University Mental Health Research Institute

This article presents a study protocol for evaluating a psychometric scale designed to identify distinctive elements in the drawings of individuals with psychotic symptoms. The study aims to validate the "Scale of Distinctive Elements in the Drawings of Subjects with Psychotic Symptoms," a tool that evaluates 25 specific features in drawings, including ambiguity, disorganization, stereotypy, and oddity. The research involved two groups: 40 participants with psychotic symptoms and 100 healthy controls. These participants created drawings that were subsequently evaluated by trained raters. The study employed both exploratory and confirmatory factor analyses to evaluate the scale's structure and validity. The research highlights the potential of art therapy as an adjunctive treatment for schizophrenia, providing insights into the mental state of patients that are challenging to capture through verbal methods alone. The development of this scale addresses the need for standardized tools to assess the effectiveness of art therapy, particularly in individuals with severe psychiatric disorders. However, the study also acknowledges the limitations of existing literature and emphasizes the importance of considering cultural and individual differences in art creation and interpretation. Overall, this study protocol outlines a comprehensive approach to assessing distinctive features in the art of individuals with psychotic symptoms, aiming to enhance the diagnostic and therapeutic utility of art therapy in clinical settings.

The V-SVZ niche is vital for adult neurogenesis in mammals, yet its regulation in humans remains poorly understood. Current models, including brain organoids, fail to replicate the unique cytoarchitecture of this niche, particularly the multiciliated ependymal cells, which are essential for its function and organization. Here, we utilize GEMC1 and MCIDAS to program human apical radial glial cells into ependymal cells, employing human brain organoids as a model. This approach induces premature ependymal cell differentiation and reorganization of the embryonic neurogenic niche, conferring characteristics of the human adult V-SVZ niche. Our findings highlight a molecular pathway that leads to ependymal cell generation and adult human V-SVZ niche reconstruction, providing a platform to study its development and function.

As mental health disorders like Major Depressive Disorder and Generalized Anxiety Disorder rise globally, effective, scalable, and personalized treatments are urgently needed. This 16-week prospective, decentralized, randomized, waitlist-controlled study investigated the effectiveness of a digital data-driven therapeutic integrating wearable sensor data with a mobile app to deliver personalized CBT-based interventions for individuals with depressive and generalized anxiety symptoms. 200 adults were randomized to intervention or control groups, with 164 completing the study. The intervention group demonstrated significant reductions in depressive (mean change = −5.61, CI = −7.14, −4.08) and anxiety symptoms (mean change = −5.21, CI = −6.66, −3.76), compared to the control group, with medium-to-large effect sizes (r = 0.64 and r = 0.62, P < 0.001). Notably, these improvements were also observed in participants with clinically significant depression and anxiety, further reinforcing the potential of digital therapeutics in targeting more severe cases. These findings, combined with high engagement levels, suggest that data-driven digital health interventions could complement traditional treatments, though further research is needed to assess their long-term impact.

Over the last decades the study of schizophrenia-spectrum disorders has been focused on early and comprehensive intervention during the first episode of psychosis (FEP), but studies in rural settings are only rare. In Greece mental healthcare in rural areas is mostly delivered by the locally-based Mobile Mental Health Units (MMHUs). The aim of the present study was to address treatment of FEP patients by the MMHUs in rural areas in Greece, focusing on patients with a first episode of schizophrenia. This is a multicenter, retrospective observational study with the participation of nine MMHUs across several areas in rural mainland and some islands of Greece. Patients of the age range of 15 to 55 years with a diagnosis of non-affective psychosis were included in the study. The study sample consisted of 216 patients, while analysis was performed for patients with a diagnosis of schizophrenia (n = 153, 70.8% of the sample). Most patients were males (n = 93, 60.8%), with a mean age at first presentation 34.9 years (Md = 34.5, SD = 11.94). The mean duration of untreated psychosis (DUP) was 7.85 months (Md = 3, IQR = 10.00) and was shorter in younger (15-25 years) patients. More than 60% of patients had been successfully engaged to treatment with the MMHUs, with a mean follow-up duration of 5.17 years (Md = 5.00, IQR = 5.00). Younger patients (26-35 years) tend to disengage from treatment, while those aged 36 to 45 years were more likely to continue follow-up. A reduction of 47.22% in hospital admissions among patients with schizophrenia was observed over follow-up of patients by the MMHUS. The most noteworthy findings of the study are the low percentage of patients seeking help from the MMHUs, compared to the expected cases and the high attendance rate of those that are examined in this context. Further research on psychosis/schizophrenia in the rural context is warranted.

