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Nasos Tselebis

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Athanasios Tselebis currently as a psychologist in the psychiatric department of "Sotiria" General Hospital of Chest Diseases in Athens, Greece.
Education history: Doctoral degree at the Medical School of the University of Crete, Department of Epidemiology. Subject " Psychological characteristics of patients with chronic obstructive pulmonary disease and the change in the pulmonary rehabilitation program".
Master's Degree in Social Psychiatry - Child Psychiatry. Medical School of the University of Ioannina.
Bachelor's degree of Psychology, Aristotle University of Thessaloniki

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Papers by Nasos Tselebis

The Mediating Role of Depression and of State Anxiety οn the Relationship between Trait Anxiety and Fatigue in Nurses during the Pandemic Crisis

Healthcare, Jan 28, 2023

This article is an open access article distributed under the terms and conditions of the Creative... more

The Mediating Role of Depression and of State Anxiety οn the Relationship between Trait Anxiety and Fatigue in Nurses during the Pandemic Crisis

Healthcare, Jan 28, 2023

This article is an open access article distributed under the terms and conditions of the Creative... more

Aggression, Alexithymia and Sense of Coherence in a Sample of Schizophrenic Outpatients

Healthcare

Schizophrenia elevates the risk for aggressive behavior, and there is a need to better understand... more Schizophrenia elevates the risk for aggressive behavior, and there is a need to better understand the associated variables predicting aggression for treatment and prevention purposes. The aim of the present study is to determine the relationship between alexithymia, sense of coherence and aggressive behavior in a sample of schizophrenic outpatients. Using a correlational research design, standardized self-report questionnaires assessed aggression (brief aggression questionnaire—BAQ), alexithymia (Toronto Alexithymia Scale—TAS) and sense of coherence (sense of coherence questionnaire—SOC) in a sample of 100 schizophrenic outpatients in clinical remission. Participants reported high levels of aggression and alexithymia along with reduced sense of coherence. Significant negative correlations were evidenced among scores on the SOC scale (p < 0.001) with both the TAS as well as with the BAQ scales. However, a positive correlation (p < 0.001) was observed between the TAS and BAQ sca...

Nursing staff fatigue and burnout during the COVID-19 pandemic in Greece

by Cris Sikaras and Nasos Tselebis

AIMS Public Health, 2021

Introduction The coronavirus pandemic (COVID-19) is an unprecedented global health crisis with em... more Introduction The coronavirus pandemic (COVID-19) is an unprecedented global health crisis with emotional and physical impact on health care workers. Objective The purpose of this study was to investigate the levels of fatigue and burnout in nursing staff during the pandemic. Methods The present study involved nursing staff from hospitals in Greece in February 2021, who completed the Fatigue (FAS) and Burnout (CBI) questionnaires. Gender, age, years of work experience, workplace (COVID-19 or non-COVID-19 wards) and SARS-CoV-2 infection status were recorded. Results The sample included 593 women and 108 men, with a mean age ± SD: 42.9 ± 9.9 years and 18.14 ± 10.8 years work experience. Slightly more than half, (367, 52.4%) worked in COVID-19 departments. Fifty-six (8%) tested positive for SARS-CoV-2 and 14 of them needed to be treated. The mean ± SD FAS and CBI scores were 25.6 ± 7.4 and 46.9 ± 18.8, respectively (67.9% and 42.9% had scores suggestive of fatigue and burnout, respectiv...

Burnout, Depression and Sense of Coherence in Nurses during the Pandemic Crisis

by Cris Sikaras and Nasos Tselebis

Healthcare, 2022

During the COVID-19 pandemic, the risk to nurses’ mental health has increased rapidly. The aim of... more During the COVID-19 pandemic, the risk to nurses’ mental health has increased rapidly. The aim of the study was to investigate the prevalence of depression and burnout and to evaluate their possible association with the sense of coherence in nursing staff during the pandemic crisis. The Copenhagen Burnout Inventory questionnaire, Beck’s Depression Inventory, and the Sense of Coherence questionnaire were completed by 101 male and 559 female nurses. Individual and demographic data were recorded. Regarding depression, 25.5% of respondents exhibited mild depression, 13.5% moderate depression and 7.6% severe depression. In the burnout scale, 47.1% had a pathological value. Female nurses had higher burnout (t test p < 0.01, 49.03 vs. 38.74) and depression (t test p < 0.01, 11.29 vs. 6.93) scores compared to men and lower levels in the sense of coherence (p < 0.05, 59.45 vs. 65.13). Regression evidenced that 43.7% of the variation in the BDI rating was explained by the CBI, while ...

