Functioning in community-dwelling patients with schizophrenia spectrum disorders in rural Greece

2019 ◽  
Vol 66 (2) ◽  
pp. 111-117 ◽  
Author(s):  
Vaios Peritogiannis ◽  
Panagiota Nikolaou
Keyword(s):  
Rural Areas ◽  
Psychotic Disorders ◽  
Population Based ◽  
Community Dwelling ◽  
Community Mental Health Service ◽  
Schizophrenia Spectrum Disorders ◽  
Level Of Functioning ◽  
Rural Residency ◽  
The Mean ◽  
Age Range

Background: There is a dearth of studies on functioning in patients with psychotic disorders in rural areas. Aim: The objective of this study was to assess functioning in a population-based sample of patients with psychotic disorders who live in rural, remote and deprived areas in Greece, and to explore the differences in functioning across ages. Methods: The sample consisted of 61 patients with psychotic disorders that were engaged to treatment with a community mental health service. The mean age of patients was 54.2 years, and the mean illness duration was 26.5 years. Results: A total of 23 patients (37.7%) had score in the Global Assessment of Functioning scale >60, and were rated as adequately functioning, and 18 patients (29.5%) had score in Clinical Global Impression scale-Schizophrenia ⩽3 and could be rated as mildly or minimally ill. Functioning was found to be inversely related to the patients’ symptomatology. No correlation with age was found. Conclusion: This study suggests that a large proportion of patients with psychotic disorders in rural Greece may achieve a satisfactory level of functioning in the long-term, across the whole age range despite the not completely remitted symptomatology. More research is needed to clarify the factors associated with rural residency that may account for patients’ functioning.

scholarly journals Salt intake and blood pressure in Iranian children and adolescents: a population-based study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Mohammad Hassan Emamian ◽  
Hossein Ebrahimi ◽  
Hassan Hashemi ◽  
Akbar Fotouhi
Keyword(s):  
Blood Pressure ◽  
Rural Areas ◽  
Urban Areas ◽  
Salt Intake ◽  
Daily Intake ◽  
Population Based ◽  
World Health ◽  
Second Phase ◽  
Salt Consumption ◽  
The Mean

Abstract Background Previous studies have reported a high prevalence of hypertension in Iranian students, especially in rural areas. The aim of this study was to investigate the daily intake of salt in students and its association with high blood pressure. Methods A random sub-sample was selected from the participants of the second phase of Shahroud schoolchildren eye cohort study and then a random urine sample was tested for sodium, potassium and creatinine. Urine electrolyte esexcretion and daily salt intake were calculated by Tanaka et al.’s formula. Results Among 1455 participants (including 230 participants from rural area and 472 girls), the mean age was 12.9 ± 1.7 year and the mean daily salt intake was 9.7 ± 2.6 g (95% CI 9.5–9.8). The mean salt consumption in rural areas [10.8 (95% CI 10.4–11.2)] was higher than urban areas [9.4 (95% CI 9.3–9.6)], in people with hypertension [10.8 (95% CI 10.3–11.3)] was more than people with normal blood pressure [9.4 (95% CI 9.3–9.6)], and in boys [9.8 (95% CI 9.7–10.0)] was more than girls [9.3 (95% CI 9.1–9.6)]. Higher age, BMI z-score, male sex and rural life, were associated with increased daily salt intake. Increased salt intake was associated with increased systolic and diastolic blood pressure. Conclusion Daily salt intake in Iranian adolescents was about 2 times the recommended amount of the World Health Organization, was higher in rural areas and was associated with blood pressure. Reducing salt intake should be considered as an important intervention, especially in rural areas.

scholarly journals Sleep Quality and Its Associated Factors among Low-Income Adults in a Rural Area of China: A Population-Based Study

2018 ◽  
Vol 15 (9) ◽  
pp. 2055 ◽  
Author(s):  
Wenwen Wu ◽  
Wenru Wang ◽  
Zhuangzhuang Dong ◽  
Yaofei Xie ◽  
Yaohua Gu ◽  
...  
Keyword(s):  
Sleep Quality ◽  
Low Income ◽  
Rural Areas ◽  
Population Based ◽  
Poor Sleep ◽  
Chinese Adults ◽  
Poor Sleep Quality ◽  
Related Factors ◽  
Health Related ◽  
The Mean

