Horticultural therapy is used as alternative treatment option in rehabilitation programs for patients suffering from chronic mental disorders. In Greece, the Psychiatric Hospital of Thessaloniki was the first that organized a organized Rehabilitation Program approved by the Greek Ministry of Health, the “Green Unit - Monada Prasinou”.

The purpose of this study was to investigate the effect of horticultural intervention on the functionality of patients employed in the Green Unit of the Psychiatric Hospital of Thessaloniki.

The Mini-ICF-APP Social Functioning Scale was used to evaluate the functionality of the patients. Horticulture therapy included actual gardening and other agricultural activities. The sample consisted of two groups, 22 inpatient of the Green Unit and 22 patients of outpatient units as a control group. The majority of the patients suffered from Schizophrenia spectrum disorders. Both patients’ groups were evaluated over 12 months (May 2018- May 2019).

At baseline evaluation, the patients of the Green Unit patients presented higher scores only in the mobility and endurance subscale. A year later there was a statistically significant difference in all thirteen subscales. Shortly, the patients were rated as more consistent, organizational, social, flexible, responsible, more confident and enterprising, more adaptable and more able to take care of themselves.

The results suggest that horticulture as a therapeutic method had beneficial effects in all dimensions of patient functionality confirming the hypothesis that such programs should be a priority in the effort of psychosocial reintegration of patients suffering from chronic mental disorders.

Adherence to antiretroviral therapy is a key factor in predicting the success or failure of treatment. Data suggest that the status of mental health and especially depression of people living with HIV can affect adherence to antiretroviral therapy.

The purpose of this study was to assess the mental health status of people living with HIV, to record adherence to antiretroviral therapy and to investigate whether mental health affects adherence to antiretroviral therapy.

A cross-sectional mixed observational correlation study in a sample of 112 HIV-positive individuals was conducted. The Simplified Medication Adherence Questionnaire (SMAQ) was used to assess adherence to antiretroviral therapy, the Beck Depression Inventory (BDI) was used to assess depression, and the WHOQOL – BREF tool was used to assess mental health.

The results of the study showed that 58.93% of patients were found to be non-adherent to antiretroviral therapy. Furthermore, according to the BDI scale, 10.7% of patients experienced marginal clinical depression, 10.7% experienced moderate levels of depression and 2.7% experienced severe or very severe levels of depression. Further, people living with HIV had a moderate level of mental health (M = 3.40, SD = 0.58).

Our study showed that a high percentage of people living with HIV are non-adherent to antiretroviral therapy. Factors that are possibly associated with decreased adherence are mental health and especially depression. Psychological support for people living with HIV and anti-depressant prevention programs could increase adherence to antiretroviral therapy.

Suicide has become a leading cause of mortality and morbidity in adolescents and young adults worldwide and has been identified as one of the key mental health problems affecting students. The aim of our study was to determine the prevalence of depressive symptoms and suicidal ideation among nursing students in Greece.

A total of 142 nursing students of the Department of Nursing of the Technological Educational Institute of Thessaloniki agreed to participate in the study. The Beck Depression Inventory II (BDI-II) was administered. Question 9 of the scale was evaluated to examine suicidal tendency.

43.9% of the students experienced depressive symptoms. The mean scores on the BDI were higher in year 1 and 3, while the lowest score was observed in year 2. The evaluation of suicidal ideation per year of studies indicated that the percentage of students who thought of suicide but wouldn’t commit it were mainly in the first or in the last (graduate) years. 88% of our total sample reported never having thoughts of suicide. Significant differences on the basis of gender were observed concerning suicidal thoughts, without actually carrying it out (males>females).

The stressors in nursing education have been consistently acknowledged in the literature. In our sample can be assumed that 2nd year students are more adjusted to the demands of their studies and appear more confident about their choice. Higher levels observed in the last study years are maybe the result of student worries about their professional future.

Religious and spiritual beliefs are widely recognized as important components of human wellness, of health care outcomes and of holistic medical and nursing care. There are controversial data suggesting a correlation between religiosity and mental health disorders among young adults and students. Aim of the study was to determine the association between self-esteem, depression and religious and spiritual beliefs among nursing students in Thessaloniki, Greece.

