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Cleft lip and palate (CL/P) is the most prevalent craniofacial birth defect in humans. None of the surgical procedures currently used for CL/P repair lead to definitive correction of hard palate bone interruption. Advances in tissue engineering and regenerative medicine aim to develop new strategies to restore palatal bone interruption by using tissue or organ-decellularized bioscaffolds seeded with host cells. Aim of this study was to set up a new natural scaffold deriving from a decellularized porcine mucoperiosteum, engineered by an innovative micro-perforation procedure based on Quantum Molecular Resonance (QMR) and then subjected to in vitro recellularization with human bone marrow-derived mesenchymal stem cells (hBM-MSCs). Our results demonstrated the efficiency of decellularization treatment gaining a natural, non-immunogenic scaffold with preserved collagen microenvironment that displays a favorable support to hMSC engraftment, spreading and differentiation. Ultrastructural analysis showed that the micro-perforation procedure preserved the collagen mesh, increasing the osteoinductive potential for mesenchymal precursor cells. In conclusion, we developed a novel tissue engineering protocol to obtain a non-immunogenic mucoperiosteal scaffold suitable for allogenic transplantation and CL/P repair. The innovative micro-perforation procedure improving hMSC osteogenic differentiation potentially impacts for enhanced palatal bone regeneration leading to future clinical applications in humans. [ABSTRACT FROM AUTHOR]

A nationwide home survey on the identification of possible factors affecting help-seeking behaviour for psychiatric reasons and the prevalence of related psychosocial problems was carried out in a sample of 3754 adults in Greece. Of the total of 570 respondents who reported at the personal interview that they had a serious mental health problem, only 40.8% reported that they had attended a physician or a psychiatrist. A significant proportion of this population (42.5%) had sought the help of a physician. Multivariate analysis revealed two opposite groups of factors determining help-seeking behaviour. Respondents with a serious psychopathological profile (suicidal, depressive and a history of hospitalization) tended to be under psychiatric care. Respondents of lower socio-economic status expressing psychosomatic symptoms were usually the clientelle of physicians. The results are discussed in relation to the need for the development of strategies and techniques in reaching out to mentally ill patients by the appropriate specialists. [ABSTRACT FROM AUTHOR]

A controlled clinical study on the outcome of family intervention in chronic schizophrenics is being carried out in Athens. All subjects participating in the study reside with their families and attend a vocational rehabilitation unit. Those belonging to families characterized by high "Expressed Emotion" (EE) are randomly assigned to either the experimental or the control condition. The former receive family intervention combined with individual treatment, the latter individual treatment alone. 75 subjects have entered the study, and 121 relatives were interviewed with the Camberwell Family Interview. 40 patients (53.3%) were found to belong to high EE families. The present article presents the results of the baseline assessment. It was found that the EE status of the family was significantly associated with measures of psychopathology and social functioning (BPRS, GAS, DAS, number of residual symptoms). Further analyses revealed that these associations exist only when all key relatives express high EE. The implications of these findings are discussed. [ABSTRACT FROM AUTHOR]

Background: Adolescents constitute an appealing target group for fighting stigma and discrimination surrounding mental illness, since it is during this developmental period that adult attitudes about mental illness are formed and consolidated. Aim: The aim of the present study was twofold, to explore adolescents' beliefs and attitudes to schizophrenia and to evaluate the effectiveness of an anti-stigma intervention in altering them. Methods: A total of 616 high school students participated in the study, divided into a control condition and an antistigma intervention group. Data were collected at three time points: before the intervention, upon its completion and at a 12-month follow-up. Results: Baseline measurements indicated that students espoused certain stereotypical beliefs about patients with schizophrenia and were reluctant to interact with them on some occasions. Upon completion of the intervention, positive changes were recorded in students' beliefs, attitudes and desired social distance; however, only the changes in beliefs and attitudes were maintained after one year. Conclusion: For anti-stigma interventions to be effective, they should be continuously delivered to students throughout the school years and allow for an interaction between students and patients. Health promotion programmes might be an appropriate context for incorporating such interventions. [ABSTRACT FROM AUTHOR]

BackgroundThe gene encoding the regulator of G-protein signaling subtype 4 (RGS4), located on chromosome 1q23-3, has been proposed as a possible susceptibility gene for schizophrenia and has been specifically linked to prefrontal cortical structural and functional integrity.MethodThe effects of four core single nucleotide polymorphisms (SNPs) within the RGS4 gene on oculomotor parameters in a battery of oculomotor tasks (saccade, antisaccade, smooth eye pursuit, fixation) were investigated in a sample of 2243 young male military conscripts.ResultsThe risk allele of RGS4SNP18 was found to be associated with two variables of antisaccade performance, increased error rate and variation in the correct antisaccade latency. By contrast, the same allele and also the risk allele of RGS4SNP4 led to an improvement in smooth eye pursuit performance (increased gain). Structural equation modeling confirmed that the combined gene variation of RGS4SNP4 and RGS4SNP18 was a significant predictor of antisaccade but not smooth eye pursuit performance.ConclusionsThese results provide evidence for a specific effect of schizophrenia-related RGS4 genotype variations to prefrontal dysfunction measured by oculomotor indices of performance in normal individuals, further validating the hypothesis that RGS4 is related to prefrontal dysfunction in schizophrenia. [ABSTRACT FROM PUBLISHER]

