Charalambos Papageorgiou’s research while affiliated with University Mental Health Research Institute and other places

Background: Increasing research data suggest that the dysfunction of emotional brain systems may be an important contributor to the pathophysiology of schizophrenia. However, contemporary psychopathology consistently underestimates the role of emotions in the phenomenology of the disease. Psychotic arousal (PA) is a conceptually defined psychopathological construct aiming to portray the experiential emotional state of acute psychosis. The concept provides an explanatory model for the emergence of psychosis, and the formation and maintenance of delusions based on neurobiological models on the formation of core consciousness and subjectivity. This is the first exploratory study of the major assumptions, endorsed in the project summarized as follows: (1) psychotic arousal is a discrete state, eligible for investigation; (2) abnormal experiential feelings are an integral part of this state; and (3) the state is responsive to antipsychotic intervention during the first weeks of treatment. Methods: We developed the Psychotic Arousal Scale (PAS) accordingly, explored its first psychometric properties and tested its relation to other psychopathological measures. Fifty-five acute schizophrenia patients were evaluated with the PAS, the Positive and Negative Syndrome Scale, the Brown Assessment of Beliefs Scale, the Hamilton Anxiety Scale, and the Calgary Depression Scale. Cronbach α coefficients, t-test analysis, correlations and mixed linear regression models were applied for testing the internal reliability of the scale, associations between parameters and sensitivity to change in three time periods during therapeutic intervention. Results: The results of the study support that (PA) is eligible for investigation as a discrete psychopathological state. Abnormal experiential feelings are an integral part of this state, presenting high affinity with other affective measures; their degree of severity relates to the delusions’ conviction and are amenable to antipsychotics early in treatment during the acute psychotic episode. Conclusions: The findings of this exploratory study are connotative of the presence of an emotional arousal permeated by abnormal experiential feelings during acute psychosis, largely overlooked by contemporary psychopathology.

Background: Increasing research data suggests that dysfunction of emotional brain systems may be an important contributor for the psychophysiology of schizophrenia. However, contemporary psychopathology consistently underestimates the role of emotions in the phenomenology of the disease. Psychotic arousal (PA) is a conceptually-defined psychopathological construct aimed to portray the experiential emotional state of acute psychosis. The concept provides an explanatory model for the emergence of psychosis, and the formation and maintenance of delusions based on neurobiological models on the formation of core consciousness and subjectivity. This is the first exploratory study of the major assumptions, endorsed in the project summarised as follows: 1) Psychotic arousal is a discrete state, eligible to investigation; 2) Abnormal experiential feelings are an integral part of this state; 3) The state is responsive to antipsychotic intervention during the first weeks of treatment.Methods: We developed accordingly the Psychotic Arousal Scale (PAS), explored its first psychometric properties and tested its relation to other psychopathological measures. 55 acute schizophrenia patients were evaluated with the PAS, the Positive and Negative Syndrome Scale, the Brown Assessment of Beliefs Scale, the Hamilton Anxiety, and the Calgary Depression. Cronbach α coefficients, t- test analysis, correlations and mixed linear regression models were applied for testing internal reliability of the scale, associations between parameters and sensitivity to change in three time periods during therapeutic intervention.Results: Results of the study support that (PA) is eligible for investigation as a discrete psychopathological state, abnormal experiential feelings are an integral part of this state, it presents high affinity with other affective measures, its degree of severity relates to the delusions’ conviction, and is amenable to antipsychotics early in treatment during the acute psychotic episode.Conclusions: Findings of this exploratory study are connotative of the presence of an emotional arousal impregnated by abnormal experiential feelings during acute psychosis, largely overlooked by contemporary psychopathology.

Introduction Background :The profile of “frequent visitors” at the psychiatric emergencies (PE) has not been sufficiently investigated in Greece. Objectives In this study we aimed to investigate the prevalence and relevant parameters of frequent PE visits in a Greek University Psychiatric Hospital for the year 2017. Methods In a retrospective study, we analyzed data of patients who presented in the PE of Eginition University Hospital in Athens during 2017. Frequent visitors were grouped under this category if they had at least five visits per year. Clinical and sociodemographic data of the patients were further related to number of visits. Results 84 patients were characterized as frequent visitors carrying out 9.8% of the total number of visits. 50% were women and 70% of them were living with family members. Anxiety, depressive and psychotic symptoms were the most frequent major complaints at the time of their visit, whereas psychosocial problems were associated with increased number of visits. Moreover, in terms of the underlying diagnosis substance use disorders significantly related to more frequent visits Conclusions Psychosocial problems and the diagnosis of substance use disorders significantly correlated to the number of visits at the PE of a university hospital setting in Greece for 2017. Disclosure No significant relationships.

