Aim: Our aim was to detect any concomitant drug abuse in patients on MMT and to reveal possible correlations with associated variables.

A large number of factors should be taken into account to understand landslide phenomena and to facilitate stabilization design especially for complex cases. In this paper the case history of the Gimigliano landslide in the Calabria region (southern Italy) is investigated by using a multidisciplinary combined-technique approach based on conventional geotechnical measurements and modern technologies. The first technique (with reference to inclinometer measurements) is usually affected by errors. Particular care is devoted to the data processing by using ad-hoc methodology to take these errors into account, with the purpose of ensuring a high reliability. For the second technique (electromagnetic sensing techniques and electrical resistivity tomography) convenient methodologies for data post-processing are used and herein presented. The combination of information taken from the different techniques allows the measurements obtained to be validated by conventional and modern approaches and the accuracy of each to be enhanced.

Obstructive sleep apnea syndrome (OSAS) is characterized by repeated episodes of upper airway obstruction during sleep, which leads to the presence of excessive daytime drowsiness. Regarding the psychological comorbidity in patients diagnosed with OSAS, previous studies focused mainly on depressive and secondarily on anxiety symptoms. Due to the lack of research data regarding the prevalence of anxiety and depressive symptoms as well as of alexithymic characteristics in patients with OSAS in Greece, the aim of the study was to record the above symptomatology in a sample of Greek OSAS patients and to investigate its relation to the respiratory parameter (Apnea-Hypopnea Index, AHI) of polysomnography. The study was conducted in a certified sleep laboratory. Thirty five randomly selected patients who attended the laboratory with symptoms of daytime drowsiness, fatigue, disrupted sleep and snoring, were examined for anxiety, depression and alexithymia using the Spielberger Trait Anxiety Inventory (STAI), the Beck Depression Inventory (BDI) and the Toronto Alexithymia Scale (TAS-20), respectively, 24 hours prior to being submitted to polysomnography. All 35 patients met the inclusion criteria of the study (age≤75 years, no other chronic diseases and no history of major psychiatric disorders). Six patients did not meet the diagnostic criteria for OSAS and were thus used as the control group of the study. A high prevalence of anxiety (41.4%) and depressive (55.2%) symptoms and of alexithymic characteristics (41.4%) was observed in OSAS patients. Although the control group showed a higher prevalence of anxiety (66.7%) and depressive (83.3%) symptoms, there were no differences between the two groups (STAI: t=-0.927, p=0.360, BDI: t=-1.537, p=0.134, TAS-20: t=0.196, p=0.846). With regard to severity, no differences were observed between control, mild, moderate and severe OSAS subgroups (STAI: F=0.583, p=0.660, BDI: F=0.829, p=0.488, TAS-20: F=0.987, p=0.412). Females scored higher on the BDI and on the STAI compared to males (STAI: t=-2.38, p=0.039, BDI: t=-3.59, p=0.01). Finally, no correlation was observed between psychometric scores and AHI (Pearson correlation p>0.05). The study confirms the high prevalence of anxiety and depressive symptoms which has been found in previous studies. Furthermore, we found a high prevalence of alexithymic characteristics, a factor that has not been investigated previously and which is positively correlated with anxiety symptoms. The coexistence of alexithymic characteristics may further complicate the clinical manifestations of OSAS due to the fact that patients with alexithymia typically have difficulty in indentifying and describing their underlying psychological symptomatology and, moreover, tend to exhibit more, and often atypical, physical symptoms. In conclusion, the study supports the presence of a high degree of psychological burden in patients diagnosed with OSAS, regardless of the severity of their symptoms, as determined by the AHI. This comorbidity should be taken into consideration during the clinical assessment of OSAS and for the treatment planning.