Insomnia, Perceived Stress, and Family Support among Nursing Staff during the Pandemic Crisis

by Cris Sikaras and Nasos Tselebis

Healthcare, 2020

The COVID-19 pandemic is likely to cause mental health issues, especially for healthcare professi... more The COVID-19 pandemic is likely to cause mental health issues, especially for healthcare professionals. The aim of this study was to investigate levels of perceived stress, insomnia, and the sense of family support among nurses in pandemic conditions. We administered in a sample of 150 nurses from different hospital departments during the COVID-19 pandemic the Athens Insomnia Scale (AIS), Perceived Stress Scale (PSS), and Family Support Scale (FSS). Individual and demographic data were recorded. In total, 120 women and 30 men completed the study questionnaires. Almost half of the participants (49.7%) reported the presence of insomnia and more than half (50.3%) experienced increased stress levels. Scores on the Athens Insomnia Scale correlated positively with Perceived Stress Scale scores (p < 0.01), and negatively with Family Support Scale scores (p < 0.01). Significantly negative correlations were observed among scores on the Perceived Stress Scale and the Family Support Scal...

Aggression, Alexithymia and Sense of Coherence in a Sample of Schizophrenic Outpatients

This article is an open access article distributed under the terms and conditions of the Creative... more

The Mediating Role of Depression and of State Anxiety on the Relationship between Trait Anxiety and Fatigue in Nurses during the Pandemic Crisis

by Cris Sikaras and Nasos Tselebis

This article is an open access article distributed under the terms and conditions of the Creative... more

Nursing staff fatigue and burnout during the COVID-19 pandemic in Greece

by Cris Sikaras and Nasos Tselebis

Introduction: The coronavirus pandemic (COVID-19) is an unprecedented global health crisis with e... more Introduction: The coronavirus pandemic (COVID-19) is an unprecedented global health crisis with emotional and physical impact on health care workers. Objective: The purpose of this study was to investigate the levels of fatigue and burnout in nursing staff during the pandemic. Methods: The present study involved nursing staff from hospitals in Greece in February 2021, who completed the Fatigue (FAS) and Burnout (CBI) questionnaires. Gender, age, years of work experience, workplace (COVID-19 or non-COVID-19 wards) and SARS-CoV-2 infection status were recorded. Results: The sample included 593 women and 108 men, with a mean age ± SD: 42.9 ± 9.9 years and 18.14 ± 10.8 years work experience. Slightly more than half, (367, 52.4%) worked in COVID-19 departments. Fifty-six (8%) tested positive for SARS-CoV-2 and 14 of them needed to be treated. The mean ± SD FAS and CBI scores were 25.6 ± 7.4 and 46.9 ± 18.8, respectively (67.9% and 42.9% had scores suggestive of fatigue and burnout, respectively). Women showed higher values in both scales (p < 0.01). Subjects working in COVID-19 wards scored significantly higher on both the FAS and CBI scales; they were also younger and with less work experience (p < 0.01). Staff treated for COVID-19 scored higher on the burnout scale (p < 0.01) than the uninfected staff. Fatigue showed a strong positive correlation with burnout (p < 0.01, r = 0.70). Stepwise multiple regression showed that the variation of fatigue was explained by 47.0% and 6.1% by the scores on the subscales of personal and work-related burnout, respectively. Conclusion: In conclusion, high rates of fatigue and burnout were found in the studied population. Nurses working with COVID-19 patients had higher rates of fatigue and burnout compared to those working elsewhere. There was a strong positive correlation (r = 0.70) between burnout and fatigue. Particular attention should be paid to staff who became ill and need to be treated.

Primary Mental Health Care in a New Era

Healthcare

Clinical experience and scientific studies highlight the pivotal role that primary health care se... more Clinical experience and scientific studies highlight the pivotal role that primary health care services have and should have as a gateway to the health care system and as a first point of contact for patients with mental disorders, particularly—but not exclusively—for patients with a disorder in the spectrum of common mental disorders [...]

Dream Recall/Affect and the Hypothalamic–Pituitary–Adrenal Axis

Clocks & Sleep, 2021

In this concise review, we present an overview of research on dream recall/affect and of the hypo... more In this concise review, we present an overview of research on dream recall/affect and of the hypothalamic–pituitary–adrenal (HPA) axis, discussing caveats regarding the action of hormones of the HPA axis (mainly cortisol and its free form, cortisol-binding globulin and glucocorticoid receptors). We present results of studies regarding dream recall/affect and the HPA axis under physiological (such as waking) or pathological conditions (such as in Cushing’s syndrome or stressful situations). Finally, we try to integrate the effect of the current COVID-19 situation with dream recall/affect vis-à-vis the HPA axis.

Nursing staff fatigue and burnout during the COVID-19 pandemic in Greece

AIMS Public Health, 2021

Introduction The coronavirus pandemic (COVID-19) is an unprecedented global health crisis with em... more Introduction The coronavirus pandemic (COVID-19) is an unprecedented global health crisis with emotional and physical impact on health care workers. Objective The purpose of this study was to investigate the levels of fatigue and burnout in nursing staff during the pandemic. Methods The present study involved nursing staff from hospitals in Greece in February 2021, who completed the Fatigue (FAS) and Burnout (CBI) questionnaires. Gender, age, years of work experience, workplace (COVID-19 or non-COVID-19 wards) and SARS-CoV-2 infection status were recorded. Results The sample included 593 women and 108 men, with a mean age ± SD: 42.9 ± 9.9 years and 18.14 ± 10.8 years work experience. Slightly more than half, (367, 52.4%) worked in COVID-19 departments. Fifty-six (8%) tested positive for SARS-CoV-2 and 14 of them needed to be treated. The mean ± SD FAS and CBI scores were 25.6 ± 7.4 and 46.9 ± 18.8, respectively (67.9% and 42.9% had scores suggestive of fatigue and burnout, respectiv...

