The Greek-Orthodox version of the Brief Religious Coping (B-RCOPE) instrument: psychometric properties in three samples and associations with mental disorders, suicidality, illness perceptions, and quality of life

Background: The B-RCOPE is a brief measure assessing religious coping. We aimed to assess the psychometric properties of its Greek version in people with and without long-term conditions (LTCs). Associations between religious coping and mental illness, suicidality, illness perceptions, and quality of life were also investigated. Methods: The B-RCOPE was administered to 351 patients with diabetes, chronic pulmonary obstructive disease (COPD), and rheumatic diseases attending either the emergency department (N = 74) or specialty clinics (N = 302) and 127 people without LTCs. Diagnosis of mental disorders was established by the MINI. Associations with depressive symptom severity (PHQ-9), suicidal risk (RASS), illness perceptions (B-IPQ), and health-related quality of life (WHOQOL-BREF) were also investigated. Results: The Greek version of B-RCOPE showed a coherent two-dimensional factor structure with remarkable stability across the three samples corresponding to the positive (PRC) and negative (NRC) religious coping dimensions. Cronbach’s alphas were 0.91–0.96 and 0.77–0.92 for the PRC and NRC dimensions, respectively. Furthermore, NRC was associated with poorer mental health, greater depressive symptom severity and suicidality, and impaired HRQoL. In patients with LTCs, PRC correlated with lower perceived illness timeline, while NRC was associated with greater perceived illness consequences, lower perceived treatment control, greater illness concern, and lower illness comprehensibility. Conclusions: These findings indicate that the Greek-Orthodox B-RCOPE version may reliably assess religious coping. In addition, negative religious coping (i.e., religious struggle) is associated with adverse illness perceptions, and thus may detrimentally impact adaptation to medical illness. These findings deserve replication in prospective studies

Clinical parameters and personality variables are associated with psychological distress and quality of life in patients with colorectal cancer

Our study divided into two phases: 1) cross-sectional study and 2) prospective study. The aim of the cross-sectional study was to test if psychological distress and personality variables are associated with quality of life in colorectal cancer patients. The prospective study aimed to assess the course of early non-metastatic colorectal cancer patients’ psychological distress and quality of life during a one-year period and to identify clinical and psychosocial predictors of psychological distress and quality of life. In the cross-sectional study 162 patients agreed to participate in the study. In prospective study, 84 patients with early non-metastatic colorectal cancer participated one year after the initial assessment. Clinical and self-report data were collected with self-report instruments. In cross-sectional study we showed that psychological distress is independently associated with quality of life in colorectal cancer patients. Also we found that personality variables were associated with quality of life independently of psychological distress. The prospective study showed an increase in a number of psychological distress symptoms and a decrease in most aspects of quality of life in colorectal cancer patients over a period of one year. Men were found to be at greater risk for developing depressive symptoms. Psychological distress and low sense of coherence were constant strong independent predictors of most aspects of quality of life, while repression was also an independent predictor of Physical Health Related Quality of LifeΗ μελέτη μας πραγματοποιήθηκε σε δύο φάσεις: 1) τη συγχρονική και 2) την προοπτική μελέτη. Στόχος της συγχρονικής μελέτης ήταν να εξεταστεί εάν η ψυχική καταπόνηση και τα χαρακτηριστικά της προσωπικότητας σχετίζονται με την ποιότητα ζωής των ασθενών με καρκίνο παχέος εντέρου. Στόχος της προοπτικής μελέτης ήταν να αξιολογηθεί η πορεία της ψυχικής καταπόνησης αλλά και της ποιότητας ζωής των ασθενών κατά τη διάρκεια ενός έτους, καθώς επίσης και να αναγνωριστούν προγνωστικοί παράγοντες της ψυχικής καταπόνησης και της ποιότητας ζωής. Στη συγχρονική μελέτη συμμετείχαν 162 ασθενείς με καρκίνο παχέος εντέρου και στην προοπτική μελέτη συμμετείχαν 84 ασθενείς με μη μεταστατικό καρκίνο ένα έτος αργότερα. Η συλλογή των δεδομένων έγινε με ημιδομημένη συνέντευξη και με τη συμπλήρωση ερωτηματολογίων. Τα ευρήματα της συγχρονικής μας μελέτης έδειξαν ότι η ψυχική καταπόνηση είναι ένα κοινό βίωμα στους ασθενείς με καρκίνο παχέος εντέρου που εκδηλώνεται κυρίως με κοινωνική δυσλειτουργία, άγχος, διαταραχές ύπνου και κατάθλιψη. Επίσης, βρέθηκε ότι η ψυχική καταπόνηση αλλά και τα χαρακτηριστικά της προσωπικότητας σχετίζονται με την ποιότητα ζωής των ασθενών. Τα ευρήματα της προοπτικής μελέτης έδειξαν ότι τα συμπτώματα της ψυχικής καταπόνησης και η ποιότητα ζωής των ασθενών με καρκίνο παχέος εντέρου επιδεινώθηκαν ένα έτος μετά την αρχική εκτίμηση. Επίσης βρέθηκε ότι ο κίνδυνος ανάπτυξης κατάθλιψης ήταν μεγαλύτερος για τους άντρες και για όσους είχαν φτωχά ψυχικά αποθέματα να διαχειριστούν θέματα υγείας. Τέλος, σταθεροί προγνωστικοί δείκτες της ποιότητας ζωής ήταν τα αρχικά επίπεδα ψυχικής καταπόνησης, η χαμηλή αίσθηση συνοχής αλλά και συγκεκριμένοι μηχανισμοί άμυνας του Εγώ, όπως η απώθησ

