Lessons learned from an intercalibration exercise on the quantification and characterisation of microplastic particles in sediment and water samples.

An intercalibration exercise on the characterisation of microplastics in marine sediment and water samples was carried out among five laboratories involved in the implementation of the Marine Strategy Framework Directive (MSFD) in their country. The samples were prepared by mixing cleaned natural sediment and sea water with microplastics sets made of particles of various polymers, shapes and colours. Overall, the errors on total counts were under 25% in absolute value. The risk of non-detection and loss of particles is greater than the risk of contamination during sample analysis. Significant differences are observed among particle types. It appears difficult to obtain reliable and comparable data on the colour of microplastics. A comparison of the errors with regards to the protocols used led to recommend NaCl [1.2 g/cm3] density separation for sediment and one filtering step (200 µm). The operators' experience appears as a key factor for the quality of the results.

Floating plastics in Adriatic waters (Mediterranean Sea): From the macro- to the micro-scale.

Macro- and microplastics abundances were determined in the Adriatic Sea following the MSFD TG10 protocol. The studied areas included populated gulfs, river outlets and offshore waters in five Adriatic countries. The use of small ships enabled us to detect small sized plastics (2.5-5 cm) and record average macroplastics densities of 251 ±â€¯601 items km-2, one order of magnitude higher than previously considered. Results from manta net tows for microplastics revealed an average abundance of 315,009 ±â€¯568,578 items km-2 (217 ±â€¯575 g km-2). We found significantly higher microplastics abundances in nearshore (≤4 km) than in offshore waters (>4 km) and this trend seems to affect also the small sized macro plastic fragments (2.5-5 cm). The dominant polymers were polyethylene and polypropylene while the presence of some rare polymers and waxes used in food and dentistry indicated waste water treatment plants as potential sources of microplastics.

Evaluation of cognitive-analytic therapy (CAT) outcome in patients with panic disorder.

Two categories of treatment have been shown to be effective in treating panic disorder with or without agoraphobia. One is pharmacotherapy using antidepressants and benzodiazepinesand the other is psychotherapy. The present study aims at the assessment of the outcome of Cognitive-Analytic Therapy (CAT), a type of brief psychotherapy, in a sample of 128 psychiatricoutpatients with DSM-IV diagnosis of panic disorder, who attended the Mental Health Center of Northwestern District of Thessaloniki. For this purpose, validated instruments for the evaluation,such as the Minnesota Multiphasic Personality Inventory (MMPI), the Beck Depression Inventory (BDI), the State-Trait Anxiety Inventory (STAI) and the Post-therapy Questionnaire (PtQ), were used.The patients were evaluated in two follow ups, 2 months and 1 year after therapy termination. The results showed that on the 2 month follow up 78 patients showed a statistically significant improvementin comparison to the intake time, in all but two (Mf, Ma) clinical scales of the MMPI, on their sum and on some research scales of the MMPI, on the BDI and on the STAI scores. On the 1-yearfollow-up, according to the results of the MMPI, BDI, STAI and PtQ, the patients maintained the achieved improvement. The above results indicate that CAT is an effective brief psychotherapeuticapproach for patients with panic disorder.

Psychiatric comorbidity in Greek patients with generalized anxiety disorder.

From a total sample of 1,448 psychiatric outpatients, 81 (5.6%) received a diagnosis of generalized anxiety disorder (GAD) according to DSM-III-R criteria. Fifty-three (65%) of them had another Axis I diagnosis, while this percentage increased to 78% (63/81) when lifetime psychiatric diagnoses were recorded. The most frequent comorbid diagnoses were panic disorder, dysthymia, major depression and social phobia. Forty-three (53%) of the GAD patients met the criteria for personality disorder. They manifested obsessive-compulsive, avoidant personality and personalities of cluster C in general significantly more frequently than the rest of the total sample. The presence of a personality disorder was related to a significantly higher score on almost all the Minnesota Multiphasic Personality Inventory clinical and research scales, to a worse level of functioning and to an earlier age of onset of GAD. The results of the present study (1) support previous findings of high rates of comorbidity of clinical syndromes in GAD, (2) indicate that GAD co-occurs frequently with cluster C personality disorders, mainly avoidant and obsessive-compulsive, and (3) that the presence of a concomitant personality disorder is related to severer psychopathology and to a worse level of functioning.

Somatoform disorders: comorbidity with other DSM-III-R psychiatric diagnoses in Greece.

