Socio-demographic determinants of coinfections by HIV, hepatitis B and hepatitis C viruses in central Italian prisoners

BACKGROUND: The coinfections HIV/HCV/HBV are an important health issue in penitentiary communities. The aim of the study was to examine HIV, HBV and HCV coinfections determinants amongst prisoners in the jails of Southern Lazio (Central Italy), in the period 1995-2000. METHODS: Diagnosis of seropositivities for HIV, HBV and HCV was made using ELISA method. A multiple logistic regression analysis was conducted to verify the influence of socio-demographic factors on the HIV/HBV/HCV coinfections. RESULTS: HIV/HCV, HBV/HCV and HIV/HBV coinfections were detected in 42 (4%), 203 (17.9%) and 31 (2.9%) inmates, respectively. These coinfections are significantly associated with the status of drug addiction (OR = 16.02; p = 0.012; OR = 4.15; p < 0.001; OR = 23.57; p = 0.002), smoking habits (OR = 3.73; p = 0.033; OR = 1.42; p = 0.088; OR = 4.25; p = 0.053) and Italian nationality (OR = 7.05; p = 0.009; OR = 2.31; p < 0.001; OR = 4.61; p = 0.04). CONCLUSION: The prevalence of HIV, HBV and HCV seropositivity in jails suggests that information and education programs for inmates could be useful to reduce the spread of such infections

Olanzapine and obsessive-compulsive symptoms

Clozapine and risperidone have been implicated in the development of obsessive-compulsive symptoms. We present three cases in which olanzapine caused a significant exacerbation of obsessive-compulsive symptoms in schizophrenia (two cases) and obsessive-compulsive disorder (one case). (C) 2000 Elsevier Science B.V. All rights reserved

Adolescents' mental health during the financial crisis in Greece: The first epidemiological data

Greek financial crisis has incurred adverse effects on the mental health of the population; however existing research is constrained in the adult population. Therefore, the present study aims to shed light on the mental health state of adolescents during the recession. In this context 2,150 adolescents were recruited from a random and representative sample of public and private schools in the greater Athens area. Mental health problems were assessed with the selfreport Strengths and Difficulties Questionnaire while additional questions enquired about students' socio-demographic characteristics. Findings indicate that roughly one out of ten adolescents scored above the cut off point for the total difficulties score, with the higher prevalence been recorded for the conduct problems sub-scale. More specifically, 7.7% of the sample scored above the abnormal cut-off point for the total difficulties score, 10.9% for emotional symptoms, 11.9% for conduct problems, 10.6% for hyperactivity and 4.8% for peer problems. Furthermore, adolescents who reported that during the previous month there was not enough food in their house displayed higher odds of manifesting mental health problems than adolescents who replied negatively in the particular query. On the grounds of these results, there is indication about the adverse effects of the financial crisis in the development of psychiatric symptomatology in adolescents in the Greek society. This is the first study providing epidemiological data on the current state of adolescents' mental health amid the recession in Greece, showing that the crisis impinges disproportionately on the most vulnerable socio-economic groups

Opioid substitution therapy: Lowering the treatment thresholds

Background: Opioid substitution therapy (OST) has been established as the gold standard in treating opioid use disorders. Nevertheless, there is still a debate regarding the qualitative characteristics that define the optimal OST intervention, namely the treatment threshold. The aim of this review is twofold: first, to provide a summary and definition of "treatment thresholds", and second, to outline these thresholds and describe how they related to low and high threshold treatment characteristics and outcomes. Method: We searched the main databases of Medline, PubMed, PsycInfo, EMBASE, CINAHL and the Cochrane Library. Original published research papers, reviews, and meta-analyses, containing the eligible keywords: "opioid substitution", "OST", "low threshold", "high threshold" were searched alone and in combination, up to June, 2015. Results: Treatment thresholds were defined as barriers a patient may face prior to and during treatment. The variables of these barriers were classified into treatment accessibility barriers and treatment design barriers. There are increasing numbers of studies implementing low threshold designs with an increasing body of evidence suggesting better treatment outcomes compared to high threshold designs. Conclusion: Clinical characteristics of low threshold treatments that were identified to increase the effectiveness of OST intervention include increasing accessibility so as to avoid waiting lists, using personalized treatment options regarding medication choice and dose titration, flexible treatment duration, a treatment design that focuses on maintenance and harm reduction with emphasis on the retention of low adherence patients. © 2016

