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ObjectiveTo investigate the effect of the time spent on quarantine on distress, anxiety, depression, and somatization of chronic disease patients during the COVID-19 quarantine in Greece and the differences in these parameters between healthy individuals and chronic disease patients.MethodThe sample consisted of 943 healthy individuals and 163 patients (respiratory, autoimmune, cardiovascular, endocrine, patients with other diseases, and patients with more than one disease) completing sociodemographic assessments as well as the 4-Dimensional Symptom Questionnaire (4DSQ) during March 30, 2020 to May 3, 2020. Pearson's correlation was used to search for the association between time spent on quarantine and the 4DSQ subscales (distress, anxiety, depression, and somatization). Independent sample T-test and Glass's Δ were used for differences between healthy individuals and chronic disease patients in these subscales, an analysis also carried out between healthy individuals and all patient subgroups.ResultsNo statistically significant correlations were noted between the 4DSQ subscales and the quarantine duration, both for the patient and the healthy individuals’ group. Chronic disease patients had significantly higher levels of distress (p = 0.001, Δ = 0.28) and somatization (p = 0.000, Δ = 0.47), but not there were no significant differences in anxiety (p = 0.098, Δ = 0.14) and depression (p = 0.052, Δ = 0.19). Concerning head-to-head comparisons between the healthy individuals’ group and each patient group, significantly higher scores in distress were found only for patients with respiratory diseases (p = 0.028, Δ = 0.42). Regarding somatization, significantly higher scores were noted for the healthy individuals’ group compared with patients with autoimmune diseases (p = 0.010, Δ = 0.62), respiratory diseases (p = 0.027, Δ = 0.42), other diseases (p = 0.003, Δ = 0.55), and more than one disease (p = 0.012, Δ = 0.60). No statistically significant differences were found in anxiety and depression.Significance of resultsThe results of this study indicate that interventional programs for chronic disease patients during quarantine should focus on distress and somatization, not on anxiety and depression. Respiratory patients might have more supportive care needs compared with patients with other diseases.

The Kentucky Inventory of Mindfulness Skills (KIMS) is a widely used multidimensional tool for assessing the tendency of the individual to be mindful in everyday life. The aim of the present study was to standardize a Greek version of KIMS and to explore its psychometric properties in the Greek population. A sample of 213 Greek undergraduate and postgraduate students from various educational institutions completed the questionnaires. The Mindful Attention and Awareness Scale (MAAS), Toronto Alexithymia Scale (TAS-20), and Perceived Stress Scale (PSS-14) were used to evaluate the criterion validity of KIMS. The Principal component analysis (PCA) resulted in a four-component solution, similar to the structure of the English version of the inventory: "Observing," "Describing," "Acting with awareness," and "Accepting without judgment." All components combined accounted for 45.79% of variance. The subscales had adequate internal consistency, and their scores were correlated with MAAS, TAS, and PSS scores, indicating satisfying criterion validity. Associations between the "Observing" subscale and demographic characteristics were also revealed. This version of KIMS can be safely utilized for assessing mindfulness skills and the efficacy of mindfulness-based interventions in Greek populations.

A growing part of the literature has focused on depression, anxiety, distress and somatization. Identifying their prevalence and recording high-risk populations is essential in order to form relevant interventional programs addressing these symptoms. The aim of this study was to examine the prevalence and associated factors of distress, depression, anxiety and somatization in a community adult sample in Greece. Participants were recruited from two Greek cities; Giannitsa in the northern area and Athens in the southern area of the country and completed sociodemographic assessments, as well as the 4-Dimensional Symptom Questionnaire (4-DSQ), a self-reported instrument assessing depression, anxiety, distress and somatization.A total of 2,425 adults, females (60.1%) and males (39.9%), 18 to 84 years of age (mean age 46.98 ± SD) participated in the study. Mental health symptoms were reported by 10.8% for depression, 12% for anxiety, 13% for distress and 5.3% for somatization of the participants. Females scored higher than males in anxiety, distress, and somatization (p=0.000 in all cases), while there were no significant sex differences in depression (p=0.593). Statistically significant associations were found between age and depression, anxiety and distress (p=0.000 in all cases), since those between 18-34 years of age had higher scores than the older age groups in all variables. Higher scores of depression, anxiety and distress were reported by students and unemployed participants (p=0.000 in all cases) than participants with other occupations. This study mapped several sociodemographic groups with worse mental health. Studies in representative population samples are needed to guide public health interventions to improve the mental and physical well-being of high-risk populations.

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.