Background This article presents a study of the Occupational Abilities and Performance Scale (OAPS), developed for administration to schizophrenic patients. The reliability and validity of the OAPS has been evaluated. Method A total of 174 schizophrenic patients who participated in the Psychosocial and Vocational Rehabilitation Unit (PVRU) of the University Mental Health Research Institute (UMHRI) in Athens were assessed. The OAPS is conducted at entry and after 18 months, when the client has completed training. Results The results of the reliability analysis showed very good internal consistency, with high split-half reliability as well as test-retest reliability and inter-rater agreement. The scale was also found to have good predictive validity, as well as concurrent validity. Finally, factor analysis with principal components extraction method was performed in order to assess the construct validity of the scale. Conclusions The results of factor analysis supported the conclusion of good reliability and validity of the OAPS and revealed the existence of five components, each correlated with a set of the original items. [ABSTRACT FROM AUTHOR]

To investigate the effect of exposure to cannabis early in adolescence on subclinical positive and negative symptoms of psychosis.Cross-sectional survey in the context of an ongoing cohort study.Government-supported general population cohort study.A total of 3500 representative 19-year olds in Greece.Subjects filled in the 40-item Community Assessment of Psychic Experiences, measuring subclinical positive (paranoia, hallucinations, grandiosity, first-rank symptoms) and negative psychosis dimensions and depression. Drug use was also reported on.Use of cannabis was associated positively with both positive and negative dimensions of psychosis, independent of each other, and of depression. An association between cannabis and depression disappeared after adjustment for the negative psychosis dimensions. First use of cannabis below age 16 years was associated with a much stronger effect than first use after age 15 years, independent of life-time frequency of use. The association between cannabis and psychosis was not influenced by the distress associated with the experiences, indicating that self-medication may be an unlikely explanation for the entire association between cannabis and psychosis.These results add credence to the hypothesis that cannabis contributes to the population level of expression of psychosis. In particular, exposure early in adolescence may increase the risk for the subclinical positive and negative dimensions of psychosis, but not for depression. [ABSTRACT FROM AUTHOR]

Rates of psychotic disorder and related attenuated psychotic experiences are higher in urban areas. We examined to what degree differences between urban and rural areas could be attributed to differences in cognitive development. Young men from urban areas had higher scores on the SPQ subscale Odd beliefs/magical thinking (OR=1.99, 95% CI: 1.42, 2.78), but lower scores on Excessive social anxiety (OR=0.63, 95% CI: 0.49, 0.81) and No close friends (OR=0.42, 95% CI: 0.29, 0.62). Adjustment for demographic factors, IQ and specific neuropsychological functions did not change the results. When the lower scores on Excessive social anxiety and No close friends were taken into account, the differences on the Odd beliefs/magical thinking subscale became even more pronounced (OR=2.33, 95% CI: 1.56, 3.49). Young men from urban areas are socially more competent, but display higher levels of positive psychotic experiences, which are not mediated by lower IQ or higher levels of neuropsychological impairment. [ABSTRACT FROM AUTHOR]

A total of 940 young men performed a task in which they actively maintained fixation for 50 s in three conditions: a) on a visual target, b) on a visual target while distracting targets appeared briefly on the periphery and c) with no visual target present. The same individuals completed psychometric evaluation tests measuring IQ, schizotypy and current state-dependent psychopathology. The proportion of fixation time decreased and saccade frequency increased in condition b compared wih condition a, and sequentially in condition c compared with condition b. A trend towards a decrease in proportion of fixation time and increase in saccade frequency was found as the subjects maintained fixation during the task and this time-dependent deterioration of performance was again most pronounced in condition c, less so in condition b and absent in condition a. Psychometric test scores were significantly correlated with fixation performance in the population. Worse performance in all three fixation conditions was observed for individuals with lower IQ scores. A deterioration of fixation performance with time in condition b was correlated with disorganization characteristics of schizotypy, suggesting that these individuals had difficulty maintaining active fixation in the presence of increased inhibitory load. A connection of such a difficulty with the frontal lobes and their role in the control of voluntary inhibitory functions is discussed. [ABSTRACT FROM AUTHOR]