Aims The potential association between oxytocin (OXT) plasma levels and clinical and hormonal parameters in panic disorder (PD) especially in its acute phase – has not been investigated as yet. This was the aim of this article. Method Twenty-four consecutively-referred, acutely-ill, medication-free PD patients with (PDA, N = 21) or without agoraphobia, moreover without comorbidities, completed the following clinical measures: Hamilton Anxiety Rating Scale (HARS); Agoraphobic Cognitions Questionnaire (ACQ); Mobility Inventory-Alone subscale (MI-alone); and number of panic attacks during last 21 d (PA21d). Plasma levels of OXT, adrenocorticotropic hormone (ACTH) and cortisol were evaluated. Results OXT levels were significantly, negatively associated with the HARS scores (r= −0.59 p=.002) and weakly, negatively correlated with the ACQ scores (r = −0.403 p=.051). No significant correlations were traced between OXT levels and PA21d, MI-alone, ACTH, and cortisol. Conclusion In acutely-ill, medication-free PD patients, OXT plasma levels may be relevant to the severity of their ‘general’ anxiety symptoms, but not to the ‘specific’ panic psychopathology.

Background Several theories in autism posit that common aspects of the autism phenotype may be manifestations of an underlying differentiation in predictive abilities. The present study investigates this hypothesis in the context of strategic decision making in autistic participants compared to a control group. Method Autistic individuals (43 adults, 35 male) and a comparison group (42 adults, 35 male) of age and gender matched individuals, played a modified version of the prisoner’s dilemma (PD) task where they were asked, if capable, to predict their opponents’ move. The predictive performance of the two groups was assessed. Results Overall, participants in the autism group had a significantly lower number of correct predictions. Moreover, autistic participants stated, significantly more frequently than the comparison group, that they were unable to make a prediction. When attempting a prediction however, the success ratio did not differ between the two groups. Conclusions These findings indicate that there is a difference in prediction performance between the two groups. Although our task design does not allow us to identify whether this difference is due to difficulty to form a prediction or a reluctance in registering one, these findings could justify a role for prediction in strategic decision making during the PD task.

Background: Prisoner's dilemma is one of the most popular concepts among scientific literature. In medical literature the majority of prisoner's dilemma experiments with human participants implement computerized means. Despite this, there is no shared validated tool for prisoner's dilemma tasks. Methods: The application is developed in Javascript programming language and makes use of the pixijs library for WebGL rendering. To create a custom trial, a set of variables have to be set. These refer to the linguistics, user controls, available choices, computer strategy, interaction flow (simultaneous or sequential), opponent's choice prediction requirement, noise induction, human opponent behavior simulation, the way resulted data will be handled and more. Results are in JSON format and include time interval data. Results: We have developed an application which, given the various parameters experimenter can modify, is able to simulate a large number of single player prisoner's dilemma versions. It is open source with no installation requirement, executable by any modern internet browser remotely or locally with the ability to post data results either locally or remotely. Experimenter only has to modify certain starting values in order to create his design of choice. Two examples are included, with initial settings and results, to demonstrate the use and validity of the application. Conclusions: Our aim is to assist future researchers in their methodological designs. In this scope, our application, has the minimum requirements, can be served either locally or remotely, has a wide range of modifiable parameters and takes care of the resulted data. In the long term, a shared and validated tool would contribute to increasing methodologies’ credibility and mitigating cross-validation discrepancies.

The Prisoner’s Dilemma (PD) is one of the most popular concepts amongst the scientific literature. The task is used in order to study different types of social interactions by giving participants the choice to defect or cooperate in a specific social setting/dilemma. This review focuses on the technical characteristics of the PD task as it is used in medical literature and describes how the different PD settings could influence the players’ behaviour. We identify all the studies that have used the PD task in medical research with human participants and distinguish, following a heuristic approach, seven parameters that can differentiate a PD task, namely (a) the opponent parties’ composition; (b) the type of the opponent as perceived by the players; (c) the interaction flow of the game; (d) the number of rounds; (e) the instructions narrative and options that are given to players; (f) the strategy and (g) the reward matrix and payoffs of the game. We describe how each parameter could influence the final outcome of the PD task and highlight the great variability concerning the settings of these parameters in medical research. Our aim is to point out the heterogeneity of such methods in the past literature and to assist future researchers with their methodology design.

The objective of this cross-sectional survey was to estimate the association between multiple socioeconomic, and health-related characteristics, COVID-19 related attitudes and adoption of public health preventive behaviors. A national cross-sectional survey among 1205 adults was conducted in April 2020 in Greece. Multivariable ordered logistic regression models were used to estimate the association between COVID-19 related attitudes and knowledge and adoption of preventive behaviors, controlling for socioeconomic and health-related characteristics. A total of 923 individuals fully completed the survey. Individuals who believed that the virus is out of control, is transmitted through the air, and is not similar to the common flu were more likely to adopt public health preventive behaviors more frequently, particularly wearing masks in public spaces, washing their hands, and spending fewer hours out of their homes. Uncertainty about the virus symptomatology was associated with less frequent mask-wearing and handwashing. Increased social support, frequent media use for COVID-19 updates, trust to authorities, older age, worse health status, female gender and being a healthcare professional were also associated with uptake of some preventive health behaviors. Attitudinal and socioeconomic determinants critically affect public engagement in preventive behaviors. Health policy initiatives should focus on community outreach approaches to raise awareness and to strengthen social support mechanisms by integrating multiple stakeholders.