Mental health problems, behavior changes, and addictive issues have been consistently documented among healthcare workers during the pandemic. The objective of this study was to investigate the levels of anger and aggression in relation to psychological resilience and alcohol abuse among healthcare workers during the first wave of the COVID-19 pandemic. A total of 120 physicians and 123 nurses completed an online survey of the Dimensions of Anger Reactions-5 (DAR-5), the Brief Aggression Questionnaire (BAQ), the Brief Resilience Scale (BRS), and the Alcohol Screening questionnaire CAGE which is an acronym for the focus of the questions (Cutting down, Annoyance by criticism, Guilty feeling, and Eye-openers). Demographic and professional data were also recorded. A total of 53 men and 190 women participated in the study. Almost one-third of the participants had a positive score on the DAR-5 scale and one out of ten respondents presented with current problematic alcohol use. Male participants demonstrated lower scores on the DAR-5 scale compared to females. Individuals with current problematic alcohol use displayed higher scores on the BAQ compared to those without alcohol use disorders. Regression analysis revealed that 16.4% of the variance in the BAQ scores can be attributed to scores on the DAR-5, 5.9% to the BRS scores, 2.1% to the CAGE scores, 1.7% to gender, and 1.2% to years of work experience. Mediation analysis highlighted the role of psychological resilience as a negative mediator in the DAR-5 and BAQ relationship. Professional experience and alcohol abuse emerged as positive and negative risk factors contributing to aggression and psychological resilience. The findings hold practical implications for implementing interventions to strengthen resilience in order to compensate for aggressive tendencies and discourage addictive issues.

Background: The nursing profession is recognized as a high-risk occupation, with the emotional toll on healthcare workers reaching a critical point. A complex interplay of anger and cynicism, often stemming from systemic pressures and chronic moral injury, seems to increasingly affect nurses’ professional and personal lives. This psychological strain does not end when the shift ends; rather, it often manifests as insomnia and nightmare distress, creating a vicious cycle of exhaustion and emotional instability. This article explores how anger, cynical distrust, nightmare distress and insomnia are interrelated and jeopardize the well-being of nursing staff and what these “invisible” symptoms reveal about the current state of healthcare by confirming their prevalence rates. Methods: This cross-sectional study was conducted online in October 2025 and included 441 hospital nurses who completed the Dimensions of Anger Reactions-5 (DAR-5), the 8-item Cynical Distrust scale (CDS-8), the Nightmare Distress Questionnaire (NDQ) and the Athens Insomnia Scale (AIS). Results: The prevalence rates of anger, nightmare distress and insomnia were 41.5%, 6.6%, and 62.1%, respectively. Based on the CDS-8 scores, a notable proportion (20.9%) of nurses fell within the highest quartile of CDS-8 scores (CDS-8 > 29), indicating relatively elevated cynical distrust within this sample; this threshold is sample-derived and does not correspond to a validated clinical cut-off. Hierarchical multiple regression analysis indicated that the DAR-5 explained 22.1% of the variance in AIS, while an additional 10.2% was explained by NDQ and another 1.5% by the CDS-8. Both cynical distrust and nightmare distress displayed a chain mediation pattern in the association between anger and insomnia; however, given the cross-sectional design, the temporal order of these variables cannot be confirmed. Conclusions: Anger exhibited significant direct and indirect associations with insomnia, with cynical distrust and nightmare distress acting as serial mediators in this cross-sectional model. Findings from this cross-sectional study tentatively suggest that future intervention efforts targeting insomnia in nurses might benefit from addressing anger alongside nightmare distress and cynical attitudes; however, experimental studies are needed to confirm whether such interventions would be effective.

