The adventures of psychiatric reform in Greece: 1999-2019

Psychiatric care in Greece has a long history of traditional in-patient treatment in large public institutions (the public asylum period), which lasted until 1983. European Economic Community (EEC) intervention in 1984 marked a transitional period (1984-1989) characterised by the beginning of the transformation of the mental healthcare system. The current reform era started in 1999 and has included new mental health law, the closure of six public mental hospitals and the establishment of several sectorised mental health services. © The Author 2019

The impact of a community mental health center on psychiatric hospitalizations in two Athens areas

This paper explores the impact of a Community Mental Health Center intervention activities on the inpatient psychiatric morbidity of two areas served by this center. Athens University established this Center, the first of its kind in the Greater Athens area. A comparison among the utilization rates of inpatient psychiatric services by community residents during the years 1979, 1985, 1991 and 1995 is made. The results of the 1995 survey show a significant reduction in the number and days of hospitalization and a remarkable cut in compulsory admissions when compared with those in 1979. It is concluded that medication monitoring, outreach, domiciliary care for patients in crisis, and day care are effective and robust principles of mental health services

Changes in the prevalence of symptoms of depression and depression across Greece

This paper reports on the regional prevalence of symptoms of depression and clinical depression (current major depressive episodes) in Greence in the years 1978 and 1984. Prevalence rates were estimated from two extensive, nationwide cross-sectional home surveys on psychosocial issues and health, carried out in four geographical areas: the Greater Athens area, the Greater Thessaloniki area, the rest of the urban areas and rural areas. The methodology used, the sampling procedure and the screening instrument (The Center for Epidemiologic Studies-Depression Scale) were the same in both surveys. Within the 6-year period a substantial increase in the prevalence of symptoms of depression in all geographic areas was observed, with the Athenian respondents expressing a higher number of symptoms of depression than their counterparts from the other areas. The prevalence of current major depressive episodes, according to specific criteria matched with criteria from the DSM III R, was increased in 1984 in Athens and in the rural areas only. We suggest that economic instability between 1978 and 1984 probably contributed to the changes in the rates of depressive disorders. © 1992 Springer-Verlag

Mental health treatment fearfulness and help-seeking

A majority of people meeting the criteria for mental disorders underutilize mental health services. Treatment fearfulness is a barrier to help-seeking. This study explores the way treatment fearfulness affects the help-seeking behaviour of individuals who sought help from the Community Mental Health Centre. A total of 290 participants completed a structured questionnaire. Information was obtained on a number of variables, including orientation toward utilization of social networks, attitudes toward seeking professional psychological help, opinions about psychiatry, and fears about therapy. Factor analysis was conducted on the scale, measuring fears about therapy. Those with fewer fears about therapy have more positive network orientation, more positive attitudes toward seeking professional psychological help, and more positive opinions about psychiatry so it is more possible for those individuals to visit a mental health service sooner than those with more fears. Reducing the delays in individuals initiating treatment requires clearer understanding of the contributing factors. © 2010 Informa Healthcare USA, Inc

The effect of rehabilitation of schizophrenic patients on their family atmosphere and the emotional well-being of caregivers

Background: In family members with a schizophrenic patient emotional problems, stressful situations, significant life changes are often observed. On the other hand rehabilitation of these patients is an integral part of their aftercare and community tenure. Aims: In this study the effect of the participation of schizophrenic patients in rehabilitation programmes, on the atmosphere of their families and the emotional well-being of their caregivers are examined. Method: Sixty six caregivers of patients in rehabilitation (group A) were compared with seventy caregivers of patients, not attending any rehabilitation programme (group B), in terms of their family atmosphere and emotional well-being, assessed by the Family Atmosphere Scale and the CES-D scale respectively. Results: The family atmosphere of the patients who were participating in a rehabilitation programme was found to be more positive (higher degree of patient's acceptance, autonomy and compliance as well as fewer economic problems) than that of their counterparts, not in rehabilitation. Group A caregivers were also found to exhibit less depressive symptomatology. Conclusions: It seems that psychosocial rehabilitation and its vanous therapeutic activities has a positive impact on several components of family atmosphere of the participating patients and the emotional status of their caregivers

