Vaitsa Giannouli

Assessment of Burn-Out and Quality of Life in Nursing Professionals: The Contribution of Perceived Social Support.

Burnout has received increased research attention in recent years. The aim of the present study is to examine levels of burnout as well as quality of life (QOL) in nursing staff in Greece. The association of social support with burnout and QOL is also investigated. One-hundred individuals working in Mental and General Hospitals in the broader area of Athens will participate in this study. The measurement tools include i) the Maslach Burnout Inventory, ii) the SF-36 Health Survey and iii) the Multidimensional Scale of Perceived Social Support. Burnout and QOL are expected to be related to the evaluation of social environment.

Sentimentality and Nostalgia in Elderly People in Bulgaria and Greece – Cross-Validity of the Questionnaire SNEP and Cross-Cultural Comparison

Sentimentality and nostalgia are two similar psychological constructs, which play an important role in the emotional lives of elderly people who are usually focused on the past. There are two objectives of this study - making cross-cultural comparison of sentimentality and nostalgia among Bulgarian and Greek elderly people using a questionnaire, and establishing the psychometric properties of this questionnaire among Greek elderly people. Sentimentality and nostalgia in elderly people in Bulgaria and Greece were studied by means of Sentimentality and Nostalgia in Elderly People questionnaire (SNEP), created by Gergov and Stoyanova (2013). For the Greek version, one factor structure without sub-scales is proposed, while for the Bulgarian version of SNEP the factor structure had four sub-scales, besides the total score. Together with some similarities (medium level of nostalgia and sentimentality being widespread), the elderly people in Bulgaria and Greece differed cross-culturally in their sentimentality and nostalgia related to the past in direction of more increased sentimentality and nostalgia in the Bulgarian sample. Some gender and age differences revealed that the oldest male Bulgarians were the most sentimental. The psychometric properties of this questionnaire were examined for the first time in a Greek sample of elders and a trend was found for stability of sentimentality and nostalgia in elderly people that could be studied further in longitudinal studies.

Exploring attitudes towards endocrine diseases in Greece

Although patients with different types of endocrine diseases exist worldwide, and relevant knowledge is rapidly progressing through clinical and experimental medical research [1], still little is known about the knowledge and attitudes that the Greek public has on health problems related to the endocrine system. Thoughts and feelings have been extensively examined mainly for psychiatric diseases [2], but attitudes and possible misconceptions for other types of physical diseases are still not thoroughly examined. The level and extent of the general public’s understanding of endocrine diseases and their prevention is related to the public health as their prevalence increases worldwide [3]. A wider or narrower knowledge among the general population means less or more emphasis on early diagnosis and management programs, while schemes for the improvement of health from the healthcare system and relative allocation of resources is influenced. More specifically, knowledge of the public’s attitudes may have direct implications for clinical practice, as the ability to treat adults may depend, in part, on understanding attitudes toward endocrine diseases. Therefore, the main objective of this cross-sectional descriptive survey is to identify the public’s attitudes towards endocrine diseases. This can be achieved by assessing the knowledge and attitudes towards endocrine diseases in Greece both in healthy adults and a subgroup of patients already suffering from an endocrine disease. A total of 894 proficient speakers of Greek, including both native Greek participants and non-native permanent Greek residents (514 men and 380 women, with ages ranging from 18–75 years) from different geographical areas of Greece (Thessaloniki, Drama, Larissa, Xanthi, Serres, Kavala, Athens, Ioannina), replied voluntarily to a questionnaire related to their attitudes towards endocrine diseases during 2012–2016. The sample consisted of 792 healthy participants and 130 endocrine patients (68 with a diagnosed thyroid disorder and 62 with diabetes with an official diagnosis no more than one year). The educational level of the participants varied from 2 to 21 years (M= 11.40, SD = 3.30). Volunteers were recruited from a variety of sources (older healthy participants at senior centers and retirement homes, younger healthy participants mainly after university classes and youth centers, and patients from various hospitals). We applied exclusion criteria for the healthy participants concerning a history of psychiatric disorder, substance abuse and/or dependence or any other medical condition relevant to endocrine diseases. The exclusion criteria were chosen based on the fact that if the above conditions were present, then the participants could not be characterized as healthy, while in particular, severe psychopathology would skew the correctness of the answers. Additionally, all participants with a medical education and/or working as healthcare professionals were also excluded, because they represent individuals with extensive medical knowledge that is not typical of the general population. The same exclusion criteria with the exception of the medical condition related to endocrine diseases, were also applied to the endocrine patient participants. The * Vaitsa Giannouli giannouliv@hotmail.com

Cognitive function in Hashimoto's thyroiditis under levothyroxine treatment.

