Stefanos Bellos

Prevalence and sociodemographic associations of common mental disorders in a nationally representative sample of the general population of Greece

BackgroundNo study in Greece has assessed so far the full range of common mental disorders using a representative sample of the population from both mainland and insular regions of the country. The aim of the present paper was to present the results of the first such study.MethodsThe study was carried out between 2009–2010 in a nationally representative sample of 4894 individuals living in private households in Greece. Common mental disorders in the past week were assessed with the revised Clinical Interview Schedule (CIS-R). We also assessed alcohol use disorders (using AUDIT), smoking and cannabis use.Results14% of the population (Male: 11%, Female: 17%) was found to have clinically significant psychiatric morbidity according to the scores on the CIS-R. The prevalence (past seven days) of specific common mental disorders was as follows: Generalized Anxiety Disorder: 4.10% (95% CI: 3.54, 4.65); Depression: 2.90% (2.43, 3.37); Panic Disorder: 1.88% (1.50, 2.26); Obsessive-Compulsive Disorder: 1.69% (1.33, 2.05); All Phobias: 2.79% (2.33, 3.26); Mixed anxiety-depression: 2.67% (2.22, 3.12). Harmful alcohol use was reported by 12.69% of the population (11.75, 13.62). Regular smoking was reported by 39.60% of the population (38.22, 40.97) while cannabis use (at least once during the past month) by 2.06% (1.66, 2.46). Clinically significant psychiatric morbidity was positively associated with the following variables: female gender, divorced or widowed family status, low educational status and unemployment. Use of all substances was more common in men compared to women. Common mental disorders were often comorbid, undertreated, and associated with a lower quality of life.ConclusionsThe findings of the present study can help in the better planning and development of mental health services in Greece, especially in a time of mental health budget restrictions.

Cross-cultural patterns of the association between varying levels of alcohol consumption and the common mental disorders of depression and anxiety: Secondary analysis of the WHO Collaborative Study on Psychological Problems in General Health Care

BACKGROUND Alcohol consumption is associated with several complications of both physical and mental health. Light or moderate alcohol consumption may have beneficial effects on physical or mental health but this effect is still controversial and research in the mental health field is relatively scarce. Our aim was to investigate the association between varying levels of alcohol consumption and the common mental disorders of depression and anxiety in a large international primary care sample. METHODS The sample consisted of 5438 primary care attenders from 14 countries who participated in the WHO Collaborative Study of Psychological Problems in General Health Care. Alcohol use was assessed using Alcohol Use Disorders Identification Test (AUDIT) and the mental disorders were assessed with the Composite International Diagnostic Interview (CIDI). RESULTS Light to moderate alcohol consumption was associated with a lower prevalence of depression and generalized anxiety disorder compared to abstinence while excessive alcohol consumption was associated with a higher prevalence of depression. This non-linear association was not substantially affected after adjustment for a range of possible confounding variables, including the presence of chronic disease and the current physical status of participants and was evident in different drinking cultures. CONCLUSION The study confirms that excessive drinking is associated with an increased prevalence of depression, but also raises the possibility that light/moderate drinking may be associated with a reduced prevalence of both depression and anxiety. Any causal interpretation of this association is difficult in the context of this cross-sectional study and further longitudinal studies are needed.

An empirical investigation of the structure of anxiety and depressive symptoms in late adolescence: Cross-sectional study using the Greek version of the revised Clinical Interview Schedule

Several studies in the past have examined whether the hierarchical structure of anxiety and depressive symptoms can explain the high comorbidity between them but more studies are needed from other settings and with different methods. The present study aimed to examine the structure of common anxiety and depressive symptoms in adolescents 16-18 years old attending secondary schools using the Greek version of the revised Clinical Interview Schedule (CIS-R), a fully structured psychiatric interview. A total of 2431 adolescents were interviewed with the computerized version of the CIS-R. The hierarchical structure of 12 depressive and anxiety symptoms was examined with confirmatory factor analytical methods. Four alternative models of increasing complexity were tested. The best-fitting model included three first-order factors, representing the dimensions of anxiety, depression and non-specific distress respectively. A model with a higher-order factor representing the broader internalizing dimension was less supported by the data. The findings of this and other studies should be taken into account in future classifications of psychiatric disorders and may have clinical practical implications.

Longitudinal association between different levels of alcohol consumption and a new onset of depression and generalized anxiety disorder: Results from an international study in primary care

BACKGROUND Several studies that have examined the full range of alcohol consumption have pointed to a possible non-linear association between alcohol use and the common mental disorders. Most of these studies are cross sectional and assessed psychiatric morbidity using non-specific instruments. Our aim was to investigate the longitudinal association between varying levels of alcohol consumption at baseline and the new-onset of depression and generalized anxiety disorder (GAD), in a large international primary care sample. METHODS The sample consisted of 3201 primary care attenders from 14 countries in the context of WHO Collaborative Study of Psychological Problems in General Health Care. Alcohol use at baseline was assessed using AUDIT and the mental disorders were assessed with the Composite International Diagnostic Interview. RESULTS Light to moderate alcohol consumption at baseline was associated with a lower incidence of depression and GAD compared to abstinence while excessive alcohol consumption was associated with a higher incidence of depression but not GAD. This non-linear association was not substantially affected after adjustment for a range of possible confounding variables. CONCLUSION Any causal interpretation of this association is difficult in the context of an observational study and further combined and consistent evidence from different sources is needed.

No debt for medical students in Greece

Background  Medical education in Greece is government‐funded by constitution. Tuition fees are therefore not payable by students. This investigation aims to identify the sources of income of medical students in Greece.

2245 – Common mental disorders and use of mental health services in the general population in greece

Introduction General population surveys of the prevalence of common mental disorders are necessary for the organization of effective mental health services. Objectives Epidemiological studies are useful for the more objective assessment of the mental health needs of the population. Aims To present data on the pattern and correlates of 12-month use of services by persons with common mental disorders from the recently completed general population survey of psychiatric morbidity in Greece. Methods The sample (n=4894; multistage stratified random sample) was representative for the Greek population aged 18-70. Common mental disorders were assessed according to the ICD-10 criteria with the revised Clinical Interview Schedule (CISR), conducted by trained lay interviewers. Results 73,9% of participants with at least one common mental disorder (CMD) do not receive any treatment for their psychological health, 52% have never spoken to the family physician and 73.3% has not spoken to a mental health professional in the past year. The disorder associated with the most frequent use of general health services for any reason (>4 visits to any physician in the past year) was depression (43.7%). Overall, 46.5% of all participants who meet the criteria for a CMD had not spoken to a doctor or mental health professional, with men showing significantly higher rates of no use compared to women (54.6% vs 41.5%). Conclusions These findings can help in the better organization of services with the aim to improve prevention and treatment of common mental disorders in Greece, especially in a time of economic hardship.