Objective: To translate the Perceived Stress Scale (versions PSS-4, -10 and -14) and to assess its psychometric properties in a sample of general Greek population. Methods: 941 individuals completed anonymously questionnaires comprising of PSS, the Depression Anxiety and Stress scale (DASS-21 version), and a list of stress-related symptoms. Psychometric properties of PSS were investigated by confirmatory factor analysis (construct validity), Cronbach’s alpha (reliability), and by investigating relations with the DASS-21 scores and the number of symptoms, across individuals’ characteristics. The two-factor structure of PSS-10 and PSS-14 was confirmed in our analysis. We found satisfactory Cronbach’s alpha values (0.82 for the full scale) for PSS-14 and PSS-10 and marginal satisfactory values for PSS-4 (0.69). PSS score exhibited high correlation coefficients with DASS-21 subscales scores, meaning stress (r = 0.64), depression (r = 0.61), and anxiety (r = 0.54). Women reported significantly more stress compared to men and divorced or widows compared to married or singled only. A strong significant (p < 0.001) positive correlation between the stress score and the number of self-reported symptoms was also noted. Conclusions: The Greek versions of the PSS-14 and PSS-10 exhibited satisfactory psychometric properties and their use for research and health care practice is warranted.

The prevalence of musculoskeletal complaints in dentists is high although relatively few studies had focus in this profession. The aim of this study was to investigate the relations between physical, psychosocial, and individual characteristics and different endpoints of musculoskeletal complaints of low back, neck, shoulders and hand/wrist. A questionnaire survey was carried out among 430 dentists (response 88%) in Thessaloniki, Greece. Questions include data on physical and psychosocial workload, need for recovery, perceived general health and (i) the occurrence of musculoskeletal complaints in the past 12 months, (ii) chronic complaints during at least 1 month, complaints which led to (iii) sickness absence, and (iv) medical care seeking. In logistic regression analysis odds ratios were estimated for all relevant risk factors. 62% of dentists reported at least one musculoskeletal complaint, 30% chronic complaints, 16% had spells of absence and, 32% sought medical care. Self-reported factors of physical load were associated with the occurrence of back pain (OR = 1.59), shoulder pain (OR = 2.57) and, hand/wrist pain (OR = 3.46). With the exception of hand/wrist complaints, the physical factors were not associated with chronic complaints and musculoskeletal sickness absence. Physical load showed a trend with the number of musculoskeletal complaints with ORs of 2.50, 3.07 and 4.40 for two, three and four musculoskeletal complaints, respectively. No consistent influence of psychosocial factors on complaints, chronicity, sickness absence and medical care seeking was observed. A perceived moderate general health was a significant factor for chronic complaints, comorbidity and medical care seeking where high perceived exertion was significant for absenteeism. Living alone was also related with increased absenteeism due to shoulder pain (OR = 5.01) and hand/wrist (OR = 4.07). The physical load among dentists seems to put them at risk for the occurrence of musculoskeletal disorders. More than one and severe complaints are related to perceived general health while high perceived exertion and social characteristics are associated with sickness absence. Chronic symptoms seem to determine medical care seeking. Ergonomic interventions may have a greater impact in prevention of hand/wrist complaints. When investigating the influence of work-related risk factors on musculoskeletal health, psychosocial and other personal characteristics should be taken into account.

Background: Stress has been considered a triggering factor for multiple sclerosis (MS) since the description of the disease by Jean-Martin Charcot. Until our times, many published studies have supported that both MS onset and relapse could be predisposed by psychological stress. This review aims to synthesize existing knowledge of the relationship between psychological stress and MS onset and relapse, focusing mainly on the quality of observational studies. Methods: We hand-searched MEDLINE with the terms ‘stress and multiple sclerosis’, using English language restrictions, from January 1980 to November 2010. We included only observational longitudinal studies. The Newcastle-Ottawa scale proposed by the Cochrane Collaboration was used for assessing the quality of the observational studies. Results: Seventeen publications were analyzed, 5 for MS onset (1 cohort and 4 case-control studies) and 12 for MS relapse (9 cohort and 3 case-control studies). We found a marked heterogeneity in stress measurement that mostly targeted the environmental approach to stress. Only 2 publications used radiological criteria for MS relapse. Quality issues were identified mainly for comparability, meaning that studies failed to control adequately for various triggering and psychosocial factors in the stress-MS relationship. Also, selection and blinding problems were identified in most case-control studies. All studies, with only 2 exceptions, resulted in favor of the stress-MS relationship, but due to marked stress measurement heterogeneity, no secure conclusions could be drawn. Conclusions: Future studies should incorporate a multidisciplinary approach to stress measurement and radiological criteria for MS. We further encourage researchers to test the effect of early life stress and stress management techniques on the clinical course of the disease.

Objectives This review aimed to quantify suicide risk among agricultural, forestry, and fishery workers and study potential variations of risk within this population. Methods We conducted a systematic literature review and meta-analysis from 1995 to 2016 using MEDLINE and following the PRISMA guidelines. A pooled effect size of suicide risk among the population of interest was calculated using meta-analysis. Subgroup analyses were conducted to investigate whether effect size differed according to population or study characteristics. Meta-regression was used to identify sources of heterogeneity. Results The systematic review identified 65 studies, of which 32 were included in the meta-analysis. Pooled effect size was 1.48 [95% confidence interval (CI) 1.30–1.68] representing an excess of suicide risk among the population of interest. Subgroup analysis showed that this effect size varied according to geographic area, with a higher effect size in Japan. The following study characteristics were found to contribute to the between-study variance: reference group, measure of effect size, and study design. Conclusions Our findings suggest an excess of suicide risk among agricultural, forestry, and fishery workers and demonstrated that this excess may be even higher for these groups in Japan. This review highlights the need for suicide prevention policies focusing on this specific population of workers. More research is also needed to better understand the underlying factors that may increase suicide risk in this population.