Investigation of Internalized Weight-Related Stigma: Progression to Dietary Addiction and the Role of Stress.

INTRODUCTION: Internalizing weight stigma can lead to the development of dietary addiction, as individuals seek food as a coping mechanism for the emotional distress caused by stigma. The influence of stress exacerbates this dynamic, encouraging the reliance on food as a stress-coping strategy. METHODS: Electronic questionnaires were completed in a special electronic form through an online platform. The Two-Factor Weight Bias Internalization Scale (WBIS-2F), the Yale Food Addiction Scale (YFAS), the Depression Anxiety Stress Scale-21 (DASS-21), Positive and Negative Affect Schedule (PANAS), the Life Orientation Test (LOT), the Brief Resilience Scale (BRS) were used at this study to examine the prevalence of Internal Weight Stigma (IWS) among adults in Greece, evaluate the degrees of stress/anxiety, food addiction, mental resilience, emotions, and positive life perspectives within this group, and explore the correlations between stress/anxiety, mental resilience, optimistic life attitudes, and both IWS and food addiction. RESULTS: 376 participants completed the questionnaire. The average BMI of the participants was 26.3 kg/m2 (SD = 5.9 kg/m2). Almost half of the participants (46.8%) fell within the normal weight range (18.5 ≤ BMI ≤ 24.9), while 28.2% were classified as overweight and 21.0% as obese. Interestingly, a significant majority (63.1%) perceived themselves as heavier than the normal weight range suggests. Most participants demonstrated typical levels of depression, anxiety, and stress, with percentages of 67.3%, 64.9%, and 71.3%, respectively. Resilience exhibited positive associations with optimism and positive emotions while displaying negative connections with depression, anxiety, stress, and negative emotions. Additionally, individuals with greater optimism reported fewer symptoms of despair, anxiety, and stress. CONCLUSION: The research highlights the intricate dimensions of mental well-being, emphasizing the need for a holistic comprehension encompassing demographic, psychological, and societal factors. The results indicate potential strategies for intervention to boost resilience, and optimism, and tackle issues such as food addiction, underscoring the significance of fostering a positive body image and self-esteem.

Depressive Symptoms and Anger Expression Among Survivors After Stroke.

INTRODUCTION: Stroke is a frequent cause of death and one of the most common causes of disability and depression in the countries of the Western world. Depression is associated with limited functionality, reduced self-care, and increased mortality in patients with stroke. Anger often occurs in these patients and may disrupt the course of their recovery. AIM: The investigation of the presence of depressive symptomatology, the expression of anger, and the degree of functioning/independence of patients after stroke. METHOD: One hundred and ten patients after stroke completed the Center for Epidemiological Studies-Depression (CES-D) scale, the State-Trait Anger Expression Inventory, and the Barthel Index. RESULTS: Patients who lived alone had a higher depressive symptomatology score than patients who did not live alone (p = 0.009). An increase in the total depressive symptomatology score was related to an increase in the anger expression score (p = 0.011), increase in anger-in score (p < 0.001), increase in anger-out score (p < 0.001), and decrease in anger control score (p = 0.001). Females had lower anger-in scores compared to men (p = 0.029). Individuals with a history of previous stroke had higher anger-out scores compared to people without a history of previous stroke (p = 0.025). An increase in the patient's functional/independence score was associated with an increase in anger control score (p = 0.015). CONCLUSIONS: Early detection and management of depression and anger will facilitate patient's compliance to the rehabilitation program in order to achieve optimal therapeutic results and ensure a better quality of life.

Associations between Physical Activity and Health-Related Quality of Life among Community-Dwelling Older Adults: A Cross-Sectional Study in Urban Greece.

Physical activity is an important factor in achieving healthy aging, offering older persons multiple benefits in terms of maintaining and improving their health and wellbeing. The aim of this study was to investigate the effect of physical activity on the quality of life of older adults. A cross-sectional study was conducted from February to May 2022, using the Short-Form Health Survey (SF-36) and the International Physical Activity Questionnaire (IPAQ). A total of 124 people aged 65 and over participated in the survey. The average age of the participants was 71.6 years, and 62.1% were women. Participants showed a moderate quality of life with regard to the physical health dimension (mean score 52.4) and a higher quality of life with regard to the mental health dimension (mean score 63.1) compared to the expected values of the population. Low levels of physical activity were recorded among older adults, reaching a rate of 83.9%. A moderate or high level of physical activity has been found to contribute to a better physical functioning (p = 0.03), vitality (p = 0.02) and general health (p = 0.01). Finally, comorbidity had a negative impact on physical activity (p = 0.03) and quality of life regarding mental and physical health in older adults. The study showed very low levels of physical activity in older Greek adults. The management of this problem, which was intensified during the COVID-19 pandemic, should be a high priority in public health programs focusing on healthy aging, as physical activity affects and promotes many of the basic aspects of quality of life.

Exploring Loneliness, Fear and Depression among Older Adults during the COVID-19 Era: A Cross-Sectional Study in Greek Provincial Towns.