IntroductionThe high prevalence of psychiatric comorbidity in drug dependent individuals is well known. However, there is limited literature available regarding the comorbidity of psychiatric disorders in drug addicts on methadone maintenance treatment (MMT).AimsTo determine the comorbidity of mental disorders in patients on MMT.MethodsThe Symptom Checklist 90-Revised (SCL-90R) [1] was completed by 85 drug addicts (65 male and 20 female) on MMT. We recorded demographic data, duration of addiction, and duration of MMT.ResultsThe mean age of the sample was 42.0 ± 8.8 years old, the mean duration of substance use was 24.3 ± 8.2 years and the mean duration of MMT was 6.8 ± 4.1. The majority of participants (78.8%) were unemployed and 58.3% of them had no children. Participants scored higher on the depression, paranoid ideation, anxiety, hostility, somatization, interpersonal sensitivity and psychoticism SCL-90R sub-scales, with average scores >1 [2]. On the contrary, lower scores were recorded in the obsessive-compulsive and phobic anxiety sub-scales. The percentage of participants that reported abnormal scores for each sub-scale was as follows: 89.3% for depression, 83.3% for paranoid ideation, 74.7% for anxiety, 66.7% for hostility, 64.7% for somatization, 51.2% for psychoticism and 35.7% for phobic anxiety. No abnormal scores were recorded regarding obsessive-compulsive symptoms. Only 8.4% of participants did not score abnormally on any sub-scale.ConclusionsDrug-addicted patients on MMT show a high comorbidity of psychiatric disorders. In particular, the likely presence of depressive and paranoid symptoms should be taken into serious account when deciding on a therapeutic strategy.

IntroductionGreece presents the highest prevalence of smokers among Western European countries with a percentage of 37.6%. Studies investigating the psychological parameters associated with habitual smoking, both among the general population as well as among health professionals are focused on anxious and depressive symptoms, without taking into account other possible psychological parameters.AimsTo assess the implication of psychological parameters in the preservation and termination of habitual smoking.MethodsOne hundred and four health professionals were randomly selected and asked to fill out the Symptom Check List - 90 - R (SCL-90R) [1]. Participant demographics, smoking habits, amount of daily cigarette consumption, and whether or not participants displayed an intention or effort to quit smoking were all taken into account.ResultsAmong smokers, 50% displayed an intention to quit smoking. Smokers who intended to quit displayed the highest levels in subscales of somatization, anxiety, depression and anger. Daily cigarette consumption, among smokers, showed a positive correlation to subscales of obsessive-compulsive symptoms, interpersonal sensitivity, depression, anxiety as well as of anger, paranoid ideation and psychoticism.ConclusionsThe fact that one in two smokers indicates an intention to quit smoking is both interesting and optimistic regarding possible termination of the smoking habit. Habitual smoking is positively correlated to psychological parameters that should be taken into account when drafting a smoking intervention programme.

Chronic Obstructive Pulmonary Disease (COPD) is mainly related to smoking habit and is characterized by airflow limitation that is not fully reversible. The airflow limitation is usually both progressive and associated with an abnormal inflammatory response of the lungs to noxious particles or gases. Worldwide and in Greece, COPD constitutes a major epidemiological issue. Incidence of depression and anxiety is high in the COPD population. Most studies on depression and anxiety in COPD deal with factors that are positively correlated with both of these comorbidities. The aim of our study was to assess whether two variables, sense of coherence (SOC) and perception of family support (FS), are negatively correlated with depressive and anxiety symptoms in outpatients with COPD. According to Aaron Antonovsky, sense of coherence refers to the ability of individuals to make sense of and manage events. Studies in other diseases suggest that sense of family support has a significant impact on the course and outcome of the disease, yet a limited number of reports across literature addresses the role of family support in COPD patients. In our present study one hundred twenty two (98 men and 24 women) outpatients with pure COPD were included. Age and years of education were recorded. Severity of COPD was assessed with spirometry before and after bronchodilation. All patients replied to self- administered questionnaires on depression (Beck Depression Inventory, BDI), anxiety (Spielberger State-Trait Anxiety Scale, STAI), family support (Family Support Scale, FSS-13) and sense of coherence (Sense of Coherence Scale, SOC). According to our results the mean BDI depression score was 11.65 (SD 7.35), mean trait anxiety score was 40.69 (SD 11.19), mean SOC score was 54.62 (SD 7.40) and mean FS score was 64.58 (SD 11.63). Women patients had higher anxiety scores and lower sense of family support compared to men. Significant negative correlations were evidenced between depression and sense of coherence as well as between anxiety and family support. Step-wise multiple linear regression analysis verified the results and quantified the aforementioned correlations. Notably, raising scores in sense of family support by one point reduces anxiety scores by 0.14 points, and increasing sense of coherence scores by one point reduces depression scores by 0.21 points. In sum, our study confirms the presence of high levels of anxiety and depressive symptoms in COPD patients, with females being in a more disadvantaged position as they tend to have higher levels of both. Sense of coherence and family support are both protective psychological factors against the risk of developing anxiety and depressive symptoms in these patients.

