Papers by Artemis Tsitsika
European journal of public health, Apr 25, 2016
Background: Overweight of children and adolescents continues to be an important and alarming glob... more Background: Overweight of children and adolescents continues to be an important and alarming global public health problem. As the adolescent's time spent online has increased, problematic internet use (PIU) potentially leads to negative health consequences. This study aimed to examine the relation between PIU and overweight/ obesity among adolescents in seven European countries and assess the effect of demographic and lifestyle factors recorded in the European Network for Adolescent Addictive Behaviour (EU NET ADB) survey (www.eunetadb.eu). Methods: A cross-sectional school-based survey of 14-to 17-year-old adolescents was conducted in seven European countries: Germany,
EMBnet.journal, Oct 22, 2021
Transition from childhood to adolescence is known to bring about many changes in the lifestyle an... more Transition from childhood to adolescence is known to bring about many changes in the lifestyle and psychoemotional state of adolescents. One of the major lifestyle factors that affect adolescents' physical and mental health is sleep. The aim of this study was to validate the Adolescent Sleep Hygiene Scale (ASHS), a tool that measures sleep hygiene, in an adolescent sample living in Greece. The study's sample consisted of 146 Greek adolescents aged 12-18 years. The Adolescent Stress Questionnaire was used for convergent validity and correlation with adolescents' stress. The pilot and the main study demonstrated sufficient internal consistency. Exploratory Factor Analysis showed an adequate adaptation of the original ASHS questionnaire to the Greek adolescents. The findings of this study support the use of ASHS as a reliable and valid tool for evaluating sleep-facilitating and sleep-inhibiting practices of Greek adolescents.
Nutrients, Dec 27, 2021
This article is an open access article distributed under the terms and conditions of the Creative... more This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY
EMBnet.journal, Aug 23, 2021
Internet is a necessary tool of everyday routine, however, concerns about the development of abno... more Internet is a necessary tool of everyday routine, however, concerns about the development of abnormal behaviours in relation to its use by adolescents are constantly growing. The need of brief screening tools for problematic internet use in teenagers in Greece is imperative. The purpose of this study was to validate the 6-item short form of the Problematic Internet Use Questionnaire (PIUQ-SF-6) in a Greek sample of adolescents. The sample consisted of 200 adolescents (55.0% males, 61.6% high school students, 38.4% junior high school students) who completed the study's questionnaires i.e., a demographic questionnaire, the PIUQ-SF-6, the Young's Diagnostic Questionnaire (YDQ) and the Adolescent Computer Addiction Test (ACAT). The internal consistency of the Greek version of PIUQ-SF-6 was sufficient and acceptable (Cronbach's alpha coefficient a = 0.80). Confirmatory Factor Analysis was significant, and goodness-of-fit was adequate. For establishing convergent validity, Pearson's and Spearman's correlation coefficients were calculated between the PIUQ-SF-6 and ACAT scales and Receiver Operating Characteristic (ROC) analysis (between PIUQ-SF-6 and YDQ) indicated an excellent accuracy. The Greek version of the PIUQ-SF-6 demonstrated satisfactory psychometric properties (reliability and validity) and is recommended as a reliable screening tool for problematic internet use in Greek adolescents.
European Journal of Pediatrics
Brain-Derived Neurotrophic Factor (BDNF) has been linked to various conditions of the cardiovascu... more Brain-Derived Neurotrophic Factor (BDNF) has been linked to various conditions of the cardiovascular and nervous systems. Scarce data exist about the concentrations of BDNF in children and adolescents in relation with obesity and metabolic syndrome (MetS). The aim of this study was to examine the serum BDNF concentrations in adolescents with metabolic syndrome and according to their body mass index (BMI) status. This was a case-control study, assessing BDNF concentrations between adolescents with MetS (with obesity vs. normal-BMI), in relation to sex, anthropometric, metabolic and endocrine parameters. Participants included male and female adolescents, whose anthropometric and metabolic panel, as well as serum BDNF concentrations were measured. A total of 59 adolescents (obesity: 29; normal-BMI: 30) were included in the study. Increased serum BDNF concentrations were observed in MetS adolescents with obesity when compared with normal-BMI adolescents (p < 0.001). Males exhibited h...
