Konstantinos Kontoangelos

Greek college students and psychopathology: new insights

Background: College students’ mental health problems include depression, anxiety, panic disorders, phobias and obsessive compulsive thoughts. Aims: To investigate Greek college students’ psychopathology. Methods: During the initial evaluation, 638 college students were assessed through the following psychometric questionnaires: (a) Eysenck Personality Questionnaire (EPQ); (b) The Symptom Checklist-90 (SCL-90); (c) The Beck Depression Inventory (BDI); (d) State-Trait Anxiety Inventory (STAI). Results: State anxiety and trait anxiety were correlated, to a statistically significant degree, with the family status of the students (p = 0.024) and the past visits to the psychiatrist (p = 0.039) respectively. The subscale of psychoticism is significantly related with the students’ origin, school, family status and semester. The subscale of neuroticism is significantly related with the students’ school. The subscale of extraversion is significantly related with the students’ family psychiatric history. Students, whose place of origin is Attica, have on average higher scores in somatization, phobic anxiety and paranoid ideation than the other students. Students from abroad have, on average, higher scores in interpersonal sensitivity and psychoticism than students who hail from other parts of Greece. The majority of the students (79.7%) do not suffer from depression, according to the Beck’s depression inventory scale. Conclusions: Anxiety, somatization, personality traits and depression are related with the students’ college life.

Suicidal Behavior in a Patient with Burning Mouth Syndrome

Introduction. Chronic pain of the oral cavity is a long-term condition and like all other types of chronic pain is associated with numerous comorbidities such as depression or anxiety. Case Presentation. This is a case of a 93-year-old patient suffering from chronic oral cavity pain who repeatedly stabbed his palate due to ongoing local pain, over the last few months, which he could not further tolerate. The patient was suffering from depression and also a diagnosis of “burning mouth syndrome” (BMS) was made. Discussion. Burning mouth syndrome (BMS) is characterized by a burning sensation in the tongue or other oral sites. BMS has high psychiatric comorbidity but can occur in the absence of psychiatric diagnosis. Patients with multiple forms of pain must be considered as potential candidates for underdiagnosed depression (major) and suicidal thoughts.

Pregabalin for Opioid-Refractory Pain in a Patient with Ankylosing Spondylitis

Background. Ankylosing spondylitis (AS) is a systemic inflammatory disease with chronic back pain as the most common presenting symptom. We present a case of a male patient with AS reporting symptoms of severe low back pain, buttock pain, and limited spinal mobility. After chronic treatment with opioids, we administered pregabalin at a dose of 300 mg as an analgesic agent while opioids were discontinued. Findings. Pain symptoms improved progressively, and opioids were gradually discontinued without any withdrawal symptoms reported. Conclusions. Pregabalin is potentially useful in the management of pain in patients with AS while effectively managing the discontinuation of opioid treatment.

The Role of the Psychiatric Approach for the Treatment of Several Urological Diseases

Introduction: Normal function of the genitourinary system relies on the coordination of endocrine, vascular, neurological, as well as psychological factors. Diseases such as enuresis, incontinence, chronic pelvic pain, and erectile dysfunction are described from a psychologic-psychiatric point of view, which will probably confront the urologist most frequently in practice. Materials and Methods: A PubMed search was used to identify evidence that a range of psychopathological features is associated with several urologic diseases. The search was concentrated on urological as well as on psychiatric journals, regarding the investigation and description of psychological interrelationships in the field of urology. Discussion: Today, it is acknowledged that some urological diseases might be psychosomatically induced or might show a psychiatric comorbidity, which has been recognized and characterized both as causative factor and as result of these diseases. Numerous studies accentuate the need for a psychiatric-psychosomatic approach of these diseases, which pathogenetic mechanisms are not fully understood yet. Conclusion: The appreciation of the adjuvant psychiatric-psychosomatic approach in diagnosis and intervention in current therapeutic strategies is growing, as it may result in an improved treatment outcome.

