), while relatives with a higher level of education expressed less warmth (p = 0.007). Relatives with a low level of warmth had higher maladaptive coping scores and tended to score worse for their overall wellbeing in comparison to relatives who showed a higher level of warmth (28.4 ± 5.0 vs. 24.1 ± 5.2, p = 0.006 and 39.1 ± 20.4 vs. 51.3 ± 22.0, p = 0.073, respectively). Since the role of warmth is important, it should be taken into account when designing family interventions, independently from lowering EE. Customized interventions to promote warmth and the routine screening of relatives are recommended.

Sleep quality in caregivers of patients with end-stage renal disease.

The aim of this study was to evaluate the self-reported quality of sleep among caregivers of patients who are receiving hemodialysis (HD) and peritoneal dialysis (PD). In 64 caregivers of patients of the University General Hospital of Evros in Northeastern Greece, who were receiving HD and PD, the following instruments were administered: Pitsburgh Sleep Quality Index (PSQI), Zung Depression Rating Scale (ZDRS), Self-Anxiety Scale (SAS), Well - Being Index (WHO- 5). The mean PSQI value of caregivers was 5.27 ±3.40 and 39% of them had poor sleep quality. "Poor sleepers" had significantly lower levels of quality of life (p=0.02), elevated levels of anxiety (p=0.006) and higher scores in the depression scale (p=0.009) compared to "good sleepers". In the regression analysis depression was found to have the greatest contribution to the variability of 'sleep quality' (standardized beta = 0.62, p<0.001) and quality of sleep seemed to improve as years of dialysis that the patient underwent increased (standardized beta = -0.28, p=0.007). Physicians should screen caregivers' sleep quality, especially during the first stages of the illness.

Sleep Quality and Mental Health of Medical Students in Greece During the COVID-19 Pandemic.

Background-Aim: Medical students have been greatly affected by the COVID-19 pandemic due to their educational program, which comprises theoretical knowledge and also clinical duties, making them vulnerable to viral exposures and possibly affecting their everyday life. The aim of this study was to explore changes in sleep and mental health parameters among medical students in Greece during the second year of the pandemic. Methods: This cross-sectional study comprised students of all medical schools in Greece (n = 7), using an anonymous online survey. Participants completed the following questionnaires: Pittsburgh Sleep Quality Index (PSQI), Athens Insomnia Scale (AIS), Fatigue Severity Scale (FSS), General Anxiety Disorder-7 (GAD-7), Patient Health Questionnaire-9 (PHQ-9). Statistical analysis was conducted with the use of SPSS v.26 (IBM SPSS, Armonk NY, USA). Results: Out of the 562 received responses, 559 met the inclusion criteria. The largest proportion of the respondents came from 4th-year (27.8%) and the majority of the sample were females (69.8%). Only 5.9% of the participants reported having been infected by SARS-COV-2. Most of the respondents experienced insomnia (65.9%, mean AIS score: 7.59 ± 4.24), poor sleep quality (52.4%, mean PSQI score: 6.6 ± 3.25) and increased fatigue (48.5%, mean 35.82 ± 11.74). Moderate to severe symptoms of anxiety (mean 9.04 ± 5.66) and depression (mean 9.36 ± 6.15) were noted. Suicidal ideation was found in 16.7% of the sample, while use of sleeping pills in the previous month was reported by 8.8% (n = 47). Further analysis revealed independent associations between sleep and mental health parameters. Higher AIS score was associated with greater FSS score; higher PSQI scores with higher GAD-7 and PHQ-9 scores. Additionally, female students were found to be significantly more affected than males by the COVID-19 pandemic, displaying higher levels of insomnia, sleep disturbances, anxiety and depression. In addition, those with a history of COVID-19 infection or in close proximity with a positive case reported significantly more significant post-traumatic symptoms in IES-COVID-19 questionnaire. Conclusions: In the aftermath of the COVID-19 pandemic, prevalence of sleep and mental health disorders among Greek medical students is significant, highlighting the need for better surveillance of students' wellbeing and subsequent counseling, with special focus on female students and other affected groups.

"Sleeping Beauty Syndrome" and Psychosis as Precursory Symptoms of Multiple Sclerosis: A Rare Case and Literature Review.

ABSTRACT: Frequently, patients with multiple sclerosis (MS) experience comorbid psychiatric symptoms. Mental disorders primarily occur simultaneously with or after an MS diagnosis; however, the probability of them being the initial manifestation of the disease is rare. We describe the case of a 22-year-old man who had previously been hospitalized because a single psychotic episode alongside symptoms of Kleine-Levin syndrome and a diagnosis of "acute and transient psychotic disorders." Two years later, he was diagnosed with MS. A literature review of the possibility of a psychiatric episode overshadowing an MS diagnosis is then presented. Clinicians should always consider the possibility of an underlying organicity in a case of psychiatric presentation with atypical features, with special attention being given during the investigation process. This approach will lead to the early diagnosis of an organic disease, which can be treated accordingly and as early as possible.