A sample of 676 healthy young males performed visually guided saccades and antisaccades and completed the Porac-Coren questionnaire measuring lateral preferences. There was no difference in mean latency between rightward versus leftward saccades or for saccades executed in the left versus right hemispace. There was also no right/left asymmetry for individuals with left or right dominance as assessed by the lateral preferences questionnaire. The same results were observed for the latency of antisaccades and for the error rate in the antisaccade task. Finally, we did not confirm any substantial subpopulation of individuals with idiosyncratic left/right latency asymmetries that persisted both in the saccade and antisaccade task. These results suggest that neither latency nor antisaccade error rate are good indicators of lateral preferences in these tasks. Other oculomotor tasks might be more sensitive to hemifield differences, or cerebral hemispheric asymmetry is not present at the level of cortical organization of saccades and antisaccades. [ABSTRACT FROM AUTHOR]

Background: The effectiveness of family intervention in schizophrenia has mainly been tested by controlled trials which recruited patients after hospital discharge. Less is known about its effectiveness when chronic schizophrenics displaying negative rather than positive symptoms are engaged in treatment. This study was conducted in two community-based rehabilitation units for chronic psychiatric patients and was planned to test: (1) whether family intervention combined with individual psychosocial treatment is more effective than individual psychosocial treatment in improving the clinical and social prognosis of schizophrenic patients belonging to high expressed emotion (high-EE) families, and (2) whether family intervention exerts its effect on the patients through the reduction of EE in their families.Methods: Forty patients from high-EE families, all under neuroleptic medication and in remission at intake, were evenly assigned to individual psychosocial treatment or to psychoeducational family intervention plus individual psychosocial treatment. Individual treatment consisted of vocational and social skills training; family intervention mainly comprised 13 group sessions with relatives. Patients were treated for 12 months and were followed-up for the next 2 years. Measures of clinical outcome comprised relapse, hospitalization and clinical exacerbation. Measures of social outcome included social functioning and role performance. Re-employment served as an additional measure at the follow-up assessments.Results: The experimentals were free of relapses and hospitalizations during the 1st year of follow-up. The difference in relapse rates between experimentals and controls over the same period was statistically significant (P = 0.05), especially if drop-outs were included in the statistical analysis. The difference in hospitalization rates did not yield any statistical significance. All differences declined in the 2nd year of follow-up. Family intervention was found to be positively, but not significantly, associated with higher reversal rates from high to low EE, especially among full attenders of relatives' group sessions. High EE was identified as a predictor of relapse, but not of hospitalization, over the 2-year follow-up period.Conclusion: Results support the importance of encompassing family members in the community care and tertiary prevention of schizophrenia. [ABSTRACT FROM AUTHOR]

Cites the simulated generation of evoked potentials components. Use of networks with distinct excitatory and inhibitory neurons; Description of long latency evoked potentials; Presentation of a neural network model; Examination of excitatory low-pass synapses.

Abstract Aim of the study was to examine the consistency of the five-factor model of schizophrenic symptoms, assess its validity and evaluate its dimensional factor structure using confirmatory factor (CFA) analysis. A sample of 258 randomly assigned DSM-III R patients with schizophrenic disorders were studied by means of the structured clinical interview for the Greek validated Positive and Negative Syndrome Scale (PANSS) and were rated on its 30 items. Patients' scores were subjected to principal component analysis (PCA) with varimax rotation. Internal consistency for each of the components was determined by the use of Cronbach's alpha. External validity of the model derived was investigated by searching for possible relationships between the components and sociodemographic characteristics with the aid of canonical correlation analysis. Confirmatory factor analysis (CFA) was also performed. Using the scree plot criterion PCA revealed a five-factor model. These factors were interpreted as representing -- in a decreasing order of relative importance -- the following dimensions of schizophrenic psychopathology: negative, excitement, depression, positive and cognitive impairment. The model was comparable with six previous factor analytic studies. Internal consistency was quite satisfactory whereas external validity was found to be not so powerful. CFA did not show that the proposed model yields an adequate factor structure. [ABSTRACT FROM AUTHOR]

Background: In this paper the geographical distribution of discharge rates of psychiatric patients in Greece, nationwide, is shown.Method: Utilization rates are estimated by the number of discharged patients from all public and private mental hospitals for the period 1978-1993.Results: During this period six prefectures were repeatedly found to exhibit the highest discharge rates for both sexes. Five out of those six areas are mountainous, socially isolated and of a lower level of socioeconomic development, lacking mental health services. The correlation coefficients for the annual mean age-standardized discharge rates of psychiatric patients and the corresponding General Index of Development score of each area were found to be statistically significant for all diagnoses, and for schizophrenic psychoses taken separately, in each prefecture for each of those years (1978-1993).Conclusions: It seems that the higher the hospital treated psychiatric morbidity is, the lower is the level of general socioeconomic development of the area. It is possible that families from socially disadvantaged areas, with limited support resources, are unable to avoid the hospitalization of their mentally ill members. [ABSTRACT FROM AUTHOR]