A total of 122 students agreed to participate in the study. Data was collected using the Greek versions of three self-administered, structured, pre-tested questionnaires: I) The Royal Free Interview for Religious and Spiritual Beliefs II) Beck Depression Inventory (BDI-II) and III) Rosenberg self-esteem scale.

Self-esteem was found normal in 89,3% of the students, low in 10,7%, but it is important to notice that nobody reported high self-esteem levels. The vast majority of the students (61,5%) reported both religious and spiritual beliefs. 27% reported only religious beliefs and 9% only spiritual beliefs. 31,9% of the students perceived depressive symptoms, most of them in mild levels (19,5%). Praying, religious reading and religious attendance were associated with normal self-esteem and low depressive symptoms. However, a consistent negative correlation was found between intrinsic religiosity and depression.

These findings indicate that religious and spiritual variables influence the psychological well-being of students. Religiosity may have a protective role against depression; however, our study sample is relative small and further studies are required in order to evaluate the effect of religious beliefs on the mental health of students.

In contrast to risperidone, aripiprazole seems to be less frequently associated with hyperprolactinemia or may even lower prolactin levels.

We present three cases of risperidone-induced hyperprolactinemia and resolution by aripiprazole.

Case1. Ms. A was a 31-year-old woman with schizophrenia who was treated with risperidone 4 mg/day. One year after risperidone treatment, the patient complained of galactorrhea, amenohrea and breast tenderness and prolactin level was 99.61 ng/ml. She was switched to aripiprazole 15 mg/day. Two weeks after aripiprazole treatment, the patient's prolactin level decreased to 6.74 ng/ml and she menstruated 1 week later. Case 2. Mr. B was a 23-year-old man with schizophrenia. He was treated with risperidone 6 mg/day. Five months after risperidone treatment, the patient developed gynecomastia and his prolactin level was 73.64 ng/ml. He was switched to aripiprazole 30 mg/day. Four weeks after aripiprazole treatment the prolactin level decreased to 17.10ng/ml and gynecomastia disappeared. Case3. Ms. C. was a 30-year-old woman with schizophrenia. She was treated with risperidone 3 mg/day. Nine weeks after risperidone treatment, she complained of galactorrhea and amenohrrea and prolactin level was 90.6 ng/ml. She was switched to aripiprazole 15 mg/day. Only 7 days after the introduction of aripiprazole, the patient's prolactin level declined to 19.6 ng/ml. Her menses resumed with 3 weeks.

Aripiprazole maybe an effective treatment for resolution of risperidone-induced hyperprolactinemia.

Drug use, in ethnocultural subgroups, has been considered either as a mechanism of social integration or as a marker/cause of social disorganization. The health status and health outcomes of many minorities have remained poor, or have deteriorated, despite massive health promotion campaigns.

This is a retrospective archives study. Admissions in Detox Unit of Thessaloniki (residential facility, part of Addictions Department at the Psychiatric Hospital and the only Detoxification Unit in Greece) for the decade 1996-2005 were studied. Socio-demographic and clinical characteristics of patients were recorded.

Patients belonging to ethnocultural subgroups represent 4.8% of the total number of patients admitted (109/2265) and 7.2% of the total admissions number (191/2655). 44% of the total admissions completed the 21 days of stay and 46% left prematurely (median length of stay 5 days). 62% were admitted only once and 43% completed the program. 38% were admitted more then once and 45% of these admissions were successfully completed. The initiation drug is cannabis (82%) and the mean age of beginning drug use is 17 years old. The main substance is heroin, the median period of drug use is 7.5 years and the main way route of administration is intravenous (85%). 48% of them tested positive for Hepatitis C, 1% for Hepatitis B, and 9.1 for both HBV&HCV. 70% have problems with the law.

The percentage of completed admissions of the minorities in Detox is comparable to the Greek patients, but more campaigns about hepatitis seem to be necessary.

Current data reveal that aripiprazole is associated with minimal weight gain. Patients who were stable and had gained excessive weight during olanzapine treatment were switched to aripiprazole. The objective was to evaluate the effect of this switch on body weight.

