CHARACTERISTICS OF SUICIDE VICTIMS WHO HAD VERBALLY COMMUNICATED SUICIDAL FEELINGS TO THEIR FAMILY MEMBERS

Background: Verbal expression of suicidal feelings has rarely been investigated in the literature, particularly regarding individuals who died by suicide. Subjects and methods: We retrospectively collected data on the suicide cases of the period November 2007-October 2009 from the Athens Greater Area and completed psychological autopsy questionnaires after phone interviews with their family members. The specific question was: “Has your relative expressed to you his/her deep suffering or the intention to end his/her life at any time during the six months prior to the suicide?” Results: Data were collected for 248 individuals who died by suicide out of a total of 335. 121 of them (48.8%) had verbally communicated their intention to die -or their profound suffering- to their family members. Suicide communicators were older (p<0.001), less educated (p=0.04), more frequently divorced or separated and less often single (p<0.01) than non-communicators. They had more often positive psychiatric history (p=0.004) and were less physically well (p=0.005), in comparison to noncommunicators. Differences regarding sex, nationality, previous attempts, suicide note-leaving, completed suicide method and hospitalization either for physical illness or psychiatric disorder the year prior to the suicide were not statistically significant among the two groups. Considered that we interviewed only one relative for every case, the actual number of suicide communicators would be probably higher; the suicidal feelings could have been disclosed to another relative instead. Conclusions: This is the first time that a similar study was carried out in Greece. We found that approximately half of the individuals who died by suicide in our sample had been (verbal) suicide communicators. The latter seem to present distinct characteristics. These findings, coupled with the observation that the relatives are keen observers of the suicidal feelings of their loved ones, could provide new insights to future suicide prevention efforts

A multidisciplinary approach for an effective and rational energy transition in Crete Island, Greece.

This article proposes a mixture of actions for the development of an effective and rational energy transition plan for all sectors and for all types of onshore final energy use in Crete. Energy transition is initiated with an appropriate capacity building campaign. The plan is based on the introduction of energy saving measures and the exploitation of all the locally available energy resources (wind, solar, geothermal potential, biomass), integrated in a cluster of centralized and decentralized power plants and smart grids to produce electricity and heat and for the transition to e-mobility. The core of the energy transition in Crete will be a set of 14 wind parks and Pumped Hydro Storage systems (PHS) for electricity generation and 12 Combined Heat and Power plants, properly designed and dispersed in the insular territory. Economic analysis is executed for the proposed essential power plants on the island. Biomass, solar and geothermal potential can cover the heating demand in Crete several times. Heat can be produced with a specific cost of 0.05 EUR/kWhth from cogeneration plants fired with solid biomass and biogas. The wind parks-PHS systems exhibit payback periods of approximately 10 years with a final electricity selling price at 0.12 EUR/kWhel. The article shows that 100% energy transition in Crete constitutes a feasible target

Hospital Anxiety and Depression Scale (HADS): validation in a Greek general hospital sample

<p>Abstract</p> <p>Background</p> <p>The Hospital Anxiety and Depression Scale (HADS) has been used in several languages to assess anxiety and depression in general hospital patients with good results.</p> <p>Methods</p> <p>The HADS was administered to 521 participants (275 controls and 246 inpatients and outpatients of the Internal Medicine and Surgical Departments in 'Attikon' General Hospital in Athens). The Beck Depression Inventory (BDI) and the State-Trait Anxiety Inventory (STAI) were used as 'gold standards' for depression and anxiety respectively.</p> <p>Results</p> <p>The HADS presented high internal consistency; Cronbach's α cofficient was 0.884 (0.829 for anxiety and 0.840 for depression) and stability (test-retest intraclass correlation coefficient 0.944). Factor analysis showed a two-factor structure. The HADS showed high concurrent validity; the correlations of the scale and its subscales with the BDI and the STAI were high (0.722 – 0.749).</p> <p>Conclusion</p> <p>The Greek version of HADS showed good psychometric properties and could serve as a useful tool for clinicians to assess anxiety and depression in general hospital patients.</p

Different control conditions can produce different effect estimates in psychotherapy trials for depression

