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Zagkas DG, Chrousos GP, Bacopoulou F, Kanaka-Gantenbein C, Vlachakis D, Tzelepi I, Darviri C. Stress and Well-Being of Greek Primary School Educators: A Cross-Sectional Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:5390. [PMID: 37048004 PMCID: PMC10093913 DOI: 10.3390/ijerph20075390] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/08/2023] [Revised: 03/08/2023] [Accepted: 03/17/2023] [Indexed: 06/19/2023]
Abstract
The teaching profession has always been challenging, while for various reasons the magnitude of observed stress in teachers has been continually growing over time. This study was conducted to demonstrate the relevance of stress in this professional group and to generate evidence for the benefit of primary school teachers and, indirectly, their pupils. To this end, we examined a large number of school teachers in a descriptive cross-sectional study. The survey comprised 786 primary school instructors aged 21 to 65 years, 646 women (82.2%) and 140 males (17.8%), and was performed from March to October 2022. Participants were asked about their gender, age, marital status, place of domicile, satisfaction with their income, whether their income met their needs, number of children, whether they cared for a person with a disability, work experience, alcohol use, eating patterns, and their height and weight for computation of their Body Mass Index (BMI). The survey included the Teacher Subjective Well-being Questionnaire (TSWQ), the Perceived Stress Scale (PSS), the Healthy Lifestyle and Personal Control Questionnaire (HLPCQ), and the Pittsburgh Sleep Quality Index (PSQI). The results showed that there were significant differences between the two sexes in age, marital status, work experience, smoking, alcohol use, and eating breakfast. Furthermore, there were significant differences between the two sexes in BMI, PSS Total, Dietary Health Choice, Harm Avoidance and Total HLPCQ. The variance of PSS Total was predicted by Sex, Teacher Efficacy, Total PSQI, Dietary Health Choice, organized physical exercise, social support and mental control, and Total HLPCQ. Between teacher efficacy, school connectedness, teacher well-being, organized physical exercise, social support and mental control, Total HLPCQ and PSS Total, the correlation coefficients were negative and significant at the <0.05 level. Between Total PSQI and PSS Total, the correlation coefficient was positive and significant at the <0.05 level. Between teacher efficacy, school connectedness and teacher well-being, organized physical exercise, social support and mental control, Total HLPCQ and Total PSQI, the correlation coefficients were negative and significant at the <0.05 level. In summary, we demonstrated that Greek primary school teachers experience significant stress, which is intertwined with their way of life, and reflected in significant decreases in their sense of well-being, quality of sleep, and overall life satisfaction, as well as in their standards of teaching.
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Affiliation(s)
- Dimitrios G. Zagkas
- Postgraduate Course of Stress Management and Health Promotion, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece (C.D.)
| | - George P. Chrousos
- Postgraduate Course of Stress Management and Health Promotion, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece (C.D.)
- Center for Adolescent Medicine and Adolescent Health Care, First Department of Pediatrics, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece
- University Research Institute of Maternal and Child Health and Precision Medicine, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece
| | - Flora Bacopoulou
- Postgraduate Course of Stress Management and Health Promotion, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece (C.D.)
- Center for Adolescent Medicine and Adolescent Health Care, First Department of Pediatrics, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece
- University Research Institute of Maternal and Child Health and Precision Medicine, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece
- Aghia Sophia Children’s Hospital, National and Kapodistrian University of Athens, 11527 Athens, Greece
| | - Christina Kanaka-Gantenbein
- Postgraduate Course of Stress Management and Health Promotion, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece (C.D.)
- Center for Adolescent Medicine and Adolescent Health Care, First Department of Pediatrics, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece
- University Research Institute of Maternal and Child Health and Precision Medicine, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece
- Aghia Sophia Children’s Hospital, National and Kapodistrian University of Athens, 11527 Athens, Greece
| | - Dimitrios Vlachakis
- Laboratory of Genetics, Department of Biotechnology, School of Applied Biology and Biotechnology, Agricultural University of Athens, 11855 Athens, Greece
| | - Ioanna Tzelepi
- Postgraduate Course of Stress Management and Health Promotion, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece (C.D.)
| | - Christina Darviri
- Postgraduate Course of Stress Management and Health Promotion, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece (C.D.)