Children
During the COVID-19 pandemic, it has been postulated that the sexual life of adolescent and young... more During the COVID-19 pandemic, it has been postulated that the sexual life of adolescent and young adults has been impacted in various aspects, potentially affecting their well-being. Our aim is to investigate the potential changes in the sexual activity and relationships of adolescents and young adults during the COVID-19 pandemic. In general, a decrease in sexual desire was reported during the COVID-19 pandemic, in both genders. Fewer sexual intercourses and bonding behaviors between partners were associated with loneliness and depressive symptoms. On the contrary, an increase in sexual desire was expressed in a few people, with masturbation to be the most preferable means of satisfaction. The present paper highlights the multifaceted impact of COVID-19 upon the sexual life of adolescents and young adults during the ongoing pandemic. The changes observed in their sexual activity and relationships, could provide the basis of future preventive and educational programs.
Children
Background: overweight and obese individuals may often face aggressive messages or comments on th... more Background: overweight and obese individuals may often face aggressive messages or comments on the internet. This study attempts to evaluate the association between cyberbullying victimization and overweight/obesity in adolescents participating in the European Network for Addictive Behavior (EU NET ADB) survey. Methods: a school-based cross-sectional study of adolescents aged 14–17.9 years was conducted (n = 8785) within the EU NET ADB survey, including data from seven European countries (Germany, Greece, Iceland, the Netherlands, Romania, Poland, Spain). Complex samples and univariate and multivariate logistic regression analyses were performed. Results: overall, overweight adolescents were more likely to have been cyberbullied compared to their normal weight peers (adjusted OR (Odds ratio) = 1.20, CI (confidence intervals): 1.01–1.42); this association was pronounced in Germany (adjusted OR = 1.58, CI: 1.11–2.25). In Iceland, obese adolescents reported cyberbullying victimization ...
Folia Medica, 2022
Fear of COVID-19, especially in vulnerable groups such as pregnant women, created excessive conce... more Fear of COVID-19, especially in vulnerable groups such as pregnant women, created excessive concern leading to unexpected psycho-emotional consequences and a need to summarize the most recent knowledge about this topic. Therefore, we conducted a narrative review of the relevant literature, synthesizing data from available databases. According to the findings of this review, pregnant women during COVID-19 pandemic were more anxious and depressed mainly due to the fear of contacting the virus, restricting measures, and concerns about the health of their unborn children. The elevated stress levels in pregnant women due to the pandemic could represent risk factors for physical health complications. Thus, strategies including relaxation, mindfulness, acceptance, and positive attitude to COVID-19 should be promoted for pregnant women.
Children, 2021
Background: Adolescents with type 1 diabetes mellitus (T1D) may differ from peers regarding sexua... more Background: Adolescents with type 1 diabetes mellitus (T1D) may differ from peers regarding sexual risk behaviors. Objectives: To explore sexual risk behaviors of adolescents with T1D in comparison with peers. Materials and methods: The subjects were 174 adolescents, 58 adolescents with T1D (mean ± SD age 16.3 ± 2.0 yrs, disease duration 6.7 ± 3.5 yrs and HbA1c:8.0 ± 1.3%) and 116 without (matched 1:2). Anonymous, self-reported questionnaires were used to evaluate sexual education and behaviors. Results: Fewer adolescents with T1D than those without had a sexual experience (74.1% vs. 87.4%, p = 0.033), with similar age of sexual debut. Among adolescents with T1D, ≥2 risky behaviors were observed less frequently than adolescents without T1D (8.62% vs. 23.27%, p = NS respectively) and in fewer girls than boys in both adolescents with T1D (0% vs. 18.5%, p = NS) and adolescents without T1D (11% vs. 44%, p = 0.022). Adolescents with T1D with ≥2 risky behaviors were older (p = 0.031), you...