OBJECTIVES: Control conditions' influence on effect estimates of active psychotherapeutic interventions for depression has not been fully elucidated. We used network meta-analysis to estimate the differences between control conditions. STUDY DESIGN AND SETTING: We have conducted a comprehensive literature search of randomized trials of psychotherapies for adults with depression up to January 1, 2019 in four major databases (PubMed, PsycINFO, Embase, and Cochrane). The network meta-analysis included broadly conceived cognitive behavior therapies in comparison with the following control conditions: Waiting List (WL), No Treatment (NT), Pill Placebo (PillPlacebo), Psychological Placebo (PsycholPlacebo). RESULTS: 123 studies with 12,596 participants were included. The I-squared was 55.9% (95% CI: 45.9%; to 64.0%) (moderate heterogeneity). The design-by-treatment global test of inconsistency was not significant (P = 0.44). Different control conditions led to different estimates of efficacy for the same intervention. WL appears to be the weakest control (odds ratio of response against NT = 1.93 (1.30 to 2.86), PsycholPlacebo = 2.03 (1.21 to 3.39), and PillPlacebo = 2.66 (1.45 to 4.89), respectively). CONCLUSIONS: Different control conditions produce different effect estimates in psychotherapy randomized controlled trials for depression. WL was the weakest, followed by NT, PsycholPlacebo, and PillPlacebo in this order. When conducting meta-analyses of psychotherapy trials, different control conditions should not be lumped into a single group

Depression prevalence using the HADS-D compared to SCID major depression classification:An individual participant data meta-analysis