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Darviri C, Zigkiri E, Simos DS, Charalampopoulou M, Kokka I, Vlachakis D, Bacopoulou F, Chrousos GP. The Effect of Pythagorean Self-Awareness Intervention on Stress and Mental Health Characteristics of Civil Servants in Crete, Greece. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2023; 1425:59-67. [PMID: 37581781 DOI: 10.1007/978-3-031-31986-0_6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/16/2023]
Abstract
Evidence is limited regarding the effects of holistic programs on work-related stress, anxiety, and depressive symptomatology. This study aimed to evaluate the effects of the Pythagorean Self-Awareness Intervention (PSAI) on stress and mental health characteristics of civil servants in Crete, Greece. This was a single arm interventional study with PSAI outcome evaluation. Validated, self-reported scales were used to assess stress and mental health characteristics (PSS, DASS, UCLA, RSE, and STAXI). Hair samples were obtained to measure cortisol concentrations as a biological stress marker. Paired-samples t-test or Wilcoxon tests were used to evaluate pre- and post-intervention measures. Overall, 48 civil servants (56.3% women, mean age 51 years) participated in the study. Statistically significant reductions were observed in all self-reported stress scales (p < 0.05). Although hair cortisol decreased, this difference was not statistically significant (p = 0.109). Statistically significant improvements were also observed on depressive symptomatology (p < 0.001), self-esteem (p < 0.001), loneliness (p < 0.001), self-efficacy (p = 0.002), and anger (p = 0.017). The PSAI appeared beneficial with respect to all self-reported outcomes. Larger studies including control groups and further follow-up evaluations are needed to ascertain these findings.
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Affiliation(s)
- Christina Darviri
- Postgraduate Course on the Science of Stress and Health Promotion, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece.
| | - Eleni Zigkiri
- Postgraduate Course on the Science of Stress and Health Promotion, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - Dimitrios S Simos
- Postgraduate Course on the Science of Stress and Health Promotion, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - Maria Charalampopoulou
- Postgraduate Course on the Science of Stress and Health Promotion, First Department of Propaideutic Surgery, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - Ioulia Kokka
- Postgraduate Course on the Science of Stress and Health Promotion, Outpatient Specialty Clinic for Sexual Health, First Department of Psychiatry, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - Dimitrios Vlachakis
- Laboratory of Genetics, Department of Biotechnology, School of Applied Biology and Biotechnology, Agricultural University of Athens, Athens, Greece
| | - Flora Bacopoulou
- Postgraduate Course on the Science of Stress and Health Promotion, Center for Adolescent Medicine and UNESCO Chair in Adolescent Health Care, First Department of Pediatrics, School of Medicine, National and Kapodistrian University of Athens, Aghia Sophia Children's Hospital, Athens, Greece
| | - George P Chrousos
- University Research Institute of Maternal and Child Health & Precision Medicine, National and Kapodistrian University of Athens, Aghia Sophia Children's Hospital, Athens, Greece
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Thurin K, Daffner K, Gale S, Donovan NJ, Urizar JC. Non-Pharmacological Treatments of Neuropsychiatric Symptoms in Mild Cognitive Impairment (MCI). Semin Neurol 2022; 42:192-203. [DOI: 10.1055/s-0042-1742486] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
AbstractMild cognitive impairment (MCI) is a syndrome defined by objective cognitive deficits that do not impact functional independence. Individuals with MCI develop dementia at an annual rate of 10 to 15%. Neuropsychiatric symptoms (NPS) are common non-cognitive features of neurocognitive disorders and have a major impact on the wellbeing and quality of life of affected individuals and their families. Non-pharmacological interventions for NPS are considered the first-line treatment because of the limited efficacy and side-effect potential of current pharmacological agents. This article summarizes the literature on non-pharmacological treatments for NPS in MCI. The limited number of studies specific to individuals with MCI and its various etiologies, as well as the overall heterogeneity of research design and methodologies, make the evidence base inconclusive. Nevertheless, some studies support psychosocial interventions aimed at individuals with MCI and their caregivers.