Insomnia, Perceived Stress, and Family Support among Nursing Staff during the Pandemic Crisis

by Nasos Tselebis, Cris Sikaras, and Dimitra Lekka

Healthcare, 2020

The COVID-19 pandemic is likely to cause mental health issues, especially for healthcare professi... more The COVID-19 pandemic is likely to cause mental health issues, especially for healthcare professionals. The aim of this study was to investigate levels of perceived stress, insomnia, and the sense of family support among nurses in pandemic conditions. We administered in a sample of 150 nurses from different hospital departments during the COVID-19 pandemic the Athens Insomnia Scale (AIS), Perceived Stress Scale (PSS), and Family Support Scale (FSS). Individual and demographic data were recorded. In total, 120 women and 30 men completed the study questionnaires. Almost half of the participants (49.7%) reported the presence of insomnia and more than half (50.3%) experienced increased stress levels. Scores on the Athens Insomnia Scale correlated positively with Perceived Stress Scale scores (p < 0.01), and negatively with Family Support Scale scores (p < 0.01). Significantly negative correlations were observed among scores on the Perceived Stress Scale and the Family Support Scal...

Strategies to improve anxiety and depression in patients with COPD: a mental health perspective

Neuropsychiatric Disease and Treatment, 2016

Chronic obstructive pulmonary disease (COPD) is a chronic inflammatory lung disease characterized... more Chronic obstructive pulmonary disease (COPD) is a chronic inflammatory lung disease characterized by progressive and only partially reversible symptoms. Worldwide, the incidence of COPD presents a disturbing continuous increase. Anxiety and depression are remarkably common in COPD patients, but the evidence about optimal approaches for managing psychological comorbidities in COPD remains unclear and largely speculative. Pharmacological treatment based on selective serotonin reuptake inhibitors has almost replaced tricyclic antidepressants. The main psychological intervention is cognitive behavioral therapy. Of particular interest are pulmonary rehabilitation programs, which can reduce anxiety and depressive symptoms in these patients. Although the literature on treating anxiety and depression in patients with COPD is limited, we believe that it points to the implementation of personalized strategies to address their psychopathological comorbidities.

Comorbid Psychopathology and Alcohol Use Patterns among Methadone Maintenance Treatment Patients

Journal of Addiction, 2015

130 patients from a methadone maintenance treatment program agreed to complete Symptoms Checklist... more 130 patients from a methadone maintenance treatment program agreed to complete Symptoms Checklist 90-Revised (SCL-90R) and Alcohol Use Disorders Identification Test (AUDIT) self-report scales. Scores higher than the proposed cut-score on SCL-90R scale were observed on depression, obsessions-compulsions, paranoid ideation, anxiety, anger-hostility, somatization, interpersonal sensitivity, and psychoticism subscales. In sum, 42.9% of our sample exhibited depressive symptomatology, 34.9% obsessive-compulsive symptoms, 29.1% somatization, 27.2% anxiety symptoms, 22.2% paranoid ideation, 19% phobic anxiety, 15.1% psychoticism, and 15.1% hostility and 11.9% presented with symptoms of interpersonal sensitivity. Mean score on AUDIT scale was6.9±7.9. 63.0% of our participants scored below cut-off and were classified as having a low level of alcohol-related problems; 24.4% scored in the range of 8–15 which is an indication of alcohol abuse whereas 12.6% scored 16 and above indicative of serio...

A pulmonary rehabilitation program reduces levels of anxiety and depression inCOPD patients

Multidisciplinary Respiratory Medicine, 2013

Background: The presence of anxiety and depressive symptoms in COPD patients has been acknowledge... more Background: The presence of anxiety and depressive symptoms in COPD patients has been acknowledged for many years. The preponderance of recent studies supports the utility of pulmonary rehabilitation programs to reduce the levels of depression and anxiety in these patients. The aim of this study is to investigate possible changes in levels of anxiety and depression among patients enrolled in a pulmonary rehabilitation program, along with the role of disease severity in these changes. Methods: In 101 COPD patients, who attended a pulmonary rehabilitation program, levels of trait anxiety (STAI) and depressive symptoms (BDI) were assessed at the beginning and at the end of the program. Age, sex, level of education in years and stage of disease severity were recorded. Results: Our study included 80 male and 21 female patients. Mean age and mean education level were 64.1 ± 8.1 and 11.3 ± 4.1 years, respectively. Regarding COPD staging, 11 patients suffered from mild, 16 from moderate, 47 from severe and 27 from very severe COPD. Significant decreases in anxiety (from 39.7 to 34.0, p < 0.001) and depression rates (from 10.7 to 6.3, p < 0.001) were observed. A statistically significant reduction in anxiety and depression was revealed (p < 0.05)at all stages of COPD. Conclusion: Pulmonary rehabilitation programs should be offered to all COPD patients irrespective of disease severity, since they all lead to improvement in anxiety and depressive symptoms.

