Background and ObjectiveMental health outcomes have reportedly worsened in several countries during the Covid-19 pandemic and associated lockdowns. In the present study we examined whether suicides increased in Greece during the first wave of the pandemic.MethodsWe used daily suicide estimates from a Suicide Observatory in Greece from 2015-2020 and followed three methodologies: A descriptive approach, an interrupted time series analysis, and a differences-in-differences econometric model.ResultsWe did not find any empirical evidence of any increase in suicides during the first wave of Covid-19 and the lockdown in any of the three approaches used.ConclusionsSuicides did not seem to increase during the first wave of covid-19 and lockdown in Greece. However, this does not mean that mental health did not deteriorate, or that we will not observe an increase in suicides during the second wave. Protective factors for Greece during the first wave may include working from home (for those able to tele-work), strong family ties, advertising of a suicide hotline and income support for the unemployed.

23 Greek pregnant women with type 1 diabetes had a higher mean score on the Maudsley Obsessive-Compulsive Inventory in the second and third trimesters of pregnancy than 13 women with gestational diabetes. Long-term changes in the lifestyle of the former may apparently lead to this higher mean. For those with gestational diabetes, higher scores of alexithymia were correlated with slightly worse glycemic control.

Telepsychiatry was introduced in the early 1950's for the provision of mental health services from a distance. In 1990 the progress made in telecommunications technologies caused a significant expansion in telepsychiatry services. It can refer to store and forward technologies, interactive technologies, remote monitoring technologies and it is applied to contribute to the lift of restrictions placed on providing mental health services. Restrictions may exist due to geographic isolation, lack of specialized services, high cost of moving patients etc. The positive cost-benefit analysis and the reliability of diagnosis and efficacy of interventions through telepsychiatry have been documented in various research papers referring to a wide range of contexts such as prisons, remote areas, general and psychiatric hospitals. Since 2003 the Mobile Mental Health Unit of South- Eastern (SE) Cyclades has been using videoconferencing in order to provide mental health services in thirteen islands. This area shares many of the characteristics of remote areas such as residential dispersion, lack of mental health services and frequent lack of access to services in urban centers. Telepsychiatry in conjunction with physical presence of professionals was launched by the Mobile Mental Health Unit in order to provide assistance to the evaluation of patients, to therapeutic interventions, to medicine prescription, to crisis intervention, to psychoeducation of patients and their families and to the implementation of educational and administrative activities . The use of existing technology in combination with the development of human resources has enabled continuity of care, crisis intervention and avoidance of involuntary hospitalization for a significant number of persons. Moreover, it has improved cooperation and coordination between the interdisciplinary team and local authorities and agencies. When professionals located in different parts are collaborating via telepsychiatry it is necessary to ensure that they have immediate and simultaneous access to data concerning the patient. This need is served by the electronic medical record that facilitates access to patient records, improves the quality of care, reduces the probability of making wrong decisions and contributes to the promotion of research and service evaluation. KLIMAKA's electronic medical record contains more than ten thousand cases of which 4544 are related to individuals served by the Mobile Mental Health Unit during the years 2003-2010. This article presents the basic functions and parameters of the electronic medical record, the applications of telepsychiatry in the whole range of services provided by the scientific staff and provides information on how human and technology resources are distributed to the branches of the Mobile Mental Health Unit of SE Cyclades.

In order to assess thyroid function in former opioid addicts undergoing adjunctive naltrexone (NA) p.o. treatment, we studied 24 subjects (BMI±SD: 23.3±3.2 kg/m2) on 50 mg NA p.o. daily for 15 days to 14.5 months continuously. Measurements included thyrotropin (TSH), total thyroxin (TT4), total triiodothyronine (TT3), while the TT3/TT4100 ratio was calculated as a marker of peripheral conversion of T4 to T3. Reverse T3 (rT3) and serum interleukin-6 (IL-6) levels were also measured. Statistical analysis of thyroid parameters among them, of thyroid parameters versus duration of NA use as well as of thyroid parameters versus BMI was done with linear regression. All the subjects received NA well. The thyroid hormone work-up showed that all the subjects on NA were overall euthyroid. Mean±SD levels for TSH were 1.59±0.29 mU/L, TT4: 171.17±14.07 nmol/L, TT3: 2.01±0.27 nmol/L, TT3/TT4100: 1.18±0.19, rT3: 0.26±0.07 nmol/L and IL-6: 20.3±36.6 pg/mL. The duration of NA use was positively correlated with TT3 (r=+0.72, p<0.001) and TT3/TT4x100 (r=+0.77, p<0.001) and negatively, but not statistically significant, with TT4 (r=-0.38, p=0.065) and with TSH (r=-0.39, p=0.062). No significant correlations were found between TT3 and BMI, duration of NA use and rT3 and IL-6. Although few subjects were studied, there are indications that the duration of naltrexone may be positively correlated with TT3 and the ratio of T4 to T3 conversion.

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