Impact of a Novel, Non-Pharmaceutical, Cognitive - Behavioral Stress Management Technique "Pythagorean Self – Awareness Intervention" on the Stress Levels of Adult Patients with Non – Communicable Diseases: A Systematic Review

Impact of a Novel, Non-Pharmaceutical, Cognitive - Behavioral Stress Management Technique "Pythagorean Self – Awareness Intervention" on the Stress Levels of Adult Patients with Non – Communicable Diseases: A Systematic Review | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Impact of a Novel, Non-Pharmaceutical, Cognitive - Behavioral Stress Management Technique "Pythagorean Self – Awareness Intervention" on the Stress Levels of Adult Patients with Non – Communicable Diseases: A Systematic Review Panagiotis Pipelias, Flora Bacopoulou, George P. Chrousos, Nikolaos Tentolouris, and 4 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-6956437/v1 This work is licensed under a CC BY 4.0 License Status: Under Review Version 1 posted 4 You are reading this latest preprint version Abstract Background: Non – communicable diseases (NCDs) are the main cause of morbidity and mortality in a worldwide range, accounting for 71% of all deaths, each year. A bidirectional link between NCDs and the stress system appears to exist, as stress system dysfunction negatively affects the human organism. Pythagorean Self – Awareness Intervention (PSAI) is a novel, non-pharmaceutical, cognitive behavioral-based, stress management technique, employed in many studies in Greece. Objective: The main aim of this systematic review is to examine the impact of PSAI on the stress levels in adults (≥ 18 years old) with NCDs. Methods: A systematic search of the medical literature for published papers was conducted from June 28, 2023 to present using the following electronic databases: PubMed, Embase Scopus, Cochrane library and SCIRP. The systematic review was conducted following the PRISMA guidelines, using prespecified MESH terms, such as “pythagorean self-awareness intervention” and “PSAI”. Results: The initial search yielded 35 studies, while the last step of the screening procedure resulted in 7 Randomized Control Trials (RCTs). Six of them had statistically significant outcomes concerning the reduction of stress and anxiety levels. Also, there were secondary outcomes regarding the improvement of the quality of life. Conclusions: PSAI seems to be useful as an holistic stress management technique and seems to have the potential to improve various health outcomes, by enhancing self empowerment, self–efficacy and healthy lifestyle decisions. Key words: Pythagorean self-awareness intervention, PSAI, NCDs, stress levels, stress management, lifestyle medicine Pythagorean self-awareness intervention PSAI NCDs stress levels stress management lifestyle medicine Full Text Cite Share Download PDF Status: Under Review Version 1 posted Reviewers agreed at journal 20 Sep, 2025 Reviewers invited by journal 17 Sep, 2025 Editor assigned by journal 31 Aug, 2025 First submitted to journal 30 Jun, 2025 You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-6956437","acceptedTermsAndConditions":true,"allowDirectSubmit":false,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":516572793,"identity":"d8a1d0fc-1de6-4437-b974-768325ac124c","order_by":0,"name":"Panagiotis Pipelias","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAAz0lEQVRIiWNgGAWjYBADOSA2IEmHgTHpWhIbiNZizn724MOfO/6kr21v3sDMU2HHIB99AL8Wy568ZGPeMwa5284cK2DmOZPMYHgugYCLDuSYSTO2AbXcyDFg5m1jZjDsIeSJ82/MJH+2GaSb3X8D0lJPhJYbOWYSvG0GCWY3eEBaDjPI8xDQYjnjjTHQL8aG286kFRycc+Y4jwEhLeb8OYbAEJOTNzt+eOODNxXVcvIEHQYiGBsgnANAzGNwgBQtYCDfgFXhKBgFo2AUjGAAAL0cP42FXiFvAAAAAElFTkSuQmCC","orcid":"https://orcid.org/0009-0007-9460-6271","institution":"National and Kapodistrian University of Athens School of Medicine: Ethniko kai Kapodistriako Panepistemio Athenon Iatrike Schole","correspondingAuthor":true,"prefix":"","firstName":"Panagiotis","middleName":"","lastName":"Pipelias","suffix":""},{"id":516572794,"identity":"6bf63c98-e52a-4862-b98b-998525db47e5","order_by":1,"name":"Flora Bacopoulou","email":"","orcid":"","institution":"National and Kapodistrian University of Athens Faculty of Medicine: Ethniko kai Kapodistriako Panepistemio Athenon Iatrike Schole","correspondingAuthor":false,"prefix":"","firstName":"Flora","middleName":"","lastName":"Bacopoulou","suffix":""},{"id":516572795,"identity":"65160a85-b9ff-4bbc-8824-8e7414df6c21","order_by":2,"name":"George P. 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