Contribution of Psychological Factors in Dropping out from Chronic Obstructive Pulmonary Disease Rehabilitation Programs

BioMed Research International, 2014

Significant positive effects, particularly on psychological state in patients who completed the f... more Significant positive effects, particularly on psychological state in patients who completed the follow-up pulmonary rehabilitation programs, are indicated by a large number of studies. Yet, a remarkable proportion of selected patients drop out from these programs. In this study, we investigated existing differences on psychological variables among COPD patients who complete and those who drop out from pulmonary rehabilitation programs. The study included 144 patients, 43 (29.9%) of whom did not complete the program. SCL-90 was used for the assessment of psychological symptoms. On the SCL-90-R scale 55.6% of patients had abnormal findings. Patients who discontinued the program had higher rates of depression and somatization compared to those who completed it. Regarding the psychopathology scales of SCL-90R, we found that patients who discontinued the program showed higher levels of psychopathology on the scales of somatization, depression, paranoid ideation, and psychotism compared t...

Psychiatric Morbidity and Other Factors Affecting Treatment Adherence in Pulmonary Tuberculosis Patients

Tuberculosis Research and Treatment, 2013

As the overall prevalence of TB remains high among certain population groups, there is growing aw... more As the overall prevalence of TB remains high among certain population groups, there is growing awareness of psychiatric comorbidity, especially depression and its role in the outcome of the disease. The paper attempts a holistic approach to the effects of psychiatric comorbidity to the natural history of tuberculosis. In order to investigate factors associated with medication nonadherence among patients suffering from tuberculosis, with emphasis on psychopathology as a major barrier to treatment adherence, we performed a systematic review of the literature on epidemiological data and past medical reviews from an historical perspective, followed by theoretical considerations upon the relationship between psychiatric disorders and tuberculosis. Studies reporting high prevalence rates of psychiatric comorbidity, especially depression, as well as specific psychological reactions and disease perceptions and reviews indicating psychiatric complications as adverse effects of anti-TB medica...

Psychological symptom patterns and vital exhaustion in outpatients with chronic obstructive pulmonary disease

Annals of General Psychiatry, 2011

Background: Several studies have reported high prevalence of anxiety and depression in chronic ob... more Background: Several studies have reported high prevalence of anxiety and depression in chronic obstructive pulmonary disease (COPD) outpatients. Moreover, these patients share psychological or psychopathological characteristics that inhibit their ability to cope with the disease. In the present study we aimed to record the prevalence of psychological symptom patterns in a sample of Greek COPD outpatients and to assess which psychological factors (and to which degree) contribute to vital exhaustion (VE). Methods: The study included 139 COPD outpatients. We used the Symptom Checklist 90-Revised (SCL-90-R) and the Maastricht Questionnaire (MQ) in order to evaluate psychological symptom patterns and VE, respectively. Results: The mean MQ score was 19.6, which is significantly higher than the corresponding score in the general population. Regarding the SCL-90-R dimensions, depression was the highest followed by somatization, obsessivecompulsive and anxiety dimensions. Additionally, a positive correlation was observed between the MQ and the SCL-90-R dimensions. MQ failed to demonstrate correlation with age, gender, education level or the severity of the disease. Depression seems to be responsible for 57.9% of the variation of VE, while obsessive-compulsiveness is responsible for an additional 2.4%. All the remaining dimensions of SCL-90-R had no statistically significant contributions. Conclusions: Our findings suggest the high prevalence of VE, together with high rates in most of the SCL-90-R dimensions with greater depression, somatization, obsessive-compulsiveness and anxiety in a Greek COPD group at various Global Initiative for Chronic Obstructive Lung Disease (GOLD) diagnostic criteria stages. The coexistence of such symptoms should be further assessed as an eventual unfavorable prognostic factor.

Burnout, Depression and Sense of Coherence in Nurses during the Pandemic Crisis

by Nasos Tselebis and Cris Sikaras

Healthcare, 2022

During the COVID-19 pandemic, the risk to nurses’ mental health has increased rapidly. The aim of... more During the COVID-19 pandemic, the risk to nurses’ mental health has increased rapidly. The aim of the study was to investigate the prevalence of depression and burnout and to evaluate their possible association with the sense of coherence in nursing staff during the pandemic crisis. The Copenhagen Burnout Inventory questionnaire, Beck’s Depression Inventory, and the Sense of Coherence questionnaire were completed by 101 male and 559 female nurses. Individual and demographic data were recorded. Regarding depression, 25.5% of respondents exhibited mild depression, 13.5% moderate depression and 7.6% severe depression. In the burnout scale, 47.1% had a pathological value. Female nurses had higher burnout (t test p < 0.01, 49.03 vs. 38.74) and depression (t test p < 0.01, 11.29 vs. 6.93) scores compared to men and lower levels in the sense of coherence (p < 0.05, 59.45 vs. 65.13). Regression evidenced that 43.7% of the variation in the BDI rating was explained by the CBI, while ...

