Objective: Psychological distress is not a new phenomenon in oncology. It has been considered a serious subject for patients diagnosed with cancer. The main method of measurement of distress is the Distress Thermometer which consists of an analogical scale from 0-10 and of 5 groups of problems which cause concern to the patient: 1. Practical problems 2. Family problems 3. Emotional problems 4. Spiritual/religious uncertainties 5. Physical problems. Purpose: Is the presentation of Distress Thermometer in greek for taking measures promptly with the aim of ensuring a better quality of life for lung cancer patients. Method: The sample consisted of 88 males, 26 females, the average age of 64,95 +- 9,3, with lung cancer from the pulmonology clinics of “Swtiria” hospital. Results: Only 18,4% of the sample showed normal values (0-4) on the analogical scale while 37,3% showed serious distress (7-10). Regarding the practical problems 36% had difficulties in movement while 22% mentioned having economic, work or insurance problems. In reference to family problems 7,9% quoted problems with their spouses. As for the emotional side it was found that nervousness accounted for 71,9% of the sample and fear 60,5%. Furthermore 20,2% started to take an interest in spiritual/religious themes. In the field of physical problems, walking proved to be a difficulty for 70,2% of the patients. Conclusion: The distress thermometer may be used as a screening tool for detecting and promptly dealing with distress.

Lung cancer is a stressful condition for both patient and family. The anxiety and pain accompanying cancer and its treatment have a significant negative influence on the patient's quality of life. The aim of this study was to investigate the correlation between anxiety, pain, and perceived family support in a sample of lung cancer patients. The sample consisted of a total of 101 lung cancer outpatients receiving treatment at the oncology department of a general hospital. Anxiety, pain (severity and impact on everyday life), and perceived family support were assessed using Spielberger's State-Trait Anxiety Inventory, the Brief Pain Inventory, and the Family Support Scale, respectively. Statistical analyses revealed correlations between anxiety, pain, and family support as perceived by the patients. The intensity of pain had a positive correlation with both state and trait anxiety and a negative correlation with family support. Anxiety (state and trait) had a significant negative correlation with family support. In conclusion, high prevalence rates of anxiety disorders were observed in lung cancer patients. Females appeared more susceptible to anxiety symptoms with a less sense of family support. A negative correlation was evidenced between family support and anxiety and a positive one between anxiety and pain.

IntroductionLung cancer is a stressful condition for both patient and family. The anxiety and pain accompanying cancer and its treatment have a significant negative influence on the patient’s life quality.AimsTo investigate the correlation between anxiety, pain and perceived family support in a sample of lung cancer patients.MethodsThe sample consists of a total of 101 lung cancer patients hospitalized at the oncology department of a general hospital. Anxiety, pain (severity and interference) and perceived family support were assessed using Spielberger’s State - Trait Anxiety Inventory (SSTAI), the Brief Pain Inventory (BPI) and the Family Support Scale (FSS) respectively.ResultsAnalysis showed that there is a correlation between anxiety, pain and family support as perceived by the patients. Pain intensity (severity and interference) has a positive correlation to both state and trait anxiety and a negative correlation to family support. The effects of pain in everyday life also exhibit a positive correlation to state and trait anxiety and a negative correlation to family support. Anxiety (state and trait) has a significant negative correlation to family support.ConclusionsPain intensity in lung cancer patients seems to have an effect on patient anxiety and perceived family support. Treating patients’ pain could lead to a decrease in anxiety symptoms as well as an increase in perceived family support.

