The impact of Covid-19 on people under opioid substitution treatment.

Given the aggravation on the general population's quality of life due to covid-19 and the vulnerability of People Who Use Drugs (PWUD) to acute stress, the aim of the current study was to better comprehend the impact of covid-19 on quality of life and mental health of PWUD as well as their drug use patterns. Another study had been conducted prior to the covid-19 outbreak, which assessed quality of life, indicative PTSD symptoms, and drug use patterns of people who were attending an Opioid Substitution Treatment (OST), in Athens, Greece. As a continuation of the aforementioned study, the same variables were assessed in May and June 2020, after the first lockdown measures. 104 patients agreed to participate. The World Health Organization Quality of Life Questionnaire (WHOQOL) and the Post-Traumatic Stress Scale (PCL-C) were used as well as toxicology tests. The only statistically significant outcome was a reduction regarding the dimension referring to the relationship between the individual and their environment. People with low quality of life were found to experience more severe Post- Traumatic Stress Disorder (PTSD) symptoms after lockdown comparing to those with high quality of life. There was also a statistically non-significant increase in PTSD scores before and after lockdown measures. Regarding drug use patterns, the present research reveals an overall decline in drug use during quarantine. There was a statistically significant decrease in opioid (22.3%) and in benzodiazepine (35%) use after lockdown. Also, a statistically significant increase in mean scores of indicative PTSD symptoms of people who decreased opioid use during and after lockdown measures was found. In regards to amphetamine use, research findings underline a non-significant increase in use (8.7%). The pandemic's impact on the life of people on opioid substitution treatment should be taken into consideration and further studies need to be conducted in order to protect this populations' quality of life and maximize the potential benefits such as reduced access to illicit substances.

Doctors' Perceptions and Practices of Breaking Bad News: A Qualitative Study From Greece.

There is limited information about doctors' communication behaviors and their salient beliefs with regard to bad news disclosure in Greece. In this qualitative study we investigated the self-reported practices of doctors on breaking bad news, their perceptions about the factors affecting the delivery of such news, and their beliefs about the most appropriate disclosure manner. A focus group discussion and individual interviews were conducted. Twenty-five resident and specialist doctors from primary health care and hospital settings participated. We analyzed the collected data with content analysis techniques. Participants were found to acknowledge the importance of appropriate and effective delivery of bad news; however, none of them reported the implementation of empirically informed communication practices. They described communication patterns mainly formed by their work experience and often guided by the patient's family requests. Doctor, patient, and family characteristics and organizational features and resources were reported to affect the delivery of bad news. Participants perceived the most appropriate disclosure manner as an individualized approach to each patient's unique needs. They suggested an interdisciplinary, collaborative management of the delivery process and the establishment of formal supportive services. These findings may provide useful information for the development of tailored, empirically informed curriculum interventions and educational programs in order to address several barriers to communication. Sociocultural characteristics that influence the disclosure practice, as well as physicians' perceptions that are consistent with the optimal information delivery, should be taken into account. System-level strategies that focus on the development of patient-centered communication also need to be prioritized.

Bullying behaviour in schools, socioeconomic position and psychiatric morbidity: a cross-sectional study in late adolescents in Greece.

BACKGROUND: Bullying is quite prevalent in the school setting and has been associated with the socioeconomic position and psychiatric morbidity of the pupils. The aim of the study was to investigate the association between bullying and socioeconomic status in a sample of Greek adolescents and to examine whether this is confounded by the presence of psychiatric morbidity, including sub-threshold forms of illness. METHODS: 5,614 adolescents aged 16-18 years old and attending 25 senior high schools were screened and a stratified random sample of 2,427 were selected for a detailed interview. Psychiatric morbidity was assessed with a fully structured psychiatric interview, the revised Clinical Interview Schedule (CIS-R), while bullying was assessed with the revised Olweus bully/victim questionnaire. The following socio-economic variables were assessed: parental educational level and employment status, financial difficulties of the family and adolescents' school performance. The associations were investigated using multinomial logit models. RESULTS: 26.4% of the pupils were involved in bullying-related behaviours at least once monthly either as victims, perpetrators or both, while more frequent involvement (at least once weekly) was reported by 4.1%. Psychiatric morbidity was associated with all types of bullying-related behaviours. No socioeconomic associations were reported for victimization. A lower school performance and unemployment of the father were significantly more likely among perpetrators, while economic inactivity of the mother was more likely in pupils who were both victims and perpetrators. These results were largely confirmed when we focused on high frequency behaviours only. In addition, being overweight increased the risk of frequent victimization. CONCLUSIONS: The prevalence of bullying among Greek pupils is substantial. Perpetration was associated with some dimensions of adolescents' socioeconomic status, while victimization showed no socioeconomic associations. Our findings may add to the understanding of possible risk factors for bullying behaviours in adolescence.

Socioeconomic inequalities in general and psychological health among adolescents: a cross-sectional study in senior high schools in Greece.

BACKGROUND: Socioeconomic health inequalities in adolescence are not consistently reported. This may be due to the measurement of self-reported general health, which probably fails to fully capture the psychological dimension of health, and the reliance on traditional socio-economic indicators, such as parental education or occupational status. The present study aimed at investigating this issue using simple questions to assess both the physical and psychological dimension of health and a broader set of socioeconomic indicators than previously used. METHODS: This was a cross-sectional survey of 5614 adolescents aged 16-18 years-old from 25 senior high schools in Greece. Self-reported general and psychological health were both measured by means of a simple Likert-type question. We assessed the following socio-economic variables: parents' education, parents' employment status, a subjective assessment of the financial difficulties experienced by the family and adolescents' own academic performance as a measure of the personal social position in the school setting. RESULTS: One out of ten (10%) and one out of three (32%) adolescents did not enjoy good general and psychological health respectively. For both health variables robust associations were found in adolescents who reported more financial difficulties in the family and had worse academic performance. The latter was associated with psychological health in a more linear way. Father's unemployment showed a non-significant trend for an association with worse psychological health in girls only. CONCLUSIONS: Socioeconomic inequalities exist in this period of life but are more easily demonstrated with more subjective socioeconomic indicators, especially for the psychological dimension of health.