The Mediating Role of Depression and of State Anxiety οn the Relationship between Trait Anxiety and Fatigue in Nurses during the Pandemic Crisis

Healthcare, Jan 28, 2023

This article is an open access article distributed under the terms and conditions of the Creative... more

The Mediating Role of Depression and of State Anxiety οn the Relationship between Trait Anxiety and Fatigue in Nurses during the Pandemic Crisis

Healthcare, Jan 28, 2023

This article is an open access article distributed under the terms and conditions of the Creative... more

Aggression, Alexithymia and Sense of Coherence in a Sample of Schizophrenic Outpatients

Healthcare

Schizophrenia elevates the risk for aggressive behavior, and there is a need to better understand... more Schizophrenia elevates the risk for aggressive behavior, and there is a need to better understand the associated variables predicting aggression for treatment and prevention purposes. The aim of the present study is to determine the relationship between alexithymia, sense of coherence and aggressive behavior in a sample of schizophrenic outpatients. Using a correlational research design, standardized self-report questionnaires assessed aggression (brief aggression questionnaire—BAQ), alexithymia (Toronto Alexithymia Scale—TAS) and sense of coherence (sense of coherence questionnaire—SOC) in a sample of 100 schizophrenic outpatients in clinical remission. Participants reported high levels of aggression and alexithymia along with reduced sense of coherence. Significant negative correlations were evidenced among scores on the SOC scale (p < 0.001) with both the TAS as well as with the BAQ scales. However, a positive correlation (p < 0.001) was observed between the TAS and BAQ sca...

Nursing staff fatigue and burnout during the COVID-19 pandemic in Greece

by Cris Sikaras and Nasos Tselebis

AIMS Public Health, 2021

Introduction The coronavirus pandemic (COVID-19) is an unprecedented global health crisis with em... more Introduction The coronavirus pandemic (COVID-19) is an unprecedented global health crisis with emotional and physical impact on health care workers. Objective The purpose of this study was to investigate the levels of fatigue and burnout in nursing staff during the pandemic. Methods The present study involved nursing staff from hospitals in Greece in February 2021, who completed the Fatigue (FAS) and Burnout (CBI) questionnaires. Gender, age, years of work experience, workplace (COVID-19 or non-COVID-19 wards) and SARS-CoV-2 infection status were recorded. Results The sample included 593 women and 108 men, with a mean age ± SD: 42.9 ± 9.9 years and 18.14 ± 10.8 years work experience. Slightly more than half, (367, 52.4%) worked in COVID-19 departments. Fifty-six (8%) tested positive for SARS-CoV-2 and 14 of them needed to be treated. The mean ± SD FAS and CBI scores were 25.6 ± 7.4 and 46.9 ± 18.8, respectively (67.9% and 42.9% had scores suggestive of fatigue and burnout, respectiv...

Burnout, Depression and Sense of Coherence in Nurses during the Pandemic Crisis

by Cris Sikaras and Nasos Tselebis

Healthcare, 2022

During the COVID-19 pandemic, the risk to nurses’ mental health has increased rapidly. The aim of... more During the COVID-19 pandemic, the risk to nurses’ mental health has increased rapidly. The aim of the study was to investigate the prevalence of depression and burnout and to evaluate their possible association with the sense of coherence in nursing staff during the pandemic crisis. The Copenhagen Burnout Inventory questionnaire, Beck’s Depression Inventory, and the Sense of Coherence questionnaire were completed by 101 male and 559 female nurses. Individual and demographic data were recorded. Regarding depression, 25.5% of respondents exhibited mild depression, 13.5% moderate depression and 7.6% severe depression. In the burnout scale, 47.1% had a pathological value. Female nurses had higher burnout (t test p < 0.01, 49.03 vs. 38.74) and depression (t test p < 0.01, 11.29 vs. 6.93) scores compared to men and lower levels in the sense of coherence (p < 0.05, 59.45 vs. 65.13). Regression evidenced that 43.7% of the variation in the BDI rating was explained by the CBI, while ...

Insomnia, Perceived Stress, and Family Support among Nursing Staff during the Pandemic Crisis

by Cris Sikaras and Nasos Tselebis

Healthcare, 2020

The COVID-19 pandemic is likely to cause mental health issues, especially for healthcare professi... more The COVID-19 pandemic is likely to cause mental health issues, especially for healthcare professionals. The aim of this study was to investigate levels of perceived stress, insomnia, and the sense of family support among nurses in pandemic conditions. We administered in a sample of 150 nurses from different hospital departments during the COVID-19 pandemic the Athens Insomnia Scale (AIS), Perceived Stress Scale (PSS), and Family Support Scale (FSS). Individual and demographic data were recorded. In total, 120 women and 30 men completed the study questionnaires. Almost half of the participants (49.7%) reported the presence of insomnia and more than half (50.3%) experienced increased stress levels. Scores on the Athens Insomnia Scale correlated positively with Perceived Stress Scale scores (p < 0.01), and negatively with Family Support Scale scores (p < 0.01). Significantly negative correlations were observed among scores on the Perceived Stress Scale and the Family Support Scal...

