Background: The Hospital Anxiety and Depression Scale (HADS) has been used in several languages to assess anxiety and depression in general hospital patients with good results. Methods: The HADS was administered to 521 participants (275 controls and 246 inpatients and outpatients of the Internal Medicine and Surgical Departments in 'Attikon' General Hospital in Athens). The Beck Depression Inventory (BDI) and the State-Trait Anxiety Inventory (STAI) were used as 'gold standards' for depression and anxiety respectively. Results: The HADS presented high internal consistency; Cronbach's α cofficient was 0.884 (0.829 for anxiety and 0.840 for depression) and stability (test-retest intraclass correlation coefficient 0.944). Factor analysis showed a two-factor structure. The HADS showed high concurrent validity; the correlations of the scale and its subscales with the BDI and the STAI were high (0.722 – 0.749). Conclusion: The Greek version of HADS showed good psychometric properties and could serve as a useful tool for clinicians to assess anxiety and depression in general hospital patients.

It remains unclear whether psychotic features increase the risk of completed suicides in unipolar depression. The present systematic review coupled with a meta-analysis attempts to elucidate whether unipolar psychotic major depression (PMD) compared to non-PMD presents higher rates of suicides. A systematic search was conducted in Scopus, PubMed, and “gray literature” for all studies providing data on completed suicides in PMD compared to non-PMD, and the findings were then subjected to meta-analysis. All articles were independently extracted by two authors using predefined data fields. Nine studies with 33,873 patients, among them 828 suicides, met our inclusion criteria. PMD compared to non-PMD presented a higher lifetime risk of completed suicides with fixed-effect pooled OR 1.21 (95% CI 1.04–1.40). In a sub-analysis excluding a very large study (weight = 86.62%), and comparing 681 PMD to 2106 non-PMD patients, an even higher pooled OR was found [fixed-effect OR 1.69 (95% CI 1.16–2.45)]. Our meta-analysis may provide evidence that the presence of psychosis increases the risk of suicide in patients suffering from severe depression. The data are inconclusive on the contribution of age, mood congruence, comorbidity, and suicide method on PMD’s suicide risk. The lack of accurate diagnosis at the time of suicide, PMD’s diagnostic instability, and the use of ICD-10 criteria constitute the main study limitations. The presence of psychosis in major depression should alert clinicians for the increased risk of completed suicide. Thus, the implementation of an effective treatment both for psychotic depression and patients’ suicidality constitutes a supreme priority.

Background/Aim: To evaluate psychometric properties of the Connor and Davidson Resilience Scale (CD-RISC) in a Greek population. Materials and Methods: Internal consistency and test-retest reliability were measured. Global Assessment of Functioning Scale (GAF), World Health Organization Quality of Life (WHOQOL) questionnaire, Perceived Stress Scale (PSS) and General Health Questionnaire (GHQ) were used as measures for convergent reliability. Factors were extracted by using exploratory factor analysis (EFA). A total of 546 subjects (244 healthy individuals and 302 psychiatric patients) were recruited. Results: The scale showed excellent internal consistency (Cronbach's alpha=0.925), as well as excellent test-retest reliability (intra-class correlation coefficient=0.925). CD-RISC scores were positively correlated to GAF and WHOQOL scores, while being negatively correlated to PSS and GHQ scores, establishing adequate convergent validity. We decided on a model with four factors, in order to form sub-scales that measure different, but related aspects of resilience. Conclusion: CD-RISC is a reliable and valid measure of resilience and can be used for clinical and research aims in the Greek population.