Ketanserin but not propranolol had a fully sedative profile and may confound pupillometric assessment of EDS. Beta adrenergic receptors do not appear to participate in arousal and pupillary functions, while 5HT1a receptors reduce pupil size without affecting arousal. Pupil size may not be used unequivocally as an index of the level of alertness in the case of drug-induced changes, when drugs interfere with the central pupil control mechanism in ways that are unrelated to their effects on arousal.

SUMMARY Alexithymia refers to dysregulation of affect characterized by difficulty in identifying and expressing emotions. Obstructive sleep apnea (OSA) is characterized by increased medical ⁄ psychiatric comorbidity and possibly by affect dysregulation. In the present case-control study, we examined alexithymia levels with the Toronto Alexithymia Scale (TAS-20) in 23 psychiatrically uncomplicated OSA outpatients and 23 same gender controls one-to-one matched for age, education and subjective depressive symptomatology. General health ⁄ quality of life was assessed with the Short-Form 36 Health Survey (SF-36) in the patient group. Hierarchical multivariate regression models were used to evaluate the association of alexithymia with the presence of OSA, and clinical and polysomnographic parameters of this condition. TAS-20 total and subscale scores were associated positively with Beck Depression Inventory (BDI)-21 and negatively with SF-36 scores. After adjusting for all confounders, OSA was positively associated with total TAS-20 score, Ôexpressing feelingsÕ and Ôexternally oriented thinkingÕ subscales. The latter was associated with increased sleepiness and reduced blood oxygenation in the OSA group. Finally, Ôdifficulty describing feelingsÕ and Ôexternally oriented thinkingÕ significantly predicted risk for OSA. Alexithymia is higher in nonpsychiatrically ill patients with OSA compared with carefully matched controls even after adjustment for subjective depressive symptoms and demographic confounders. Total alexithymia is associated with greater subjective depression and poor general health ⁄ quality of life, while Ôexternally oriented thinkingÕ is associated with disease severity and together with Ôdifficulty describing feelingsÕ may be vulnerability factors for OSA, although reverse causality cannot be excluded.

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IntroductionIn Greece, current legislation prohibits smoking in hospitals, but not in psychiatric units, that may be associated with significant Second Hand Smoking (SHS) adverse effects on nonsmoking patients/staff.ObjectivesTo examine the extent of SHS, and investigate the attitude of the nursing staff regarding smoking in a psychiatric inpatients unit.AimTo measure objectively indoor air pollution using PM2.5 in the Psychiatric Inpatient Unit of the University General Hospital of Heraklion, Crete (PIU/UOC).To investigate the attitude of the nursing staff towards the smoking permission in psychiatric units.MethodsData on smoking were collected for all inpatients between Nov’12-Sept’12. Pollution levels in PIU/UOC due to SHS were recorded by using the TSI Sidepack device. Nursing staff from the psychiatric unit, and medical and surgical units completed a short Questionnaire including demographics, smoking habits and attitude about the existing legislation on smoking.ResultsAmong 444 inpatients, 42% were non-smokers. Within the PIU/UOC, indoor pollution attributable to smoking, averaged 318 μgr/m3(range: 82–730 μg/m3). 295 nurses (mean age 39.6 ± 7.5 yrs) completed the questionnaire and only 31.2% disagreed with the existing legislation, whereas 64% responded that they wouldn’t avoid working in a psychiatric unit because of smoking permission.ConclusionsSHS concentrations within a psychiatric inpatient unit are comparable to those in bars, suggesting a detrimental effect on nonsmoking patients’/employees’ health. These results suggest the need to increase awareness among nursing staff of the adverse effects of SHS and to implement measures to decrease SHS’s impact on other patients/staff, i.e. nicotine patches

IntroductionDeinstitutionalization in Crete, as part of the psychiatric reform, resulted in the closure of the only psychiatric hospital of the island in 2006.ObjectivesTo explore the trends of yearly involuntary admissions in the Psychiatric Department of the University Hospital of Crete (PD/UHC) (2008-2011), the only inpatient public unit to receive involuntary admissions in a region of 400,000 residents, and the profile of the patients admitted.AimsTo find possible associations between the closure of the Psychiatric Hospital in Crete and the number of involuntary admissions.MethodsWe examined the records of total and involuntary admissions in PD/UHC between 2008–2011. In a subset of 400 inpatients admitted between Nov/2011 and Aug/2012, sociodemographic/psychopathology parameters were also examined. Statistical analysis was conducted with chi-square and regression analysis models.ResultsYearly involuntary admissions have increased by 245% during a period of 4 years, with the number of total admissions having increased by 22%. Within the subset of patients admitted during the last year, involuntary admissions account for the 47% of total admissions. Mean age of patients was 41.3 ± 1.38 years. Chi-square tests showed that male gender, aggression and positive psychotic symptoms at admission, absence of spouse/children are associated with involuntary admissions. Multivariate analysis revealed significant correlations for male gender and aggression.ConclusionDeinstitutionalization, i.e. closure of the only psychiatric hospital in Crete, has resulted in a significant and marked increase of involuntary admissions, a fact that also reflects the lack of community services and infrastructure.