Mental health problems, behavior changes, and addictive issues have been consistently documented among healthcare workers during the pandemic. The objective of this study was to investigate the levels of anger and aggression in relation to psychological resilience and alcohol abuse among healthcare workers during the first wave of the COVID-19 pandemic. A total of 120 physicians and 123 nurses completed an online survey of the Dimensions of Anger Reactions-5 (DAR-5), the Brief Aggression Questionnaire (BAQ), the Brief Resilience Scale (BRS), and the Alcohol Screening questionnaire CAGE which is an acronym for the focus of the questions (Cutting down, Annoyance by criticism, Guilty feeling, and Eye-openers). Demographic and professional data were also recorded. A total of 53 men and 190 women participated in the study. Almost one-third of the participants had a positive score on the DAR-5 scale and one out of ten respondents presented with current problematic alcohol use. Male participants demonstrated lower scores on the DAR-5 scale compared to females. Individuals with current problematic alcohol use displayed higher scores on the BAQ compared to those without alcohol use disorders. Regression analysis revealed that 16.4% of the variance in the BAQ scores can be attributed to scores on the DAR-5, 5.9% to the BRS scores, 2.1% to the CAGE scores, 1.7% to gender, and 1.2% to years of work experience. Mediation analysis highlighted the role of psychological resilience as a negative mediator in the DAR-5 and BAQ relationship. Professional experience and alcohol abuse emerged as positive and negative risk factors contributing to aggression and psychological resilience. The findings hold practical implications for implementing interventions to strengthen resilience in order to compensate for aggressive tendencies and discourage addictive issues.

The COVID-19 pandemic is likely to cause mental health issues, especially for healthcare professionals. The aim of this study was to investigate levels of perceived stress, insomnia, and the sense of family support among nurses in pandemic conditions. We administered in a sample of 150 nurses from different hospital departments during the COVID-19 pandemic the Athens Insomnia Scale (AIS), Perceived Stress Scale (PSS), and Family Support Scale (FSS). Individual and demographic data were recorded. In total, 120 women and 30 men completed the study questionnaires. Almost half of the participants (49.7%) reported the presence of insomnia and more than half (50.3%) experienced increased stress levels. Scores on the Athens Insomnia Scale correlated positively with Perceived Stress Scale scores (p < 0.01), and negatively with Family Support Scale scores (p < 0.01). Significantly negative correlations were observed among scores on the Perceived Stress Scale and the Family Support Scale (p < 0.01). The regression models revealed that 'scores on Perceived Stress Scale' and 'years of work experience' were significant predictors of 'scores on Athens Insomnia Scale', each explaining 43.6% and 2.3% of the variance. 'Scores on Athens Insomnia Scale' and 'scores on Family Support Scale' were significant predictors of 'scores on Perceived Stress Scale', explaining 43.7% and 9.2% of the variance. In conclusion, we confirmed that working with COVID-19 patients has a negative impact on the sleep of nurses, possibly mediated by increased levels of stress. Family support, as a protective factor, appears to moderate the deleterious consequences of stress.

Suicide is defined as the voluntary, and intentional, act of causing one’s own death. As a topic of scientific study, suicide has continuously been the focus of attention for a multitude of disciplines such as sociology, anthropology, psychology and psychiatry, to name a few. The act of suicide has been documented since antiquity. The present study is focused on highlighting suicidal behaviors in Greek mythology as well as on determining the method used and the motive behind each act of suicide. The cases of suicidal behavior presented in this study were drawn from a selection of various Greek myths, and were chosen on the basis of whether or not the mythical figures involved caused their own death either directly or indirectly, according to the main myth or a version of it. The Myth can provide helpful insight into the understanding of suicidal behaviors and of the mechanisms that govern human existence and conscience, inasmuch as mythological cases of suicide constitute important examples, useful to therapeutic practices focusing on suicide, regardless of psychotherapeutic perspective.

Chronic obstructive pulmonary disease (COPD) is a chronic inflammatory lung disease characterized by progressive and only partially reversible symptoms. Worldwide, the incidence of COPD presents a disturbing continuous increase. Anxiety and depression are remarkably common in COPD patients, but the evidence about optimal approaches for managing psychological comorbidities in COPD remains unclear and largely speculative. Pharmacological treatment based on selective serotonin reuptake inhibitors has almost replaced tricyclic antidepressants. The main psychological intervention is cognitive behavioral therapy. Of particular interest are pulmonary rehabilitation programs, which can reduce anxiety and depressive symptoms in these patients. Although the literature on treating anxiety and depression in patients with COPD is limited, we believe that it points to the implementation of personalized strategies to address their psychopathological comorbidities.