Background: There is limited population-based research focusing on sleep quality among low-income Chinese adults in rural areas. This study aimed to assess sleep quality among low-income adults in a rural area in China and identify the association between sleep quality and sociodemographic, lifestyle and health-related factors. Methods: The study was conducted from September to November in 2017 using a cross-sectional survey questionnaire. A total of 6905 participants were recruited via multistage, stratified cluster sampling. Data were collected using the Chinese versions of Pittsburgh Sleep Quality Index and Food Frequency Questionnaire, while we also determined the sociodemographic profiles of the participants. Results: The mean age of the sample was 58.71 ± 14.50 years, with 59.7% being male, while the mean duration of daily sleep was 5.95 ± 1.31 h, with 56.7% reportedly experiencing poor sleep quality. Multiple regression analysis revealed that older age, unemployment, lower income, disability and chronic disease comorbidities were significant factors associated with an increased risk of poor sleep quality for both genders. Moreover, married and higher education level were associated with decreased risk of poor sleep quality for females, while a meat-heavy diet and illness during the past two weeks increased the risk of poor sleep quality for males. Conclusions: Sociodemographic, lifestyle and health-related factors had an impact on the frequently poor sleep quality of low-income Chinese adults in rural areas. Thus, comprehensive measures must be developed to address the modifiable predictive factors that can possibly enhance sleep quality.

scholarly journals Long-term Benzodiazepine Treatment in Patients with Psychotic Disorders Attending a Mental Health Service in Rural Greece

2016 ◽  
Vol 07 (S 01) ◽  
pp. S026-S030 ◽  
Author(s):  
Vaios Peritogiannis ◽  
Thiresia Manthopoulou ◽  
Venetsanos Mavreas
Keyword(s):  
Mental Health ◽  
Treatment Regimen ◽  
Psychotic Disorders ◽  
Population Based ◽  
First Episode ◽  
Future Research ◽  
History Of ◽  
The Mean ◽  
Mobile Mental Health

ABSTRACT Introduction: Long-term benzodiazepine (BZD) treatment in patients with mental disorders is widespread in clinical practice, and this is also the case of patients with schizophrenia, although the evidence is weak and BZD prescription is discouraged by guidelines and medical authorities. Data on BZD prescription are usually derived from national or regional databases whereas information on the use of BZD by patients with schizophrenia and related psychoses in general population-based samples is limited. Materials and Methods: Information for 77 patients with psychotic disorders who were regularly attending follow-up appointments with the multidisciplinary Mobile Mental Health Unit of the prefectures of Ioannina and Thesprotia, Northwest Greece, during 1-year period (2015) was obtained from our database. Results: From the total of 77 engaged patients, 30 (39%) were regularly prescribed BZDs in the long term, as part of their treatment regimen. Prescribed BZDs were mostly diazepam and lorazepam, in 43.3% of cases each. The mean daily dose of these compounds was 13 mg and 3.77 mg, respectively. Statistical analysis showed a correlation of long-term BZD use with the history of alcohol/substance abuse. Most patients were receiving BZD continuously for several years, and the mean dose was steady within this interval. Conclusions: A large proportion of patients with psychotic disorders were regularly prescribed BZD in long term. It appears that when BZDs are prescribed for some period in the course of a psychotic disorder, their use commonly exceeds the recommended interval and then becomes a regular part of the chronic treatment regimen. Future research should address the factors that may be related to the long-term BZD use by patients with psychotic disorders. Interventions for the reduction of regular BZD prescription should target the primary care setting and all those who treat first episode patients.

scholarly journals Predictors of Psychiatric Aftercare among Formerly Hospitalized Adolescents

2012 ◽  
Vol 57 (11) ◽  
pp. 666-676 ◽  
Author(s):  
Corine E Carlisle ◽  
Muhammad Mamdani ◽  
Russell Schachar ◽  
Teresa To
Keyword(s):  
Rural Areas ◽  
Psychotic Disorders ◽  
Suicide Attempts ◽  
Psychiatric Hospitalization ◽  
Psychiatric Treatment ◽  
Population Based ◽  
Care Physician ◽  
Administrative Databases ◽  
Timely Access ◽  
Self Harm