Objectives: Validated diagnostic interviews are required to classify depression status and estimate prevalence of disorder, but screening tools are often used instead. We used individual participant data meta-analysis to compare prevalence based on standard Hospital Anxiety and Depression Scale – depression subscale (HADS-D) cutoffs of ≥8 and ≥11 versus Structured Clinical Interview for DSM (SCID) major depression and determined if an alternative HADS-D cutoff could more accurately estimate prevalence. Methods: We searched Medline, Medline In-Process & Other Non-Indexed Citations via Ovid, PsycINFO, and Web of Science (inception-July 11, 2016) for studies comparing HADS-D scores to SCID major depression status. Pooled prevalence and pooled differences in prevalence for HADS-D cutoffs versus SCID major depression were estimated. Results: 6005 participants (689 SCID major depression cases) from 41 primary studies were included. Pooled prevalence was 24.5% (95% Confidence Interval (CI): 20.5%, 29.0%) for HADS-D ≥8, 10.7% (95% CI: 8.3%, 13.8%) for HADS-D ≥11, and 11.6% (95% CI: 9.2%, 14.6%) for SCID major depression. HADS-D ≥11 was closest to SCID major depression prevalence, but the 95% prediction interval for the difference that could be expected for HADS-D ≥11 versus SCID in a new study was −21.1% to 19.5%. Conclusions: HADS-D ≥8 substantially overestimates depression prevalence. Of all possible cutoff thresholds, HADS-D ≥11 was closest to the SCID, but there was substantial heterogeneity in the difference between HADS-D ≥11 and SCID-based estimates. HADS-D should not be used as a substitute for a validated diagnostic interview.This study was funded by the Canadian Institutes of Health Research (CIHR, KRS-144045 & PCG 155468). Ms. Neupane was supported by a G.R. Caverhill Fellowship from the Faculty of Medicine, McGill University. Drs. Levis and Wu were supported by Fonds de recherche du Québec - Santé (FRQS) Postdoctoral Training Fellowships. Mr. Bhandari was supported by a studentship from the Research Institute of the McGill University Health Centre. Ms. Rice was supported by a Vanier Canada Graduate Scholarship. Dr. Patten was supported by a Senior Health Scholar award from Alberta Innovates, Health Solutions. The primary study by Scott et al. was supported by the Cumming School of Medicine and Alberta Health Services through the Calgary Health Trust, and funding from the Hotchkiss Brain Institute. The primary study by Amoozegar et al. was supported by the Alberta Health Services, the University of Calgary Faculty of Medicine, and the Hotchkiss Brain Institute. The primary study by Cheung et al. was supported by the Waikato Clinical School, University of Auckland, the Waikato Medical Research Foundation and the Waikato Respiratory Research Fund. The primary study by Cukor et al. was supported in part by a Promoting Psychological Research and Training on Health-Disparities Issues at Ethnic Minority Serving Institutions Grants (ProDIGs) awarded to Dr. Cukor from the American Psychological Association. The primary study by De Souza et al. was supported by Birmingham and Solihull Mental Health Foundation Trust. The primary study by Honarmand et al. was supported by a grant from the Multiple Sclerosis Society of Canada. The primary study by Fischer et al. was supported as part of the RECODEHF study by the German Federal Ministry of Education and Research (01GY1150). The primary study by Gagnon et al. was supported by the Drummond Foundation and the Department of Psychiatry, University Health Network. The primary study by Akechi et al. was supported in part by a Grant-in-Aid for Cancer Research (11−2) from the Japanese Ministry of Health, Labour and Welfare and a Grant-in-Aid for Young Scientists (B) from the Japanese Ministry of Education, Culture, Sports, Science and Technology. The primary study by Kugaya et al. was supported in part by a Grant-in-Aid for Cancer Research (9–31) and the Second-Term Comprehensive 10-year Strategy for Cancer Control from the Japanese Ministry of Health, Labour and Welfare. The primary study Ryan et al. was supported by the Irish Cancer Society (Grant CRP08GAL). The primary study by Keller et al. was supported by the Medical Faculty of the University of Heidelberg (grant no. 175/2000). The primary study by Love et al. (2004) was supported by the Kathleen Cuningham Foundation (National Breast Cancer Foundation), the Cancer Council of Victoria and the National Health and Medical Research Council. The primary study by Love et al. (2002) was supported by a grant from the Bethlehem Griffiths Research Foundation. The primary study by Löwe et al. was supported by the medical faculty of the University of Heidelberg, Germany (Project 121/2000). The primary study by Navines et al. was supported in part by the Spanish grants from the Fondo de Investigación en Salud, Instituto de Salud Carlos III (EO PI08/90869 and PSIGEN-VHC Study: FIS-E08/00268) and the support of FEDER (one way to make Europe). The primary study by O'Rourke et al. was supported by the Scottish Home and Health Department, Stroke Association, and Medical Research Council. The primary study by Sanchez-Gistau et al. was supported by a grant from the Ministry of Health of Spain (PI040418) and in part by Catalonia Government, DURSI 2009SGR1119. The primary study by Gould et al. was supported by the Transport Accident Commission Grant. The primary study by Rooney et al. was supported by the NHS Lothian Neuro-Oncology Endowment Fund. The primary study by Schwarzbold et al. was supported by PRONEX Program (NENASC Project) and PPSUS Program of Fundaçao de Amparo a esquisa e Inovacao do Estado de Santa Catarina (FAPESC) and the National Science and Technology Institute for Translational Medicine (INCT-TM). The primary study by Simard et al. was supported by IDEA grants from the Canadian Prostate Cancer Research Initiative and the Canadian Breast Cancer Research Alliance, as well as a studentship from the Canadian Institutes of Health Research. The primary study by Singer et al. (2009) was supported by a grant from the German Federal Ministry for Education and Research (no. 01ZZ0106). The primary study by Singer et al. (2008) was supported by grants from the German Federal Ministry for Education and Research (# 7DZAIQTX) and of the University of Leipzig (# formel. 1–57). The primary study by Meyer et al. was supported by the Federal Ministry of Education and Research (BMBF). The primary study by Stone et al. was supported by the Medical Research Council, UK and Chest Heart and Stroke, Scotland. The primary study by Turner et al. was supported by a bequest from Jennie Thomas through Hunter Medical Research Institute. The primary study by Walterfang et al. was supported by Melbourne Health. Drs. Benedetti and Thombs were supported by FRQS researcher salary awards. No other authors reported funding for primary studies or for their work on this study. No funder had any role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; and decision to submit the manuscript for publication

Polycyclic aromatic hydrocarbons estimation in urban and suburban areas: The case of Attica