130 patients from a methadone maintenance treatment program agreed to complete Symptoms Checklist 90-Revised (SCL-90R) and Alcohol Use Disorders Identification Test (AUDIT) self-report scales. Scores higher than the proposed cut-score on SCL-90R scale were observed on depression, obsessions-compulsions, paranoid ideation, anxiety, anger-hostility, somatization, interpersonal sensitivity, and psychoticism subscales. In sum, 42.9% of our sample exhibited depressive symptomatology, 34.9% obsessive-compulsive symptoms, 29.1% somatization, 27.2% anxiety symptoms, 22.2% paranoid ideation, 19% phobic anxiety, 15.1% psychoticism, and 15.1% hostility and 11.9% presented with symptoms of interpersonal sensitivity. Mean score on AUDIT scale was 6.9±7.9. 63.0% of our participants scored below cut-off and were classified as having a low level of alcohol-related problems; 24.4% scored in the range of 8–15 which is an indication of alcohol abuse whereas 12.6% scored 16 and above indicative of serious abuse/addiction. Scores on AUDIT scale were positively correlated with length of time on methadone treatment, but not with length of time on drug use or age of our participants. Positive correlations were observed among AUDIT and SCL-90R scores, namely, with global severity index score, positive symptom distress index, positive symptom total, and all primary symptom dimensions subscales except phobic anxiety.

Significant positive effects, particularly on psychological state in patients who completed the follow-up pulmonary rehabilitation programs, are indicated by a large number of studies. Yet, a remarkable proportion of selected patients drop out from these programs. In this study, we investigated existing differences on psychological variables among COPD patients who complete and those who drop out from pulmonary rehabilitation programs. The study included 144 patients, 43 (29.9%) of whom did not complete the program. SCL-90 was used for the assessment of psychological symptoms. On the SCL-90-R scale 55.6% of patients had abnormal findings. Patients who discontinued the program had higher rates of depression and somatization compared to those who completed it. Regarding the psychopathology scales of SCL-90R, we found that patients who discontinued the program showed higher levels of psychopathology on the scales of somatization, depression, paranoid ideation, and psychotism compared to those who completed the program. The final regression model showed that patients with low educational status and psychotism were more likely to leave the program. In conclusion, psychopathology contributes to patients dropping out from a COPD rehabilitation program; thus, psychological assessment prior to inclusion in rehabilitation programs may reduce dropouts.

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.

As the overall prevalence of TB remains high among certain population groups, there is growing awareness of psychiatric comorbidity, especially depression and its role in the outcome of the disease. The paper attempts a holistic approach to the effects of psychiatric comorbidity to the natural history of tuberculosis. In order to investigate factors associated with medication nonadherence among patients suffering from tuberculosis, with emphasis on psychopathology as a major barrier to treatment adherence, we performed a systematic review of the literature on epidemiological data and past medical reviews from an historical perspective, followed by theoretical considerations upon the relationship between psychiatric disorders and tuberculosis. Studies reporting high prevalence rates of psychiatric comorbidity, especially depression, as well as specific psychological reactions and disease perceptions and reviews indicating psychiatric complications as adverse effects of anti-TB medication were included. In sum, data concerning factors affecting medication nonadherence among TB patients suggested that better management of comorbid conditions, especially depression, could improve the adherence rates, serving as a framework for the effective control of tuberculosis, but further studies are necessary to identify the optimal way to address such issues among these patients.

Background: The presence of anxiety and depressive symptoms in COPD patients has been acknowledged for many years. The preponderance of recent studies supports the utility of pulmonary rehabilitation programs to reduce the levels of depression and anxiety in these patients. The aim of this study is to investigate possible changes in levels of anxiety and depression among patients enrolled in a pulmonary rehabilitation program, along with the role of disease severity in these changes. Methods: In 101 COPD patients, who attended a pulmonary rehabilitation program, levels of trait anxiety (STAI) and depressive symptoms (BDI) were assessed at the beginning and at the end of the program. Age, sex, level of education in years and stage of disease severity were recorded. Results: Our study included 80 male and 21 female patients. Mean age and mean education level were 64.1 ± 8.1 and 11.3 ± 4.1 years, respectively. Regarding COPD staging, 11 patients suffered from mild, 16 from moderate, 47 from severe and 27 from very severe COPD. Significant decreases in anxiety (from 39.7 to 34.0, p < 0.001) and depression rates (from 10.7 to 6.3, p < 0.001) were observed. A statistically significant reduction in anxiety and depression was revealed (p < 0.05)at all stages of COPD. Conclusion: Pulmonary rehabilitation programs should be offered to all COPD patients irrespective of disease severity, since they all lead to improvement in anxiety and depressive symptoms.