Objective: Timely aftercare can be viewed as a patient safety imperative. In the context of decreasing inpatient length of stay (LOS) and known child psychiatry human resource challenges, we investigated time to aftercare for adolescents following psychiatric hospitalization. Method: We conducted a population-based cohort study of adolescents aged 15 to 19 years with psychiatric discharge between April 1, 2002, and March 1, 2004, in Ontario, using encrypted identifiers across health administrative databases to determine time to first psychiatric aftercare with a primary care physician (PCP) or a psychiatrist within 395 days of discharge. Results: Among the 7111 adolescents discharged in the study period, 24% had aftercare with a PCP or a psychiatrist within 7 days and 49% within 30 days. High socioeconomic status (adjusted hazard ratio [AHR] 1.31; 95% CI 1.21 to 1.43, P < 0.001) and psychotic disorders (AHR 1.24; 95% CI 1.12 to 1.36, P < 0.001) were associated with greater likelihood of aftercare. Youth in the northern part of the province (AHR 0.48; 95% CI 0.32 to 0.71, P < 0.001), rural areas (AHR 0.82; 95% CI 0.76 to 0.89, P < 0.001), and with self-harm or suicide attempts (AHR 0.58; 95% CI 0.53 to 0.64, P < 0.001) and substance use disorders (AHR 0.50; 95% CI 0.44 to 0.56, P < 0.001) were less likely to receive aftercare. Conclusions: Hospitalization is our most intensive, intrusive, and expensive psychiatric treatment setting, yet in our cohort of formerly hospitalized adolescents fewer than 50% received psychiatry-related aftercare in the month postdischarge. Innovations are necessary to address geographic inequities and improve timely access to mental health aftercare for all youth.

scholarly journals Treatment Engagement of Psychotic Patients with a Mobile Mental Health Unit in Rural Areas in Greece: A Five-Year Study

2013 ◽  
Vol 2013 ◽  
pp. 1-6 ◽  
Author(s):  
Vaios Peritogiannis ◽  
Athina Tatsioni ◽  
Nefeli Menti ◽  
Aikaterini Grammeniati ◽  
Vassiliki Fotopoulou ◽  
...  
Keyword(s):  
Mental Health ◽  
Community Mental Health ◽  
Low Income ◽  
Rural Areas ◽  
Psychotic Disorders ◽  
Low Income Countries ◽  
Community Mental Health Service ◽  
Health Unit ◽  
Mobile Mental Health ◽  
Mental Health Unit

Objectives. Treatment of psychotic disorders is impended by high rates of disengagement from mental health services and poor adherence to antipsychotic medication. This study examined the engagement rates of psychotic patients with a community mental health service during a 5-year period.Methods. The Mobile Mental Health Unit of Ioannina and Thesprotia (MMHU I-T) delivers services in remote, rural, mountainous areas using the resources of the primary care system. Clinical and demographic information for patients with a diagnosis of schizophrenia and related psychoses was obtained from the medical records of our unit.Results. A total of 74 psychotic patients initially engaged in treatment with our unit. In half of cases treatment was home-based. With the exclusion of patients who died or discharged, engagement rates were 67.2%. Statistical analysis was performed for 64 patients, and no differences were found between engaged and disengaged patients regarding clinical and demographic parameters. All engaged patients regularly refilled their antipsychotic prescriptions.Conclusion. Engagement rates in our study were comparable to previous research, involving urban settings and shorter follow-up duration. Community mental health teams may ensure treatment continuation for psychotic patients in deprived, remote areas. This is important for low-income countries, affected by economic crisis, such as Greece.

Prevalence of Dyslipidemia in Urban and Rural Areas of the Northwest of Iran: The Sociodemographic, Dietary and Psychological Determi-nants

2019 ◽  
Author(s):  
Jafar Sadegh TABRIZI ◽  
Leila NIKNIAZ ◽  
Homayoun SADEGHI-BAZARGANI ◽  
Mostafa FARAHBAKHSH ◽  
Zeinab NIKNIAZ ◽  
...  
Keyword(s):  
Physical Activity ◽  
Rural Areas ◽  
Salt Intake ◽  
Population Based ◽  
Major Health Problem ◽  
Psychological Determinants ◽  
Preventable Risk Factor ◽  
Low Hdl ◽  
Northwest Of Iran ◽  
The Mean

