Papers by Elias Angelopoulos
Journal of Clinical Psychopharmacology, Dec 1, 2010
Postsynaptic 5-HT1A receptors are involved in the excitatory action of 8-OH-DPAT on prefrontal co... more Postsynaptic 5-HT1A receptors are involved in the excitatory action of 8-OH-DPAT on prefrontal cortex pyramidal neurons. Society for Neuroscience (Chicago).
Acta neurochirurgica, Apr 2, 2016
This study investigated whether certain cognitive deficits are associated with frontal lobe epile... more This study investigated whether certain cognitive deficits are associated with frontal lobe epilepsy (FLE) aiming to contribute with localization data to the preoperative assessment of epilepsy surgery candidates. We evaluated 34 patients with refractory FLE, 37 patients with refractory medial temporal lobe epilepsy (MTLE), and 22 healthy individuals in attention, psychomotor speed, motor function, verbal memory span, verbal fluency, response inhibition/interference, concept formation and set shifting, anticipation and planning, global memory. Neuropsychological performances of FLE and MTLE were similar, with the only exception the WCST-number of categories index, measuring mental flexibility, in which MTLE patients performed significantly worse than FLE patients. Left-FLE patients presented more perseverative responding compared to both other patient groups and healthy controls (HCs), while left-MTLE patients showed worse sorting abilities than the other epilepsy groups. Our findings suggest a weak cognitive differentiation between FLE and MTLE, probably attributed to the intricate nature of fronto-temporal connectivity frequently resulting in overlapping deficits as well as the confounding effects of seizure-related variables. In clinical practice, a highly individualized (idiographic) neuropsychological approach along with the inclusion of concurrent EEG recordings (e.g., interictal coupling) may be of help for neuropsychologists in identifying FLE patients from those with medial temporal pathology presenting frontal dysfunction as a secondary cognitive symptom.
World Psychiatry, Feb 1, 2016
Social Psychiatry and Psychiatric Epidemiology, May 13, 2016
Purpose A series of repeated cross-sectional surveys conducted in 2008, 2009, 2011 and 2013 were ... more Purpose A series of repeated cross-sectional surveys conducted in 2008, 2009, 2011 and 2013 were conducted with the aim of estimating the prevalence of major depression and suicidality as well as of investigating its risk factors. The present report concentrates on the 2013 survey. Methods A random and representative sample of 2.188 people was telephone interviewed with regard to various socioeconomic indicators and the presence of major depression and suicidality, which were assessed with the germane module of the Structured Clinical Interview. Results Findings suggest a rise in 1-month prevalence of major depression (12.3 %) and a decline in prevalence of suicidality (2.8 %). Female gender, residence in rural area, low educational attainment, unemployment and economic hardship were found to increase the odds of suffering from major depression. The influence of economic hardship and unemployment on suicidality was also substantial and independent of major depression. Conclusions Results stress the imperative need for the design and implementation of social policies and interventions that would offset the dire impact of the sustained recession in Greece.
Psychiatry Research-neuroimaging, Nov 1, 2021
Psychiatric hospitalization poses a risk for Posttraumatic Stress Disorder (PTSD), partly because... more Psychiatric hospitalization poses a risk for Posttraumatic Stress Disorder (PTSD), partly because of coercion. However, the role of legal status is less clear, while factors like insight, exposure to violence and affective disorders have not been addressed adequately. The present study aims at assessing PTSD rates after hospitalization and evaluating the potential role of these factors. 98 inpatients were assessed for PTSD, insight, main diagnosis, adverse events during hospitalization and legal status. Assessment took place at discharge (T1) and three months later (T2). Three months after discharge, 74.2% of patients with affective disorders met symptom-criteria for PTSD. Voluntarily hospitalized patients had more severe PTSD-symptoms. This relation vanished after controlling for affective disorders. The latter, as well as exposure to violence were the most significant risk factors at T2. Female gender, marital status (not married) and employment status (not employed), were additional risk factors at T1, while involuntary medication had a negative effect on PTSD-symptoms. Voluntarily hospitalized patients are more vulnerable to PTSD, due to higher rates of affective disorders. Females suffering from affective disorders who are not married and not employed should be monitored for PTSD symptoms during and after hospitalization, especially if exposed to violence.