ABSTRACT Background: Involuntary psychiatric admission is a controversial issue with legislation varying from country to country. Research on elderly individuals being involuntary admitted has been limited. This study aims first at assessing whether elderly involuntary admitted patients (IAPs) differ with regard to demographic, psychopathological, and behavioral characteristics from voluntary admitted psychiatric patients (VAPs) and second to assess whether the former group should be treated in a different (special) way. Methods: Forty IAPs were compared to 39 VAPs with regard to sociodemographic data, DSM-IV diagnosis, as well as behavioral issues recorded by the Patient–Staff Conflict Checklist – Shift Report (PSCC-SR). All patients were aged 60 years and over and were admitted in the psychiatric departments of four general hospitals in Athens. The study period lasted 12 months. Results: VAPs were more likely to be suffering from mood disorders, while IAPs presented higher rates of delirium. From the 20 items of the PSCC-SR, differences were found only in two: IAPs presented more aggressive behavior during the first few days of admission whereas VAPs had committed recent suicide attempt just before admission. Conclusion: From the clinical point of view, IAPs presented with delirium and more aggressive behavior, whereas, the VAPs presented with higher rates of mood disorder and suicidality. However, from the medicolegal point of view, our findings lend support to the argument of either setting a limited time frame for involuntary admission in elderly patients, and/or allowing for elderly individuals with acute organic conditions to be treated against their will.

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Introduction Involuntary admission is a controversial issue with legislation varying from country to country. Objectives Research on elderly individuals being involuntary admitted is limited. Aim Firstly at assessing whether involuntary admitted (IA) elderly individuals differ from voluntary admitted (VA) patients and secondly to assess whether IA should be treated in a different way. Methods 40 IA were compared to 39 VA with regard to demographic data, DSM-IV diagnosis as well as behavioral issues recorded with the Patient Staff Conflict Checklist Shift Report (PSCCSR). All patients were aged 60 and over and were admitted in the psychiatric departments of four general hospitals in Athens. The study period was 12 months. Results VA patients were more likely to be married, working and suffering from mood disorders, whilst IA patients presented with delirium. From the 20 items of the PSCCSR, differences were found only in two: IA presented more aggressive in the first few days of admission and VA had recent suicide attempt just before admission. Conclusions The patients’ characteristics as well as the psychiatric and nursing needs of VA and IA elderly individuals in an acute psychiatric ward do not differ. They tentatively support the argument that since IA and VA elderly psychiatric inpatients exhibit similar behaviour being kept under section for long periods is unwarranted.

Background Several studies have reported high prevalence of anxiety and depression in chronic obstructive pulmonary disease (COPD) outpatients. Moreover, these patients share psychological or psychopathological characteristics that inhibit their ability to cope with the disease. In the present study we aimed to record the prevalence of psychological symptom patterns in a sample of Greek COPD outpatients and to assess which psychological factors (and to which degree) contribute to vital exhaustion (VE). Methods The study included 139 COPD outpatients. We used the Symptom Checklist 90 - Revised (SCL-90-R) and the Maastricht Questionnaire (MQ) in order to evaluate psychological symptom patterns and VE, respectively. Results The mean MQ score was 19.6, which is significantly higher than the corresponding score in the general population. Regarding the SCL-90-R dimensions, depression was the highest followed by somatization, obsessive-compulsive and anxiety dimensions. Additionally, a positive correlation was observed between the MQ and the SCL-90-R dimensions. MQ failed to demonstrate correlation with age, gender, education level or the severity of the disease. Depression seems to be responsible for 57.9% of the variation of VE, while obsessive-compulsiveness is responsible for an additional 2.4%. All the remaining dimensions of SCL-90-R had no statistically significant contributions. Conclusions Our findings suggest the high prevalence of VE, together with high rates in most of the SCL-90-R dimensions with greater depression, somatization, obsessive-compulsiveness and anxiety in a Greek COPD group at various Global Initiative for Chronic Obstructive Lung Disease (GOLD) diagnostic criteria stages. The coexistence of such symptoms should be further assessed as an eventual unfavorable prognostic factor.