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Affiliation(s)
- Kristina Thurin
- Department of Psychiatry and Behavioral Health, The Ohio State University Wexner Medical Center, Columbus, Ohio
| | - Kirk Daffner
- Division of Cognitive and Behavioral Neurology, Department of Neurology, Center for Brain/Mind Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
| | - Seth Gale
- Division of Cognitive and Behavioral Neurology, Department of Neurology, Center for Brain/Mind Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
| | - Nancy J. Donovan
- Division of Geriatric Psychiatry, Departments of Psychiatry and Neurology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
| | - Juan Carlos Urizar
- Division of Geriatric Psychiatry, Departments of Psychiatry and Neurology, Brigham andWomen's Hospital, Harvard Medical School, Boston, Massachusetts
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The effects of Pythagorean Self-Awareness Intervention on patients with major depressive disorder: A pilot randomized controlled trial. J Psychiatr Res 2021; 138:326-334. [PMID: 33894540 DOI: 10.1016/j.jpsychires.2021.03.067] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/28/2020] [Revised: 03/26/2021] [Accepted: 03/31/2021] [Indexed: 11/20/2022]
Abstract
Stress plays an important role in major depressive disorder (MDD). Thus, a variety of stress management programs have been developed for people with this diagnosis. This is a pilot randomized clinical trial which implemented a holistic stress management program, Pythagorean Self-Awareness Intervention (PSAI) in adults with MDD, aiming to evaluate the effectiveness of PSAI compared to standard care for reduction of depressive symptoms (primary aim), improving mental health and quality of life (secondary aims). A total of 69 participants were randomized to an intervention group (N = 34), who received the usual care provided for patients with major depression and attended the PSAI program, and a control group (N = 35), who received the usual care only. Measurements were taken in both groups before and after the intervention and included: 1. Self-report questionnaires for measuring depressive symptoms, healthy lifestyle, perceived stress, anxiety, positive and negative affect and sleep quality, 2 Cognitive function assessment tools, 3. Hair and salivary cortisol. The intervention group demonstrated significantly greater reductions in depressive symptoms, negative affect, perceived stress, sleep quality and significantly greater increase in visual memory and healthy lifestyle compared to the control group. In addition, the intervention group demonstrated a significant reduction in first morning salivary cortisol, indicating a reduction in diurnal stress levels, while no significant change of salivary cortisol was observed in the control group. Finally, none of the study's groups demonstrated a significant change in hair cortisol concentration. In conclusion, PSAI can be applied to adults suffering from MDD with significant benefits for their mental health and quality of life. TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT04536714.