Schizophrenia has been associated with increased inflammatory and metabolic disturbances. Perceived family support possibly effectuates changes in inflammatory and metabolic biomarkers. The aim of the present study was to determine the associations between family support, C-reactive protein (CRP) and Body Mass Index (BMI) in a sample of schizophrenic outpatients. In this cross-sectional correlation study 206 schizophrenic outpatients in clinical remission completed the standardized self-report questionnaire that assessed family support (family support scale-FSS). Sociodemographic, clinical and laboratory data were also recorded. 49.5% of the participants had detectable CRP values (≥0.11mg/dl), whereas 14.6% had positive CRP levels (>0.6mg/dl). There was a significant difference in CRP levels across the different BMI groups (normal-weight/ overweight vs. obese). For obese patients, the crude odds ratio (OR) for detectable CRP values was 1.980 with 95% confidence interval (CI) [1.056, 3.713] and for positive CRP values the OR was 27.818 (95% CI [6.300, 122.838]). Significant positive correlations were observed among CRP, BMI and illness duration, while scores on FSS were negatively associated with these variables. Results from the binary logistic regression analysis indicated that both BMI and family support were significant factors in determining the likelihood of having positive CRP levels, with each unit increase in the BMI associated with a 17% (95% CI [0.025, 0.337]) increase in the odds and with each unit increase in family support leading to a 8.6% (95% CI [0.018, 0.15]) decrease. The moderation analysis revealed that the association between family support and the probability of having positive CRP levels depends on BMI values, but the magnitude of the decreased risk for positive CRP associated with the protective effect of family support is significant (b=-0.1972, SE=0.053, OR=0.821, p=0.000, 95% CI [-0.3010, -0.0934]) only for obese patients. The effect of perceived family support on inflammatory responses becomes evident in cases where beyond metabolic complications inflammatory processes have already been established. However, primary interventions are considered necessary for schizophrenic patients in order to maintain BMI within normal limits and avoid the subsequent nosological sequelae.

Background/Objectives: Schizophrenia has been associated with increased inflammatory and metabolic disturbances. Perceived family support potentially affects inflammatory and metabolic biomarkers. The aim of this study was to determine the interrelations between family support, C-reactive protein (CRP) and Body Mass Index (BMI) in a sample of outpatients with schizophrenia. Importantly, this study sought to elucidate the effect of perceived family support on inflammatory processes among patients with schizophrenia. Methods: In this cross-sectional correlation study, 206 outpatients with schizophrenia in clinical remission completed a standardized self-report questionnaire that assessed family support (Family Support Scale—FSS). Sociodemographic, clinical and laboratory data were also recorded. Results: Among the participants, 49.5% had detectable CRP values (≥0.11 mg/dL), whereas 14.6% had positive CRP levels (>0.6 mg/dL). There was a significant difference in CRP levels among the different BMI groups (normal weight/overweight vs. obese). For obese patients, the crude odds ratios (ORs) for detectable and positive CRP values were 1.980 (95% confidence interval (CI) [1.056, 3.713]) and 27.818 (95% CI [6.300, 122.838]), respectively. Significant positive correlations were observed among CRP, BMI and illness duration, while scores on the FSS were negatively associated with these variables. The results of binary logistic regression analysis indicated that both BMI and family support were significant factors in determining the likelihood of having positive CRP levels, with each unit increase in the BMI associated with a 17% (95% CI [0.025, 0.337]) increase in the odds, and with each unit increase in family support leading to an 8.6% (95% CI [0.018, 0.15]) decrease. A moderation analysis revealed that the association between family support and the probability of having positive CRP levels depends on the BMI value, but only for obese patients did the protective effect of family support significantly decrease the magnitude of the risk of having positive CRP (b = −0.1972, SE = 0.053, OR = 0.821, p = 0.000, 95% CI [−0.3010, −0.0934]). Conclusions: The effect of perceived family support on inflammatory responses becomes evident in cases where beyond metabolic complications, inflammatory processes have already been established. Increased perceived family support seems to protect against inflammation and, notably, the association between low perceived family support and increased inflammation is even stronger. Establishing the role of family involvement during the treatment of patients with schizophrenia through inflammatory processes is a novelty of this study, emphasizing the need to incorporate family therapy into psychiatric treatment plans. However, primary interventions are considered necessary for patients with schizophrenia in order to maintain their BMI within normal limits and avoid the subsequent nosological sequelae.