BACKGROUND:The Julkunen Family Support Scale aims to record the sense of support that a subject receives from the members of his family. The object of the present study was to investigate the reliability and to assess the validity of the Greek translation of the Julkunen Family Support Scale in Greek health care professionals in a public general hospital.METHODS:In order to determine the indicator of validity of content we addressed nine expert professionals and one sociologist, asking them to evaluate how much relevant to the sense of familial support are the items of the questionnaire. Additionally, to assess reliability we used a sample of health care professionals.RESULTS:There was agreement among experts for the validity of content. Cronbach's alpha for the total items was 0.820, pointing to high validity. Only replacing item four could increase the scale's validity, but without significant differences.CONCLUSIONS:The scale, in its Greek version, appears to be a brief and reliable tool that can be used for inpatients, in clinics as well as in epidemiologic studies of received family support.

Sleep disturbance symptoms and their associations with alexithymia, depression and anxiety Dionisios Bratis, Asimoula Spanopoulou, Silvia Dumitru, Sofia Lagou, Christina Diamandi, Athanasios Tselebis, Georgios Moussas, Athanasios Karkanias, Sotirios Gyftopoulos, Epaminondas Kosmas From 1 International Congress on Neurobiology and Clinical Psychopharmacology and European Psychiatric Association Conference on Treatment Guidance Thessaloniki, Greece. 19-22 November 2009

Background: Chronic obstructive pulmonary disease (COPD) is a major health problem, especially in adults over 40 years of age, and has a great social and economic impact. The psychological morbidity of COPD patients with regard to anxiety and depressive symptoms has been extensively studied in the past. However, few studies have investigated the prevalence of alexithymia in these patients, as well as its association with this comorbidity. Based on this fact, we studied the prevalence of alexithymia and its association with anxiety and depressive symptoms in COPD outpatients.Methods: The present study included 167, randomly selected, outpatients diagnosed with COPD. Alexithymia, anxiety and depression were assessed using the Toronto Alexithymia Scale (TAS-20), Spielberger Trait Anxiety Inventory (STAI), and Beck Depression Inventory (BDI), respectively.Results: The mean BDI score was 12.88 (SD: 7.7), mean STAI score 41.8 (SD: 11.0) and mean TAS-20 score 48.2 (SD: 11.5). No differences were observed between genders regarding age and alexithymia (t test P > 0.05), while female patients presented higher depression and trait anxiety scores than males (t test P < 0.05). Clinically significant levels of anxiety were present in 37.1% of men, and in 45.7% of women. The mean depression score was also higher than the corresponding mean score in the general population (one-sample t test P < 0.01), while 27.7% and 30.5% of the sample presented mild and moderate to severe depression, respectively. Finally, a strong correlation was observed between alexithymia, depression and anxiety.Conclusions: This study confirms the high prevalence of anxiety and depression symptoms in Greek outpatients with COPD. The prevalence of alexithymia in COPD patients, contrary to what has been observed in patients with other chronic respiratory diseases, seem to be lower. However, we observed a strong association between alexithymia, depression and anxiety levels. This observation suggests that alexithymia should be taken into consideration when drafting specific psychotherapeutic interventions for these patients.

Association between depression and body mass index in patients with chronic obstructive pulmonary disease Athanasios Tselebis, Dionisios Bratis, Maria Harikiopoulou, Elpida Theodorakopoulou, Georgios Moussas, Athanasios Karkanias, Elias Kainis, Epaminondas Kosmas, Nikolaos Tzanakis, Nikolaos Siafakas From 1 International Congress on Neurobiology and Clinical Psychopharmacology and European Psychiatric Association Conference on Treatment Guidance Thessaloniki, Greece. 19-22 November 2009