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The Effects of Pythagorean Self-Awareness Intervention on Irritable Bowel Syndrome Patients: A Non-randomized Controlled Trial. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2021; 1337:345-354. [DOI: 10.1007/978-3-030-78771-4_39] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
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Miskedaki A, Vagiakis E, Bacopoulou F, Vlachakis D, Artemiadis A, Chrousos GP, Darviri C. The Role of Pythagorean Self-Awareness Intervention in Obstructive Sleep Apnea. A Randomized Controlled Trial. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2021; 1337:83-87. [DOI: 10.1007/978-3-030-78771-4_10] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Charalampopoulou M, Bacopoulou F, Syrigos KN, Filopoulos E, Chrousos GP, Darviri C. The effects of Pythagorean Self-Awareness Intervention on breast cancer patients undergoing adjuvant therapy: A pilot randomized controlled trial. Breast 2019; 49:210-218. [PMID: 31901782 PMCID: PMC7375672 DOI: 10.1016/j.breast.2019.12.012] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2019] [Revised: 12/11/2019] [Accepted: 12/16/2019] [Indexed: 12/24/2022] Open
Abstract
Introduction Breast cancer patients undergo extended treatments that affect their psychological state and quality of life. There is a lack of studies examining the effects of holistic stress management interventions (that combine stress perception, cognitive and lifestyle interventions) on mental health and biological indices (e.g. cortisol concentrations) of breast cancer patients. Materials and methods This pilot randomized controlled trial provided the first assessment of the effects of a novel, cognitive-based intervention, the Pythagorean Self-Awareness Intervention (PSAI), on psychological symptoms, quality of life, sleep quality and lifestyle as well as on stress-related biological measures of breast cancer patients undergoing adjuvant therapy. Standardized questionnaires were administered at baseline and 8-weeksafter the intervention to evaluate quality of life, stress, depression, and anxiety (primary outcomes). Sleep quality, lifestyle and hair cortisol concentrations were also assessed (secondary outcomes). Results Forty-five breast cancer patients undergoing adjuvant therapy were randomly assigned to the PSAI group (n = 25) or the control group (n = 20).Women in the PSAI group reported significant improvements post-intervention in total Quality of Life, specific aspects of Quality of Life [Physical well-being, Social well-being, Emotional well-being, Functional well-being, Breast cancer concerns] as well as Perceived stress, depression, anxiety and stress. Improvements in secondary outcomes included increase in sleep quality, empowerment for healthy lifestyle and reduction of hair cortisol concentrations. Conclusions The PSAI was beneficial as complementary therapy in the women studied. Larger randomized controlled trials with longer follow-up are needed to ascertain these findings. Breast cancer patients face physical and psychological cancer-related stressors. Pythagorean self-awareness is a novel stress-management intervention (PSAI). Breast cancer patients were allocated to PSAI group and control group. Mental health, quality of life and sleep were ameliorated in PSAI group. Hair cortisol concentrations were reduced significantly in the PSAI group.
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Affiliation(s)
- Maria Charalampopoulou
- Postgraduate Course of Stress Management and Health Promotion, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece.
| | - Flora Bacopoulou
- Center for Adolescent Medicine and UNESCO Chair on Adolescent Health Care, First Department of Pediatrics, School of Medicine, National and Kapodistrian University of Athens, Aghia Sophia Children's Hospital, Athens, Greece; Unit of Clinical and Translational Research in Endocrinology, First Department of Pediatrics, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - Konstantinos N Syrigos
- Oncology Unit, 3rd Department of Medicine, School of Medicine, National and Kapodistrian University of Athens, Sotiria General Hospital, Athens, Greece
| | - Evaggelos Filopoulos
- Breast Cancer Department, General Anti-Cancer Hospital Agios Savvas, Athens, Greece
| | - George P Chrousos