Narcissistic rage: The Achilles’ heel of the patient with chronic physical illness

Thomas Hyphantis1, Augustina Almyroudi1, Vassiliki Paika1, Panagiota Goulia1, Konstantinos Arvanitakis2,31Department of Psychiatry, Medical School, University of Ioannina, Ioannina, Greece; 2Canadian Institute of Psychoanalysis, Mcgill University, Montreal, Canada; 3Departments of Philosophy and Psychiatry, Mcgill University Health Centre, Montreal, CanadaAbstract: Based on the psychoanalytic reading of Homer’s Iliad whose principal theme is “Achilles’ rage” (the semi-mortal hero invulnerable in all of his body except for his heel, hence “Achilles’ heel” has come to mean a person’s principal weakness), we aimed to assess whether “narcissistic rage” has an impact on several psychosocial variables in patients with severe physical illness across time. In 878 patients with cancer, rheumatological diseases, multiple sclerosis, inflammatory bowel disease, and glaucoma, we assessed psychological distress (SCL-90 and GHQ-28), quality of life (WHOQOL-BREF), interpersonal difficulties (IIP-40), hostility (HDHQ), and defense styles (DSQ). Narcissistic rage comprised DSQ “omnipotence” and HDHQ “extraverted hostility”. Hierarchical multiple regressions analyses were performed. We showed that, in patients with disease duration less than one year, narcissistic rage had a minor impact on psychosocial variables studied, indicating that the rage was rather part of a “normal” mourning process. On the contrary, in patients with longer disease duration, increased rates of narcissistic rage had a great impact on all outcome variables, and the opposite was true for patients with low rates of narcissistic rage, indicating that narcissistic rage constitutes actually an “Achilles’ Heel” for patients with long-term physical illness. These findings may have important clinical implications.Keywords: consultation-liaison psychiatry, psychosomatics, narcissism, physical illness, quality of life, psychological distress, personalit

The relationship of the perceived impact of the current Greek recession with increased suicide risk is moderated by mental illness in patients with long-term conditions

Objective: Adverse life events may contribute to the emergence of suicidality. We aimed to test the relationship between the impact of the Greek recession and suicidal risk in people with long-term conditions (LTCs) and to determine whether this relationship is moderated by the presence of a mental disorder. Methods: Suicidal risk (RASS) and crisis parameters were assessed in a cross-sectional survey including 376 patients with LTCs (type-II diabetes mellitus, rheumatological disorders and chronic obstructive pulmonary disease) attending the Emergency Department or specialty clinics. A diagnosis of mental disorder was confirmed by the Mini International Neuropsychiatric Interview (MINI) interview. Hierarchical regression models were used to quantify moderator effects. Results: Suicidal risk was significantly associated with the perceived impact of the recession (p =0.028). However, moderation analysis showed that this relationship was significant only in those diagnosed with either major depressive disorder or generalized anxiety disorder. Conclusions: These findings suggest that the perceived impact of the current Greek recession is not correlated with suicidal risk per se, but the recession may act as precipitator in combination with other risk factors, such as the presence of a mental illness, thus supporting the importance of early diagnosis and treatment of mental disorders in vulnerable groups