Validity and reliability of the Greek version of the semistructured Schedule Clinical Interview for personality disorders (SCID-II).

The semistructured Schedule of Clinical Interview for Personality Disorders (SCID-II) is a useful tool for measuring personality disorders according to DSM criteria. Personality traits and their assessment are culturally sensitive. Because of this, it is important for clinicians and researchers to have a clearer view of the performance of such instruments in their own culture. Despite the fact that the SCID-II interview has been translated to the Greek language, the psychometric properties of this version have yet to be tested. To address this need, we conducted this study to assess the validity and reliability of the SCID-II interview in its DSM-III-R version in the Greek population. A total of 32 patients, 13 men and 19 women, were involved in this study. Sixteen patients were interviewed three times by three different interviewers. The first two interviewers used the Greek version of the SCID-II, and the third interviewer used the International Personality Disorder Examination (IPDE), which was used as the gold standard. Of the remaining 16 patients, 14 were interviewed with the SCID-II by two interviewers, and 2 were unable to complete the interview and were excluded from the study. A total of 69 interviews were performed. The internal consistency of the interview was acceptable, with a Cronbach's alpha coefficient of 0.623. The SCID-II also demonstrated good reliability. Cohen's Kappa score ranged between 0.375 for histrionic disorder and 1.000 for defeatism and antisocial personality disorder. Pearson's correlation coefficient was also very strong for both the individual criteria score and the overall diagnosis between the interviewers. There was an exception for the not otherwise specified personality disorder, where there was no agreement in any of the reliability measures between the interviewers. The interview validity was high when measured against the gold standard. The specificity of the SCID-II ranged from 79-100%, with the expectation of not otherwise specified personality disorder being 66%. The overall sensitivity was moderate and ranged from 0-100%. The Greek version of the SCID-II is a reliable, valid and easy-to-use instrument that can be adopted by various mental health professionals for clinical as well as research purposes.

The challenge of treating Roma outpatients in the Eastern Macedonia and Thrace region of Greece.

The Roma people are one of the most unknown and interesting nations in Europe. Although they are severely marginalised within European societies, they have greatly influenced European culture. Despite this fact, there is a deep prejudice against them. In the region of East Macedonia and Thrace, a significant proportion of the population are Roma. Their marginalisation leads to many problems and also affects their mental health. Their psychopathological manifestations differ from the majority population. They express more somatic complaints and higher overall stress in a histrionic background. The main obstacles regarding their mental health issues and treatment appear to be the following: gender inequality, illiteracy and lack of cultural sensitivity in healthcare system. Although all of these obstacles must be removed, some are easier to remove than others. Cultural sensitivity could be applied by using more culturally sensitive diagnostic tools, improving overall training for mental health professionals and treating Roma wherever they seek help, because they often have a nomadic style of living. Telemedicine can be quite useful in serving this goal. Improving their educational status and addressing gender inequalities issues, on the other hand, are more difficult and long-term goals.

Validating Dissociative Experience Scale (DES) in a Greek sample.

This study aimed to validate the Greek version of the Dissociative Experience Scale (DES). A sample of 340 psychiatric outpatients and controls was selected. Part of the sample went through a retest procedure after a two-week period. Due to the absence of equivalent tests, the Multiscale Dissociation Inventory (MDI), the Structured Clinical Interview for DSM-IV-Dissociative Disorders Revised (SCID-D-R), and the Zung Self-Rating Anxiety Scale were used. Explanatory factor analysis was performed, resulting in a 28-item scale; the analysis revealed four factors, explaining 61% of total variation: Depersonalization, Amnesia, Absorption, and Miscellaneous. Cronbach's alpha coefficient for the DES was 0.95. Intraclass correlation coefficient (ICC) of the total score between the first and second interview was 0.84. Concurrent and convergent validity, as assessed by correlations with clinical assessment used as a "gold standard," (0.77), MDI (0.96), and Zung scale (0.75) were satisfactory to excellent. The total score on the DES was significantly higher in the clinical sample than in the controls (17.8 ± 16.2 vs. 5.8 ± 7.2, p < .001), indicating high discriminant validity. After the ROC analysis was run, the best compromise between sensitivity/specificity was achieved at the value of 20. The Greek version of the DES is a reliable and valid tool suitable to assess dissociation in clinical and healthy populations.

First Alarm and Time of Diagnosis in Autism Spectrum Disorders.

