Hair loss in a female patient after administration of fluoxetine: a case report and review of the literature.

OBJECTIVE: Fluoxetine is a pharmacological agent that has been widely used to determine the neurotransmission of serotonin in the central nervous system. It is the drug of choice in the treatment of depression due to its safer profile, fewer side effects, and greater tolerability. PATIENTS AND METHODS: This is a case of a 30 year-old woman suffering from mild depression according to the DSM-V criteria who had been prescribed and administered fluoxetine in a dose of 20 mg p.o./per day. RESULTS: Six weeks after the initiation of the medication, the patient reported hair loss in the frontal area of the skull. CONCLUSIONS: Since fluoxetine is a widely used antidepressant, clinicians should be aware of the skin complications in patients treated with antidepressants. There is further need for therapeutic monitoring in everyday clinical practice and before the prescription of an antidepressant agent, the specific guidelines, side-effect profile, drug-drug interactions and most current indications should always be taken into consideration.

Adolescents' mental health during the financial crisis in Greece: The first epidemiological data.

Greek financial crisis has incurred adverse effects on the mental health of the population; however existing research is constrained in the adult population. Therefore, the present study aims to shed light on the mental health state of adolescents during the recession. In this context 2,150 adolescents were recruited from a random and representative sample of public and private schools in the greater Athens area. Mental health problems were assessed with the selfreport Strengths and Difficulties Questionnaire while additional questions enquired about students' socio-demographic characteristics. Findings indicate that roughly one out of ten adolescents scored above the cut off point for the total difficulties score, with the higher prevalence been recorded for the conduct problems sub-scale. More specifically, 7.7% of the sample scored above the abnormal cut-off point for the total difficulties score, 10.9% for emotional symptoms, 11.9% for conduct problems, 10.6% for hyperactivity and 4.8% for peer problems. Furthermore, adolescents who reported that during the previous month there was not enough food in their house displayed higher odds of manifesting mental health problems than adolescents who replied negatively in the particular query. On the grounds of these results, there is indication about the adverse effects of the financial crisis in the development of psychiatric symptomatology in adolescents in the Greek society. This is the first study providing epidemiological data on the current state of adolescents' mental health amid the recession in Greece, showing that the crisis impinges disproportionately on the most vulnerable socio-economic groups.

Attitudes of psychology students to depression and its treatment: Implications for clinical practice.

Stigma and mental health literacy affect access to and quality of treatment of major depression. Though mental health professionals seem better able to recognize major depression than the general public, they often hold similarly stigmatizing attitudes towards people suffering from the disorder. These attitudes are shaped jointly by the public stigma attached to mental illnesses as well as by the content and delivery of mental health professionals' undergraduate training. In line with this, the present study aimed to explore psychology students' ability to recognize major depression, their attitudes towards the disorder, and their views surrounding helpfulness of various interventions. A random sample of 167 undergraduate students was recruited from the psychology department of one public university in Athens. During one university hour, students were administered a vignette describing a woman fulfilling the DSM-IV criteria for major depression. A self-report questionnaire exploring students' recognition abilities, attitudes to depression and views on the helpfulness of various treatment modes was also administered. In total, 80.2% of students correctly recognized major depression from the vignette. Concerning their attitudes, students were unsure about the illness and ambivalent towards the person who suffers from it. With regard to available treatments for depression, students considered discussion with a friend to be the most helpful intervention. Counseling, cognitive behavioural therapy and psychoanalysis were also viewed in a positive light. On the contrary, antidepressants were not deemed helpful by most students. Finally, recognition of as well as attitudes towards depression and its treatments seemed to improve during the second year of undergraduate study; however they remained unchanged thereafter. Consistent with these, psychology students seem to have only a rudimentary knowledge on depression, that cannot not be qualified as mental health literacy. The core misconception espoused pertains to the view that major depression is not a medical illness; a finding which can also be interpreted in light of the lingering controversy on the medicalization of normal sadness and human predicament. The clinical implications of these findings are substantial. Mental health professionals-educators should reflect on their own beliefs and attitudes towards depression, as they may convey stigmatizing messages to their students and thus perpetuate the stigmatization of the illness. Concomitantly, psychology students' attitudes to depression and its treatment might render them incapable of understanding their patients, responding to their needs and providing them with appropriate help, while they may hinder their effective collaboration with psychiatrists.

[Economic crisis and mental health: effects on the prevalence of common mental disorders].

Economic crises have been found to bring adverse repercussions on physical and mental health internationally through various pathways. Research corroborates a link between financial distress and common mental disorders. In this context, the University Mental Health Research Institute conducted epidemiological nationwide surveys in an endeavour to gauge the impact of the ongoing financial crisis on the mental health of the Greek population. The purpose of the present analysis pertains to investigating changes in the prevalence of common mental disorders in the population as a whole as well as in various population sub-groups between years 2009 and 2011. In addition, the association of financial strain with common mental disorders was also explored. For investigating the particular research objectives, two cross-sectional surveys following the same methodology were conducted. A random and representative sample of 2192 respondents in 2009 and 2256 respondents in 2011 took part in telephone interviews. Generalized anxiety disorder and major depression were assessed with the germane modules of Structured Clinical Interview, while financial difficulties with the Index of Personal Economic Distress (IPED), an original scale developed for the purposes of the particular surveys. All measures displayed good psychometric properties. Between the two years, a noteworthy, albeit non-significant, increase in one-prevalence of major depression was documented. On the other hand, the prevalence of generalized anxiety disorder remained largely unchanged. Statistically significant differences in the prevalence of both disorders were reported for particular population subgroups, with married persons and employed people emerging as the most afflicted individuals. Regarding financial distress, it was found to bear a statistically significant association with major depression but not with generalized anxiety disorder. For mitigating the mental health effects of the crisis on the general population, study findings underline the necessity of implementing targeted interventions, tailored to the needs and difficulties of each population sub-group.

[Depression telephone helpline: help seeking during the financial crisis].

Mental health telephone help-lines usually play a significant role in mental health services system. Their importance is substantiated during periods of financial crisis, where the mental health of the population is gravely inflicted. Media reports have documented a large increase in calls made to mental health telephone help-lines around the world as a corollary to the global economic crisis; however, a systematic investigation of this observation is still lacking. In this context, the present study endeavours to fill this gap in the literature, while it adds strength to the handful of studies which have empirically supported the impact of the financial crisis on mental health in Greece. Data were extracted from information gleaned during the calls made to the Depression Telephone Helpline of the Greek University Mental Health Research Institute. The information entailed the reason for calling, the socio-demographic and clinical profile of the person with mental health problems, his/her previous and current contacts with mental health professionals and the treatment he/she might be receiving. The results showed a steep increase in calls with direct or indirect reference to the economic crisis during the first half of 2010 and onwards. The callers who referred to the economic crisis manifested depressive symptomatology of clinical significance to a greater degree than callers who made no such reference. The latter exhibited increased levels of distress and agitation as well as drug/alcohol misuse. Concomitantly, a higher frequency of depressive symptomatology was discerned among the unemployed, whereas employed people were found to experience anxiety symptoms to a higher degree. The impact of the financial crisis on the mental health of the Greek population has been considerable, underscoring in this way the importance of mental health help-lines as emotional buffers and as guides for timely and appropriate service use in response to the emerging mental health problems.

Fighting psychiatric stigma in the classroom: the impact of an educational intervention on secondary school students' attitudes to schizophrenia.

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 anti-stigma 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.