Psychiatrikē = Psychiatriki
-
Despite the indisputable negative psychosocial consequences of the COVID-19 pandemic, positive consequences are also possible. Resilience and coping strategies have been assumed to contribute to these outcomes. However, findings are still scarce and inconclusive. ⋯ The so-called "second wave" of the outbreak that started in August 2020 indicates that the study of the psychosocial impact of the COVID-19 pandemic and lockdown and of the internal resources (resilience and coping) to deal with, is necessary. The findings contribute to a more comprehensive understanding of the coping strategies used by population subgroups (e.g., HCWs) in dealing with the COVID-19 lockdown in Greece. Enhancing internal resources through supportive services will ameliorate HCWs ability to withstand, recover, and thrive with benefits in their psychological health and well-being.
-
As of the end of 2020, the COVID-19 pandemic has led to over 82 million verified infections and almost 1.8 million COVID-19-related deaths worldwide,1 resulting to an unprecedented public health response around the globe. The COVID-19 pandemic, together with the applied multi-level restrictive measures, has generated a unique combination of an unpredictable and stressful biomedical and socioeconomic environment (i.e., syndemic),2 introducing real-life threat, involuntary and drastic every-day life-style changes with uncertain financial and future prospects, alongside with minimized coping and stress management possibilities.3 This combination of so many different and vital stressors may lead to acute as well as long-term, direct, indirect and even transgenerational unfavourable effects on physical and mental health and functioning, which might even represent the most precarious and still unpredictable public-health-related part of the pandemic.4 Thereby, specific population groups could be at particular risk of poor health outcomes in relation to applied public health measures.4, 5 However, not every individual will experience the same level of negative impact on health and well-being during the pandemic, as several additional national, socioeconomic, environmental, behavioural, emotional and cognitive factors can moderate individual resilience and coping.6 Pandemic-related research should, thus, assess as many multidimensional risk and protective factors as possible in a longitudinal, large-scale and multi-national manner, enabling a profound and comprehensive understanding of the complex health and societal impact of the pandemic worldwide.7 Nevertheless, to date, most research findings are cross-sectional, report on small and non- representative samples from individual countries, or on specific population groups (e.g., health care workers, students, clinical populations) and usually assess only a very restricted set of outcomes and time-points. Thereby, only few studies assess coping strategies, medical history or detailed socioeconomic, demographic and environmental data. ⋯ Currently, the COH-FIT survey actively collects the largest sample on multifactorial data on the impact of the COVD-19 pandemic on health and functioning not only in Greece, but around the globe. The elaborated design of COH-FIT and similar studies may allow a better identification of key parameters and population groups at increased risk during the pandemic, as well as potential targets for acute and long-term prevention or intervention strategies in the current as in possible future pandemics. A profound understanding of the health and societal impact of the pandemic could facilitate an optimized governmental, social and individual health preparedness during infection times8 and the bridging of individuals', societal and systemic needs and actions through multi-level guideline development with the aim to improve mental health outcomes globally.
-
During the coronavirus disease 2019 (COVID-19) pandemic, all European countries were hit, but mortality rates were heterogenous, with some countries being hit very hard, while others including Greece had a much lower death rate during the first wave of spring 2020. The ultra-fast application of measures was probably the reason of this outstanding success. This outbreak is expected to trigger feelings of fear, worry, and stress, as responses to an extreme threat for the community and the individual. ⋯ These studies were among the first published, they went deeper in the data collection and even led to the creation of a model with distinct stages for the development of mental disorders during the lockdown. The analysis of the international data will probably provide further insight into the prevalence of mental disorders and the universal but also culturally specific models and factors pertaining to their development. At the time this editorial was in press, more than 40 countries representing more than two thirds of earth's population were participating with more than 45,000 responses already gathered.
-
Financial crisis has significant impact on the mental health of the population, resulting in increasing incidence of mental disorders and suicides. Specific social and financial factors mediate the effects of financial crisis on mental health, such as poverty, financial difficulties and unemployment. During the recent international financial crisis, studies in many countries have shown that the worsening of various mental health indicators was related to financial difficulties and unemployment. ⋯ There was also an increase in the rate of unemployed individuals among these cases, from 10% in 2008 to 41.7% in 2009, reaching the highest level in 2011 (53.3%). The findings of this study suggest that during economic crisis unemployment plays an important role in the development of anxiety and depressive disorders and is closely related to suicide attempts. Our results were derived from a specific catchment area and therefore they have high ecological validity.
-
Review
The DSM-ICD diagnostic approach as an essential bridge between the patient and the "big data".
The use of diagnostic manuals in psychiatry is generally necessitated by the lack of tests that would corroborate psychiatric diagnosis. Criticism towards the today prevailing DSM-ICD diagnosis traditionally regards among others such problems as hyponarrativity, biologism, "death of phenomenology", and a questionably valid over-fragmentation of diagnosis. Lately, and especially after the appearance of the 5th edition of DSM (2013), criticism focuses at such issues as lack of validity, having failed to adopt a dimensional model, not adequately relying on genetics and neurobiology, and impeding, rather than facilitating, research into the etiology of mental disorders, the DSM becoming an "epistemic prison". ⋯ Moreover, the particularity of the psychiatric object, the clinical significance of the categorical approach to diagnosis, as well as the need for a "irreducible psychological level of explanation" are discussed. In our view, today, the DSM-ICD diagnosis lies between two different and potentially opposing demands and tendencies: on the one hand, the demand for the individual, subjective and phenomenological particularity of the mentally ill to be taken into consideration (a demand that sometimes underestimates the need for clinical communication); on the other hand, the (largely future) vision for more and more analysis of biological data in the name of a yet to be clarified personalized therapy (the very notion of diagnosis becoming potentially redundant). Finally, considering the particularity of the psychiatric object, we conclude that matthe DSM-ICD approach, with its categorical diagnoses and its descriptive operational criteria, despite its inherent imperfections and inadequacies, continues to have a place in psychiatry as an essential bridge/interface between clinic and research data, as a common clinical language, and as an epistemic hub; and that prerequisites for diagnostic validity should be sought both in the cells of RDoC and in those theoretical approaches which examine human subjectivity as such, included phenomenology and psychoanalysis.