From a total sample of 1,448 psychiatric outpatients, 175 (12.1%) received a diagnosis of a somatoform disorder according to DSM-III-R criteria. One hundred twenty-two (70%) of these patients had another current axis I diagnosis, and this rate increased to 79% (139 of 175) when lifetime psychiatric diagnoses were recorded. The most frequent comorbid diagnoses were depressive disorders, i.e., dysthymia and major depression, and then anxiety disorders, mainly panic disorder. One hundred ten (63%) of the somatoform patients met the criteria for a personality disorder, significantly higher than the rate (52%) for the rest of the total sample (n = 1,273), who were used as a control group. The most frequent comorbid personality disorders were histrionic, dependent, and personalities of cluster B in general. Hypochondriasis was the only somatoform disorder that was additionally significantly related to obsessive-compulsive personality disorder. Somatoform patients with a concomitant personality disorder manifested more severe overall psychopathology as measured by the Minnesota Multiphasic Personality Inventory (MMPI) and a worse level of functioning than those without. The results of the present study show that (1) patients with somatoform disorders have a high rate of comorbidity with other clinical syndromes and personality disorders, and (2) the presence of a personality disorder is related to more severe overall psychopathology and a worse level of functioning. All of the above indicate that special attention must be paid to the interaction between somatoform disorders, other clinical syndromes, and personality structure at the level of both clinical and research practice.

Personality disorders in dysthymia and major depression.

OBJECTIVE: The purpose of the present study was to investigate the comorbidity of personality disorders in patients with primary dysthymia compared to those with episodic major depression. METHOD: A total of 177 out-patients with primary dysthymia and 187 outpatients with episodic major depression were administered a structured diagnostic interview for DSM-III-R Axis II disorders. In addition, all of these patients completed the BDI, and those with the appropriate level of education also completed the Minnesota Multiphasic Personality Inventory (MMPI). RESULTS: A significantly higher proportion of dysthymic patients than patients with major depression met the criteria for a personality disorder, for borderline, histrionic, avoidant, dependent, self-defeating types and for personality disorders of clusters B and C. Further analysis revealed that the above differences were mainly due to the subgroup of patients with 'early-onset dysthymia'. Finally, patients with a personality disorder, both dysthymics and those with major depression, had significantly higher scores on the BDI and on the majority of the MMPI scales compared to those without a personality disorder. CONCLUSION: The data indicated that (i) dysthymia--mainly that of early onset--is associated with significantly higher personality disorder comorbidity than episodic major depression, and (ii) the presence of a personality disorder is related to more severe overall psychopathology.

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.

Greek version of the General Health Questionnaire: accuracy of translation and validity.

The purpose of this study was to examine the accuracy of translation and to test the validity of the Greek version of the General Health Questionnaire (GHQ). In the translation study, the English and the Greek versions of the GHQ were administered to a sample of 50 bilingual respondents. The internal consistency, item-by-item and the subject-by-subject analysis have shown that the 2 versions are equivalent and therefore the Greek translation is highly accurate. In the validity study, 100 consecutive patients attending an internal medicine outpatient clinic completed the Greek version of the GHQ-60 and were interviewed independently using the Present State Examination (PSE). The validity of the shorter forms of the questionnaire (GHQ-30 and GHQ-28) was tested by disembedding the relevant items from the larger set. The correlations obtained between the scores of the questionnaire and the PSE ratings, as well as all the validity indices (sensitivity, specificity, positive predictive value, negative predictive value and overall misclassification rate) were quite satisfactory for all the GHQ forms, thus confirming the validity of the questionnaire in its Greek version. The best cut-off points as found by receiver-operating characteristics analysis were 11/12 for the GHQ-60, 5/6 for the GHQ-30 and 4/5 for the GHQ-28. The revised (CGHQ) scoring system for the GHQ-30 has not been proved superior to the conventional scoring method. The above results are discussed in relation to the pertinent literature and especially the studies carried out in similar settings and in countries with similar cultural backgrounds.

Mental health and primary care in ethnic groups Greek Cypriots in London: a preliminary investigation.

The psychiatric symptoms of 50 consecutive Greek Cypriot attenders at a primary health care centre in North London were compared with 50 consecutive native English attenders using the 28 item General Health Questionnaire. No differences were identified between the two ethnic groups. However, the less 'acculturated' Greek Cypriot patients manifested a higher level of psychological disturbance.

Psychopathology and personality characteristics of epileptic patients: epilepsy, psychopathology and personality.

The psychiatric investigation of a sample of 101 epileptic patients (65 temporal lobe epileptics (TLE) and 36 non-TLE) through various methods of evaluation, showed that only a minority of TLE with DSM-III diagnoses of Organic Brain Syndromes had severe psychopathology and manifested some personality traits. Thus, these patients seem to be differentiated from the rest of epileptics, TLE and non-TLE, who had quite "benign" psychological problems, if at all. It is quite probable that this sub-group of TLE could be the main instigators and perpetrators of the "bad image" of epileptics. The findings are discussed in relation to the pertinent literature and some hypotheses are offered for their explanation.