The Validity of the Distress Thermometer in Greek Colon Cancer Patients.

BACKGROUND: Although screening for distress is a crucial part of psycho-social care for cancer patients, there has not been a validation study for this purpose in Greece. The purpose of this study was to evaluate for the first time the psychometric properties of the Greek translation of the Distress Thermometer (DT) and Problem List (PL) in Greek colorectal cancer patients (CRC). METHODS: Participants were 84 CRC inpatients of the 1st Surgical Propedeutic Department of the Aristotle University of Thessaloniki with a mean age of 70.8±9.5 years. Participants completed the DT, PL and the Hospital Anxiety and -Depression Scale (HADS). RESULTS: The Cronbach's alpha coefficient in the DT was 0.795. Patients' mean score in the DT was 5.7±2.74, while the mean number of the reported problems in the PL was 18.85±5.50 and the mean total score of the HADS was 15.61±6.95. ROC-analysis supported that a cut-off score of 7 gives the optimal sensitivity and specificity for the DT. CONCLUSION: The index sample has manifested high levels of distress, which correspond to high need for support and improvement of the patient-provider relationship. This is probably a difficult task, since the Greek healthcare system has minimal experience of providing psycho-oncology care. The present study has indicated that the DT can be reliably used in the Greek clinical setting. Future studies, along with state provision, are essential in order to offer Greek cancer patients state-of-the-art and comprehensive care.

[Biological factors associated with depression in patients with type ΙΙ diabetes mellitus].

This study was undertaken in order to identify the prevalence and factors associated with depression in a group of patients with type II diabetes mellitus. 200 patients (127 women/73 men) with type II diabetes mellitus, from Diabetic Clinic of 1st Propedeutic Medical Department of Aristotle's University of Thessaloniki, AHEPA Hospital, were enrolled in our study. Patients, sex, age, duration of diabetes, antidiabetic treatment, diabetic complications, body mass index (BMI), waist circumference, blood pressure, smoking, physical exercise and alcohol intake were assessed. BDI-II(Beck Depression Inventory-II) scale was used to measure the presence of depression. Prevalence of depression was high in the total of our patients (31.5%) and also in men (26%) and women (34.6%) separately. Depression appeared not to be related to patients' age, duration of diabetes, smokingand physical exercise, in the total of them (p>0.05). Patients, who were prescribed insulin, seemed to be more often depressed compared to those undertaking oral antidiabetic medication. The presence of depression was statistically significant increased in patients with diabetic complicationsin the total (p=0.013) and in men (p=0.001), while it was almost significantly increased in patients with diabetic nephropathy (p=0.052) and stroke (p=0.097). Depression was statistically significant related to obese patients compared to normal weight patients, in the total (p=0.003), and in menseparately (p=0.013), and also statistically significant was the relationship of depression with central obesity in the total (p=0.011) and in men (p=0.014). Statistically important was the relationship of arterial hypertension with depression in diabetic men (p=0.030), while in the limits of statistical importance was the relationship between depression and modest to heavy alcohol consumption in women (p=0.063). In a clinical aspect, depression seems to influence the development of type II diabetes mellitus, as it is shown by the significant association of diabetic complications anddepressive symptoms. The development of depression has often been considered a secondary response to the onset of complications, but depression might also play a primary role in the development or exacerbation of diabetic complications. It would be reasonable to speculate that obesity and arterial hypertension are biological variables that may interact with depression to produce diabetic complications. Further studies are needed to identify the pathways that mediate this association. These observations demonstrate that depression has a significant role in the development of type II diabetes mellitus, implying the necessity of its diagnosis and treatment, for the most optimal confrontation of the diabetic patient.

Medical students' attitudes toward psychiatry in Greece : an eight-year comparison.

This study is a comparative investigation of the attitudes toward psychiatry of two medical student groups who did their undergraduate training in psychiatry in 1985 and 1993. Attitude assessments were carried out by using the Libertarian Mental Health Ideology Scale (LMHIS). The students completed the questionnaire twice, at the beginning and at the end of their clerkship. The LMHIS was also completed by the teaching staff. Both medical student groups showed a significant change in their attitudes toward psychiatry after the end of the training. The change consisted of a shift to a more medical orientation. However, the 1993 group manifested a significantly higher medical orientation both before and after their undergraduate training in psychiatry compared with the 1985 group. Furthermore, the former group's opinions at the end of their education were similar to those of their teaching staff, whereas the 1985 students continued to have a lower medical orientation compared with the teaching staff. These findings indicate that 1) psychiatric education during medical school may significantly mold students' attitudes toward psychiatry and 2) if these medical student groups represent the larger Greek society, then significant changes may be occurring in the Greek society about attitudes toward psychiatry.

Negative symptoms of schizophrenia and the dexamethasone suppression test.

The dexamethasone suppression test (DST) was administered to 30 inpatients who met the DSM-III-R criteria for chronic schizophrenia and shared similar environments. Four of them (13%) were DST nonsuppressors. The mean and maximum postdexamethasone cortisol levels were correlated with the patient's score on the scale for the Schedule for the Assessment of Negative Symptoms and with the score on the anergia subscale of the Brief Psychiatric Rating Scale. None of the correlations were statistically significant. Furthermore, the scores on the above scales were not significantly correlated with clinical variables such as duration of illness, number of admissions or length of hospitalization, nor were any significant correlations found between the postdexamethasone cortisol levels and the score on the Beck Depression Inventory. In addition, depressed and nondepressed schizophrenics did not differ regarding the rate of nonsuppression and the postdexamethasone cortisol levels. This study found that: 1) dexamethasone nonsuppression in schizophrenia was not related to the presence of negative symptoms; 2) there was no relationship between negative symptoms and illness variables; and 3) the depressed schizophrenics did not display increased nonsuppression compared with nondepressed schizophrenics.

The Greek cancer patient's knowledge and attitudes towards his diagnosis and prognosis.

One hundred and sixteen cancer patients were interviewed in order to investigate whether the Greek cancer patient wants to be informed and whether he knows his true diagnosis and prognosis of his illness. A semistructured interview was used and also a number of psychological parameters were assessed. Though only 15.5% of the patients named their real diagnosis, according to the interviewer's assessment 53% were strongly suspicious of their real diagnosis and 55% suspected their real prognosis. Furthermore, 49% when asked directly answered that they wanted to know if they had cancer and 49% disagreed with the policy of withholding the truth from the patient. The policy of telling or not telling the truth to the cancer patient in Greece is discussed in comparison with policies and attitudes in other countries.

Evaluation of the need for prophylactic antiparkinsonian medication in psychotic patients treated with neuroleptics.

A double-blind study of 42 psychotic patients treated with neuroleptics evaluated the need for prophylactic use of antiparkinsonian medication. The patients assigned to placebo (N = 27) presented significantly more severe extrapyramidal symptomatology, particularly dystonias, than those given trihexyphenidyl (N = 15), indicating a need for the prophylactic use of antiparkinsonian medication during treatment with neuroleptics.