Introduction: Psychological comorbidities such as anxiety and depression are common in COPD. Recent studies suggest a decrease in both anxiety and depression in patients with COPD who attended a pulmonary rehabilitation program (RP). However there is insufficient literature on changes in general psychopathology after RP. Aims and Objectives: To examine the changes in general psychopathology of patients with COPD after participating in a rehabilitation program. Methods: The participants were patients (80 men and 21 women) with pure COPD who attended a three month RP. The patients9 psychopathology was assessed, by the start and by the end of the PR, using the Symptom Checklist-90-R (SCL-90-R), which is a self-report questionnaire widely used in both normal and distressed populations. In order to determine COPD severity a spirometric evaluation before and after bronchodilation was performed. Results: Means of age and of FEV1 % of predicted were 64.15 ±8.13 and 43.51±21.53, respectively.Statistically significant changes (Paired t test) were observed at the end of the RP on the following scales: somatisation (0.70 VS 0.45, p 0.05). Conclusions: A pulmonary rehabilitation program may improve psychopathological symptoms, particularly those of the neurotic spectrum, of COPD patients.

Introduction: Obstructive sleep apnea syndrome (OSAS) is characterized by repeated episodes of upper airway obstruction during sleep, which leads to the presence of excessive daytime sleepiness. Regarding the psychological comorbidity in patients diagnosed with OSAS, previous studies focused mainly on depressive and, secondarily, to anxiety symptoms. Aims and Objectives: To record the prevalence of anxiety and depressive symptoms and of alexithymic characteristics in a sample of OSAS patients and to investigate their relation to respiratory parameter (Apnea - Hypopnea Index, AHI) of polysomnography. Methods: The study was conducted in a certified sleep laboratory. 35 randomly selected patients 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. Results: A high prevalence of anxiety (41.4%) and depressive symptoms (55.2%) 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 (t-test p> 0.05). With regard to severity, no differences were observed between subgroups (mild, moderate and severe OSAS, ANOVA p> 0.05). Women showed higher scores in BDI and STAI compared to men (t-test p 0.05). Conclusions: This study supports the presence of a high degree of psychological burden on patients diagnosed with OSAS, regardless of the severity, as determined by the AHI.