Early diagnosis of autism spectrum disorder (ASD) is of paramount importance as it opens the road to early intervention, which is associated with better prognosis. However, early diagnosis is often delayed until preschool or school age. The purpose of the current retrospective study was to explore the age of recognition of first alarming symptoms in boys and girls as well as the age at diagnosis of different subtypes of ASD in a small sample. A total of 128 parents' of children with ASDs were participated in the survey by completing a self-report questionnaire about early signs and symptoms that raised their concern. Parents of children with autism voiced concerns earlier and obtained diagnosis significantly earlier compared to parents of children with Asperger syndrome (p value <0.000). No significant difference (p value<0.05) has been detected between males and females in early manifestation of first signs and symptoms of ASD. The mean age at diagnosis was 3.8 years for autistic disorder, 6.2 years for children with Asperger syndrome and 6.4 years for other, e.g., PDD-NOS. The most commonly reported symptoms were speech and language problems (p value = 0.001) for children who were later diagnosed with autism, while behavior problems (p value = 0.046) as well as difficulties in education at school (p value = 0.013) for children with Asperger syndrome. The gap between early identification and diagnosis pinpoints the urgent need for national systematic early screening, the development of reliable and sensitive diagnostic instruments for infants and toddlers and heightened awareness of early signs of ASD among parents, teachers, and healthcare professionals and providers as well.

Medical students' attitudes to mental illnesses and to psychiatry before and after the psychiatric clerkship: Training in a specialty and a general hospital.

Medical students' attitudes to mental illnesses and psychiatry may be reshaped during the psychiatric training, with important implications in their future practice of the profession. Therefore, the present study set out to explore the impact of the psychiatric clerkship in students' attitudes, while taking into consideration the site of their practical training. To this end, a total of 678 final-year medical students were recruited. Students completed a self-reported questionnaire entailing the Attitudes to Psychiatry scale, the Attitudes to Mental Illness scale and the Greek Social Distance scale before and after their placement. Findings indicate that the psychiatric clerkship had a positive effect in reducing stigma towards both psychiatry and mental illnesses, with the effect being more pronounced in the general hospital with respect to the former, while in the specialty hospital was more marked regarding the latter. A further exploration of the determinants of change revealed that the improvement discerned in the general hospital was only among those without professional experience of mental illnesses. Therefore, the psychiatric clerkship may exert a substantial influence on shaping favourable attitudes towards mental illnesses and psychiatry; however, other elements should also be taken into consideration, if the clerkship is to tackle stigma in healthcare.

Cross-Cultural Approach of Postpartum Depression: Manifestation, Practices Applied, Risk Factors and Therapeutic Interventions.

It is a well known fact that postpartum depression (PPD) is a global phenomenon that women may experience, regardless of cultural identity and beliefs. This literature review presents the cultural beliefs and postnatal practices around the world, in each continent and people's origins, looking through the extent to which they contribute positively or negatively to the onset of the disease. 106 articles were used in this research, through a systematic electronic search of Pubmed (Medline) and Scopus. Comparison is also made between the prevalence, the risk factors and the different ways of appearance of the disease around the world and among immigrants. Finally, the initiatives and interventions made so far by the governments and institutions with a view to prevent and address this global problem are presented. The results showed (a) that different cultures share the same risk factors towards the disease (b) significant differences in the prevalence of the disease among both Western and non Western cultures and between the cultures themselves (c) more tendencies for somatization of depressive symptoms in non-Western cultures, (d) different postnatal practices between cultures, which are not always effective (e) the more non-West a culture is, the less interventions concern on mental health; the same phenomenon is observed on populations burdened by immigration. The beliefs held by culture should be taken seriously in detecting of PPD, as well as the assessment of the needs of women who have recently given birth.

HIV infection and depression.

Major depression is highly prevalent among HIV-positive patients (HIVpp). The prevalence of depression ranges between 18% and 81%, depending on the population studied and the methodology of the study. The etiology of depression in HIVpp is likely determined by: (i) biological factors (alterations in the white matter structure, hypothalamic-pituitary-thyroid dysfunction, Tat-protein-induced depressive behavior); (ii) psychosocial factors (HIV stigma, occupational disability, body image changes, isolation and debilitation); (iii) history or comorbidity of psychiatric illness; and (iv) the perinatal period in HIVpp women. Symptomatology of depression differs between HIVpp and HIV-negative patients (HIVnp). Depression may also alter the function of lymphocytes in HIVpp and decrease natural killer cell activity, contributing to the increased mortality in these patients. Selective serotonin re-uptake inhibitors are considered the first-line treatment. Treatment of depression can improve quality of life and lead to a better prognosis of HIV infection.