Background: As dyslipidemia is a preventable risk factor for Coronary heart disease (CHD), precise estimation of its prevalence and determinants is crucial for proper development of health actions. This population-based study aimed at investigating the socioeconomic, dietary and psychological determinants of dyslipidemia in Iran. Methods: The data (n=700) for this study were collected in 2015 as a part of the major Lifestyle Promotion Project (LPP) conducted in East Azerbaijan (urban and regional parts). The data for socio-demographic status, dietary information, and physical activity and anxiety levels were collected through validated questionnaires. Then, physical examinations including blood pressure, body mass index (BMI) and conicity index were performed. The levels of serum lipids were measured by enzymatic colorimetric methods. Results: The prevalence of hypercholesterolemia, high LDL-C, hypertriglyceridemia, low HDL-C and dyslipidemia was 29.4%, 10.3%, 62.3%, 41.4%, 83.3% respectively. The mean TC (184.3±41.2 vs. 174.5±38.1 mg/dl), LDL-C (94.6±30.3 vs. 88.1±28.7 mg/dl) and HDL-C (46.7±10.4 vs. 39.5±8.0 mg/dl) in women were significantly higher than men (P<0.05). However, the mean of TG (182.3±119.3 vs. 145.1±87.8 mg/dl) was significantly higher in men compared to women (P<0.05). Obesity, family history of dyslipidemia, sedentary lifestyle, smoking habits, salt intake, and anxiety were risk factors for different components of dyslipidemia in men and women. Conclusion: Dyslipidemia is a major health problem in northwest of Iran. Focusing on screening, regular drug intake, proper nutrition, physical activity, and changing lifestyles of patients with dyslipidemia are essential.  

Hepatitis B virus prevalence in rural areas in south-west Chad

2017 ◽  
Vol 47 (4) ◽  
pp. 374-377 ◽  
Author(s):  
Julian Suesstrunk ◽  
Fédéric Berniba Djongali
Keyword(s):  
Hepatitis B Virus ◽  
Hepatitis B ◽  
Rural Areas ◽  
Population Based ◽  
South West ◽  
B Virus ◽  
High Prevalence ◽  
Hbv Prevalence ◽  
Hepatitis B Antigen ◽  
Age Range

In Chad, hepatitis B virus (HBV) is thought to have a high prevalence and is consequently responsible for numerous acute and long-term complications. It is often detected during screening in potential blood donors. However, no general population-based study on the prevalence of hepatitis B has been performed. The aim of this study was to gain an impression of the HBV prevalence in rural areas in south-west Chad. A total of 1309 individuals (745 boys/men, 564 girls/women) with a median age of 15 years (age range, 6–81 years) were screened for the presence of the hepatitis B antigen (HBsAG). We found an overall prevalence of 22.9%. The youngest age group (6–15 years) and the boys/men showed a significantly higher HBsAG prevalence compared to the older groups and the girls/women, respectively ( P < 0.01). Vertical infection during birth and horizontal infection by sharing food, water and shelter are believed to be the main sources of infection.

One-Year Prevalence of Migraine in Sweden: A Population-Based Study in Adults

Cephalalgia ◽  
2001 ◽  
Vol 21 (6) ◽  
pp. 664-671 ◽  
Author(s):  
C Dahlöf ◽  
M Linde
Keyword(s):  
Rural Areas ◽  
Time Window ◽  
International Headache Society ◽  
Population Based ◽  
Point Of View ◽  
Opinion Poll ◽  
Swedish Population ◽  
Ihs Criteria ◽  
The Mean ◽  
Urban And Rural Areas

A randomly selected sample of 1668 individuals (782 women and 886 men) aged 18–74 years was interviewed by telephone using a standardized questionnaire including the International Headache Society (IHS) criteria for migraine. The survey was performed by SIFO, the national public opinion poll agency. The results obtained demonstrate that 21% of the Swedish population had suffered from severe headaches during the past year. A majority of these headache sufferers (61%) fulfilled the IHS-criteria for migraine. The 1-year prevalence of migraine in Sweden was found to be 13.2 ± 1.9% (16.7% among women and 9.5% among men). The prevalence of migraine in this Swedish population did not differ between the northern, middle and southern part of Sweden, or between urban and rural areas or different income groups. Only about half (49%) of the migraineurs had been diagnosed by a physician. Among the individuals who fulfilled the IHS criteria for migraine the mean attack-frequency was 1.3 per month and the mean attack-duration was 19 h. If the duration of the attack was disregarded as a strict criterion for migraine (attacks < 4 h and > 72 h were included), the prevalence increased to 17.0 ± 1.9% without affecting the sex distribution. With this amendment, 92% of those who considered their headaches to be migraine or migraine-like in fact fulfilled the alternative criteria for migraine. However, only 76% of those who believed that they had migraine or migraine-like headaches fulfilled the strict IHS criteria for migraine. An extension of the time window from 4 to 72 h may be reasonable both from a pragmatic and from a rational clinical point of view.

