Objective To investigate the effect of the time spent on quarantine on distress, anxiety, depression, and somatization of chronic disease patients during the COVID-19 quarantine in Greece and the differences in these parameters between healthy individuals and chronic disease patients. Method The sample consisted of 943 healthy individuals and 163 patients (respiratory, autoimmune, cardiovascular, endocrine, patients with other diseases, and patients with more than one disease) completing sociodemographic assessments as well as the 4-Dimensional Symptom Questionnaire (4DSQ) during March 30, 2020 to May 3, 2020. Pearson's correlation was used to search for the association between time spent on quarantine and the 4DSQ subscales (distress, anxiety, depression, and somatization). Independent sample T-test and Glass's Δ were used for differences between healthy individuals and chronic disease patients in these subscales, an analysis also carried out between healthy individuals and all patient subgroups. Results No statistically significant correlations were noted between the 4DSQ subscales and the quarantine duration, both for the patient and the healthy individuals’ group. Chronic disease patients had significantly higher levels of distress (p = 0.001, Δ = 0.28) and somatization (p = 0.000, Δ = 0.47), but not there were no significant differences in anxiety (p = 0.098, Δ = 0.14) and depression (p = 0.052, Δ = 0.19). Concerning head-to-head comparisons between the healthy individuals’ group and each patient group, significantly higher scores in distress were found only for patients with respiratory diseases (p = 0.028, Δ = 0.42). Regarding somatization, significantly higher scores were noted for the healthy individuals’ group compared with patients with autoimmune diseases (p = 0.010, Δ = 0.62), respiratory diseases (p = 0.027, Δ = 0.42), other diseases (p = 0.003, Δ = 0.55), and more than one disease (p = 0.012, Δ = 0.60). No statistically significant differences were found in anxiety and depression. Significance of results The results of this study indicate that interventional programs for chronic disease patients during quarantine should focus on distress and somatization, not on anxiety and depression. Respiratory patients might have more supportive care needs compared with patients with other diseases.

Background: According to the current state of knowledge, addictions are often developed as a maladaptive coping response to elevated stress levels. Stress management has a beneficial effect on various mental health problems. Yet, there is no strong evidence concerning the effect of stress management on stress levels of individuals with addictive behaviors, although such an effect might benefit their addictive symptoms. Objective: To investigate the effect of stress management on stress levels of persons with addictive behaviors. Methods: A systematic review of the literature was carried out on Biomed Central, PubMed, Scopus and Web of Science searching for relevant trials investigating the effect of stress management techniques, specifically of Progressive Muscle Relaxation (PMR), Autogenic Training (AT) and Guided Imagery (GI), on stress levels of individuals with addictive behaviors. In order to be included, the studies had to be randomized trials using an intervention and a non-intervention or a placebo control group, to apply PMR, GI or AT, to include a sample with addictive behaviors, to be published in English, to involve a baseline and at least one subsequent measurement, to be published in peer-review journals and to measure stress through instruments or biochemical assessments. The trials’ quality was assessed by the use of the Jadad Scale. Results: A total of four studies met the inclusion criteria and were further analyzed. The findings indicated that PMR might lead to a reduction of stress levels, while no such evidence is found concerning GI and AT. The quality of all trials was low. Conclusion: Progressive Muscle Relaxation and GI might have a divergent effect on persons with addictive behaviors. Yet, the low number of the studies and their poor quality debars drawing reliable conclusions for potential beneficial effects.

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A growing part of the literature has focused on depression, anxiety, distress and somatization. Identifying their prevalence and recording high-risk populations is essential in order to form relevant interventional programs addressing these symptoms. The aim of this study was to examine the prevalence and associated factors of distress, depression, anxiety and somatization in a community adult sample in Greece. Participants were recruited from two Greek cities; Giannitsa in the northern area and Athens in the southern area of the country and  completed sociodemographic assessments, as well as the 4-Dimensional Symptom Questionnaire (4-DSQ), a self-reported instrument assessing depression, anxiety, distress and somatization.A total of 2,425 adults, females (60.1%) and males (39.9%), 18 to 84 years of age (mean age 46.98 ± SD) participated in the study. Mental health symptoms were reported by 10.8% for depression, 12% for anxiety, 13% for distress and 5.3% for somatization of the participants. Females scored higher than males in anxiety, distress, and somatization (p=0.000 in all cases), while there were no significant sex differences in depression (p=0.593). Statistically significant associations were found between age and depression, anxiety and distress (p=0.000 in all cases), since those between 18-34 years of age had higher scores than the older age groups in all variables. Higher scores of depression, anxiety and distress were reported by students and unemployed participants (p=0.000 in all cases) than participants with other occupations. This study mapped several sociodemographic groups with worse mental health. Studies in representative population samples are needed to guide public health interventions to improve the mental and physical well-being of high-risk populations.