- Postgraduate Course of Stress Management and Health Promotion, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece; Center for Adolescent Medicine and UNESCO Chair on Adolescent Health Care, First Department of Pediatrics, School of Medicine, National and Kapodistrian University of Athens, Aghia Sophia Children's Hospital, Athens, Greece; Unit of Clinical and Translational Research in Endocrinology, First Department of Pediatrics, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - Christina Darviri
- Postgraduate Course of Stress Management and Health Promotion, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
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The effects of mindfulness and health education programs on the emotional state and cognitive function of elderly individuals with mild cognitive impairment: A randomized controlled trial. J Clin Neurosci 2019; 68:211-217. [DOI: 10.1016/j.jocn.2019.05.031] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2019] [Accepted: 05/21/2019] [Indexed: 02/08/2023]
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9
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Simos DS, Kokkinos A, Tentolouris N, Dimosthenopoulos C, Mantzou E, Artemiadis A, Bacopoulou F, Nicolaides NC, Kosta O, Chrousos GP, Darviri C. Pythagorean self-awareness intervention: A novel cognitive stress management technique for body weight control. Eur J Clin Invest 2019; 49:e13164. [PMID: 31421060 DOI: 10.1111/eci.13164] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/30/2018] [Revised: 07/11/2019] [Accepted: 08/15/2019] [Indexed: 11/30/2022]
Abstract
BACKGROUND Over the past decades, the prevalence of obesity has markedly increased worldwide. Stress is recognized as a substantial contributor to increased body weight; therefore, stress management interventions, especially cognitive behavioural, are becoming increasingly popular. The impact of stress management on stress- and obesity-related biomarkers (eg blood lipid profile, HBA1c, inflammatory biomarkers, such as CRP) has been scarcely studied. The aim of this study was to assess the effect of a novel cognitive behavioural stress management intervention, called 'Pythagorean Self-Awareness Intervention' (PSAI), in overweight/obese adults. MATERIALS AND METHODS This was a two-armed 1:1 randomized, nonblind controlled study including overweight/obese individuals. The control group followed a personalized Mediterranean low-calorie diet, and the intervention group followed the same diet in addition to the PSAI intervention for 8 weeks. Measurements included demographic, anthropometric (ie BMI, waist-to-hip ratio), stress (ie perceived stress, salivary cortisol), dietary behaviour (ie emotional eating) and metabolic parameters (ie blood lipid profile, HBA1c, CRP, body composition in fat and water). Outcome per-protocol analysis was performed using mixed linear models adjusted for age and gender. RESULTS A total of 49 of 62 eligible adults were analysed in the study (there were three dropouts in the intervention group and 10 dropouts in the control group); 28 were assigned to the intervention group (mean age 54.7 ± 11.9 years) and 21 to the control group (mean age 51.8 ± 11.9 years). The intervention group showed a statistically significant decrease in perceived stress, cortisol concentrations 30 minutes after awakening, cortisol's area under the curve, BMI, waist-to-hip ratio, restrained, emotional and external eating behaviour, fasting glucose, LDL, triglycerides, HbA1c and body and trunk fat, compared with the control group. Based on the observed effect sizes, clinically meaningful changes may be more evident in stress perception, restrained and external eating behaviour, Hb1ac and trunk fat. The compliance to the PSAI intervention reached 100%, and there were no adverse effects. CONCLUSIONS The PSAI technique may be an effective stress management method for overweight/obese adults. Future and larger randomized controlled studies are needed to allow generalization of these findings.
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Affiliation(s)
- Dimitrios S Simos
- Postgraduate Course Stress Management and Health Promotion, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Alexandros Kokkinos
- First Department of Propaedeutic Internal Medicine, Medical School, Diabetes Center, Laiko General Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Nikolaos Tentolouris
- First Department of Propaedeutic Internal Medicine, Medical School, Diabetes Center, Laiko General Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | | | - Emily Mantzou
