Effectiveness of remote neuropsychological interventions: A systematic review.

OBJECTIVE: Remote healthcare services is an upgrowing dynamic field that has been used to reduce potential disease spread and prevent overloading of the healthcare system during COVID-19 pandemic. The need for online interventions during the pandemic required immediate response with sometimes inadequate preparation. The aim of the present study is to investigate the effectiveness of remote healthcare services in the field of neuropsychological interventions. METHODS: A systematic literature search was conducted in the electronic databases of PubMed, PsychINFO and Google Scholar. The main search terms were "remote neuropsychological intervention or training." The included articles were RCT studies published in English, examining the effectiveness of remote healthcare services in neuropsychological interventions for adults with neurological disease diagnoses. Studies involving psychiatric disorders were excluded. Two reviewers assessed the quality of the studies and risk of bias using the PEDro Scale. RESULTS: A total of 10 studies with 2.221 participants were included. All studies concluded that remote healthcare intervention programs can be feasible, safe and effective in the rehabilitation process of neurological diseases. DISCUSSION: The present review demonstrated that the domains of neuropsychology have opportunities to forge ahead beyond traditional settings and have the ability to adapt to constantly changing environmental conditions with a view to providing patient care. Health policy plans should therefore be reformulated to include these needs in accordance with the social and cultural context of implementation.

Forced social isolation and lockdown during the COVID-19 pandemic: depression, anxiety, trauma-distress and coping mechanisms of a Greek sample.

Aim: The COVID-19 outbreak escalated into a global pandemic, pushing many governments around the world to impose measures affecting all aspects of life. Similar to other countries, Greece adopted social restriction, lockdowns, and quarantines to reduce transmission from person-to-person. This cross-sectional study investigated the association between social restriction measures, an mental health and coping strategies employed by a Greek adult sample. Subject and methods: An online questionnaire was used to collect data during the second national lockdown (February to May 2021). A total of 650 participants (M age 33.13, 71.5% female) comprised the final sample. Results: The results show 21.3% of respondents reported moderate-to-extremely severe anxiety, 33% moderate-to-extremely severe depression, 31.8% moderate-to-severe stress, and 38% clinically significant trauma-related distress. Hierarchical linear regression analyses revealed that the strongest contributors to adverse mental health outcomes were being female, of younger age, experiencing increases in verbal arguments at home, being separated from family and close friends, and being unable to afford enough or healthy food. Lastly, participants reported moving away from social support and into more individual strength and resilience-based coping strategies to cope with challenges. Conclusion: These findings suggest that in addition to the detrimental effects on physical health, social restriction measures related to COVID-19 also imposed a heavy psychological burden on the population via forced social isolation, which, by design, increased not only physical distancing but also psychological distancing between people. Supplementary Information: The online version contains supplementary material available at 10.1007/s10389-023-01907-3.

Neuropsychology in Greece: Results from a survey of practicing professionals.

Neuropsychology is a fast-growing specialty in Greece. This study surveyed the status of neuropsychologists in Greece investigating several aspects of the profession. An online-based questionnaire collected data from December 2019 to February 2020. A total of 133 participants specialized in neuropsychology were included in the final sample: 81% of the participants were women with a mean age of 35 years. In the total sample, 25.8% of the participants reported working in the hospital system, 18.5% in the university or college, and 17.7% in a private practice job. Greek professionals cited to engage actively in assessment (87.9%), in research (65.1%), in rehabilitation (47.7%), and teaching (30.2%). Professionals primarily declared to assess individuals with dementia (80.3%), depression (47.7%), and stroke (44.0%), and they reported neurologists, psychiatrists and psychologists as their leading sources of referrals. The top five perceived barriers to the field include the lack of recognized specialty (75.9%), the lack of clinical training opportunities (63.9%), the lack of strong professional associations (57.9%), the lack of access to neuropsychological instruments (57.9%) and the lack of willingness to collaborate between professionals (48.9%). The average monthly income of professionals represents a ratio of 0.76 in comparison to that of other scientists in the country and is the lowest reported among other countries. Despite the significant development of the profession, it is essential to create more clinical training opportunities, apply practices systematically to diverse populations, redefine the specialty of neuropsychology in the national health system of the country, and advocate for the profession.

The Greek translation and validation of the electronic version of the Meno-D rating scale for post-menopausal depression.