Psychosocial support and cognitive deficits in adults with schizophrenia.

BACKGROUND: In recent decades there has been an increasing interest in cognitive deficits in schizophrenia. However, only a few studies have examined the impact of psychosocial support on the prevention of cognitive deterioration in patients who suffer from schizophrenia. AIM: The aims of the present study are: (1) to confirm the presence of cognitive deficits among patients with schizophrenia; (2) to explore any correlations between such deficits and a range of clinical and/or demographic characteristics of the patients; and (3) to investigate any association between cognitive deficits and psychosocial support. METHOD: A total of 118 patients with schizophrenia (the patient group) and 102 healthy volunteers (the control group) had a cognitive assessment using a battery of neuropsychological tests. The patients were allocated to one of the following groups: (1) patients under routine outpatient follow-up; or (2) patients receiving or having recently received intensive psychosocial support, in addition to follow-up. This included daily participation in vocational and recreational activities provided by dedicated mental health day centers. The findings of the neuropsychological testing of individuals in all groups were compared, after controlling for clinical or demographic factors. RESULTS: The scores in the neuropsychological tests were lower overall in the patients group compared to healthy volunteers. Within the patients group, those receiving/having received psychosocial support had higher scores compared to those on routine follow-up alone. There were no significant differences between patients currently receiving psychosocial support and those having received it in the past. Lower education, age and illness duration (but not severity of positive or negative symptoms) were factors associated with lower test scores. CONCLUSIONS: The study provides some evidence that psychosocial support may be beneficial for the cognitive functioning of patients with schizophrenia and this benefit may be a lasting one.

Concurrence of anorexia nervosa and Noonan syndrome.

Noonan syndrome (NS) is a genetic disease inherited in an autosomal dominant mode; it presents significant genetic heterogeneity and varying penetrance. Mutations have been identified in several genes, and they account for 75% of all known cases. The majority of reported mutations are localized on PTPN11 gene, which encodes the non-receptor type protein tyrosine phosphatase SHP-2. Diagnosis, however, is mainly established after clinical examination. Anorexia nervosa (AN) is an eating disorder characterized by fear of gaining weight, refusal to maintain normal body weight and distorted perceptions of body image or body shape. AN is independently predicted by female sex and feeding problems in childhood, whereas NS symptoms include feeding difficulties. No comorbidity between NS and AN has been reported to date. The authors reported the case of a 38-year-old female patient with AN who met the van der Burgt criteria for NS with confirmed (a) comorbidity of AN and NS and (b) the absence of the most common mutation in PTPN11 and presence of a novel T > A transversion within intron 8-9.

Victimization of the severely mentally ill in Greece: the extent of the problem.

BACKGROUND: In contrast to extensive research on psychiatric patients' dangerousness, very few studies have examined their victimization. AIM: The aim of our study is to record reported victimization of seriously mentally ill outpatients in Greece and compare them with healthy controls. METHOD: We interviewed 150 severely mentally ill outpatients and a matched group of healthy controls using a semi-structured interview. This recorded incidents of victimization and perceived discrimination during the previous year. Logistic regression models were used to examine the influence of demographic parameters on both victimization and discrimination. RESULTS: In this study 59.3% of patients and 46.0 % of controls (p = .02) reported being victims of a criminal act at least once and 52.0% of patients and 24.0 % of controls (p < .001) reported experiencing discrimination during the previous year. Patients, in comparison to controls, were more likely to report being victims of any kind of victimization (OR = 1.85, 95% CI = 1.07-3.21), of assault/threat (OR = 4.62, 95% CI = (2.32-9.19) and of discrimination (OR = 3.34, 95% CI = (2.1-5.62). In addition, patients reported experiencing higher distress in assault/threat crime compared to controls (p = .03). CONCLUSIONS: Patients with serious mental illness are more likely than the general population to report being victims of criminal acts and experiencing discrimination.

Social support and non-safe use of licit substances by Greek medical students.

This study aims to investigate the relationship between social support and non-safe use of nicotine and alcohol among medical students, in relation to other contributing factors. Data were collected during 2002-2003. Participants (N = 135), medical students at the Democritus University of Thrace, Alexandroupolis, Greece, were allocated into groups per sex according to their smoking and alcohol drinking patterns. Comparisons were made with respect to rating scores on measures assessing perceived social support, psychopathological problems, stressful life events, physical health, and satisfaction with life. Data were analyzed using chi-square, Mann-Whitney U test, and factor analysis. Female students' non-safe use of licit substances is positively related to higher scores on perceived social support and lower scores on psychopathological dimensions. Despite some limitations of this study, findings bring about implications on antismoking and antialcoholic campaigns.