- Division of Endocrinology, Metabolism and Diabetes, First Department of Pediatrics, Medical School, Aghia Sophia Children's Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Artemios Artemiadis
- Postgraduate Course Stress Management and Health Promotion, Medical School, National and Kapodistrian University of Athens, Athens, Greece.,Medical School, University of Cyprus, Nicosia, Cyprus
| | - Flora Bacopoulou
- First Department of Pediatrics, Medical School, Center for Adolescent Medicine and UNESCO Chair on Adolescent Health Care, Aghia Sophia Children's Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Nicolas C Nicolaides
- Postgraduate Course Stress Management and Health Promotion, Medical School, National and Kapodistrian University of Athens, Athens, Greece.,Division of Endocrinology, Metabolism and Diabetes, First Department of Pediatrics, Medical School, Aghia Sophia Children's Hospital, National and Kapodistrian University of Athens, Athens, Greece.,Division of Endocrinology and Metabolism, Biomedical Research Foundation of the Academy of Athens, Athens, Greece
| | - Ourania Kosta
- First Department of Propaedeutic Internal Medicine, Medical School, Diabetes Center, Laiko General Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - George P Chrousos
- Postgraduate Course Stress Management and Health Promotion, Medical School, National and Kapodistrian University of Athens, Athens, Greece.,Division of Endocrinology, Metabolism and Diabetes, First Department of Pediatrics, Medical School, Aghia Sophia Children's Hospital, National and Kapodistrian University of Athens, Athens, Greece.,Division of Endocrinology and Metabolism, Biomedical Research Foundation of the Academy of Athens, Athens, Greece
| | - Christina Darviri
- Postgraduate Course Stress Management and Health Promotion, Medical School, National and Kapodistrian University of Athens, Athens, Greece
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Anagnostouli M, Babili I, Chrousos G, Artemiadis A, Darviri C. A novel cognitive-behavioral stress management method for multiple sclerosis. A brief report of an observational study. Neurol Res 2018; 41:223-226. [PMID: 30451648 DOI: 10.1080/01616412.2018.1548745] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
OBJECTIVES Psychological stress is an important risk factor for multiple sclerosis (MS) onset, relapse, neurological symptoms and psychosocial adjustment to the disease. Mounting evidence suggests that stress management could halt the disease progression and improve patients' wellbeing. The aim of this study was to investigate the effectiveness of a novel cognitive-behavioral stress management technique (called Pythagorean Self-Awareness Intervention - PSAI) routinely used in our clinics in patients with MS. METHODS In this observational study, 148 MS patients receiving PSAI for 8-weeks were compared patients who followed only usual care. Measurements included cognitive function, psychological distress and physical fatigue. Propensity score (PS) methods (given the observational design) and linear mixed models were employed to address study's endpoints. RESULTS A total of 128 (86.5%) of MS patients fulfilled the PS criteria for analyses (72 in the PSAI group and 56 in the control group). Patients of tertiary education, longer disease duration, higher cognitive score and psychological distress were more likely to choose to participate in the PSAI group. PSAI patients were found with statistical significant beneficial changes in cognitive speed processing, verbal memory, stress, anxiety, depression and fatigue. Based on the numbers-needed-to-treat of the weighted data, PSAI was particularly effective in improving cognitive speed processing (NNT = 10) and stress (NNT = 12). DISCUSSION PSAI can benefit cognitive function and psychological distress in MS patients. Future studies should expand these results in randomized trials and by using longer follow-up and MS activity-related endpoints. ABBREVIATIONS BICAMS: Brief International Cognitive Assessment for Multiple Sclerosis BVMT-R: Brief Visuospatial Memory Test Revised CVLT: California Verbal Learning Test DASS: Depression Anxiety Stress Scale EDSS: Expanded Disability Status Scale MS: Multiple Sclerosis NNT: Numbers Needed to Treat PS: Propensity Score PSAI: Pythagorean Self-Awareness Intervention RR: Relapsing Remitting SDMT: Symbol Digits Modalities Test VAS-PF: Visual Analogue Scale Physical Fatigue.