The effective dosage of aripiprazole 15 mg/day was started while olanzapine 10 mg/day was gradually tapered and stopped.

Case 1. M.A, a 49 -year old woman, had a history of bipolar disorder. She was treated with olanzapine and had gained 14 Kgr while taking aripiprazole, she had lost 9 kgr.

Case 2. Ms B, a 34-year-old woman had a history of schizophrenia. She had been treated with olanzapine and gained 10 kgr. She took aripiprazole and lost 4 Kgr.

Case 3. Mr C, a 45-year-old man, had a history of delusional disorder. He was treated with olanzapine and gained 12 kgr. He took aripiprazole and lost 5 Kgr

Case 4. Mr D, a 25-year-old man, had a diagnosis of schizotypal personality disorder. He was treated with olanzapine and gained 9 kgr, while taking aripiprazole, he had lost 8 Kgr

Case 5. Mr E, a 40-year-old woman, had a diagnosis of schizophrenia. She was treated with olanzapine and had gained 14 kgr, while taking aripiprazole, she had lost 6 Kgr

This study suggests that switching treatment to aripiprazole may be a useful strategy for patients who have gained excessive weight with olanzapine.

The presence of anxiety in addicted patients, although it is expected, has been connected to poorer outcome of addiction treatment, decreased percentages of completion in patients admitted to substance abuse detoxification programmes and shorter period of abstinence. The Addictions Department at the Psychiatric Hospital of Thessaloniki in Greece has an integrated Therapeutic Program which delivers a therapeutic continuum and attempts to cover the needs of various populations through a flexible, interconnected network of multi-dimensional services.

Sixty (60) subjects -equally regarded in a randomized way from three different domains of a Therapeutic Program in Addictions (Detoxification Unit, Residential Therapeutic Community, Reintegration Programme)- were examined. They were screened with the Stait-Trait Anxiety Inventory (STAI) and with the General Health Questionnaire (GHQ-30).

Most of the subjects were young single men, with a secondary educational level. Anxiety level at the Detoxification Unit was quite high (median Stait Score: 56.35±10.37, median Trait Score: 50.70±10.58) as well as at the Therapeutic Community (median Stait Score: 52.90±9.10, median Trait Score: 45.20±7.48). Although there is a gradual decrease of anxiety level, it is not statistically significant. Anxiety level is decreased statistically significant at the Reintegration Programme (median Stait Score: 45.95±6.67, median Trait Score: 41.25±5.35) (p<0.05).

Addicted patients express high anxiety levels at the first stages of a therapeutic detoxification programme. As the therapeutic procedure goes on and abstinence is established, anxiety is decreased –although they are treated as outpatients at the final stage.

Drug use, in isolated "primitive" communities, has been considered as a mechanism of social integration; in ethnocultural subgroups in contact with mainstream society, drug use has been considered as a marker, or sometimes as a cause of social disorganization.

This is a retrospective archives study. Admissions in Detox Unit of Thessaloniki (residential facility, part of Addictions Department at the Psychiatric Hospital and the only Detoxification Unit in Greece) for the decade 1996-2005 were studied. Socio-demographic and clinical characteristics of patients were recorded.

Patients belonging to ethnocultural subgroups represent 4.8% of the total number of patients admitted (109/2265) and 7.2% of the total admissions number (191/2655). 86.73% are men and 13.27% are women. The mean age is 29.68 years old. The vast majority (77%) is Greek repatriated from European Community Countries and the Former Soviet-Union Republics, and some are from Albania. The median length of stay in Greece is 8.9 years. The rest (17%) belong to ethnocultural Greek subgroups (Roma, Greek Muslim minority). Most of the patients admitted are singles and have a secondary education level. The vast majority (84.6%) are unemployed.

The very low percentage of these admissions, 7.2%, doesn't necessarily represent the actual ratio of users in ethnocultural subgroups in Greece. Specific programs would undoubtedly lift some of the obstacles that hinder minority users from seeking help.