Aggression, Alexithymia and Sense of Coherence in a Sample of Schizophrenic Outpatients

This article is an open access article distributed under the terms and conditions of the Creative... more

The Mediating Role of Depression and of State Anxiety on the Relationship between Trait Anxiety and Fatigue in Nurses during the Pandemic Crisis

by Cris Sikaras and Nasos Tselebis

This article is an open access article distributed under the terms and conditions of the Creative... more

Nursing staff fatigue and burnout during the COVID-19 pandemic in Greece

by Cris Sikaras and Nasos Tselebis

Introduction: The coronavirus pandemic (COVID-19) is an unprecedented global health crisis with e... more Introduction: The coronavirus pandemic (COVID-19) is an unprecedented global health crisis with emotional and physical impact on health care workers. Objective: The purpose of this study was to investigate the levels of fatigue and burnout in nursing staff during the pandemic. Methods: The present study involved nursing staff from hospitals in Greece in February 2021, who completed the Fatigue (FAS) and Burnout (CBI) questionnaires. Gender, age, years of work experience, workplace (COVID-19 or non-COVID-19 wards) and SARS-CoV-2 infection status were recorded. Results: The sample included 593 women and 108 men, with a mean age ± SD: 42.9 ± 9.9 years and 18.14 ± 10.8 years work experience. Slightly more than half, (367, 52.4%) worked in COVID-19 departments. Fifty-six (8%) tested positive for SARS-CoV-2 and 14 of them needed to be treated. The mean ± SD FAS and CBI scores were 25.6 ± 7.4 and 46.9 ± 18.8, respectively (67.9% and 42.9% had scores suggestive of fatigue and burnout, respectively). Women showed higher values in both scales (p < 0.01). Subjects working in COVID-19 wards scored significantly higher on both the FAS and CBI scales; they were also younger and with less work experience (p < 0.01). Staff treated for COVID-19 scored higher on the burnout scale (p < 0.01) than the uninfected staff. Fatigue showed a strong positive correlation with burnout (p < 0.01, r = 0.70). Stepwise multiple regression showed that the variation of fatigue was explained by 47.0% and 6.1% by the scores on the subscales of personal and work-related burnout, respectively. Conclusion: In conclusion, high rates of fatigue and burnout were found in the studied population. Nurses working with COVID-19 patients had higher rates of fatigue and burnout compared to those working elsewhere. There was a strong positive correlation (r = 0.70) between burnout and fatigue. Particular attention should be paid to staff who became ill and need to be treated.

Primary Mental Health Care in a New Era

Healthcare

Clinical experience and scientific studies highlight the pivotal role that primary health care se... more Clinical experience and scientific studies highlight the pivotal role that primary health care services have and should have as a gateway to the health care system and as a first point of contact for patients with mental disorders, particularly—but not exclusively—for patients with a disorder in the spectrum of common mental disorders [...]

Dream Recall/Affect and the Hypothalamic–Pituitary–Adrenal Axis

Clocks & Sleep, 2021

In this concise review, we present an overview of research on dream recall/affect and of the hypo... more In this concise review, we present an overview of research on dream recall/affect and of the hypothalamic–pituitary–adrenal (HPA) axis, discussing caveats regarding the action of hormones of the HPA axis (mainly cortisol and its free form, cortisol-binding globulin and glucocorticoid receptors). We present results of studies regarding dream recall/affect and the HPA axis under physiological (such as waking) or pathological conditions (such as in Cushing’s syndrome or stressful situations). Finally, we try to integrate the effect of the current COVID-19 situation with dream recall/affect vis-à-vis the HPA axis.

Nursing staff fatigue and burnout during the COVID-19 pandemic in Greece

AIMS Public Health, 2021

Introduction The coronavirus pandemic (COVID-19) is an unprecedented global health crisis with em... more Introduction The coronavirus pandemic (COVID-19) is an unprecedented global health crisis with emotional and physical impact on health care workers. Objective The purpose of this study was to investigate the levels of fatigue and burnout in nursing staff during the pandemic. Methods The present study involved nursing staff from hospitals in Greece in February 2021, who completed the Fatigue (FAS) and Burnout (CBI) questionnaires. Gender, age, years of work experience, workplace (COVID-19 or non-COVID-19 wards) and SARS-CoV-2 infection status were recorded. Results The sample included 593 women and 108 men, with a mean age ± SD: 42.9 ± 9.9 years and 18.14 ± 10.8 years work experience. Slightly more than half, (367, 52.4%) worked in COVID-19 departments. Fifty-six (8%) tested positive for SARS-CoV-2 and 14 of them needed to be treated. The mean ± SD FAS and CBI scores were 25.6 ± 7.4 and 46.9 ± 18.8, respectively (67.9% and 42.9% had scores suggestive of fatigue and burnout, respectiv...