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Affiliation(s)
- Maria Anagnostouli
- a 1st Department of Neurology, Aeginition Hospital, Faculty of Medicine , National Kapodistrian University of Athens , Athens , Greece.,b Post Graduate Course, "Stress Management and Health Promotion", Faculty of Medicine , National Kapodistrian University of Athens , Athens , Greece
| | - Ioanna Babili
- b Post Graduate Course, "Stress Management and Health Promotion", Faculty of Medicine , National Kapodistrian University of Athens , Athens , Greece
| | - George Chrousos
- b Post Graduate Course, "Stress Management and Health Promotion", Faculty of Medicine , National Kapodistrian University of Athens , Athens , Greece.,c 1st Department of Pediatrics, Children's Hospital Aghia Sofia, Faculty of Medicine , National Kapodistrian University of Athens , Athens , Greece
| | - Artemios Artemiadis
- a 1st Department of Neurology, Aeginition Hospital, Faculty of Medicine , National Kapodistrian University of Athens , Athens , Greece.,b Post Graduate Course, "Stress Management and Health Promotion", Faculty of Medicine , National Kapodistrian University of Athens , Athens , Greece.,d Medical School , University of Cyprus , Nicosia , Cyprus
| | - Christina Darviri
- b Post Graduate Course, "Stress Management and Health Promotion", Faculty of Medicine , National Kapodistrian University of Athens , Athens , Greece
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García-Betances RI, Cabrera-Umpiérrez MF, Arredondo MT. Computerized neurocognitive interventions in the context of the brain training controversy. Rev Neurosci 2018; 29:55-69. [PMID: 28822228 DOI: 10.1515/revneuro-2017-0031] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2017] [Accepted: 06/29/2017] [Indexed: 11/15/2022]
Abstract
This article presents, in the form of an analytic narrative review, a complete picture of the state-of-the-art, challenges, and perspectives in the field of information and communication technology (ICT)-based neurocognitive interventions for older adults. The narrative particularly focuses on applications aimed at mild cognitive impairment and similar age-related cognitive deficits, which are analyzed in the context of the brain training controversy. Clarifying considerations are provided about the nature and present extent of the brain training debate, regarding the possible influence it has on the support received by research and development initiatives dealing with innovative computerized neurocognitive interventions. It is recommended that, because of the preliminary nature of most data currently available in this area, further research initiatives must be supported in the quest for better effectiveness of computer-based interventions intended for age-related cognitive impairment. The conclusion suggests that advanced ICT-based tools, such as virtual and augmented reality technologies, are the most fitting platforms for applying nonpharmacological computerized neurocognitive interventions.
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Affiliation(s)
- Rebeca Isabel García-Betances
- Life Supporting Technologies (LifeSTech), Superior Technical School of Telecommunications Engineers (ETSIT), Universidad Politécnica de Madrid (UPM), Av. Complutense no. 30, Ciudad Universitaria, E-28040 Madrid, Spain
| | - María Fernanda Cabrera-Umpiérrez
- Life Supporting Technologies (LifeSTech), Superior Technical School of Telecommunications Engineers (ETSIT), Universidad Politécnica de Madrid (UPM), Av. Complutense no. 30, Ciudad Universitaria, E-28040 Madrid, Spain
| | - María T Arredondo
- Life Supporting Technologies (LifeSTech), Superior Technical School of Telecommunications Engineers (ETSIT), Universidad Politécnica de Madrid (UPM), Av. Complutense no. 30, Ciudad Universitaria, E-28040 Madrid, Spain
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Chatzikonstantinou F, Miskedaki A, Antoniou C, Chatzikonstantinou M, Chrousos G, Darviri C. A novel cognitive stress management technique for acne vulgaris: a short report of a pilot experimental study. Int J Dermatol 2018; 58:218-220. [DOI: 10.1111/ijd.14227] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/21/2018] [Revised: 08/08/2018] [Accepted: 08/21/2018] [Indexed: 11/30/2022]
Affiliation(s)
- Foteini Chatzikonstantinou
- Postgraduate Course Stress Management and Health Promotion, School of Medicine; National Kapodistrian University of Athens; Athens Greece
| | - Anastasia Miskedaki
- Postgraduate Course Stress Management and Health Promotion, School of Medicine; National Kapodistrian University of Athens; Athens Greece
| | - Christina Antoniou
- 1st Department of Dermatology, “Andreas Syggros” Hospital, School of Medicine; National Kapodistrian University of Athens; Athens Greece
| | | | - George Chrousos
- Postgraduate Course Stress Management and Health Promotion, School of Medicine; National Kapodistrian University of Athens; Athens Greece
| | - Christina Darviri
- Postgraduate Course Stress Management and Health Promotion, School of Medicine; National Kapodistrian University of Athens; Athens Greece
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A novel cognitive behavioral treatment for patients with chronic insomnia: A pilot experimental study. Complement Ther Med 2018; 37:61-63. [DOI: 10.1016/j.ctim.2018.01.015] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2017] [Revised: 01/29/2018] [Accepted: 01/30/2018] [Indexed: 10/18/2022] Open
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