OBJECTIVE: Although overt hypothyroidism has been documented as exerting detrimental effects on cognition and behavior, it remains controversial whether subclinical hypothyroidism or euthyroid patients with Hashimoto’s thyroiditis (HT) under levothyroxine (LT4) treatment may experience any noticeable decline in cognitive function. PATIENTS: Two otherwise healthy, highly-functioning, first-degree relatives with a diagnosis of HT, under LT4 treatment for two years, were prospectively recruited into a clinical research study setting and followed for a year. MEASUREMENTS: Thyroid functions tests and a detailed battery of tests assessing global cognitive status, attention, verbal and working memory, visuoperceptual skills, executive functions and mood were performed at baseline and at one year after recruitment. RESULTS: Overall, patients’ performance on the neuropsychological battery was good and, in the majority of cognitive functions, their performance could be characterized as exceptional. No noticeable changes in any of the studied parameters were detected. CONCLUSIONS: The present case study failed to detect any noticeable changes in the cognitive and emotional function of two women with HT under LT4 treatment. The course of cognitive function of the two HT patients, evaluated by a detailed battery of tests, tends to confirm the benign nature of HT.

Attitudes towards music as a means of therapy: can it help to overcome depression and/or cardiovascular disease?

Music is well-known for its healing properties since the time of the ancient Greek asclepieia. Exposure to various genres of music (e.g. classical) is widely claimed to improve quality of life and serve as an effective way for the reduction of pain, reduction of blood pressure, improvement in cardiorespiratory variables, such as heart rate (HR) and heart rate variability (HRV), reduction of chronic headaches and migraines, boosting of immunity and at the same time it is claimed to enhance intelligence, learning and IQ (especially memory performance, concentration, attention, reading and literacy skills, spatial-temporal reasoning and mathematical abilities).1-5 Although, not all studies show the same magical influence of music on human health and cognition,6-11 it is interesting to explore what are the attitudes of people for music, health and psychology, especially from a different cultural and musical background (as is the case for Greece). The purpose of this study was to reveal something still unknown: the attitudes that young adults have for music and its applications on psychology-psychiatry. 300 volunteers (188 women, 112 men; mean age = 21.91 years, SD = 4.95) filled a short demographic survey (age, sex, education, profession) along with a brief semi-structured questionnaire. The participants were all non-musicians and non-patients at the time of the examination. They were asked to write down their views about music and its applications on nuclear medicine and music and psychology/psychiatry.12 The main questions at which they had to respond were: 1. Can music help you with a physical problem? (67% yes, 33 % no), 2. What kind of problem (heart diseases 56%, hypertension 44%), 3. Can music improve the quality of life in chronic disease? (82% yes, 18% no), 4. In what way does music influence your health? (through regulation of the impact that the emotion has on my health 54%, through regulation of the impact that the cognition has on my health 30%, in a still unknown way 16%) 5. Can music help you pass a psychological problem? (78% yes, 22 % no), 6. What kind of problem (major depression 54%, anxiety disorders 46%), 7. Can music improve your cognitive performance? (69% yes, 31 % no), 8. What kind of cognitive tasks do you believe that can be improved with music? (spatial-temporal reasoning tasks 42%, mathematical tasks 30%, attention 28%), 9. In which way can it help you? (passive listening 56%, playing an instrument 20%, singing in a choir 24%), 10. Which would you prefer, if only one was available for you? (passive listening of favorite pieces 86%), 11. Why? (it is available at any time 34%, at low cost 40%, it does not stigmatize me as a patient 26%), 12. What would you propose to psychiatrists and mental health experts? [Introduce music therapy, passive (also called music medicine) and active-creative music therapy to the public 67%, combine classic techniques and new ones involving music 20%, try at first music therapy interventions (especially for depression) and continue in parallel with classic psychotherapy or pills 13%]. For all the above questions statistical analyses did not show any differences between men-women and educational and professional groups. Exploring people’s ideas and expectations about the connection of music and health-illness (especially mental health), backs up what might always have seemed like common sense, that music may help us alter our physical and mental status. So, music could be used in accompanying psychological interventions concerning health and disease and/or rehabilitation programs. Even if music’s influence on health is not yet fully scientifically proved, the vast majority of young Greeks see it as a tool for change, and these perceived benefits of music should be further explored and incorporated in health services, such as the general hospital.