Insomnia, Perceived Stress, and Family Support among Nursing Staff during the Pandemic Crisis

by Nasos Tselebis, Cris Sikaras, and Dimitra Lekka

Healthcare, 2020

The COVID-19 pandemic is likely to cause mental health issues, especially for healthcare professi... more The COVID-19 pandemic is likely to cause mental health issues, especially for healthcare professionals. The aim of this study was to investigate levels of perceived stress, insomnia, and the sense of family support among nurses in pandemic conditions. We administered in a sample of 150 nurses from different hospital departments during the COVID-19 pandemic the Athens Insomnia Scale (AIS), Perceived Stress Scale (PSS), and Family Support Scale (FSS). Individual and demographic data were recorded. In total, 120 women and 30 men completed the study questionnaires. Almost half of the participants (49.7%) reported the presence of insomnia and more than half (50.3%) experienced increased stress levels. Scores on the Athens Insomnia Scale correlated positively with Perceived Stress Scale scores (p < 0.01), and negatively with Family Support Scale scores (p < 0.01). Significantly negative correlations were observed among scores on the Perceived Stress Scale and the Family Support Scal...

Strategies to improve anxiety and depression in patients with COPD: a mental health perspective

Neuropsychiatric Disease and Treatment, 2016

Chronic obstructive pulmonary disease (COPD) is a chronic inflammatory lung disease characterized... more Chronic obstructive pulmonary disease (COPD) is a chronic inflammatory lung disease characterized by progressive and only partially reversible symptoms. Worldwide, the incidence of COPD presents a disturbing continuous increase. Anxiety and depression are remarkably common in COPD patients, but the evidence about optimal approaches for managing psychological comorbidities in COPD remains unclear and largely speculative. Pharmacological treatment based on selective serotonin reuptake inhibitors has almost replaced tricyclic antidepressants. The main psychological intervention is cognitive behavioral therapy. Of particular interest are pulmonary rehabilitation programs, which can reduce anxiety and depressive symptoms in these patients. Although the literature on treating anxiety and depression in patients with COPD is limited, we believe that it points to the implementation of personalized strategies to address their psychopathological comorbidities.

Comorbid Psychopathology and Alcohol Use Patterns among Methadone Maintenance Treatment Patients

Journal of Addiction, 2015

130 patients from a methadone maintenance treatment program agreed to complete Symptoms Checklist... more 130 patients from a methadone maintenance treatment program agreed to complete Symptoms Checklist 90-Revised (SCL-90R) and Alcohol Use Disorders Identification Test (AUDIT) self-report scales. Scores higher than the proposed cut-score on SCL-90R scale were observed on depression, obsessions-compulsions, paranoid ideation, anxiety, anger-hostility, somatization, interpersonal sensitivity, and psychoticism subscales. In sum, 42.9% of our sample exhibited depressive symptomatology, 34.9% obsessive-compulsive symptoms, 29.1% somatization, 27.2% anxiety symptoms, 22.2% paranoid ideation, 19% phobic anxiety, 15.1% psychoticism, and 15.1% hostility and 11.9% presented with symptoms of interpersonal sensitivity. Mean score on AUDIT scale was6.9±7.9. 63.0% of our participants scored below cut-off and were classified as having a low level of alcohol-related problems; 24.4% scored in the range of 8–15 which is an indication of alcohol abuse whereas 12.6% scored 16 and above indicative of serio...

A pulmonary rehabilitation program reduces levels of anxiety and depression inCOPD patients

Multidisciplinary Respiratory Medicine, 2013

Background: The presence of anxiety and depressive symptoms in COPD patients has been acknowledge... more Background: The presence of anxiety and depressive symptoms in COPD patients has been acknowledged for many years. The preponderance of recent studies supports the utility of pulmonary rehabilitation programs to reduce the levels of depression and anxiety in these patients. The aim of this study is to investigate possible changes in levels of anxiety and depression among patients enrolled in a pulmonary rehabilitation program, along with the role of disease severity in these changes. Methods: In 101 COPD patients, who attended a pulmonary rehabilitation program, levels of trait anxiety (STAI) and depressive symptoms (BDI) were assessed at the beginning and at the end of the program. Age, sex, level of education in years and stage of disease severity were recorded. Results: Our study included 80 male and 21 female patients. Mean age and mean education level were 64.1 ± 8.1 and 11.3 ± 4.1 years, respectively. Regarding COPD staging, 11 patients suffered from mild, 16 from moderate, 47 from severe and 27 from very severe COPD. Significant decreases in anxiety (from 39.7 to 34.0, p < 0.001) and depression rates (from 10.7 to 6.3, p < 0.001) were observed. A statistically significant reduction in anxiety and depression was revealed (p < 0.05)at all stages of COPD. Conclusion: Pulmonary rehabilitation programs should be offered to all COPD patients irrespective of disease severity, since they all lead to improvement in anxiety and depressive symptoms.