The presence of depression in addicted patients has been connected to poorer therapeutic outcome, increased percentages of drop-outs and shorter period of abstinence. The Addictions Department at the Psychiatric Hospital of Thessaloniki in Greece has an integrated Therapeutic Programme which delivers a therapeutic continuum and attempts to cover the needs of various populations through a flexible, interconnected network of multi-dimensional services.

Sixty (60) subjects were examined –they were divided in three groups of twenty persons each, equally regarding (in a randomized way) the three facilitating sections for drug abuse: Detoxification Unit, Residential Therapeutic Community and Reintegration Programme. They were screened with the Beck Depression Inventory (BDI-II), and with the General Health Questionnaire (GHQ-30).

Most of the subjects were young single men, with a secondary educational level. Depression level was statistically significant higher at the Detoxification Unit (BDI Score: 24.55±12.45) compared to the Residential Therapeutic Community (BDI Score: 13.35±10.24) (p<0.05). Furthermore, depression level was decreased at the Reintegration Programme (BDI score: 8.60±5.31) -statistically significant compared to the Detoxification Unit (p<0.000).

Addicted patients seem to have mild severe depression at the first stages of a therapeutic detoxification programme. As the therapeutic procedure goes on and abstinence is established, depression is rapidly decreased in a stable way. Future studies with larger groups of addicted patients are warranted to further investigate the role of depression during the early period of abstinence.

Religious and spiritual beliefs are widely recognized as important components of human wellness, of health care outcomes and of holistic medical and nursing care. There are also studies supporting the theory that anxiety is lower in highly religious and spiritual persons.

The aim of this study was to explore the relationship between religious and spiritual beliefs and psychological wellness among nursing students in Greece

A total of 72 students agreed to participate in the study. Students completed the Greek versions of three instruments: I) The Royal Free Interview for Religious and Spiritual Beliefs, a scale which focuses on the strength and the consequences of faith, rather than on the specific nature of each belief. II) Beck Depression Inventory (BDI-II) and III) The State-Trait Anxiety Inventory (STAI).

The vast majority of the students (55.6%) reported both a religious and a spiritual belief, most of them where females. 16.7% reported a religious belief and 15.3% a spiritual belief. 12.5% stated that they had no religious or spiritual understanding of their life. The majority of the students (86.4%) perceived stress, most of them in mild levels (50.9%). About 3.5% reported very high levels of stress. Depressive symptoms were reported only by 22.5% of the sample. A positive correlation existed among anxiety and depression. On the other hand a consistent negative correlation was found between intense religiosity, state-trait anxiety and depression.

These results are suggesting that religious and spiritual variables may influence psychological well-being of students.

Of all the Second-Generation Antipsychotics (SGAs) risperidone and amisulpride have the highest propensity to elevate prolactin levels. Ziprasidone seems to be less frequently associated with hyperprolactinemia and aripiprazole may even lower prolactin levels. We describe the case of a patient who developed clinically significant hyperprolactinemia while taking both amisulpride and ziprasidone, which resolved with the introduction of aripiprazole

Ms. A a 22- year old woman had a history of paranoid schizophrenia. Two years ago, she was treated with amisulpride 400 mg/day. After 8 weeks of amisulpride treatment, the patient complained of galactorrhea and amenorrhea and her prolactin level was 54 ng/ml. Brain magnetic resonance imaging showed no evidence of a pituitary microadenoma. Two weeks after she stopped taking amisulpride, her prolactin level was 3.8 ng/ml and she menstruated 1 week later. She was given ziprasidone 120 mg/day. Her psychotic symptoms disappeared, but she did not menstruate and her prolactin level rose to 37,4 ng/ml. Ms. A was switched to aripiprazole 10 mg/day.

Only 2 days after the beginning of aripiprazole treatment, the patients prolactin level decreased to 5,6 ng/ml. Her menses resumed with 3 weeks of stopping ziprasidone and remained regular for at least 20 months. Her prolactin level remained normal (the last one was 3,23 ng/ml).

While aripiprazole appears to modulate dopaminergic and serotonergic neurotransmission in a manner similar to that of SGAs, it's partial D2 receptor agonism provides decreased liability for hyperprolactinemia.

Limited research exists worldwide on medical students’ substance use patterns including alcohol and marijuana use.

