Biomedical subjects

Petros Skapinakis

Publications and source records attributed to Petros Skapinakis.

8 recordsLinked to original sources

PubMed2006

Antipsychotic augmentation of serotonergic antidepressants in treatment-resistant obsessive-compulsive disorder: a meta-analysis of the randomized controlled trials.

This study aimed to determine the effectiveness of antipsychotic augmentation of serotonergic antidepressants in the management of treatment-resistant obsessive compulsive disorder by carrying out a meta-analysis of all randomized controlled trials. Studies selected through a literature search conducted in March 2006. Ten trials comparing antipsychotic drugs versus placebo met inclusion criteria (haloperidol [n=1], risperidone [n=3], olanzapine [n=2], quetiapine [n=4]). A total of 157 patients were randomized to study drug and 148 were randomized to placebo. Response occurred more often among patients randomized to antipsychotic drugs. The weighted combined response rate ratio by random effects meta-analysis was 3.31 (95% CI 1.40-7.84). Significant between studies heterogeneity was partly explained by the definition of refractoriness, the type and dose of the drug used and the inclusion or exclusion of patients with tic disorders. The study supports the use of antipsychotic drugs as an augmentation strategy but more and larger trials are needed.

Antidepressive Agents↗

PubMed2006

Socio-economic position and common mental disorders. Longitudinal study in the general population in the UK.

BACKGROUND: Individuals in lower socio-economic groups have an increased prevalence of common mental disorders. AIMS: To investigate the longitudinal association between socio-economic position and common mental disorders in a general population sample in the UK. METHOD: Participants (n=2406) were assessed at two time points 18 months apart with the Revised Clinical Interview Schedule. The sample was stratified into two cohorts according to mental health status at baseline. RESULTS: None of the socio-economic indicators studied was significantly associated with an episode of common mental disorder at follow-up after adjusting for baseline psychiatric morbidity. The analysis of separate diagnostic categories showed that subjective financial difficulties at baseline were independently associated with depression at follow-up in both cohorts. CONCLUSIONS: These findings support the view that apart from objective measures of socio-economic position, more subjective measures might be equally important from an aetiological or clinical perspective.

Adolescent↗

PubMed2006

Gender differences in reoffending after discharge from medium-secure units. National cohort study in England and Wales.

BACKGROUND: Previous research has shown that there are gender differences in reoffending after discharge from medium-secure units, but these have not been adequately explained. AIMS: To investigate gender differences in reoffending after discharge from medium-secure psychiatric units. METHOD: All people discharged from medium-secure units in England and Wales between April 1997 and March 1998 were followed up for 1 year (n=959; 12% women). Reoffending was estimated by collecting reconviction data from the Home Office's Offenders' Index or from files at the mental health unit up to 2 years after discharge. RESULTS: Women were less likely than men to be reconvicted within 2 years of discharge (9% v. 16%, OR=0.49, 95% CI 0.25-0.98). Adjustments for history of self-harm, drug or alcohol problems and previous offending substantially reduced the gender difference. In the full model the OR was 0.97 (95% CI 0.45-2.12). CONCLUSIONS: Some or all of the gender differences in reoffending between men and women are explained by self-harm, alcohol and drug problems and previous criminal history.

Adolescent↗

PubMed2005

Mental health inequalities in Wales, UK: multi-level investigation of the effect of area deprivation.

BACKGROUND: Geographical variation in the prevalence of common mental disorders has not been explained adequately. AIMS: To investigate whether regional mental health differences in Wales would persist after having taken into account the characteristics of individuals and regional social deprivation. METHOD: Data from the 1998 Welsh Health Survey were used. Common mental disorders were assessed with the mental health index included in the Short-Form 36 health survey (SF-36). The data were analysed using a multi-level linear regression model. RESULTS: Of the total variance in the mental health index, 1.47% occurred at regional level (95% CI 0.56-2.38). Adjustment for individual characteristics did not explain the between-region variation. A higher area deprivation score was associated with a higher score on the mental health index. CONCLUSIONS: Mental health differences in Wales are partly explained by the level of regional social deprivation.

Adolescent↗

PubMed2003

Leg wound infection after coronary artery bypass grafting: a meta-analysis comparing minimally invasive versus conventional vein harvesting.