printing supported by . Visit Chiesi at Stand B2.10 SUNDAY, SEPTEMBER 2ND 2012 symptoms, 8 showed mild depression, and 6 moderate depression. None showed severe depression. Mean PCS and MCS were 46.4 (±10.4) and 47.5 (±9.6) respectively. PCS and MCS values lower respect to mean value of Italian general population were found in 22 and 17 subjects, respectively. A negative relationship was found between BDI-II and PCS (p=0.02). BDI-II was linearly correlated to BODE (p<0.0001) but not to GOLD stage. PCS was inversely correlated to BODE (p=0.02), but not to GOLD Stage. MCS was not correlatet to BODE and to GOLD Stage. Among individual components of BODE, only MRC was a good and direct predictor for depression (p=.007), and an inverse predictor for both MCS (p=.007) and PCS (p=.0002). In conclusion, a greater dyspnea perception, regardless of disease severity, is associated with higher depression score and poorer QoL. P1462 Self-efficacy and quality of life in COPD patients Marinella Sommaruga1, Paola Gremigni2, Vincenzo Zagà3, Claudia Goti2 , Linda Bassi4, Pierachille Santus4. 1Psychology Unit, Maugeri Foundation, Care and Research Institute, Milano, Italy; 2Department of Psychology, University of Bologna, Bologna, Italy; 3Pneumotisiology Unit, City of Bologna Health Unit, Bologna, Italy; 4Pulmonary Rehabilitation, Università degli Studi di Milano, Maugeri Foundation, Care and Research Institute, Milano, Italy Background and purpose: Chronic obstructive pulmonary disease (COPD) is a complex chronic multi-component disease. Understanding the mechanisms of health related quality of life (HRQL) impairment should help identifying targets of pulmonary rehabilitation (PR). Research has shown positive correlations between efficacy expectations and outcome in patients with COPD (Kaşikçi MK. Int J Nurs Practice 2011; 17:1–8; Arnold R et al., Behav Med, 2005 31:107-15). This study sought to evaluate the relative role of self-efficacy and socio-demographic variables in the prediction of HRQOL in COPD patients. Methods: A total of 103 COPD patients (60% males, mean aged 70±14 years) before entering a PR program, completed dimensional rating scales on self-efficacy (Perceived Health Competence Scale) and HRQOL (Airways Questionnaire 20). Regression analysis was performed to identify the impact of self-efficacy and demographic variables (gender, age, level of education, and marital status) on HRQOL. Results: Stepwise multiple regression analysis revealed that age and self-efficacy were correlated with HRQOL (R2= 0.27). These findings suggest that the HRQOL is negatively correlated with age (b = -0.30) and positively correlated with selfefficacy (b = 0.36), independent of gender, level of education, and marital status. Conclusions: In a chronic diseases such as COPD, it is important to work at improving confidence in the patient’s ability to follow a self-care regimen by increasing self-efficacy, especially in older patients, as it may positively affect quality of life. Therefore, clinicians should include careful assessment of self-efficacy in their routine evaluation of patients before entering a pulmonary rehabilitation program. P1463 Validation of CAT as an independent assessment tool in pulmonary rehabilitation (PR) for chronic obstructive pulmonary disease (COPD) Shakila Devi Perumal1,2 , Cormac McCarthy2, Mary Frances O’Driscoll2, Timothy J. McDonnell2. 1Department of Physiotherapy, St. Michael’s Hospital, Dun Laoghaire, Dublin, Ireland; 2Department of Respiratory Medicine, St. Michael’s Hospital, Dun Laoghaire, Dublin, Ireland The benefits of PR in COPD are well recognised but the practical assessment of patients undergoing PR can be complex. The COPD assessment test (CAT) is a recently introduced simple, validated 8-item questionnaire designed to assess the impact of COPD symptoms on quality of life (QOL). We hypothesized that CAT could be used as a screening tool and outcome measure to assess QOL in COPD. 60 patients with COPD enrolled in 8 weeks outpatient PR between January 2011 and October 2011 were studied. Patients completed CAT score, chronic respiratory disease questionnaire (CRDQ), hospital anxiety and depression (HAD) at baseline and at 8 weeks. Functional status (6 min walk test (6MWT) and incremental shuttle walk test (ISWT)), dyspnoea (MRCD) and body mass index (BMI) were measured. 52 COPD patients completed the 8 weeks PR and data were available for 37 patients with mean (SD) age 68.7 (9.2) yrs and FEV1 48.64 (20.79) % predicted. There was a significant difference in 6MWT (47.03m), ISWT (47.84m), MRCD (0.3 points), CRDQ (-3.02 points), Anxiety (1.5points), depression (0.6points) and CAT (3.63 points) post PR. CAT correlated closely with CRDQ at baseline and following PR whereas there was good correlation only with ISWT, anxiety and depression post PR. CAT is an independent, simple and highly responsive outcome measure that can also be utilized for screening patients with COPD for PR. P1464 Developing a patient reported experience measure for COPD Michael Roberts1, Sharon Andrew2, Susan Walker3, Matthew Hodson4, Robyn Hudson5. 