BackgroundMany studies have attempted to delineate the relation-ship between the input in family support (FS) of patientswith acute or chronic disease, as well as the effect ofthis support in the confrontation of illness. These stu-dies showed a negative cross-correlation between thesense of family support and depressive or anxiety symp-toms [1,2]. On the other hand, it has been observed thatthe presence of vital exhaustion (VE), characterized byunusual tiredness, is an aggravating factor, especially inpatients with cardiovascular diseases [3,4]. Aim of thestudy is to investigate the association between the senseof family support and the degree of vital exhaustion inpatients with chronic obstructive pulmonary disease(COPD).Materials and methodsOne hundred and four (87 males and 17 females) out-patients with COPD participated in the study. Familysupport and vital exhaustion were assessed by using the13-item Julkunen Family Support Scale (FSS) and theMaastricht Questionnaire (MQ), respectively. Age andeducation level were also recorded.ResultsMean age was 65.3 (± 8.1) and mean education levelwas 10.97 (± 4.2, in years). As to clinical measurements,mean FSS score was 54.87 (± 7.1), whereas mean MQscore was 19.83 (± 8.46), which is significant higherthan the corresponding score (14.94) of the generalpopulation (sample t- test p 0.05). In contrary, a strongnegative correlation was presented between FS and VE(Pearson correlation p < 0.05).ConclusionsVital exhaustion seems to be present also in patientswith COPD. However, further studies are required inorder to clarify its associations with the comorbidities ofdepression and anxiety, which are common in thesepatients. Finally, our findings suggest the protective roleof the sense of family support against vital exhaustion.

Materials and methods For a two months period, all the patients examined and diagnosed with anxiety and/or mood disorders (according to D.S.M – IV – TR) in the Emergency Department of two General Hospitals, completed the Cage Test, which traces covered alcoholism problems. The test includes 4 items and is specified to detect alcoholism in the general population and in general hospital patients. Two or more positive answers suggests alcohol dependance – abuse. Residents acquainted with its use gave the test. Finally, we recorded the demographics (sex, age, education and family status) of all examined patients included in the study.

Background The effect of weather conditions on the need to admit patients in psychiatric wards has been studied; more particularly this effect has been focused on the influence of exposure to sunlight and ambient temperature. Relative atmospheric humidity and rainfall may influence medical admissions. Thus, the aim of the present study was to assess the effect of ambient temperature and rainfall on Greek inpatients' psychiatric admissions.

To assess correlations for perceived family support with burnout in Greek nurses, the Julkunen Family Support Questionnaire and the Maslach Burnout Inventory were administered to nurses (22 men and 88 women; M age = 35.6 yr., SD = 5.7 yr.; M work experience = 12.2 yr., SD = 6.2 yr.). The correlation was positive but low for family support and sense of personal accomplishment by women; all the other correlations were low, accounting for very small variance.

BACKGROUND:Depression necessitating assistance from health professionals has a lifetime prevalence of 10%. Chronic disease increases comorbidity with mood and/or anxiety disorders. Patients with chronic pulmonary disease present with severely impaired functionality, chronic somatic and psychogenic pain, require frequent hospitalizations and have a dependency upon medical and nursing personnel. In the present study we assessed anxiety and depression in patients hospitalized for pulmonary disease in a pulmonary disease hospital.METHODS:We assessed anxiety, using the Spielberger state-trait anxiety scale, and depression, using the Beck Depression Inventory, in 132 patients with pulmonary disease.RESULTS:A total of 49.2% of the sample had moderate or severe depression and 26.5% had anxiety. Women had higher depression and anxiety scores than men (t test, p < 0.05). Depression was positively correlated with anxiety, age and time from diagnosis. Anxiety was positively correlated with depression and time from diagnosis (Pearson r = 0.62 and 0.29, p < 0.01). Patients with chronic obstructive pulmonary disease and bronchial asthma had higher depression scores than patients with tuberculosis (t test, p < 0.01).CONCLUSION:Depression and anxiety are very prevalent in patients with pulmonary disease, especially chronic disease. This may be a very important negative factor in patients' adaptation to the chronic course of their disease.

Background Several studies have indicated the participant role of the season of the year as a factor of manifestation of mood disorders. Furthermore, although the seasonal pattern of admissions of patients with mood disorders have been extensively studied in international bibliography, just few relative references are present in Greece. The objective of this study is to investigate the seasonal necessity of hospitalization in Greek patients with mood disorders.