Ankle edema after administration of selective serotonin reuptake inhibitors

Clinical manifestations of drug-induced skin reactions include a wide range of symptoms, from mild drug-induced exanthemas to dangerous and life-threatening generalized systematic reactions. Drug-induced skin reactions to psychotropic medication are usually associated with antiepileptic drugs. However, a significant role can be assigned to selective serotonin reuptake inhibitors. We report a case of a female patient, who after approximately one month therapy with escitalopram developed a bilateral ankle edema, which resolved completely within the first week following its discontinuation. Although serious complications are rare, clinicians should be aware of severe skin complications in patients treated with antidepressants, which necessitate careful clinical monitoring and management. Individualization of pharmacotherapy is crucial, together with regular evaluation of safety and tolerance of the treatment.

Arterial Hypertension and Health-Related Quality of Life

Purpose To investigate the effect of awareness of arterial hypertension on quality of life in hypertensive patients in Greece. Materials and methods This was a prospective observational study that included 189 aware hypertensive patients on treatment with antihypertensive therapy. Patients were ambulatory men or women ≥18 years old, with diagnosed essential hypertension. The administration and fulfillment of the questionnaires was given at the outpatient hypertensive clinic starting with the SF-36 and continuing with the BDI-I test. Results The mean BDI score was 9.9 ± 6.9, and 58, 25, 8.9, and 7.3% were identified as without, with minimal, moderate, and 0.8% with severe depression, respectively. The mean score for physical component summary (PCS-36) was 48.9 ± 7.6, and the mean score for mental component summary (MCS-36) was 46.0 ± 10.6. The stage of hypertension was not an independent predictor for any of the SF-36 dimensions. Dippers had not different levels of health-related quality of life (HRQOL) as compared with non-dippers. LV hypertrophy was associated with lower scores on bodily pain (p < 0.05) and kidney failure was associated with lower scores on general health perception (p < 0.05). Female gender, increased age, and the presence of COPD were independently associated with lower physical and mental health scores (p < 0.05). Score on BDI independently correlated with all dimensions of SF-36, indicating that greater depression levels are associated with lower levels of HRQOL. Conclusion The stage as well as awareness of arterial hypertension does not affect physical and mental health. The fact that arterial hypertension per se is not a symptomatic disease may explain these results at least in patients with uncomplicated hypertension.

Reliability, Validity, and Psychometric Properties of the Greek Translation of the Cambridge Depersonalization Scale (CDS) -

Introduction: The Cambridge Depersonalisation Scale is meant to capture the frequency and duration of depersonalisation symptoms over the ‘last 6 months’. Methods: In order to develop a Greek version of CDS scale, the CDS scale was translated in Greek by 2 psychiatrists. Then, the Greek version of CDS scale was back-translated by a person who did not knew the original English version. The back-translated version was reviewed in order to establish whether is consistent with the original English version. After this procedure we administered the Greek version of CDS scale to a sample of 294 Greeks in order to assess the reliability and the validity of the Greek version of scale. Results: The five components solution accounted for 58.204% of the total variation. Initial eigenvalues of the five components were: factor 1=11.555, factor 2=1.564, factor 3=1.356, factor 4=1.247 and factor 5=1.157. Six items did not load on any factor. Correlations between factors were low ranged from 0.134 to 0.314 and no complex variables were found. Cronbach’s alpha and Guttman split-half coefficient were used to evaluate interval consistency of CDS scale in 294 individuals. The alpha coefficients and Guttman split-half coefficient of the CDS scale were 0.938 and 0.921, respectively. The test-retest reliability proved to be satisfactory. The intraclass correlation coefficients for the total CDS score was very good and equal to 0,883. The CDS scale correlated highly with the SCL-90 and all subscales (p-value<0.0001). Conclusion: The psychometric strength of CDS – Greek its reliable for its future use, particularly for screening for subjects with possible diagnosis of CDS.