European Neuropsychopharmacology, Nov 1, 1998
International Journal of Bipolar Disorders, Jun 17, 2014
Bipolar disorders have been characterized by powerful fluctuations of energy, mood, and thinking ... more Bipolar disorders have been characterized by powerful fluctuations of energy, mood, and thinking patterns. Mood episodes (manic or depressive) could be considered as deviations of a psycho-physiological index above or below a conventionally defined value called 'normothymia'. In the present study, we analyzed the feedback techniques used to suppress the oscillatory activity exhibited on an inverted pendulum device. Subsequently, we examine the degree that this multimodal feedback design could be considered on a hypothetical pendulum where the mood plays the role of the suspended mass, and the force balance compensation circuitry is substituted by drug-specific therapeutic interventions. The study does not concern a model of bipolar illness that could simulate numerically various phases of mood episodes but focuses on the functional similarities regarding the correction treatments applied on the two different oscillating systems giving a potential perspective of how techniques of feedback control may enhance the conceptualization of the treatment schemes followed in recent guidelines for biological treatment of bipolar disorders. Our theoretical consideration, along with observations on clinical level, gives support to the concept that the compensation of the mood oscillations should be adaptive with selective therapeutic interventions that compensate the excited system in different time scales.
Schizophrenia Research, Mar 1, 2014
Thought blocks (TBs) are characterized by regular interruptions in the stream of thought. Outward... more Thought blocks (TBs) are characterized by regular interruptions in the stream of thought. Outward signs are abrupt and repeated interruptions in the flow of conversation or actions while subjective experience is that of a total and uncontrollable emptying of the mind. In the very limited bibliography regarding TB, the phenomenon is thought to be conceptualized as a disturbance of consciousness that can be attributed to stoppages of continuous information processing due to an increase in the volume of information to be processed. In an attempt to investigate potential expression of the phenomenon on the functional properties of electroencephalographic (EEG) activity, an EEG study was contacted in schizophrenic patients with persisting auditory verbal hallucinations (AVHs) who additionally exhibited TBs. In this case, we hypothesized that the persistent and dense AVHs could serve the role of an increased information flow that the brain is unable to process, a condition that is perceived by the person as TB. Phase synchronization analyses performed on EEG segments during the experience of TBs showed that synchrony values exhibited a long-range common mode of coupling (grouped behavior) among the left temporal area and the remaining central and frontal brain areas. These common synchrony-fluctuation schemes were observed for 0.5 to 2 s and were detected in a 4-s window following the estimated initiation of the phenomenon. The observation was frequency specific and detected in the broad alpha band region (6-12 Hz). The introduction of synchrony entropy (SE) analysis applied on the cumulative synchrony distribution showed that TB states were characterized by an explicit preference of the system to be functioned at low values of synchrony, while the synchrony values are broadly distributed during the recovery state. Our results indicate that during TB states, the phase locking of several brain areas were converged uniformly in a narrow band of low synchrony values and in a distinct time window, impeding thus the ability of the system to recruit and to process information during this time window.
European Psychiatry, 1997
SummaryThe prolactin, cortisol and growth hormone (GH) responses to intravenous administration of... more SummaryThe prolactin, cortisol and growth hormone (GH) responses to intravenous administration of 25 mg clomipramine (CMI) were studied in young male psychotic patients who had never received neuroleptics and suffered from schizophrenia (13 patients), delusional disorder (three patients) or schizoaffective disorder (one patient). The test was repeated after 1 month in 16 patients who were hospitalized and treated with haloperidol in doses appropriate for best clinical response (range: 7.5–40 mg daily). Symptomatology was assessed by the Brief Psychiatric Rating Scale (BPRS). There was no association of the side effects caused by the administration of CMI (nausea and emesis) to the GH responses. The side effects appeared significantly less in the after treatment trials. Treatment with haloperidol did not influence the response patterns of the three hormones. An indication that high haloperidol doses may inhibit the prolactin response to CMI was obtained when the data were compared between low (7.5–10 mg/day, mean 9.7) and high (15–40 mg/day, mean 22.0) dose subgroups. Significant positive correlations were found between the prolactin and cortisol responses to CMI in the drug-free state, and the scores in the positive symptoms subscale of the BPRS. The degree of improvement did not correlate to any of the hormonal data.