Children, 2021
Background: Anorexia nervosa (AN) is a serious, multifactorial mental disorder affecting predomin... more Background: Anorexia nervosa (AN) is a serious, multifactorial mental disorder affecting predominantly young females. This systematic review examines neuroimaging findings in adolescents and young adults up to 24 years old, in order to explore alterations associated with disease pathophysiology. Methods: Eligible studies on structural and functional brain neuroimaging were sought systematically in PubMed, CENTRAL and EMBASE databases up to 5 October 2020. Results: Thirty-three studies were included, investigating a total of 587 patients with a current diagnosis of AN and 663 healthy controls (HC). Global and regional grey matter (GM) volume reduction as well as white matter (WM) microstructure alterations were detected. The mainly affected regions were the prefrontal, parietal and temporal cortex, hippocampus, amygdala, insula, thalamus and cerebellum as well as various WM tracts such as corona radiata and superior longitudinal fasciculus (SLF). Regarding functional imaging, alterat...
Trauma, Violence, & Abuse, 2021
Background: COVID-19 outbreak and the followed confinement measures have raised concerns to speci... more Background: COVID-19 outbreak and the followed confinement measures have raised concerns to specialists worldwide regarding the imminent increase in domestic violence cases. The present systematic review aims to identify the international trends in domestic violence during the COVID-19 epidemic and to examine the possible differences among all population groups and different geographic areas worldwide. Method: The following databases were accessed: DOAJ, ERIC, Google Scholar, ProQuest, Pubmed, PsycNet, and SCOPUS, up to July 22, 2020. Results: A total of 32 studies were considered eligible. Data from North America, Europe, Asia-Pacific Area, Africa, and worldwide researches were retrieved. COVID-19 has caused an increase in domestic violence cases, especially during the first week of the COVID-19 lockdown in each country. In children, however, although the specialists’ estimations suggested an increase in child maltreatment and abuse cases, the rate of police and social services’ re...
Children, 2021
Vulvar varicosities in nonpregnant females, either isolated or as a part of the pelvic congestion... more Vulvar varicosities in nonpregnant females, either isolated or as a part of the pelvic congestion syndrome, are rare. We present a case of an adolescent girl with morbid obesity with bilateral bluish protrusions on the labia minora, as an incidental finding, that coincided with her excessive weight gain. The adolescent underwent thorough clinical examination, doppler ultrasound, contrast venography and varicography, and magnetic resonance angiography to rule out alternative diagnoses. Imaging results confirmed the presence of large venous lakes. Venous drainage to the internal iliac vein and connections with the long saphenous vein were delineated. Incompetence, dilatation, or reflux of ovarian or internal iliac veins, or their main tributaries, were not noted. Since the adolescent was asymptomatic and other pathologies, such as vascular malformations or hemangiomas were excluded, she was managed conservatively with counseling about lifestyle modification and weight reduction. This ...
Children, 2020
Background: Eating disorders are more common among adolescents and young adults. An increase in t... more Background: Eating disorders are more common among adolescents and young adults. An increase in the rates of these disorders has been reported during the last years. Meanwhile, vegetarianism is becoming more popular in these age groups. The purpose of the present paper is to evaluate the association between eating disorders and vegetarian diets in adolescents and young adults. Methods: Systematic review of related articles published in PubMed, PsycInfo and Google Scholar up to 30 May 2019. Results: A total of 20 studies (14,391 subjects) were deemed eligible for this systematic review. The majority of the studies reported significant correlations between vegetarianism and eating disorders. However, due to the cross-sectional design, a causal link between eating disorders and vegetarian status cannot be established. Conclusions: Vegetarianism seems to be associated with eating disorders. Longitudinal studies are needed to establish temporal patterns between vegetarianism and the emer...
Children, 2021
As a result of COVID-19 restrictions, conventional ways of schooling were not possible, and in or... more As a result of COVID-19 restrictions, conventional ways of schooling were not possible, and in order to continue the educational process new digital resources, such as online learning platforms, were imposed. Although virtual courses provided high-quality educational material, the efficiency in children’s and adolescents’ academic performance in general is yet to be known. The purpose of this systematic review is to examine whether the academic performance of school-aged students was impacted or not through online learning and modified educational methods during the ongoing COVID-19 pandemic. According to the studies, either students suffered from learning losses comparing to pre-pandemic years or, in some cases, they benefited from online learning, especially in mathematics. Younger students and students with neurodevelopmental disorders or special education needs seemed to suffer more. Parents/caregivers reported that their children’s performance deteriorated, while others thought...