Ethnicity, mortality, and severe mental illness

In The Lancet Psychiatry, Das-Munshi and colleagues address the important problem of excess mortality in severe mental illness (defined as schizophrenia, schizoaffective disorders, and bipolar affective disorders). One of their major findings is that irrespective of ethnicity, people from a large sample living in the UK with severe mental illness have excess mortality. As the authors state, there is an urgent need to address tractable causes within this group of people. Among those people with severe mental illness, some ethnic minorities have lower mortality than the white British group; the reasons for this difference deserve further investigation. One research direction could be the perceived role of family bonds and the religiosity–spirituality in the lives of the individuals. These two factors seem to play an important role not only in treatment maintenance, adherence, and outcome for these types of illness, but also in exposure to environmental risk factors and by improving the management of other comorbid medical diseases that can eventually cause death. The first variable is included in the form of marital status in the Das-Munshi and colleagues study, but the quality and the specific characteristics of these relationships were not recorded. Unfortunately, the role of spirituality and religion was not analysed by the authors. A plethora of studies show that people who have an active religious identity have lower mortality rates, which could be partly explained by improved health practices, increased social contacts, and more stable marriages, as well as the possibility that these individuals might respond differently to existential threats such as mental illness. The authors do not address these two vital points in their research of mortality and severe mental illness as they follow the research tradition of just documenting that people with serious mental illnesses are among the most vulnerable. A new approach of examining simultaneously a large number of not only demographic, but also emotional, cognitive, behavioural, and cultural variables will help us to elucidate which of the several factors that are involved, predicts better excess mortality. So, the research focus should be on posing different questions that aim to answer through the use of appropriate questionnaires or other research instruments and statistical analyses why excess mortality exists in severe mental illness and how we can prevent this from happening.

Is there a specific Vivaldi effect on verbal memory functions? Evidence from listening to music in younger and older adults:

Brief exposure to music has been reported to lead to transient improvement of cognitive functions in no-music domains. Regarding the possible roles of working memory, processing of acoustic regularities, arousal and emotions in mediating the effects of music on subsequent cognition, the present study explored if brief listening to music might produce a subsequent transient change of verbal functions. A large sample (n = 448) of younger (mean 28 years) and older (mean 72 years) individuals were studied to represent different background abilities. Verbal working memory (WM) and phonologically-cued semantic retrieval were assessed using the forward digit span test (F-DST) and word fluency test (WFT). To account for arousing, emotional and previous expertise effects, F-DST and WFT scores were measured only in non-musicians after listening to novel (unknown) excerpts of three different composers (Mozart, Vivaldi and Glass) and after silence, with individual preference for each condition subjectively rated. It was found that brief exposure to music had no beneficial effect on verbal WM, with even a transient impairment emerging after Vivaldi. In contrast, Vivaldi’s excerpt induced a marked enhancement of word fluency, but only in young adults, whereas listening to Mozart’s composition was followed by decreased WFT scores in the two age groups. These results show that depending on composer- or excerpt-specific music features, listening to music can selectively facilitate or inhibit ongoing verbal functions. It is suggested that these effects are mediated by pro-active priming or interference of residual activations induced by music in working memory loops.

Exploring emotional aspects of infertility in women from two countries

A plethora of studies have examined the prevalence and severity of anxiety and depression in relation to infertility, while ignoring social and cultural factors. The aim of this cross-cultural study is to examine emotions related to quality of life, perceived social support, depression and anxiety in two groups of young women with identical demographic characteristics (age, education, and duration of infertility - years to have a child) who experience fertility problems in two neighboring countries, Greece and Bulgaria. A total of one hundred forty-eight women from both countries completed a demographics questionnaire along with the Multidimensional Scale of Perceived Social Support (MSPSS), the Subscale regarding State Anxiety from the State-Trait Anxiety Inventory (STAI), the Center for Epidemiologic Studies Depression Scale (CES-D), and some chosen questions from the Fertility Quality of Life (FertiQol). Seventy-four female participants from Northern Greece and seventy-four female participants from Southern Bulgaria were examined. The two groups of women did not show any statistically significant differences regarding their age, years of education, and the years needed in order to have their first child. The women were not on any type of medical treatment for their infertility problem at the time of the completion of the questionnaires. Results indicated that women in both countries did not have different levels of anxiety and depression regarding their infertility, but they had statistically different self-reported perceptions of social support and related to infertility quality of life. Future research should further investigate infertility and its relation to other emotional variables in larger samples of varying age ranges from different cultural environments.

