[Comparative study of the operation of two day's Hospitals in Athens].

The present paper describes the preparation for the commencement of services by the University Mental Health Research Institute (UMHRI) Day Hospital and Eginition Day Hospital whose operation (in 1977) signifies the beginning of the Psychiatric Reform in our country. The two units' functional characteristics and the type of offered services are mentioned. Psychotherapeutic, biological and sociotherapeutic approaches are practiced on a daily basis within a framework of Therapeutic Community services. Moreover, relations, similarities and differences among the two day hospitals are pointed out. Special mention is given to the problems and difficulties that these two units faced upon their commencement, which took place at different time periods, set 32 years apart. The lack of legislative framework with regards to the operation of Day Hospitals, the bureaucratic obstacles and the skepticism towards the new treatment approach of patients, were the basic obstacles that had to be overcome in order for the first Day Hospital to become operational in 1977. Licensing and funding were the main obstacles that the creation of UMHRI's Day Hospital faced, although these two units had already been established. Emphasis was placed on the staff's training, which mainly consisted of young professionals and at the social environment's and all those services' (health-care, community etc) attitude, in the specific catchment area (6th Mental Health Sector). The study of patients' characteristics hospitalized in Eginition's Day Hospital throughout its first year of operation (1977-1978) and of patients hospitalized at UMHRI's Day Hospital, also at its first year of operation (2009-2010), showed, among other things, that in both cases, the number of hospitalized male patients is larger than the number of female patients. This constitutes an exception compared to other countries, whereby female patients outnumber male patients in Day Hospitals. Especially at UMHRI's Day Hospital, the number of men is twice the number of women and three times the number of women in the subgroup of patients with schizophrenia. In addition, at Eginition Day Hospital, the men- women ratio is 3:2 in the total number of hospitalized patients and 2:1 in the schizophrenia subgroup. The comparison between the hospitalized patients in Eginition Day Ηospital and UMHRI. Day Hospital brought out the following differences: inpatients at UMHRI's day Hospital were more often older, (x²= 29.52, p=0.0001), unemployed (x²=14.65, p=0.0001) and used public means of transportation more rarely (x²=7.38, p=0.005). No other differences were found in the rest of the sociodemographic variables such as education, marital status, insurance agency, living conditions, traveling time to the day Hospital, referral source, diagnosis of schizophrenia, past hospitalizations. To conclude, it is worth mentioning that the Day Hospital is in a position to treat patients with active psychotic symptomatology, preventing thus their hospitalization on a 24 hour basis.

Suicide attempts among Greek and Danish women and the quality of their relationships with husbands or boyfriends.

Greek and Danish women 15-45 years old who attempted suicide were interviewed with an extensive semistructured schedule, in Athens and Copenhagen, after admission to the intensive care unit of 2 general hospitals and one psychiatric reception ward. This article presents 2 groups from each country, a group of married women and a group with steady relationships (n = 56), focusing on the quality of their relationships and their significance for the women's suicide attempts. Most of the women in both countries had very poor relationships, as concerns communication, intimacy, concern, recreation, sharing of everyday activities and social and private life. A high degree of psychological and physical violence was found in all 4 groups. The burdensome and humiliating relationship created shame in the women. After unsuccessful attempts to change the relationship and inability to leave it because of financial and emotional dependence, the women attempted suicide to escape from the situation.

[Is prolonged psychological stress an etiological factor in breast cancer?]. / Le surmenage psychique prolongé est-il un facteur étiologique du cancer mammaire?

1,088 women with cancer were seen in a period of 4 1/2 years at the Cancer Centre of the Greek Social Security Department in Athens. The authors present their results as far as psychological stress influences the development of cancer of the breast in 813 patients (Group A) and in 685 women who did not have cancer of the breast (Group B). They were able to show that Group A had a positive correlation which was statistically very significant (p less than 0.001) with the following parameters: the death of a much-loved person; the negative behaviour of the husband; an unexpected change in life style; continual conflicts in the family; financial problems; unsatisfactory sex life; consultations with a psychiatrist and allergy. There was a positive correlation which was statistically significant (p less than 0.01) with the parameters: disappointment in sentiment; a lowering in life style; a family history of cancer of the breast; hypertension; late start in the menarche and the onset of the menopause. The authors conclude that they believe that it is useful to look at all the factors that are known as risks for cancer of the breast, including the influence of psycho-traumatic factors.

A scale for detection of negative attitudes towards medication among relatives of schizophrenic patients.

The validity of a questionnaire developed to assess negative attitudes towards drug therapy by relatives of schizophrenic patients is examined. The questionnaire items are tested against the statement: "Patients should not take drugs, they can only be helped by good advice". The prejudice of relatives of schizophrenics against drug therapy may have an effect on the patients' compliance to maintenance therapy and, subsequently, on their relapse rate. A number of factors, social and psychological, were examined as possible determinants of the negative attitudes of relatives. These factors include age, sex, profession, education, positive family history, and use of drugs among the relatives; mental state, residence, duration of illness, relapse rate and clinical features in the patients. Poor education of relatives correlated to negative attitudes towards drug therapy.

Short-term social prognosis of schizophrenia.

Two groups of schizophrenic patients with diametrically opposed illness outcomes were compared, 14 months after discharge, with respect to 21 parameters. The first group comprised patients who relapsed and were readmitted into hospital and the second group comprised patients who achieved satisfactory occupational rehabilitation in the community. Satisfactory occupational rehabilitation was positively associated and relapse was negatively associated with the following parameters: compliance to maintenance pharmacotherapy, satisfactory work record, compulsory admission into hospital, living apart from parents or spouse after discharge, illness precipitated by stressful events, longer duration of hospitalization and more advanced age at onset of illness. The authors express the view that awareness of the parameters influencing short-term social outcome might contribute to a more efficient management of schizophrenic patients.

Problems related to the organization and opening of the first day hospital in Athens.

Problems in connection with the preparation and opening of the first Day Hospital in Athens are described, as well the difficulties created by local conditions. These problems are mainly related to our out-dated legislation, bureaucracy, public prejudice about the psychiatric patient, the lack of supplementary helping services and more general state care for the rehabilitation of psychiatric patients, as well as the fact that the single Day Hospital in Athens will be called upon to cover a very large sector of our population.

Factors associated with occupational rehabilitation of psychiatric patients.

Factors related to occupational rehabilitation of 40 psychiatric patients (and a subgroup of 30 schizophrenic patients) hospitalized at the Day Hospital of Athens' University Department of Psychiatry were studied. Rehabilitation was negatively associated to a statistically significant degree with: chronicity of illness, time spent in unemployment, and male sex. Time spent in unemployment was also negatively related to rehabilitation at the previous employment setting. More women than men were rehabilitated. Duration of illness and duration of present hospitalization were longer for men, commitment to the hospital's daily schedule was stronger for women, and male patients had more absences from treatment sessions in comparison to female patients.