European Neuropsychopharmacology, Apr 1, 2001
We present the case of a never medicated patient with a diagnosis of DSM-IV paranoid schizophreni... more We present the case of a never medicated patient with a diagnosis of DSM-IV paranoid schizophrenia in which olanzapine therapy induced manic symptoms. The latter remitted after drug discontinuation.
Psychiatry Research-neuroimaging, Aug 1, 2016
Rises in unemployment as a corollary to the global economic crisis may impinge on the prevalence ... more Rises in unemployment as a corollary to the global economic crisis may impinge on the prevalence of depression disproportionally for the two genders. Therefore, differences in the prevalence of the disorder as a function of gender and age were explored in four nationwide surveys in Greece in 2008, 2009, 2011 and 2013. Results indicate that in 2013, men of productive age had a higher prevalence of major depression than women, in contrast to the epidemiology of the disorder. The psychiatry community should be in tune to future changes in the mental health landscape elicited by the social fermentation processes of the global recession.
Psychiatry Research-neuroimaging, May 1, 2000
The aim of this study was to evaluate the reliability and validity, as well as the specificity, o... more The aim of this study was to evaluate the reliability and validity, as well as the specificity, of the Greek version of the Calgary Depression Scale for Schizophrenia (CDSS). Schizophrenic inpatients consecutively admitted at the Eginition Hospital, University of Athens, were included in the study. Patients were assessed on admission using the CDSS, the Hamilton Depression Rating Scale (HDRS), the Positive and Negative Syndrome Scale (PANSS), the Rating Scale for Extrapyramidal Side Effects (RSESE), the Rating Scale for Drug-Induced Akathisia (RSDIA) and the Abnormal Involuntary Movement Scale (AIMS). The CDSS was found to have a high inter-rater reliability, as well as test-retest reliability or split-half reliability. The internal consistency of the CDSS was good (a=0.87). There were positive correlations between the CDSS and the HDRS, or the depression cluster of the PANSS. The mean score on the CDSS showed no significant correlations with that of the PANSS negative subscale (r=0.123); a negative but not significant correlation with that of the PANSS positive subscale (r=-0.036); a weak correlation with that of the PANSS general psychopathology subscale (r=0.218); and no significant correlations with that of the RSESE (r=0.197), the RSDIA (r=0.160) or the AIMS (r=0.031). Our results give further support to the reliability, the validity, and the specificity of the CDSS.
Journal of Neurology, Neurosurgery, and Psychiatry, Aug 1, 2000
International Journal of Bipolar Disorders, Jun 22, 2023
Background Sunlight contains ultraviolet B (UVB) radiation that triggers the production of vitami... more Background Sunlight contains ultraviolet B (UVB) radiation that triggers the production of vitamin D by skin. Vitamin D has widespread effects on brain function in both developing and adult brains. However, many people live at latitudes (about > 40 N or S) that do not receive enough UVB in winter to produce vitamin D. This exploratory study investigated the association between the age of onset of bipolar I disorder and the threshold for UVB sufficient for vitamin D production in a large global sample. Methods Data for 6972 patients with bipolar I disorder were obtained at 75 collection sites in 41 countries in both hemispheres. The best model to assess the relation between the threshold for UVB sufficient for vitamin D production and age of onset included 1 or more months below the threshold, family history of mood disorders, and birth cohort. All coefficients estimated at P ≤ 0.001. Results The 6972 patients had an onset in 582 locations in 70 countries, with a mean age of onset of 25.6 years. Of the onset locations, 34.0% had at least 1 month below the threshold for UVB sufficient for vitamin D production. The age of onset at locations with 1 or more months of less than or equal to the threshold for UVB was 1.66 years younger. Conclusion UVB and vitamin D may have an important influence on the development of bipolar disorder. Study limitations included a lack of data on patient vitamin D levels, lifestyles, or supplement use. More study of the impacts of UVB and vitamin D in bipolar disorder is needed to evaluate this supposition.