EMBnet.journal, 2021
Several months after the onset of the epidemic, COVID-19 remains a global health issue. Scientifi... more Several months after the onset of the epidemic, COVID-19 remains a global health issue. Scientific data on pregnancy, perinatal outcomes and vertical transmission of SARS-CoV-2 are constantly emerging but are still limited and unclear. The purpose of this systematic review was to summarize current evidence on vertical transmission rates, maternal, perinatal and neonatal outcomes and mode of delivery in pregnancies affected by COVID-19. An extensive search was conducted in PubMed, Google Scholar, Embase, and Scopus databases up to June 20, 2020. A total of 133 articles (51 case reports, 31 case series, 40 cohort studies and 2 case-control studies) reporting data from 8,092 subjects (6,046 pregnant women and 2,046 neonates) were considered eligible for inclusion in the systematic review. A substantial proportion of pregnant women with COVID-19 underwent caesarean section (case reports 82.2%, case series 74.2% and cohort studies 66.0%). Regarding vertical transmission, most neonates we...
Eating disorders and substance use disorders frequently co-occur. Twin studies reveal shared gene... more Eating disorders and substance use disorders frequently co-occur. Twin studies reveal shared genetic variance between liabilities to eating disorders and substance use, with the strongest associations between symptoms of bulimia nervosa (BN) and problem alcohol use (genetic correlation [rg], twin-based=0.23-0.53). We estimated the genetic correlation between eating disorder and substance use and disorder phenotypes using data from genome-wide association studies (GWAS). Four eating disorder phenotypes (anorexia nervosa [AN], AN with binge-eating, AN without binge-eating, and a BN factor score), and eight substance-use-related phenotypes (drinks per week, alcohol use disorder [AUD], smoking initiation, current smoking, cigarettes per day, nicotine dependence, cannabis initiation, and cannabis use disorder) from eight studies were included. Significant genetic correlations were adjusted for variants associated with major depressive disorder (MDD). Total sample sizes per phenotype rang...
BMC public health, Jan 10, 2018
The increasing use of the Internet and social network sites (SNS) has created a new domain of soc... more The increasing use of the Internet and social network sites (SNS) has created a new domain of socio-emotional development for adolescents. The aim of this cross-sectional study was to explore cybervictimization across seven European countries, in relation to socio-demographic, Internet use and psychosocial variables. A cross-sectional school-based study was conducted in the participating countries: Germany, Greece, Iceland the Netherlands, Poland, Romania and Spain. Anonymous self-completed questionnaires included sociodemographic data, internet usage characteristics, school achievement, parental control, the Internet Addiction Test and Achenbach's Youth Self-Report. The highest rate of cyber victimization was found in Romania (37.3%) and the lowest in Spain (13.3%). Multiple logistic regression analyses gave differing results between countries. In Romania, Poland and Germany cyberbullying victimization was associated with SNS use, whereas Internet use was associated with increa...
Molecular Psychiatry, 2017
Anorexia nervosa (AN) is a complex neuropsychiatric disorder presenting with dangerously low body... more Anorexia nervosa (AN) is a complex neuropsychiatric disorder presenting with dangerously low body weight, and a deep and persistent fear of gaining weight. To date, only one genome-wide significant locus associated with AN has been identified. We performed an exome-chip based genome-wide association studies (GWAS) in 2158 cases from nine populations of European origin and 15 485 ancestrally matched controls. Unlike previous studies, this GWAS also probed association in low-frequency and rare variants. Sixteen independent variants were taken forward for in silico and de novo replication (11 common and 5 rare). No findings reached genome-wide significance. Two notable common variants were identified: rs10791286, an intronic variant in OPCML (P=9.89 × 10−6), and rs7700147, an intergenic variant (P=2.93 × 10−5). No low-frequency variant associations were identified at genome-wide significance, although the study was well-powered to detect low-frequency variants with large effect sizes, ...
International Journal of Child and Adolescent Health, 2013
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Papers by Artemis Tsitsika