Decrease of hospitalizations and length of hospital stay in patients with schizophrenia spectrum disorders treated in a community mental health service in rural Greece

2020 ◽  
Vol 66 (7) ◽  
pp. 693-699
Author(s):  
Vaios Peritogiannis ◽  
Panagiota Gioti ◽  
Afroditi Gogou ◽  
Maria Samakouri
Keyword(s):  
Mental Health ◽  
Community Mental Health ◽  
Hospital Stay ◽  
Hospital Admissions ◽  
Length Of Hospital Stay ◽  
Community Mental Health Service ◽  
Schizophrenia Spectrum Disorders ◽  
Schizophrenia Spectrum ◽  
The Mean ◽  
Spectrum Disorders

Background: The treatment of severe and chronic mental disorders, such as schizophrenia and related syndromes, is largely based on community mental health services. Aims: The objective of the present study was to assess hospital admissions and length of hospital stay in patients with schizophrenia and related disorders, who are engaged to treatment with a Mobile Mental Health Unit (MMHU I-T) in a defined rural catchment area in Greece. Method: Data were retrieved retrospectively for 76 patients with schizophrenia and related disorders. For each patient, comparison was made for the same interval prior and after engagement to treatment with the MMHU I-T. Results: The average age of patients was 56 years and the mean illness duration was 28 years. The mean follow-up duration was 5.3 years. There was a statistically significant decrease in the annual average of the number of voluntary and involuntary hospitalizations and on days of hospital stay after treatment engagement with the MMHU I-T. Conclusions: Treatment of schizophrenia spectrum disorders in rural residents by the MMHUs may contribute to the reduction of patients’ admissions and length of hospital stay. Future research should address the cost-effectiveness of such interventions.

scholarly journals Cerebrospinal fluid abnormalities in first- and multi-episode schizophrenia-spectrum disorders: impact of clinical and demographical variables

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Tatiana Oviedo-Salcedo ◽  
Elias Wagner ◽  
Mattia Campana ◽  
Anna Gagsteiger ◽  
Wolfgang Strube ◽  
...  
Keyword(s):  
Cerebrospinal Fluid ◽  
Psychotic Disorders ◽  
Retrospective Chart Review ◽  
First Episode ◽  
Schizophrenia Spectrum Disorders ◽  
Response Predictors ◽  
Schizophrenia Spectrum ◽  
Episode Psychosis ◽  
The Mean ◽  
Spectrum Disorders

AbstractMultiple lines of evidence indicate that immunological and inflammatory alterations contribute at least in a subgroup to the pathophysiology of schizophrenia. In this retrospective chart review, we investigated whether clinical factors contribute to altered cerebrospinal fluid (CSF) findings in schizophrenia-spectrum disorders. Clinical data from electronic medical records of patients with psychotic disorders (ICD-10: F20-F29) who received routine CSF diagnostics at the Department of Psychiatry and Psychotherapy, LMU Munich, Germany, were included. Chi² tests for dichotomous outcomes and independent t tests for continuous outcomes were used to compare differences between groups. A total of 331 patients were included in the analyses (43.2% female and 56.8% male). The mean age was 37.67 years (±15.58). The mean duration of illness was 71.96 months (±102.59). In all, 40% (128/320) were first-episode psychosis (FEP) patients and 60% (192/320) were multi-episode psychosis (MEP) patients. Elevated CSF protein levels were found in 19.8% and elevated CSF/serum albumin ratios (QAlb) in 29.4% of the cases. Pleocytosis was found in 6.1% of patients. MEP patients showed significantly higher mean QAlb compared with FEP patients (t(304.57) = −2.75, p = 0.006), which did not remain significant after correcting for age. QAlb elevation occurred more frequently in men (X2(1) = 14.76, p = <0.001). For treatment resistance, family history, and cMRI alterations, no significant differences in CSF-related outcomes were detected. Our work extends other retrospective cohorts confirming a relevant degree of CSF alterations in schizophrenia-spectrum disorders and shows the difficulty to relate these alterations to clinical and disease course trajectories. More research is needed to develop treatment response predictors from CSF analyses.

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