In order to investigate the influence of various environmental parameters on melatonin excretion, the night-time urinary melatonin excretion of 16 healthy volunteers was measured in samples collected monthly over a period of one year. No significant interindividual differences were detected in the monthly rate of change of melatonin excretion. A seasonal bimodal pattern did, however, emerge. Peak values were observed in June and November. In these months a combination of high daylength stability and low values of the vertical component of the geomagnetic field was recorded. Trough values were found in April and August-October when low daylength stability was combined with high values of the vertical component of the geomagnetic field. We propose that the daylength variation rate, and the fluctuations of the vertical component of the geomagnetic field, interact to induce the changes in melatonin secretion which signalize the different seasons in humans. [ABSTRACT FROM AUTHOR]

A nationwide study of suicide in Greece from 1980 through 1995 demonstrated: 1. A mean age-standardized suicide rate of 5.86/100,000 for males and 1.89/100,000 for females. 2. An increase in suicide rates with age, especially in males. 3. Significant rising trends of male suicides in the 45-54 age group. 4. Significant declining trends of female suicides in age groups 15-24, 75-84, and total. 5. The lowest suicide rates among married men and women. 6. Exceptionally high rates in young widowed men. 7. Rural suicide rates were twice as high as urban rates. 8. Suicide methods were mostly violent, especially in males. 9. Hanging was the most common method, employed in approximately 50% of all suicides. The low suicide rates and the trends observed can probably be attributed to a synthesis of social and cultural characteristics of the Greek people and ongoing changes in Greek lifestyle. [ABSTRACT FROM AUTHOR]

This paper reports on the regional prevalence of symptoms of depression and clinical depression (current major depressive episodes) in Greence in the years 1978 and 1984. Prevalence rates were estimated from two extensive, nationwide cross-sectional home surveys on psychosocial issues and health, carried out in four geographical areas: the Greater Athens area, the Greater Thessaloniki area, the rest of the urban areas and rural areas. The methodology used, the sampling procedure and the screening instrument (The Center for Epidemiologic Studies-Depression Scale) were the same in both surveys. Within the 6-year period a substantial increase in the prevalence of symptoms of depression in all geographic areas was observed, with the Athenian respondents expressing a higher number of symptoms of depression than their counterparts from the other areas. The prevalence of current major depressive episodes, according to specific criteria matched with criteria from the DSM III R, was increased in 1984 in Athens and in the rural areas only. We suggest that economic instability between 1978 and 1984 probably contributed to the changes in the rates of depressive disorders. [ABSTRACT FROM AUTHOR]

Until recently mental health care in Greece was mainly delivered by old traditional mental hospitals and few outpatient services. In order to induce the process of change the University of Athens started to experiment with a community mental health service. In order to study what has been achieved in a relatively short time, data relating to the delivery of care cohorts of patients from a pilot area in Athens and from an area in the north of the Netherlands were compared. The overall new contact rate was much higher in the Groningen area, except for the category of psychoneuroses and personality disorders. Patients with a psychosis received more intensive treatment and left the services at a later stage in Athens. Differences of patterns of care in other diagnostic and age groups are discussed. [ABSTRACT FROM AUTHOR]

Until recently mental health care in Greece was mainly delivered by old traditional mental hospitals and few outpatient services. In order to induce the process of change the University of Athens started to experiment with a community mental health service. In order to study what has been achieved in a relatively short time, data relating to the delivery of care cohorts of patients from a pilot area in Athens and from an area in the north of the Netherlands were compared. The overall new contact rate was much higher in the Groningen area, except for the category of psychoneuroses and personality disorders. Patients with a psychosis received more intensive treatment and left the services at a later stage in Athens. Differences of patterns of care in other diagnostic and age groups are discussed. [ABSTRACT FROM AUTHOR]

Forty schizophrenic patients attended for one year a rehabilitation programme consisting of vocational training, and social therapy in the context of medication. Clinical and family environment assessments were carried out at intake and discharge. The results indicate a highly significant improvement in terms of patients' deficit symptomatology and social functioning, but only a marginal modification of family environment by the end of the programme. Particular dimensions of family environment, concerning acceptance of the patient by other family members, intrafamilial relationships, and family structure, were not affected at all by the therapeutic intervention. The results suggest that intensive individual psychosocial treatment exerts its main effect on the patient, and imply that the modification of negative family atmosphere necessitates direct family intervention. [ABSTRACT FROM AUTHOR]