1Institute for Health Sciences Education, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, United Kingdom; 2Department of Acute Care, Anglia Ruskin University, Chelmsford, United Kingdom; 3Department of Primary and Public Health, Anglia Ruskin University, Chelmsford, United Kingdom;4Acute COPD Early Response Service, Homerton University Hospital NHS Foundation Trust, London, United Kingdom; 5North East London, North Central London & Essex (NCLES), Health Innovation Education Cluster (HEIC), London, United Kingdom Introduction: The patient experience and patient outcomes are metrics for quality improvements in healthcare. There is no currently available patient reported experience measure (PREM) for COPD. Study Aim The aim of the study is to create a valid and reliable PREM for patients with COPD. Methods: Sixty four people with COPD across the community of North East London, North Central London and Essex and 19 with recent hospital experience were interviewed to capture their patient journey with COPD. Analysis of the interview data was by a two layer approach: content and then by affective (emotive or felt) responses. Results: Eighteen different affective responses were described by patients and were grouped as positive, negative or ambivalent. Positive responses included: hope, gratitude, comfort/reassured, acceptance, optimism, altruism, happy and respect. Negative responses included scared, anxiety, fear, frustration, worry, feeling depressed, denial and embarrassment. ’Self-motivation’ and control were contextual and could be either positive or negative. The community patient groups’ experience centred around five categories identified in the content analysis: ’Journey to Diagnosis’; ’Smoking’; ’Usual Care’; ’Exacerbation (’flare-up)’ and ’My Everyday Life’. The hospital patient experience was categorised as: ’Going to Hospital’; ’On Arrival to Hospital’; ’On the Ward’; ’Discharge from hospital’ and ’Follow-up care’. Items based on patients’ affective responses were generated from the categories to develop a PREM-COPD scale. Conclusion: Completion of the testing of the PREM-COPD will result in a valid and reliable instrument to be used to measure self-defined important patient experiences when using healthcare services. P1465 Correlations between disease-specific and generic health status questionnaires in patients with COPD Sarah Wilke1, Daisy J.A. Janssen1,2,3, Emiel F.M. Wouters1,4 , Jos M. G. A. Schols5, Frits M.E. Franssen1, Martijn A. Spruit1 . 1Program Development Centre, CIRO+, Centre of Expertise for Chronic Organ Failure, Horn, Netherlands; 2CAPHRI, Maastricht University, Maastricht, Netherlands; 3Department of Elderly Care Medicine, Proteion Thuis, Horn, Netherlands; 4Department of Respiratory Medicine, Maastricht University Medical Centre+ (MUMC+), Maastricht, Netherlands; 5Department of General Practice and Department of Health Services Research, Faculty of Health, Medicine and Life Sciences/CAPHRI, Maastricht University, Maastricht, Netherlands Purpose: Aims of this longitudinal study were to determine whether and to what extent a disease-specific health status questionnaire correlates with generic health status questionnaires at 4 different time points in patients with advanced COPD; and to determine the correlation between the changes in these questionnaires during 1-year follow-up. Methods: Demographic and clinical characteristics were assessed in 105 outpatients with advanced COPD. Disease-specific health status (Saint George’s Respiratory Questionnaire, SGRQ) and generic health status (EuroQol-5-Dimensions, EQ-5D; Assessment of Quality of Life instrument, AQoL; Short Form-36, SF-36) were assessed at baseline, 4, 8 and 12 months. Correlations were determined between SGRQ and EQ-5D, AQoL and SF-36 scores and changes in these scores. Agreement in direction of change was assessed. Results: 84 patients (80.0%) were included for analysis (61.9% male, age 65.7 (9.2) yrs, FEV1 34.2 (13.7)% pred). SGRQ total score and EQ-5D index score, AQoL total score and SF-36 Physical Component Summary measure (SF-36 PCS) score were moderately to strongly correlated (r = -0.49 to -0.68). The correlations of the changes between SGRQ and EQ-5D, AQoL, SF-36 PCS and SF-36 Mental Component Summary measure (SF-36 MCS) score were weak or absent (r = -0.13 to -0.27). The direction of changes in SGRQ agreed slightly with the direction of changes in EQ-5D, AQoL and SF-36 PCS score (Cohen’s Kappa = 0.11 to 0.18, p<0.05). Conclusions: Disease-specific health status questionnaires and generic health status questionnaires should be used together to gain complete insight in health status and changes in health status over time in patients with advanced COPD. P1466 Psychiatric comorbidity in COPD and its determinants Mohamed Zidan1, Rasha Daabis1, Heba Essam

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

BackgroundIt is well known that an operation is undoubtedly a sig-nificant factor of anxiety symptoms development [1].Aim of the study is to investigate the associationbetween the trait and the state anxiety in patients priora surgery, as well as the association of these psychologi-cal features with the ASA classification of the patientphysical status, the age and the gender.Materials and methodsOne hundred and fifty two patients (99 males and 53females), with ASA I-III and mean age 42.10 ± 16.01years, who were undergoing an operation included inthe study. All participants filled out the SpielbergerState-Trait Anxiety Inventory (STAI) [2,3] 12 - 15 hoursbefore the operation. The inventory differentiates thestate anxiety from the personality’s trait anxiety.ResultsMeans of state and trait anxiety were 42.55 ± 11.30 and38.33 ± 8.01, respectively, with significant difference(t-test, p 0.05). However,patients with ASA III presented significant higher stateanxiety scores compared to patients with ASA I andASA II (Anova test p < 0.05).ConclusionsOur findings suggest that younger patients, females andpatients with ASA III are more vulnerable to anxiety.Therefore, these factors should be taken into accountfor the preoperative assessment in order to develop sup-portive psychological interventions.

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.