Menopausal transition and post-menopause constitute windows of increased vulnerability to depression. Recently, the Meno-D was introduced, a novel 12-item, with five distinct subscales. The aim of our study was to translate and validate the electronic version of the Meno-D among Greek post-menopausal women. Translation and back-translation were performed by an expert group, while face validity was assessed by five experts. Along with the Beck Depression Inventory-II, the Meno-D scale was distributed online to 502 post-menopausal women. A confirmatory factor analysis was performed to investigate construct validity and both convergent and discriminant validity were evaluated. The data analysis was performed using Statistical Package for Social Sciences and AMOS. The 5-factor model of Meno-D achieved adequate levels of goodness-of-fit indices, scoring lower values in discriminant validity examined with heterotrait-monotrait ratio and composite reliability. The significant correlation with the Beck Depression Inventory-ΙΙ revealed for all subscales was indicative of good convergent validity. An exploratory factor analysis was additionally performed, suggesting a 12-item tool comprising two subscales: (i) psychological and (ii) biological and achieving good levels of fit. Our data confirmed that the electronic version of Meno-D is a valid tool that can be used for screening and evaluation of depression in Greek post-menopausal women.

Off-road assessment of cognitive fitness to drive.

Road safety is a major issue in every society. The assessment of driving ability with a real vehicle is a lengthy and costly process; therefore, there is a growing need for the development of a neuropsychological battery that can provide a fast and reliable evaluation of a person's cognitive fitness to drive. In the present study, we examined the relationship of an off-road lab-type test, namely, the Driving Scenes test, with performance on a driving simulator, as well as the influence of cognitive factors on driving ability as evaluated by Driving Scenes. Our results demonstrated a relationship between Driving Scenes and driving simulator performance. They also showed that some cognitive factors (namely, selective attention and verbal memory), were predictive of driving ability (as determined by the Driving Scenes test), but not others (namely visuospatial perception/memory, working memory, and visuospatial recognition). In addition, age strongly predicted performance on this test (younger age was associated with better performance). The conclusions derived from the present study highlight the need to identify off-road tools with high predictive value in assessing driving ability.

Prevalence of smoking during pregnancy and associated risk factors: a cross-sectional study in Northern Greece.

Background: Many pregnant women smoke despite the extensive data available on the detrimental perinatal outcomes. The aim of this study was to estimate the prevalence of smoking during pregnancy and to identify the factors associated with smoking among pregnant women in Northern Greece. Methods: A sample of pregnant women (mean gestational age: 12.6 weeks) participated in a cross-sectional study assessing the prevalence of smoking. Univariate and multivariate logistic regression analyses were used to examine the factors associated with their smoking behavior. Results: A total of 3688 pregnant women (mean age: 31.1 ± 5.0 years) completed the survey. On the basis of their answers, 36.1% (n = 1330) were smokers before pregnancy and 13.2% (n = 487) were still smoking at the end of the first trimester. Eight hundred and forty-three women (63.4%) gave up smoking, apparently motivated by their pregnancy. A multivariate analysis showed an independent positive association of nulliparity, Greek ethnicity, age >35 years and a BMI > 30 with smoking before pregnancy. Smoking during pregnancy was more common among naturally conceived pregnancies and women with a BMI > 30.Cessation rates were lower for naturally conceived pregnancies, immigrants and multiparous women. Conclusion: About one third of women who smoked before pregnancy continued to smoke during pregnancy. Naturally conceiving, multiparous and immigrant women are less likely to quit smoking when pregnant. Tailored smoking cessation interventions should target women early in their pregnancy.

The role of working memory and information processing speed on wisconsin card sorting test performance in Parkinson disease without dementia.

INTRODUCTION: Wisconsin Card Sorting Test (WCST) performance is often compromised in Parkinson disease (PD). OBJECTIVE: We aimed to investigate (a) the role of working memory (WM) and information processing speed (IPS) in the WCST performance of PD without dementia and (b) the profile of PD without dementia optimal WCST performance. METHODS: 73 nondemented patients with PD were examined in WCST, WM (Digit Span Backwards [DSPANB] and Arithmetic subscale, Wechsler Adult Intelligence Scale [WAIS]), and IPS (Digit Symbol subscale-WAIS and Trail Making Test, part A [TMT-A]) and compared to a group of 48 healthy participants. The group with PD was further divided into 2 subgroups on the basis of their WCST performance, number of categories achieved (CAT):0-2 and CAT:3-6, and comparisons were performed. RESULTS: The DSPANB correlated significantly and was the only neuropsychological variable that significantly contributed to the WCST perseverative errors (WPERRORS) performed by the PD group. Differences in the cognitive performance between CAT:3-6 and CAT:0-2 PD subgroups were no longer significant after controlling for age and general level of intelligence (full IQ [FIQ]). Age and FIQ significantly contributed to the WPERRORS performed by CAT:3-6 PD subgroup, while DSPANB was the only variable that significantly contributed to their WCST overall performance. CONCLUSIONS: Our findings address the relationship between WM and inflexible behavior exhibited by PD without dementia, argue for the importance of lower age, higher education, and level of intelligence for the successful performance on WCST; yet, the differences in cognitive performance regardless of the duration of illness within our patients with PD provide support to cognitive reserve concept.