Background:Many cancer patients use a wide variety of techniques to improve their physical and mental well-being, including relaxation therapy and, specifically, Progressive Muscle Relaxation (PMR). However, there is no strong evidence that supports the efficacy of this technique.Objective:Our aim was to review the evidence regarding the use of PMR as a supportive intervention for cancer patients undergoing chemotherapeutic treatment.Method:Six databases were electronically searched: AMED, the Cochrane Library, MEDLINE, PsychINFO, Scopus, and the Web of Science. After removing duplicates, 700 publications were screened and 57 identified as potentially relevant. The flow of information from record identification to study inclusion was conducted in accordance with the PRISMA statement. Original articles published in peer-reviewed journals that studied the use of PMR as an intervention, were randomized or included a matched control group, and that included patients receiving chemotherapy were included. Studies that combined PMR with other interventions were excluded. The methodological quality of included trials was assessed using the Jadad Scale and the CONSORT guidelines.Results:A total of 5 of the 57 papers fulfilled the preset criteria and were included in our systematic review. Our findings indicate that PMR might improve comfort and reduce the anxiety levels and side effects caused by chemotherapy, with the exception of vomiting. Nonetheless, the quality of all the included studies was extremely low.Significance of results:There is evidence that PMR might have a few benefits for patients undergoing chemotherapy. Still, the small number of studies included and their poor quality limit the significance of our results. Despite the fact that pharmaceutical approaches for controlling side effects might be reaching their full potential and that there might be further usefulness for such integrative treatments as PMR, the need to run more high-quality trials testing the efficacy of this technique is warranted before suggesting its adoption as part of standard cancer care.

Objective. To assess the effects of an 8-week stress management and health promotion program on women undergoing breast cancer chemotherapy treatment. Patients and methods. A total of 61 patients were recruited in 2 cancer centers and were randomly assigned to the intervention program (n = 30) or control group (n = 31). The intervention program consisted of different stress management techniques, which were combined with instructions for lifestyle modification. Assessments were carried out through questionnaires and measurement of body mass index (BMI) at baseline and at the end of the 8-week program. Results. In all, 25 participants completed the intervention program, whereas 28 participants completed the observational control program. The intervention program resulted in a small effect size on internal dimension of Health Locus of Control (HLC) and a medium effect size on stress, depression, anxiety, night sleep duration, and chance dimension of HLC. A strong effect size was recorded for BMI and sleep onset latency. Self-rated health, spiritual well-being, and powerful others dimension of HLC were not significantly affected. Additionally, some of the participants reported a reduction in the side effects caused by chemotherapy. Conclusions. The intervention resulted in several benefits for the general health status of patients. Therefore, it should be considered as feasible and potentially beneficial for women undergoing breast cancer chemotherapy. However, it is necessary for this intervention to be tested through a randomized controlled trial in a larger sample of patients before adopting this program in standard cancer care.

Centenarian research contributes to expanding our knowledge on longevity and healthy aging. In Greece, a variety of studies have been conducted in order to explore exceptional longevity. This is a retrospective study of 106 centenarians employing both quantitative and qualitative measures in order to explore centenarians own perspective on longevity. Basic socio demographic and life style variables where associated with centenarians beliefs and perceptions about their longevity. The majority of centenarians attributed their longevity to God and to living a good life overall. God and social networks were reported as their main source of strength in order to continue living. Gender differences were also evident as male centenarians reported non abusive behaviors and a sense of having a measure in daily living, as well as nutrition as their main source of longevity, while female emphasized on God and social networks. Gender differences on Body Mass Index and Smoking are also evident. Centenarians own perception of longevity could be further explored and findings could be incorporated in future research and intervention programs aiming at healthy longevity.

Intense stress has a harmful effect on the human body and is considered as a causative factor for a plethora of disorders [1], while regarding cancer the belief that its onset may be associated with a stressful experience is found in the British, French, and United States medical literature at least as far back as 1701 [2]. Apart from these premature scientific hypotheses, there is evidence that a high proportion of the general population also believes that “stress causes cancer” [3]. Nevertheless, this might not be true since it is still unknown if there is a link between stress and cancer’s occurrence. In fact, both epidemiological and molecular biological studies have established that breast cancer is the only type of cancer whose onset could be attributed to intense stress [4,5].

Background: Panic disorder during adjuvant chemotherapy for breast cancer occurs rarely and thus there are no studies, nor specific guidelines to treat its troubling symptoms that may lead to treatment discontinuation. Case report: We describe a patient with breast cancer developing panic disorder during adjuvant chemotherapy treatment putting at risk its completion. We used progressive muscle relaxation (PMR) to effectively control her symptoms and achieved completion of her therapy. To our knowledge, this is the first reported case of a patient with breast cancer developing adjuvant chemotherapyrelated panic disorder. PMR is highlighted through our study as an effective way of handling panic disorder in oncology units.