The aim of the study was to examine the prevalence of substance use, including marijuana, alcohol and other illicit substances (i.e. cocaine, hallucinogens and ecstasy) in a sample of medical students in Greece.

655 students from the School of Medicine of Thessaloniki completed an anonymous, web-based survey including the CAGE questionnaire for alcohol abuse. Students were asked to report the frequency (lifetime, past year, past month) and the motive of the use.

72% percent of the students reported having never used any illegal substance and 21% reported marijuana use at least once in their lifetime. 20.9 % were nicotine smokers. No gender difference regarding marijuana use was observed. Marijuana users underestimated the risk of marijuana use on their health compared to non users. Although the relative mean Cage scores are low indicating a lack of severe alcohol related problems in our sample, there is a significantly higher mean CAGE score in students who use marijuana. The use of other illicit substances was rare (3% used inhalers, 2.3 % cocaine, 2.3% ecstasy, 2% ketamine, 1.8% amphetamines and 1.7% mephedrone). However, the use of marijuana was significantly correlated with use of cocaine, LSD, ecstasy, ketamine, amphetamine and mephedrone.

The findings represent initial data on the prevalence of substance use among Greek medical students. Nationwide studies are needed further investigating the prevalence, the motivation and the impact of this risky behaviour among this population.

Pregnancy complications may require admission in a high-risk pregnancy unit (HRPU). A complicated pregnancy and hospital admission might negatively affect the pregnant woman's mental health.

To screen for depressive symptoms in pregnant women admitted in a high-risk pregnancy unit due to threatened preterm labour and also to investigate for associated risk factors.

Early identification of prenatal depression will decrease the risk of pregnancy complications and postnatal depression.

A prospective study enrolled pregnant women admitted at 324 gestational weeks due to threatened preterm labour in a university hospital HRPU, between 9/2014 and 11/2015. The Edinburgh Postnatal Depression Scale (EPDS) was used to assess depressive symptoms and a cut-off score 313 was considered as indicative of depression. Test results were then correlated with the indication for admission, demographic and socio-economic parameters.

Overall, 80 of the women admitted in the HRPU were eligible for the study and agreed to complete the questionnaire. The mean age was 29.4 ± 6.23 years and the mean gestational week at the admission was 31.6 ± 3.33 weeks. The prevalence of prenatal depression (score 313) was 25% (20/80). In the multivariable model, depression was significantly correlated with the existence of thoughts for pregnancy termination [P = .03 OR = 4.560 95% CI: (1.162–17.892)].

One quarter of pregnant women admitted in the HRPU with the indication of threatened preterm labour may suffer from clinically significant depression. An unwanted pregnancy was found to be independently associated with prenatal depression whereas no association was found with any obstetric parameters.

The authors have not supplied their declaration of competing interest.

Teachers serve as models for young people and significantly influence their health behavior.

We were interested in conducting the first epidemiological survey about tobacco smoking among Greek teachers.

A total of 1032 teachers of the two biggest cities of Greece participated in the study. A questionnaire was created to include questions regarding tobacco smoking, history of tobacco use, nicotine dependence as well as health attitudes. Frequencies and relative frequencies were determined for all the questions. Pearson's Chi2 and Chi2 adjusted tests were used to examine the potential association of current smoking status with gender, age and school level in a statistical significance level of 0.05.

Prevalence of current smokers in the sample was 25.6%. Cigarette emerged as the tobacco product of choice reported by 88,3% of the respondents, followed by e-cigarette (5.2%), cigar (2.4%), hookah (2.4%) and pipe (1.7%). The highest prevalence of current smoking was found in the age group of 40–49 years old (46.1%). Current smoking proportion was higher among female (26.0%) than male teachers (24.9%). Intention to quit smoking was reported by 18.1% of the sample.

As compared to other countries, teachers in Greece have a moderate percentage regarding tobacco smoking. A concerted effort must be made towards smoking cessation in this population with gender specific interventions. It is of great importance for teachers to act as public health promoters, as performers of tobacco prevention curricula and as leaders in the implementation of school tobacco control policies.

The authors have not supplied their declaration of competing interest.