Contribution of Psychological Factors in Dropping out from Chronic Obstructive Pulmonary Disease Rehabilitation Programs

BioMed Research International, 2014

Significant positive effects, particularly on psychological state in patients who completed the f... more Significant positive effects, particularly on psychological state in patients who completed the follow-up pulmonary rehabilitation programs, are indicated by a large number of studies. Yet, a remarkable proportion of selected patients drop out from these programs. In this study, we investigated existing differences on psychological variables among COPD patients who complete and those who drop out from pulmonary rehabilitation programs. The study included 144 patients, 43 (29.9%) of whom did not complete the program. SCL-90 was used for the assessment of psychological symptoms. On the SCL-90-R scale 55.6% of patients had abnormal findings. Patients who discontinued the program had higher rates of depression and somatization compared to those who completed it. Regarding the psychopathology scales of SCL-90R, we found that patients who discontinued the program showed higher levels of psychopathology on the scales of somatization, depression, paranoid ideation, and psychotism compared t...

Psychiatric Morbidity and Other Factors Affecting Treatment Adherence in Pulmonary Tuberculosis Patients

Tuberculosis Research and Treatment, 2013

As the overall prevalence of TB remains high among certain population groups, there is growing aw... more As the overall prevalence of TB remains high among certain population groups, there is growing awareness of psychiatric comorbidity, especially depression and its role in the outcome of the disease. The paper attempts a holistic approach to the effects of psychiatric comorbidity to the natural history of tuberculosis. In order to investigate factors associated with medication nonadherence among patients suffering from tuberculosis, with emphasis on psychopathology as a major barrier to treatment adherence, we performed a systematic review of the literature on epidemiological data and past medical reviews from an historical perspective, followed by theoretical considerations upon the relationship between psychiatric disorders and tuberculosis. Studies reporting high prevalence rates of psychiatric comorbidity, especially depression, as well as specific psychological reactions and disease perceptions and reviews indicating psychiatric complications as adverse effects of anti-TB medica...

Psychological symptom patterns and vital exhaustion in outpatients with chronic obstructive pulmonary disease

Annals of General Psychiatry, 2011

Background: Several studies have reported high prevalence of anxiety and depression in chronic ob... more Background: Several studies have reported high prevalence of anxiety and depression in chronic obstructive pulmonary disease (COPD) outpatients. Moreover, these patients share psychological or psychopathological characteristics that inhibit their ability to cope with the disease. In the present study we aimed to record the prevalence of psychological symptom patterns in a sample of Greek COPD outpatients and to assess which psychological factors (and to which degree) contribute to vital exhaustion (VE). Methods: The study included 139 COPD outpatients. We used the Symptom Checklist 90-Revised (SCL-90-R) and the Maastricht Questionnaire (MQ) in order to evaluate psychological symptom patterns and VE, respectively. Results: The mean MQ score was 19.6, which is significantly higher than the corresponding score in the general population. Regarding the SCL-90-R dimensions, depression was the highest followed by somatization, obsessivecompulsive and anxiety dimensions. Additionally, a positive correlation was observed between the MQ and the SCL-90-R dimensions. MQ failed to demonstrate correlation with age, gender, education level or the severity of the disease. Depression seems to be responsible for 57.9% of the variation of VE, while obsessive-compulsiveness is responsible for an additional 2.4%. All the remaining dimensions of SCL-90-R had no statistically significant contributions. Conclusions: Our findings suggest the high prevalence of VE, together with high rates in most of the SCL-90-R dimensions with greater depression, somatization, obsessive-compulsiveness and anxiety in a Greek COPD group at various Global Initiative for Chronic Obstructive Lung Disease (GOLD) diagnostic criteria stages. The coexistence of such symptoms should be further assessed as an eventual unfavorable prognostic factor.

Burnout, Depression and Sense of Coherence in Nurses during the Pandemic Crisis

by Nasos Tselebis and Cris Sikaras

Healthcare, 2022

During the COVID-19 pandemic, the risk to nurses’ mental health has increased rapidly. The aim of... more During the COVID-19 pandemic, the risk to nurses’ mental health has increased rapidly. The aim of the study was to investigate the prevalence of depression and burnout and to evaluate their possible association with the sense of coherence in nursing staff during the pandemic crisis. The Copenhagen Burnout Inventory questionnaire, Beck’s Depression Inventory, and the Sense of Coherence questionnaire were completed by 101 male and 559 female nurses. Individual and demographic data were recorded. Regarding depression, 25.5% of respondents exhibited mild depression, 13.5% moderate depression and 7.6% severe depression. In the burnout scale, 47.1% had a pathological value. Female nurses had higher burnout (t test p < 0.01, 49.03 vs. 38.74) and depression (t test p < 0.01, 11.29 vs. 6.93) scores compared to men and lower levels in the sense of coherence (p < 0.05, 59.45 vs. 65.13). Regression evidenced that 43.7% of the variation in the BDI rating was explained by the CBI, while ...