The great saphenous vein remains the most commonly harvested conduit for revascularization in coronary artery bypass grafting (CABG). Our aim is to compare minimally invasive vein harvest techniques to conventional vein harvest with regards to leg wound infection rates. A meta-analysis of identified randomized controlled trials, reporting a comparison between the two techniques published between 1965 and 2002, was undertaken. The outcome of interest was leg wound infection. Fourteen randomized studies were identified and included in the meta-analysis. Our study revealed that wound infection was significantly lower in the minimally invasive vein harvest group (odds ratio 0.22 with 95% confidence intervals of 0.14 to 0.34). Our study suggests that using minimally invasive techniques might reduce leg wound infection rate following great saphenous vein harvesting for CABG. Further research is required to evaluate the potential benefits of minimally invasive vein harvesting techniques on the cost of postoperative care and quality of the harvested vein.

Coronary Artery Bypass↗

PubMed2003

Unexplained fatigue syndromes in a multinational primary care sample: specificity of definition and prevalence and distinctiveness from depression and generalized anxiety.

OBJECTIVE: The authors investigated whether narrow definitions of unexplained fatigue syndromes that require additional minor somatic symptoms are more strongly associated with psychiatric morbidity than wider ones. METHOD: This was a secondary analysis of the World Health Organization Collaborative Project on Psychological Problems in General Health Care. A total of 5,438 primary care patients from 14 countries were assessed with the Composite International Diagnostic Interview. RESULTS: The prevalence of fatigue syndromes fell from 7.99 to 1.69 as somatic criteria were added. Patients with depression or anxiety were more likely to report unexplained fatigue, but this association was stronger for definitions of unexplained fatigue with more somatic criteria. CONCLUSIONS: Definitions of unexplained fatigue syndromes that require more somatic criteria selected more patients with psychiatric disorders in this culturally diverse sample. These findings might have implications for the revision of existing international diagnostic criteria for neurasthenia or chronic fatigue syndrome.

Anxiety Disorders↗

PubMed2003

Cross-cultural differences in the epidemiology of unexplained fatigue syndromes in primary care.

BACKGROUND: Unexplained fatigue has been extensively studied but most of the samples used were from Western countries. AIMS: To present international data on the prevalence of unexplained fatigue and fatigue as a presenting complaint in primary care. Method Secondary analysis of the World Health Organization study of psychological problems in general health care. A total of 5438 primary care attenders from 14 countries were assessed with the Composite International Diagnostic Interview. RESULTS: The prevalence of unexplained fatigue of 1-month duration differed across centres, with a range between 2.26 (95% CI 1.17-4.33) and 15.05 (95% CI 10.85-20.49). Subjects from more-developed countries were more likely to report unexplained fatigue but less likely to present with fatigue to physicians compared with subjects from less developed countries. CONCLUSIONS: In less-developed countries fatigue might be an indicator of unmet psychiatric need, but in more-developed countries it is probably a symbol of psychosocial distress.

Adolescent↗

PubMedDate not supplied

Temporal relations between unexplained fatigue and depression: longitudinal data from an international study in primary care.

OBJECTIVE: Unexplained fatigue syndromes, such as chronic fatigue syndrome and neurasthenia, are strongly associated with depression, but the temporal nature of this association is not clear. METHODS: The authors examined this issue by using data from the World Health Organization collaborative study of psychological problems in general health care. Three thousand two hundred one subjects from 15 primary care centers in 14 countries were followed up for 12 months. The Composite International Diagnostic Interview was the main instrument used. Odds ratios and their 95% confidence intervals (CI) were calculated using logistic regression models adjusted for sociodemographic variables, physical morbidity and intercenter variability. RESULTS: Cases of depression were found to have an increased risk of developing a new episode of unexplained fatigue at follow-up with an adjusted odds ratio of 4.15 (95% CI = 2.64-6.54). Similarly, cases of unexplained fatigue were found to have an increased risk of developing a new episode of depression at follow-up with an adjusted odds ratio of 2.76 (95% CI = 1.32-5.78). Further adjustment for subthreshold symptoms at baseline weakened the reported associations, especially between fatigue and development of a new episode of depression, but these remained significant. CONCLUSIONS: The findings support the view that unexplained fatigue and depression might act as independent risk factors for each other.

Adult↗