IntroductionIt is known that patients with chronic and life - threatening diseases often presents anxiety and depressive symptoms.ObjectivesThe comparison of the levels of anxiety and depression in patients with chronic obstructive pulmonary disease (COPD) and in patients with lung cancer.MethodsThe completion of the HADS scale was requested in 42 randomly selected patients (21 with lung cancer and 21 with COPD).ResultsHigher rates appeared in the subscales of anxiety and depression of the HADS (12.88 SD 5.03 and 13.45 SD 5.60, respectively) compared to the general hospitalized patients. Pathological rates of anxiety appeared at the 59.5% of the sample, while pathological rates of depression were found at 45.2%. Patients with lung cancer presented higher total score at HADS against patients with COPD (29.48 SD 9.3 vs 23.19 SD 8.26, t test p < 0. 05). In the subscale of anxiety appeared statistically higher average rate in patients with cancer against patients with COPD (14.43 SD 4.97 vs 11.33 SD 4.33, t test p < 0.05). Among the demographic factors, only age seemed to participate to the anxiety variation.ConclusionsPatients with COPD such as patients with lung cancer are presented with high rates of anxiety and depressive symptoms. Patient's age seems to be a significant factor at the variation of the anxiety symptoms.

IntroductionIn substance – related disorders comorbidity refers to any preexisting or following psychological or psychiatric condition that influence the course and prognosis of a patient.ObjectivesTo determine the extent of comorbid substance use and psychiatric disorders among hospitalized in a General Hospital Psychiatric Unit patients and reveal the implications of treatment in such a unit.MethodAll patients hospitalized during a year, were included in the study. Demographics, final diagnosis, substance of use and means of admission (voluntary or involuntary) were recorded.Results7.4% of the total of 339 inpatients met the diagnostic criteria of comorbid substance use disorders. Eleven of them were diagnosed with alcohol use disorder comorbidity, 7 with illicit drug use comorbidity and 7 with both legal and illicit drug use comorbidity. Among inpatients with comorbid use disorders male patients had a significantly higher percentage versus females (x2 p < 0.05). Mean age of inpatients with comorbidity was significantly less than the mean age of the sample (t-test p < 0.05). Duration of hospitalization for inpatients with comorbidity was 15.16 ± 12.4 days versus 21.2 ± 18.4 days for the rest of patients (t-test p < 0.05). Concerning the way of admission, 72% of inpatients with comorbid use disorders were involuntary admitted (x2 p < 0.05).ConclusionConcerning age, sex and means of admission patients with a psychiatric disorder and substance use disorder comorbidity seem to vary from the rest of inpatients. These parameters are probably associated with serious difficulties in therapeutic compliance and with increased hazard.

ObjectivesMany studies have attempted to delineate the positive relationship between anxiety and depressive symptomatology in outpatients with bronchial asthma. However, do not exist reports on the relation between the depression, anxiety and vital exhaustion in these patients.Aim of the study is to investigate the levels and the associations between anxiety, depression and vital exhaustion in outpatients with bronchial asthma.MethodsThe study was performed in one of the largest hospitals of chest diseases in Greece. Forty (14 men και 26 women) outpatients with bronchial asthma participated in the study. Using the BDI (Beck Depression Inventory), the STAI (Spielberger Anxiety Trait Inventory) and the Maastricht Questionnaire (MQ) we assessed depression, anxiety and vital exhaustion, respectively. Age and duration of the disease were also recorded.ResultsMeans of age and of duration of the disease were 43.22±13.05 and 9.24±6.01 years, respectively. The mean STAI score was 42.47±9.9, mean BDI score was 14,16±7,54, and the mean MQ score was 21.02±11.05. Percentages of 29% and 60% of the sample were presented with significant anxiety and depressive symptoms, respectively. No correlation was observed between the demographics (age and duration of disease) and the STAI's and MQ's scores. In contrary, a positive correlation was observed between the levels of depression, anxiety and vital exhaustion (pearson correlation p< 0.001).ConclusionsThe study confirms the coexistence of the depressive symptomatology with anxiety and vital exhaustion in outpatients with bronchial asthma. Therefore, this comorbidity should be taken into account in order to develop specific supportive psychological interventions.

Conclusion Although therapy seems effective in reducing symptoms, further studies must prove that positive results persist over time. The OCDS seems useful for assessing treatment and has follow-up reliability. The small number of females in the sample renders it unsafe to make any generalisations regarding gender related results in this study.

