Psychological distress, anxiety and depression among nursing students in Greece

It is usually observed that nursing students undergo tremendous stress during various stages oftheir course but the knowledge about the stress process and depressive symptoms in this population is limited. TheAim of the present study was to determine the prevalence of psychological distress, anxiety and depression amongnursing students in Greece. For that purpose 170 nursing students (34 males, 136 females) of the Department of Nursingof the Technological Educational Institute of Thessaloniki completed 3 self-report questionnaires, the General HealthQuestionnaire (GHQ), the Beck Depression Inventory II (BDI-II) and the State-Trait Anxiety Inventory (STAI). The mean agewas 21.5 years. No difference in stress and depression on the basis of gender was observed. Our results showed that thescores on the GHQ, BDI and STAI tend to increase in the year 2 and 3. The majority of students reported relatively highscores on the GHQ suggesting increased psychiatric morbidity. 52.4% of students experienced depressive symptoms(34.7% mild, 12.9% moderate and 4.7% severe). The scores on the state scale were higher in the years 2 and 3, whilethe majority of students who had no or mild stress was observed in the first and the last year. Low stress personalitytraits were also observed in the first and the last year. However, no significant differences between the four years wereobserved. Our results suggest that nursing students experience different levels of stress and depression and that thesefactors are positively correlated

Psychological distress, anxiety and depression among nursing students in Greece

A B S T R A C T : It is usually observed that nursing students undergo tremendous stress during various stages of their course but the knowledge about the stress process and depressive symptoms in this population is limited. The Aim of the present study was to determine the prevalence of psychological distress, anxiety and depression among nursing students in Greece. For that purpose 170 nursing students (34 males, 136 females) of the Department of Nursing of the Technological Educational Institute of Thessaloniki completed 3 self-report questionnaires, the General Health Questionnaire (GHQ), the Beck Depression Inventory II (BDI-II) and the State-Trait Anxiety Inventory (STAI). The mean age was 21.5 years. No difference in stress and depression on the basis of gender was observed. Our results showed that the scores on the GHQ, BDI and STAI tend to increase in the year 2 and 3. The majority of students reported relatively high scores on the GHQ suggesting increased psychiatric morbidity. 52.4% of students experienced depressive symptoms (34.7% mild, 12.9% moderate and 4.7% severe). The scores on the state scale were higher in the years 2 and 3, while the majority of students who had no or mild stress was observed in the first and the last year. Low stress personality traits were also observed in the first and the last year. However, no significant differences between the four years were observed. Our results suggest that nursing students experience different levels of stress and depression and that these factors are positively correlated. K E Y -W O R D S : Nursing students, psychological distress, anxiety, depression, Greec

Mandibular radiomorphometric measurements as indicators of possible osteoporosis in postmenopausal women

Objective: The use of mandibular anatomic indicators on panoramic radiographs, i.e. the number of lost teeth, mandibular cortical width at the mental region (MCW), panoramic mandibular index (PMI), alveolar crest resorption degree (M/M ratio) and morphologic classification of the mandibular inferior cortex (MIC grade) can be useful in the evaluation of bone resorption in different age groups of women to determine the presence of osteoporosis. The purpose of this study was to assess the validity of mandibular radiomorphometric measurements and to determine the frequency of tooth loss in postmenopausal women. Subjects and methods: An assessment of the number of lost teeth, MCW, PMI, M/M ratio and MIC grade was performed on dental panoramic radiographs in a group of 133 postmenopausal women 38-80 years-of-age. BMD at the lumbar spine was measured by dual energy X-ray absorptiometry. BMD values were categorized as normal (T-score greater than 1.0), and as indicative of osteopenia (T-score -1.0 to -2.5) or osteoporosis (T-score less than -2.5) according to the World Health Organization classification. Results: In our study when the T-score at the lumbar spine is decreased, the age of menopause is increased, and the MCW is decreased to a point of statistical significance. A decrease in MCW by 1 mm increases the likelihood of osteopenia or osteoporosis to 43%, having taken into consideration the effect of the years elapsed since menopause. It was also shown that age, years since menopause, MCW value, and the number of teeth lost have a statistically important effect on the incidence of moderate or severe cortical erosion. Moreover, when the MCI is C2 or C3 (mild or severe erosions) the age is increased, the years since menopause are increased and the MCW is decreased to a point of statistical significance. As far as tooth loss is concerned, an increase by 1 unit in the number of teeth lost, increase the likelihood of moderate or severe erosion to 6%, having taken into account the years elapsed since menopause. Our study also demonstrated that postmenopausal women tend to lose their teeth at an age older than 50 years. They usually lose the 1st and 2nd mandibular molars and the 1st and 2nd maxillary premolars. Loss of front teeth and canines occurs at an age older than 60 years (except for the lateral maxillary incisors). At a younger age they tend to lose the 2nd maxillary premolars more frequently than their mandibular counterparts. Conclusions: In conclusion, panoramic radiographs constitute an integral part of almost every routine dental evaluation and can be useful for the early diagnosis of osteoporosis in postmenopausal women. Dentists have sufficient clinical and radiographic information that enables them to play a significant role in patient screening for osteoporosis. © 2007 Elsevier Ireland Ltd. All rights reserved

Relationship between BMD, dental panoramic radiographic findings and biochemical markers of bone turnover in diagnosis of osteoporosis

Objective: Mandibular indices, measured on panoramic radiographs, may be useful screening implements for low skeletal bone mass density (BMD). Recent studies suggest that radiographic examination of mandible may constitute an effective process for the early diagnosis of osteoporosis. Biochemical markers of bone turnover may be of value for prediction of individual bone loss and they may help in predicting risk of fracture in elderly women. In contrast to the vast information available on dental radiographic findings and BMD only scarce data exist on the relationship between panoramic mandibular indices and biochemical markers. The aim of this study was to examine the diagnostic performance of dental panoramic radiography and biochemical markers of bone turnover in relation to BMD at the spine in a group of postmenopausal women. Subjects and methods: An assessment of the number of lost teeth, mandibular cortical width (MCW) at the mental region and morphologic classification of mandibular inferior cortex (MIC grade) was performed on dental panoramic radiographs in a group of 141 postmenopausal women 38-81 years of age. BMD at the lumbar spine was measured by dual energy X-ray absorptiometry. BMD values were categorized as normal (T-score greater than 1.0), and as indicative of osteopenia (T-score -1.0 to -2.5) or osteoporosis (T-score less than -2.5) according to the World Health Organization classification. Serum bone alkaline phosphatase (BAP) was measured with an enzyme immunoassay. Cross-linked N-telopeptides of type I collagen (NTx) corrected for creatinine secretion, was measured with a competitive-inhibition enzyme-linked immunosorbent assay ELISA. Results: In our study, a decrease in MCW by 1 mm increases the likelihood of osteopenia or osteoporosis to 47% (p-value < 0.05), having taken into consideration the effect of the years elapsed since menopause. The increase of alkaline phosphatase (ALP) per unit increase the likelihood of osteopenia or osteoporosis to 14% (p-value < 0.05), having checked the effect of the years since menopause. A decrease in MCW by 1 mm increases the likelihood of moderately or severely eroded cortex to 97% (p-value < 0.001). The increase in ALP per 1 unit increases the likelihood of moderate or severe erosion per 10% (p-value < 0.05), taking into account the years since menopause. Conclusions: Our results suggest that dentists have sufficient clinical and radiographic information that enables them to play a significant role in early diagnosis of osteoporosis in postmenopausal women. Panoramic radiographs and biochemical markers of bone turnover may be of value for prediction of individual bone loss and they may help in predicting risk of fracture in elderly women. © 2008