WOS, 2021
Background: Bipolar disorder is associated with circadian disruption and a high risk of suicidal ... more Background: Bipolar disorder is associated with circadian disruption and a high risk of suicidal behavior. In a previous exploratory study of patients with bipolar I disorder, we found that a history of suicide attempts was associated with differences between winter and summer levels of solar insolation. The purpose of this study was to confirm this finding using international data from 42% more collection sites and 25% more countries. Methods: Data analyzed were from 71 prior and new collection sites in 40 countries at a wide range of latitudes. The analysis included 4876 patients with bipolar I disorder, 45% more data than previously analyzed. Of the patients, 1496 (30.7%) had a history of suicide attempt. Solar insolation data, the amount of the sun's electromagnetic energy striking the surface of the earth, was obtained for each onset location (479 locations in 64 countries). Results: This analysis confirmed the results of the exploratory study with the same best model and slightly better statistical significance. There was a significant inverse association between a history of suicide attempts and the ratio of mean winter insolation to mean summer insolation (mean winter insolation/mean summer insolation). This ratio is largest near the equator which has little change in solar insolation over the year, and smallest near the poles where the winter insolation is very small compared to the summer insolation. Other variables in the model associated with an increased risk of suicide attempts were a history of alcohol or substance abuse, female gender, and younger birth cohort. The winter/summer insolation ratio was also replaced with the ratio of minimum mean monthly insolation to the maximum mean monthly insolation to accommodate insolation patterns in the tropics, and nearly identical results were found. All estimated coefficients were significant at p < 0.01. Conclusion: A large change in solar insolation, both between winter and summer and between the minimum and maximum monthly values, may increase the risk of suicide attempts in bipolar I disorder. With frequent circadian rhythm dysfunction and suicidal behavior in bipolar disorder, greater understanding of the optimal roles of daylight and electric lighting in circadian entrainment is needed.
Psychiatric Annals, Mar 1, 2021
Occupational therapy is an essential component of psychiatric treatment. The purpose of this natu... more Occupational therapy is an essential component of psychiatric treatment. The purpose of this naturalistic cohort study is to evaluate the impact of a structured occupational therapy program in an acute mental health setting (AMHS) on psychiatric inpatients' function and occupational performance. The participants ( N = 397) attended the structured occupational therapy program during their hospitalization in an AMHS. Function and occupational performance were evaluated with the Occupational Abilities and Performance Scale. The results indicate a positive therapeutic role in the structured occupational therapy program. An interesting finding is related to the adequate duration of patient participation needed to improve their function and occupational performance. The inclusion of structured, purposeful, and comprehensive occupational therapy programs of adequate duration in the daily routine of an AMHS could be a valuable therapeutic component of the treatment armamentarium, as it may enhance patients' occupational performance, social functioning, and well-being. [ Psychiatr Ann . 2021;51(3):131–139.]
WOS, Oct 2, 2014
This is a PDF file of an unedited manuscript that has been accepted for publication. As a service... more This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting galley proof before it is published in its final citable form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain. Relationship between sunlight and the age of onset of bipolar disorder: an international multisite study.
Acta Psychiatrica Scandinavica, 2017
ObjectiveTo confirm prior findings that the larger the maximum monthly increase in solar insolati... more ObjectiveTo confirm prior findings that the larger the maximum monthly increase in solar insolation in springtime, the younger the age of onset of bipolar disorder.MethodData were collected from 5536 patients at 50 sites in 32 countries on six continents. Onset occurred at 456 locations in 57 countries. Variables included solar insolation, birth‐cohort, family history, polarity of first episode and country physician density.ResultsThere was a significant, inverse association between the maximum monthly increase in solar insolation at the onset location, and the age of onset. This effect was reduced in those without a family history of mood disorders and with a first episode of mania rather than depression. The maximum monthly increase occurred in springtime. The youngest birth‐cohort had the youngest age of onset. All prior relationships were confirmed using both the entire sample, and only the youngest birth‐cohort (all estimated coefficients P < 0.001).ConclusionA large increas...
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Papers by Elias Angelopoulos