ObjectiveThe objectives of this study were to elicit self-reported health status, quantify osteoporosis-related burden, and understand preferences for treatment attributes among postmenopausal women with severe osteoporosis in Greece.MethodsPostmenopausal women with self-reported severe osteoporosis, defined as having suffered at least one osteoporotic fracture and reporting a T-score of ≤−2.5, were asked to evaluate their health status, osteoporosis management, and disease-related physical, emotional, and financial burden. Participants were also asked to rate a series of treatment attributes and state their preference for unlabeled anabolic treatments, based on scenarios describing key treatment characteristics.ResultsApproximately one third (31%) of the 186 participants who responded to the survey in full had been living with severe osteoporosis for more than 10 years. Three quarters of participants (72%) considered their overall quality of life (QoL) to be worse than it had been 10 years prior, and the vast majority (89%) attributed this deterioration to osteoporosis. Direct, out of pocket, disease-related costs of at least €100 per month were reported by 86% of participants. Patients attached the greatest value to a treatment that would decrease probability of future fractures, followed by increase in bone density, safety, and mode and frequency of administration. When asked to select their preferred treatment scenario between two anabolic treatments, 70% of participants opted for the scenario that shared treatment characteristics with romosozumab over a scenario that shared treatment characteristics with teriparatide.ConclusionOur study revealed that osteoporosis placed a considerable burden on QoL for postmenopausal women with severe osteoporosis in Greece. Patients reported valuing treatment efficacy, measured through reduction in future fractures and increase in bone density, and safety, as key treatment attributes.

(1) Background: Access to laboratory testing services for HIV in Greece is persistently challenged and this impacts both the continuum of care and, potentially, equity in access. (2) Methods: A cross-sectional study with two parts (first part: HIV-positive people/PLWHIV; second part: HIV clinicians) was conducted in Greece to quantify challenges regarding access to laboratory testing for HIV. Data were collected through online surveys, during a one-month period, between 2019 and 2020. The total sample consisted of 153 PLWHIV and 26 HIV clinicians. (3) Results: Access to viral load testing varied significantly according to place of residence (p = 0.029) and year of diagnosis (p = 0.054). Patients diagnosed after 2015 reported worse access to viral load testing (72.7% vs. 85.9%). Over one third of respondents perceived viral load tests as being not at all accessible (11.4%) or somewhat accessible, only after facing multiple systemic obstacles (24.2%). Equally, most of HIV clinicians reported barriers or no access to baseline viral load testing (80%) and baseline genotype resistance tests (96%). (4) Conclusions: Access of people diagnosed with HIV to CD4 lymphocyte tests and genotype resistance screening is significantly challenged in Greece, especially after 2015. Addressing this challenge is critical in removing access barriers and achieving the UNAIDS 95-95-95 HIV elimination goals.

Wearable technologies and digital phenotyping foster unique opportunities for designing novel intelligent electronic services that can address various well-being issues in patients with mental disorders (i.e., schizophrenia and bipolar disorder), thus having the potential to revolutionize psychiatry and its clinical practice. In this paper, we present e-Prevention, an innovative integrated system for medical support that facilitates effective monitoring and relapse prevention in patients with mental disorders. The technologies offered through e-Prevention include: (i) long-term continuous recording of biometric and behavioral indices through a smartwatch; (ii) video recordings of patients while being interviewed by a clinician, using a tablet; (iii) automatic and systematic storage of these data in a dedicated Cloud server and; (iv) the ability of relapse detection and prediction. This paper focuses on the description of the e-Prevention system and the methodologies developed for the identification of feature representations that correlate with and can predict psychopathology and relapses in patients with mental disorders. Specifically, we tackle the problem of relapse detection and prediction using Machine and Deep Learning techniques on all collected data. The results are promising, indicating that such predictions could be made and leading eventually to the prediction of psychopathology and the prevention of relapses.

SummaryGlucocorticoids are important for proper organ maturation and their levels are tightly regulated during development. Here we use human cerebral organoids and mice to study cell-type specific effects of glucocorticoids on neurogenesis. We show that glucocorticoids increase a specific type of basal progenitors (co-expressingPAX6andEOMES) that has been shown to drive cortical expansion in gyrified species. This effect is mediated via the transcription factorZBTB16and leads to increased production of neurons. A phenome-wide mendelian randomization analysis of an enhancer variant that moderates glucocorticoid-inducedZBTB16levels, reveals causal relationships with higher educational attainment and altered brain structure. The relationship with postnatal cognition is supported by data from a prospective pregnancy cohort. This study provides a novel cellular and molecular pathway for the effects of glucocorticoids on human neurogenesis that relates to lasting postnatal phenotypes.