BACKGROUND: With the onset of the COVID-19 pandemic, life changed abruptly for older adults in Greece. Social isolation, lockdowns, the fear of serious illness and death, all contributed to an increased risk of developing depression. OBJECTIVE: To explore the presence and severity of depression in older adults in Greek provincial towns during the pandemic and to explore any possible relationships with loneliness and fear. METHODS: A convenience sample of 200 participants aged >65, completed a socio-demographic form, the Revised UCLA Loneliness Scale, the Geriatric Depression-15 Scale (GDS-15) and the COVID-19 Fear Scale (FCV-19S). Data were collected from April to May 2022. RESULTS: The average age of participants was 76.6 years and 35.5% of the participants presented depressive symptoms (mean prevalenceof depression 5 ± 3.7). A moderate to low level of loneliness (mean value 39 ± 11.3) and a moderate level of COVID-19 fear (mean value 18.9 ± 6.5) were also experienced. Higher levels of loneliness were found among participants with lower perceived health status and among those participants registered in Primary Health and Social Care (PHSC) services. Loneliness was positively correlated with depression (r = 0.7, p < 0.001), and increased loneliness and depression were associated with an increase in fear of COVID-19 (r = 0.2, p = 0.01 for both). CONCLUSIONS: During the pandemic, older adults experienced loneliness, fear of COVID-19 and depression which were positively associated with each other. It is imperative to develop PHSC policies that are aimed at addressing the mental health problems of the older population, which have been caused by the COVID-19 pandemic, through developing their resilience, offering psychological support and promoting social connections.

Reflux-Qual-Short-Form Questionnaire: Translation and Validation of the Greek Version.

The aim of this study was the translation and validation of the Reflux-Qual Short-Form (RQS), a quality of life questionnaire in a Greek sample of 148 individuals with gastroesophageal reflux disease (GERD). This tool through eight items explores the effects of GERD in five dimensions of quality of life: daily activity, well-being, psychological impact, sleep, and eating. Exploratory factor analysis yielded a one-factor scale for the Greek-translated version. Internal consistency reliability of the questionnaire was deemed very satisfactory based on Cronbach's alpha coefficient, which was equal to 0.816. Split-half reliability was evaluated as an additional measure of internal consistency. The test-retest reliability analysis revealed a good stability after a 1-month interval. Construct validity was measured by the correlation level between each item and the adjusted global score, resulting in an acceptable level of convergence between the items. Concurrent validity was confirmed using the 36-Item Short Form Health Survey (SF-36) as a reference scale. This study indicates that RQS Questionnaire is a short, simple, reliable, and valid tool that can be used to assess quality of life in Greek individuals with GERD.

Transanal Endoscopic Microsurgery (TEMS) for Rectal Cancer: Patient Decision-making, Postoperative Experience and Quality of Life.

BACKGROUND/AIM: Transanal endoscopic microsurgery (TEMS) is a form of minimally invasive surgery for selected rectal cancers. The aim of this study was to explore the factors affecting patients' decision-making concerning the choice of surgical treatment as well as to measure the Quality of Life (QoL) post-TEMS. PATIENTS AND METHODS: Thirty-four patients with rectal cancer stage T1/T2-N0-M0 that underwent TEMS were studied. The questionnaires used included the Short Form SF12v2, Wexner Score (CCF-FIS) and the Sexual Function Questionnaire (SFQ). The patients' views on experience and treatment decision were obtained with a custom-designed questionnaire. Questionnaires were completed at a mean of 6.9 years following treatment. RESULTS: The factors that influenced the patients' decisions were: experience satisfaction (p=0.003), postoperative bowel function (p<0.001), lower incontinence score (p=0.020) and agreement of TEMS experience with preoperative information (p=0.049). Treatment experience satisfaction was associated with family support (p=0.034) and agreement with preoperative information (p=0.047), better bowel function (p=0.026) and mental QoL (MCS) (p=0.003). CONCLUSION: factors important to patients when reflecting on treatment experience are adequate and reliable information, a good QoL and the presence of family support. Clinicians should incorporate those parameters in their practice when assisting patients in making a surgical treatment choice and provide informed consent on TEMS for rectal cancer.

Heavy Smoking is Associated with Low Depression and Stress: a Smokers' Paradox in Cardiovascular Disease?

INTRODUCTION: Smoking, anxiety and depression constitute predisposing factors of coronary artery disease. AIM: The aim of this study was to investigate the degree of nicotine dependence in coronary patients and its relationship to anxiety and depression. METHODS: The study population consisted of 208 coronary patients, 131 men and 77 women, who were hospitalized in a hospital in Attica and were all smokers. The degree of nicotine dependence was measured by the Fagerstrom scale, while depression and anxiety intensity were assessed with the Zung SDS and SAS scales respectively. RESULTS: 158 participants (75.9%) were moderately to highly dependent on nicotine, 108 participants (51.9%) reported moderate to severe depression intensity levels while 91 participants (43.8%) reported moderate to severe anxiety intensity levels. The degree of dependence on nicotine was negatively related to the intensity of anxiety and depression experienced by coronary patients. Additionally, the degree of nicotine dependence, anxiety and depression was associated with various sociodemographic and clinical factors such as educational level, social support, and information on their condition and treatment. CONCLUSION: Overall, the findings of this study point to an inverse relationship of nicotine dependence, depression and anxiety. However, this paradoxical association could be a product of shared risk factors or confounding. Nonetheless, the development of individualized educational and supportive interventions to quit smoking in coronary patients should primarily focus on the assessment of depression and stress.