Is psychosocial rehabilitation of schizophrenic patients preventing family burden? A comparative study

This study examined the dimensions of perceived burden by caregivers-relatives of patients suffering from schizophrenia and participating in a rehabilitation programme (group A) compared to a group of patients and their corresponding caregivers who were maintained in regular treatment procedure (group B). Subjective and objective burden perceived by caregivers group A patients attending a rehabilitation programme, was found to be lower compared to that of group B of caregivers of patients in regular maintenance treatment. Low level of functioning of patients was correlated with higher degree of family burden and the more psychological distress of the caregiver. The patient's compliance with medication and psychosocial functioning as well as the participation in a rehabilitation programme, the diagnostic subtypes and the mean daily hours spent with the patient were found to predict the presence of burden of caregiver. It seems that the various socio-therapeutic activities of rehabilitation improve patient's levels of psychosocial functioning, and alleviate the serious psychosocial and emotional problems of caregivers caused by their relative's chronic and severe illness. © 2005 Blackwell Publishing Ltd

Who needs treatment? A nationwide psychiatric case identification study

'Case' identification has been considered a major issue in cross-sectional psychiatric epidemiologic surveys. The question is: what is a 'case' and how reliable and valid can criteria be selected? This paper deals with this issue with respect to our experience obtained from a cross-sectional home survey on psychosocial issues and mental health carried out in Greece, with a nationwide probability sample of 4,292 respondents. Mental health status was assessed by use of the CES-D and Langner scales. A high proportion (29%) of respondents was characterized by a degree of mental impairment scoring above the cut-off points in both scales. In order to identify the true psychiatric 'cases', a total of 9 clinical and help-seeking criteria were selected after examining their discriminant power. Finally, a much lower proportion of the sample was identified as probable (7.2%) and definite (8.0%) psychiatric cases in need of care

Prevalence of psychiatric disorders among homeless people in Athens area: A cross-sectional study

Purpose: Homelessness is a chronic social phenomenon in European and other Western cities. In the recent years, the number of homeless people in Greece, mainly in Athens, is also increasing. Method: The aim of this study was to explore the prevalence of psychiatric disorders among a sample of 254 homeless people, using the Mini International Neuropsychiatric Interview (M.I.N.I.). The sample was drawn from the existing shelters, soup kitchens, and the streets. Results: The sample was predominantly male (74 %) with mean age 51 years, being in their majority homeless for over 25 months, 27 % of them living in the streets. The vast majority of the sample was single or separated with an education level <12 years. Current prevalence of psychiatric disorders was 56.7 % with 20.8 % comorbidity. For psychotic and mood disorders, current prevalence rates were 13 and 16 %, respectively. One year prevalence of alcohol and drug dependence was found to be low. Logistic regression analysis revealed that being older with higher number of months living in the streets and exposed to high frequency of adverse social events, increase the likelihood to become a psychiatric case. Finally, the vast majority of the identified psychiatric cases were lacking any current psychiatric care. Conclusions: The magnitude of the prevalence of psychiatric morbidity was more than three times higher than that of the general population in Athens. Implications for psychosocial care and the organization of a support network for the homeless people are discussed. © 2013 Springer-Verlag Berlin Heidelberg

Psychiatric morbidity among repatriated greek migrants in a rural area

This paper reports on psychiatric case identification by the application of the Structured Clinical Interview for DSM-III-R (SCID) in a sample of 198 Greek migrants repatriated from western europe in a northwestern province of Greece. The current (1 month) prevalence of psychiatric morbidity, based on the total number of diagnosed cases, was found to be 43.4%. Lifetime prevalence of psychiatric disorders was found to be higher (49.4%). The majority of the sample were diagnosed as suffering from anxiety disorders and dysthymia. Psychiatric disorders were found to be more prevalent among middle-aged respondents. Duration of stay in the foreign country was a factor correlated with psychiatric morbidity. Of short-term migrants 54% were found to suffer from specific nosological entities, whereas 32% of long-term migrants were diagnosed as cases. The results are discussed within the framework of the existing sociocultural context of emigration and repatriation. © 1995 Springer-Verlag