Preoperative anxiety in children undergoing neurosurgical operations and proposed effective interventions

Dear Editor, Preoperative anxiety is characterized by the patient’s experience of Bbeing stressed and anxious^ while awaiting surgery. As Perks, Chakravarti and Manninen indicated in their original study [1], the incidence of preoperative anxiety in neurosurgery patients was 89%, while the 55% diagnosed with a high level of anxiety. Patients’ anxiety mainly related to concerns about surgical factors, such as results of the operation and the possible physical injuries or mental suffering, while a small proportion of the patients reported anxiety due to the anesthesia procedure. It was pointed out that patients who experienced a high level of anxiety, presented more worries about the operation and needed more information about the surgical procedure. Although neurosurgical interventions and their outcome are great sources of anxiety for patients, little attention has been given on this field. Relative to this notion, we state that the research is even more scarce in pediatric patients [1]. Young patients come up with many emotional and physical challenges when preparing for surgery. It has been argued that preoperative procedures such as venipuncture, anesthesia induction, pre-surgical injection, and parting from the parents, may provoke fear, anxiety, distress, and physical pain to the pediatric patients [2]. Similar to these findings, Wennstrom, Hallberg, and Bergh carried out interviews in children undergoing day surgery and supported that prior to the surgery, children’s anxiety was related to fears about the Bunknown^ and feelings of insecurity and uncertainty about surgical procedure and potential postoperative discomfort [3]. Furthermore, preoperative anxiety may lead to adverse postoperative outcomes. Kain et al. found in their study [4] that children rated high in preoperative anxiety measures experienced more postoperative pain, consumed more analgesics, and had a higher incidence of postoperative anxiety and sleep disturbances, than children who were not anxious. Interestingly enough, little attention has been given in regard to preoperative anxiety in pediatric neurosurgery patients. A noteworthy study conducted by Chieng et al. [5], clarified that in children undergoing many types of surgery, including neurosurgery, preoperative anxiety may be related to negative emotional behaviors. Additionally, children who experienced anxiety prior to the surgery, had more postoperative pain [5]. A more recent paper of Riquin et al. [6], examined the psychological impact of surgery while awake in children for resection of brain tumors. Patients experienced little anticipatory anxiety. No child presented symptoms of posttraumatic stress disorder or acute stress. As authors quoted Bthe results are encouraging, allowing us to contemplate using brain surgery while awake for children without particular worries about the psychologic aspect^ [6]. Moreover, it has been found that parental anxiety may increase the preoperative anxiety in children [7]. Under those circumstances, there is an imperative need for the implementation of effective preparation programs in the medical environment. Looking beyond the Btraditional^ anesthetic care and pharmacological interventions, children facing preoperative anxiety need psychological support as well as extensive information about the surgery, possible pain effects, anesthesia, and thorough informing about the pre-surgical procedures, the perioperative medical environment, and potential detrimental outcomes [8]. As Chow et al. suggested in their recent review [9], preoperative anxiety symptoms in children may be effectively alleviated by audiovisual interventions such as providing comprehensive procedural information through interactive videos and games and multi-faceted programs. The effectiveness of such interventions can be amply demonstrated by a randomized clinical trial where the use of * Nikolaos Ch. Syrmos milanako76@yahoo.gr

Are there any links among psychopathological symptoms, musical preferences and verbal working memory in female adults?

The question ‘Do psychopathology dimensions correlate with musical preferences in healthy individuals?’ still remains poorly investigated. Additionally, verbal working memory, psy cho pa tho logy and music preferences have not been examined together. Participants consisted of ninety-three young women without a previous or current psychiatric diagnosis. All participants were examined with the Forward Digit Span Task, and com pleted a psychopathology symptom instrument along with a musical preferences question. Results revealed that the Global Score Index, Somatization, Hos tility and Depression correlated in a statistically signif i cant way with musical preferences in female adults. Hostility and Depression predicted classical music preferences. De pres sion, Obsessive/Compulsive, Somatization and Hostility pre dicted a pop preference, while Somatization and Psycho ticism predicted a rock preference. No significant correlations were found between the above variables and verbal working memory, except for a significant correlation between age and the span of the working memory. Certain psychopathology dimensions do not influence cognition in the form of the verbal working memory in women, but can predict a specific choice of music genres. Findings suggest that music listening preferences may re present a field of inner experiences that could reveal easyto-obtain information about the mental health of women who have not an official psychiatric diagnosis, but may be at risk of developing psychological problems due to high self-re ported symptoms of psychopathology.