Η παρούσα διδακτορική διατριβή έχει σαν στόχο τον προσδιορισμό των πηγών των Πολυκυκλικών Αρωματικών Υδρογονανθράκων (ΠΑΥ) με τη συνδυαστική χρήση θεωρητικών μοντέλων. Η καταγραφή των πηγών των ρύπων σε μια περιοχή που παρουσιάζει έντονη αστική και βιομηχανική δραστηριότητα, αποτελεί μια πολύ δύσκολη και χρονοβόρα διαδικασία, η οποία δεν είναι δυνατό να πραγματοποιηθεί σε πραγματικό χρόνο, δεδομένου ότι όλες οι πηγές και ειδικότερα οι ανθρωπογενείς μεταβάλλονται πολύ γρήγορα. Για το λόγο αυτό, έχουν αναπτυχθεί διάφορες μέθοδοι, οι οποίες χρησιμοποιούνται για τον προσδιορισμό της συνεισφοράς των διαφόρων πηγών ρύπανσης στις περιοχές ενδιαφέροντος καθώς και την ποσοτικοποίηση της συνεισφοράς αυτής. Ουσιαστικά με τη βοήθεια των μεθόδων αυτών, που ονομάζονται μέθοδοι «source apportionment», πραγματοποιείται καταμερισμός των συγκεντρώσεων των παρατηρούμενων ρύπων στις πηγές, με αποτέλεσμα να καθίσταται δυνατή η ανίχνευση ομάδων πηγών με συγκεκριμένα χαρακτηριστικά ως προς τη χημική τους σύσταση. Τέτοιες μέθοδοι είναι οι: Chemical Mass Balance Method (CMB), η Principal Component Analysis (PCA) και η Positive Matrix Factorization (PMF). Βασικό μειονέκτημα των μεθόδων source apportionment είναι ότι καμία από αυτές δεν προσδιορίζουν χωρικά τις ίδιες τις πηγές που κυριαρχούν κατά περίπτωση. Επιπλέον, σημαντικό μειονέκτημα αποτελεί και μια σειρά από παραδοχές, μεταξύ των οποίων εκείνες που δέχονται α) ότι η σύσταση των εκπομπών θεωρείται σταθερή για όλη την περίοδο δειγματοληψίας στην πηγή και το περιβάλλον και β) ότι τα χημικά στοιχεία δεν αντιδρούν μεταξύ τους αλλά προστίθενται γραμμικά. Στην παρούσα διδακτορική διατριβή, γίνεται μια προσπάθεια προσδιορισμού συγκεκριμένων πηγών ΠΑΥ, με τη συνδυαστική χρήση μιας από τις source apportionment μεθόδους (PMF) και ενός μοντέλου οπισθοτροχιών, το οποίο είναι σε θέση να προσδιορίσει τη διαδρομή των σωματιδίων που μεταφέρουν ΠΑΥ, πριν αυτά καταλήξουν στα σημεία παρατήρησης. […

Sulbutiamine, an `innocent&apos; over the counter drug, interferes with therapeutic outcome of bipolar disorder

A case of a patient with bipolar disorder with a history of hospitalizations and addiction to sulbutiamine is presented. Sulbutiamine is a precursor of thiamine that crosses the blood-brain barrier and is widely available without prescription in most countries or over the internet. Because of this patient’s need to consume ever increasing quantities of sulbutiamine, his psychiatric care was severely compromised through him defaulting appointments and frequent changes of psychiatrists. This paper reviews the current scientific knowledge about sulbutiamine, and some of the information and claims available on the web about its use and potential. It is argued that doctors need to be aware of the potential misuse of medication available over the counter or on the internet and its potential harmful influence

Investigation of Loneliness and Social Support in Patients with Eating Disorders: A Case-Control Study

Loneliness and, to a lesser degree, social support are considered under-researched topics in the literature on eating disorders (ED). This study attempted to expand the relevant body of research by examining loneliness in combination with social support in ED patients and in healthy controls (HC). Binge-eating problems, emotional eating, resilience, anxiety, and depression symptoms were also assessed. Thirty-two patients with ED and twenty-nine HC completed the following measures: UCLA Loneliness Scale, Social Support Questionnaire—Short Form, Binge Eating Scale, Emotional Eating Scale, Connor–Davidson Resilience Scale, Hospital Anxiety and Depression Scale, and the Eating Disorder Examination Questionnaire. Eating-disorder patients showed higher levels of loneliness and lower levels of social support—both in terms of perceived availability and satisfaction—than HC. Anorexia nervosa (AN), bulimia nervosa (BN), and binge-eating disorder (BED) subgroups did not differ significantly on either of these variables. In ED patients, loneliness was only correlated with Social Support Satisfaction (negatively) and depressive symptomatology (positively). Patients with ED appear to be lonelier and less satisfied with their social support compared to HC. We found similar levels of loneliness and social support between AN, BN, and BED sufferers. Decreased social support satisfaction and elevated symptoms of depression could account for ED patients’ high levels of loneliness