Gambling in adolescents during the financial crisis in Greece

Problem gambling emerges as a serious and ever growing problem of modern societies, largely affecting adolescents as well. The etiology of gambling disorder is complex and multifaceted as it is governed by multiple and interrelated factors. In this context and in light of the pervasive financial crisis in Greece, we conducted a study in order to explore adolescents' gambling involvement in Athens region and also to identify the socio-economic characteristics of adolescents who have engaged into gambling activities. Students were recruited from a sample of schools in Athens area. For the assessment of gambling involvement in adolescents, the Diagnostic and Statistical Manual of Mental Disorders-IV Multiple Response Adapted for Juveniles Questionnaire (DSM-IV-MR-J) was administered. Additional self-constructed questions enquired about students' socio-demographic and economic characteristics. Our results indicate that adolescents that had problem with gambling or had at least one pathological item on DSM were more likely to be boys and to have been born in a country other than Greece. Additionally, the proportion of those having at least one pathological item on DSM was greater in those with low school grades. Τhe lack of food in the household due to inability of providing food during the last month was significantly associated with both having problem with gambling and having at least one pathological item on DSM. Furthermore, having been worried that there would not be enough food during the last month and having been fed with a restrained variety of food due to lack of recourses were associated with at least one pathological item on DSM. These findings are congruent with the literature suggesting that youth living under poverty often resort to gambling. In conclusion, our results point out the adverse effects of the financial crisis on the development of problem gambling in adolescents within the Greek society. Problem gambling may have developed in response to the ubiquitous insecurity characterizing the Greek society during this rough time period. Interventions should prioritize endowing adolescents with the necessary coping skills for dealing with daily obstacles or life adversities productively and without losing their self-control

Adolescents’ Self-reported Running Away from Home and Suicide Attempts During a Period of Economic Recession in Greece

Background: Running away from home and suicide attempts during adolescence are high-risk behaviors for safety and health, and a “way out” from negative life experiences. Objective: To examine the self-reported prevalence of running away and suicide attempts among adolescents in Greece in the midst of a severe economic recession which is exerting pressure on families, and to identify associated psychosocial factors. Methods: Data were drawn from a nationally representative school survey (n = 23,279, 15–19 years old). Students answered in their classrooms an anonymous questionnaire under the supervision of trained researchers. Results: Each behavior was reported by one in nine adolescents (11.3 % for lifetime suicide attempts and 11.6 % for lifetime running away). Among those who reported the one behavior, a quarter also reported the other. Logistic regression analyses indicated that these behaviors share several common psychosocial correlates: family related (quality of parental relationships, parental monitoring), school related (poor performance and dissatisfaction), substance use, and emotional, psychological and behavioral problems. Gender was a significant correlate but in opposite directions for running away (more common among boys) and suicide attempts (more common among girls). Socioeconomic status was not a significant correlate for either behavior, possibly because the impact of the economic crisis on parents had not yet filtered down to their children in 2011 (the survey year). Conclusions: Findings suggest the need for timely interventions towards vulnerable youth and their families by identifying personal, familial and school factors associated with these two health- and life-compromising behaviors. © 2014, Springer Science+Business Media New York

Quality of life in newly diagnosed children with specific learning disabilities (SpLD) and differences from typically developing children: A study of child and parent reports

Introduction Research on quality of life (QoL) of school children with specific learning disabilities (SpLD) and their parents is scarce. The present study explores QoL deficits in newly diagnosed children with SpLD and their parents, in comparison to a similar age group of typically developing children. Possible associations between parental and child QoL were statistically explored in both groups of children. Methods 70 newly diagnosed children with SpLD [International Classification of Diseases-10 (ICD-10) criteria] (38 boys, 32 girls, mean age 10.1 years) and a control group of 69 typically developing children of the same age (40 boys, 29 girls, mean age 10.6 years) were recruited. Children were of normal intelligence quotient, attending mainstream schools. Their parents were also recruited so a child's scores could be associated with corresponding parental scores (mother or father). Children's QoL was assessed by the German questionnaire for measuring quality of life in children and adolescents (KINDLR) questionnaire and parental QoL by World Health Organization Quality of Life brief questionnaire (WHOQOL-BREF) of the World Health Organization. Results Children with SpLD in comparison to typically developing children reported according to the KINDLR measurement poorer emotional well-being, lower self-esteem and satisfaction in their relationships with family and friends. Surprisingly, school functioning was not reported by these children as an area of concern. Parents of children with SpLD indicated experiencing lower satisfaction in the WHOQOL-BREF domains of social relationships and environment. Correlational and regression analysis with parental-child QoL scores provided evidence that in the SpLD group, parental scores on WHOQOL-BREF social relationships and psychological health domains could be predictors of the child's emotional well-being, satisfaction with family, friends and school functioning. Stepwise regression analysis verified the effect of parents' WHOQOL-BREF social relationships domain on several dimensions of children's KINDLR QoL. Conclusions The results may suggest certain significant effects of the SpLD condition on newly diagnosed children's QoL. Emotional and social deficits seem to be experienced by this cohort of children and their parents. Investigation into the possible interrelationships between parental and child QoL seems to indicate that parental social wellbeing may to a certain extend influence some dimensions of the child's QoL. The findings are useful for policy making and specialized interventions for children with SpLD and their families. © 2012 John Wiley & Sons Ltd