ObjectivesAn operation is undoubtedly a stressful event, which can induce emotional, cognitive and physiological reactions in preoperative patients. Aim of our study is to investigate the associations between the levels of state - trait anxiety and the demographics (gender and age) in patients prior a thoracic surgery.MethodsSeventy-six (57 males and 19 females) patients, with ASA I-III and with mean age 45.65±15.17 years were included in the study. All subjects fulfilled the Spielberger State-Trait Anxiety Inventory (SSTAI), 12 - 15 hours before the thoracic surgery.ResultsMean state and trait anxiety scores were 42.35±11.50 and 38.55±9.03, respectively and presented a strong positive correlation (Pearson Correlation, p< 0.001, r=0.585). Percentages of 30.3% and 13.2% of the sample were presented with clinically significant anxiety levels (t-test, p=0.001). Females appeared with higher state (t-test, p=0.001) and trait (t-test, p=0.076) anxiety scores compared to males. As to age, we observed a negative correlation with the levels of state and trait anxiety. (Pearson Correlation, p=0.05, r=-0,226 and p=0.006, r=-0.313, respectively).ConclusionsOur findings suggest that females and younger patients are more vulnerable to anxiety symptoms prior a thoracic surgery. Thus, gender and age should be taken into account for the preoperative assessment in order to develop supportive psychological interventions.

It is well known that there is high co morbidity between psychiatric disorders (particularly depression and personality disorders) and alcoholism. Aim of this study is to investigate the co morbidity of alcohol abuse/dependence in outpatients seeking psychiatric help in the Emergency Psychiatric Department (EPD) of two General Hospitals. For a three-month period, all the adult outpatients examined in the EPD of two General Hospitals completed the CAGE (Cut down, Annoyed, Guilty, Eye-opener) questionnaire, which uncovers hidden alcoholism. The outpatients’ demographics and reason of psychiatric examination were noted. CAGE was given by residents acquainted with its use. The sample included 320 outpatients (mean age±SD: 41.79±15.4) years. There were 27.5% positive answers. Men presented significantly higher CAGE scores compared to women (t test p<0.01). Patients diagnosed with personality disorders had higher scores compared to patients with other psychiatric disorders. In conclusion, alcohol abuse seems to be high in Greek psychiatric outpatients compared to the general population, a finding in accordance with the international bibliography. The systemic investigation of alcohol abuse as a comorbidity factor and as a factor that is associated with psychiatric illness seems to be important. Males with personality disorders seem to be a high-risk group.

Suicide represents a major public health issue and much research is focusing on the prevention and management of suicidal behavior. The present study aims at the assessment of Warning Signs of Suicide. For this purpose, 100 patients admitted for attempted suicide in Sotiria General Hospital have been included in the study. All patients have been examined through a semi-structured psychiatric interview, the somministration of Beck Depression Inventory (BDI) and the assessment of the following Warning Signs: Internalization, Feeling gloomy, Presence of recent trauma in the patient's history, Change of behavior, Fear, Giving gifts, Depression and Aggression. The results showed that 80% of the sample presented at least two warning signs whereas only 10% of the patients had no warning signs. Moreover, a strong correlation was observed between the total score of depression as assessed with the BDI Scale and the number of Warning Signs. Warning Signs are present with a high percentage in patients who attempt suicide and many authors suggest that they should be included in suicide prevention. Therefore, it is important for all mental health clinicians to integrate the assessment of Warning Signs into their practices and to educate both patients and family members to recognize them.

Background and Aims: Neuropsychiatric literature demonstrates the high impact of cognitive deficits in patients with Multiple Sclerosis (MS), as well as the increased prevalence of anxiety and depression in patients with chronic illnesses, especially in the subgroup of MS patients. The aim of our study is to investigate the existence of an association between depression, anxiety and cognitive deficits in patients with MS. Methods: Demographic data, MS subtypes, and years since diagnosis were documented for 60 patients with MS, who participated in our study. Patients were evaluated for depression and anxiety by the Beck’s Depression Inventory (BDI) and the Spielberger’s questionnaire (State-Trait Anxiety Inventory) respectively. The Symbol Digital Modalities Test (SDMT) was used to evaluate cognitive deficits. Results: According to our preliminary data, 60% of MS-patients scored higher than normal in the BDI. There was a significant negative correlation between years since diagnosis and SDMT (Pearson’s correlation <0.01), as well as between BDI and SDMT (Pearson’s correlation <0.01). No correlation was established between anxiety and both depression and SDMT. Conclusions: Depression and cognitive deficits have a high prevalence in patients with MS. This is due to the severity and chronicity of MS. In our study, depression is strongly associated with cognitive deficits and years since diagnosis of MS, although it is still in progress for further data evaluation. More studies are required to elucidate the cause of this established association.