Psychotherapists

Tsixiseli Anna MSc, BSc is a Clinical Psychologist - Systemic Psychotherapist and maintains a private practice in Cholargos. She holds a degree in Psychology from the University of Sheffield and a master's degree in Clinical and Community Psychology from the University of East London. Additionally, she trained in Applied Counseling at the Center for Applied Psychotherapy and Counseling, and to this day, she continues her training in Systemic Therapy and Counseling (individuals, families, couples, groups) at the Systemic Education and Therapy Center "Entropy".

In her work, she is interested in seeing the person within the context of their life – the relationships, experiences, and transitions that have shaped them. She believes in a therapeutic process that does not provide ready-made answers but creates space for understanding, meaning-making, and change. Her goal is to offer a safe and supportive environment where each person can express themselves freely and approach their concerns in their own way. She works with adults, adolescents, and couples on issues such as anxiety, depression, emotional difficulties, interpersonal relationships, and life transitions, as well as more complex psychological challenges. She provides individual sessions (in-person and online), with respect for the uniqueness and pace of each person.

Papaioannou Giouli is a Psychologist - Psychotherapist for adults, children, and adolescents, maintaining a private practice in Thessaloniki at 3 Grigoriou Palama Street (City Center). She holds a degree in Psychology from Aristotle University of Thessaloniki and a Master's degree (MSc) in Child & Adolescent Mental Health from King's College London, UK.

She has received further training in Postmodern Systemic Approaches, such as Narrative Therapy, Solution-Focused Therapy, and the Collaborative-Dialogical Approach, at the Solution-Focused Therapy Center "Bienestar" in Thessaloniki. Additionally, she has completed a two-year cycle of Introductory Lectures on Psychoanalytic Practice at the Northern Greece Psychoanalytic Society (NGPS). Finally, she participates in the Annual Infant Observation Seminar of the same institution (NGPS), which includes weekly infant observation within the family environment and participation in a supervision group for understanding early mental mechanisms and non-verbal communication.

She possesses extensive clinical experience, having worked in various settings and organizations for children, adolescents, and adults in both the UK and Greece. Her most recent engagement involved supporting students and staff at the American College of Thessaloniki (ACT).

She receives ongoing supervision and personal analysis.

Plessa Martha is a Psychologist - Psychotherapist (license number 612900). She holds a BSc (Hons) degree in Psychology from the University of Essex, UK, and a Master's degree (MSc) in Integrative Counselling and Psychotherapy from the University of Derby. Additionally, she has an HND diploma in Counselling and Psychotherapy. She maintains a private practice in Pallini, offering counselling and psychotherapy services to adolescents and adults. She is a member of the Hellenic Society of Counselling.

She continues her education and professional development by participating in the annual Psychoanalytic Training Seminars of the Psychoanalytic Research Center of Athens.

She has completed certified training programs such as: "Promotion of Mental Health for Children and Adolescents" from the University of West Attica, "Trainer-Coordinator of Parent Schools" focusing on the "Developmental System" by Maria Chourdaki, "Basic Principles of Psychotherapy - Psychodynamic Psychotherapy" from the National and Kapodistrian University of Athens, "Adult Trainer Education" from the University of Patras, "Special Education" from the University of Patras. She is certified as a "Coordinator against Domestic Violence" by ACTA S.A. She has gained extensive experience in mental health settings, including at the residential care facility "IASIS" Psychosocial Rehabilitation Unit as a therapeutic group coordinator, and at the elderly care unit "LOIDA", providing counselling services.

Dallas Athanasios is a Psychologist - Psychotherapist licensed to practice since 2016. He holds a master's degree in Person-Centered Psychotherapy (Keele University) and is currently undergoing further training in Cognitive Behavioral Therapy (CBT) for children and adolescents. At the core of his therapeutic approach lies the human relationship characterized by non-judgment, empathy, acceptance, and honesty. Every individual possesses the capacity for change and often simply needs a safe space of understanding and meaningful communication to activate it. Mr. Dallas offers online sessions for adults, adolescents, and children, as well as counseling support for parents and couples. His approach focuses on addressing anxiety, emotional difficulties, relationship problems, and self-esteem, aiming to empower and promote personal growth. With experience in schools, mental health centers, and social support structures, he has accompanied individuals from diverse backgrounds and ages on personal journeys of relief, empowerment, and self-awareness. If you are seeking someone who will truly listen without judgment and support you with respect and confidentiality, he is here to help you wherever you are, through the internet.

Το πιο σημαντικό για εμάς είναι η δημιουργία ενός χώρου συνάντησης χωρίς προκαθορισμένες απαντήσεις, μακριά από παγιωμένες πεποιθήσεις. Είναι η αποδοχή της ιδιαιτερότητας του υποκειμένου που θα μας επισκεφτεί. Η από κοινού δημιουργία ενός πλαισίου ασφάλειας και εμπιστοσύνης, όπου θα αναπνεύσει και θα εκφραστεί το προσωπικό αίτημα, μέσα από έναν τρόπο ενικό.

Διανοίγουμε έτσι την προοπτική ρήξης με το πεπρωμένο, τον εξαναγκασμό της επανάληψης, την οδύνη του συμπτώματος, την δυσφορία που αναστέλλει τη ζωή.

Έτσι, κάνοντας τομές στις προκαταλήψεις (φύλου, ηλικίας, θρησκευτικών και πάσης φύσεως κοινωνικών επιταγών) διεκδικούμε σταδιακά τον ορίζοντα της προσωπικής επιθυμίας, μέσα από διαφορετικές επιλογές.

Ο Καλυβίτης Παναγιώτης είναι Κλινικός Ψυχαναλυτικής κατεύθυνσης (λακανικού προσανατολισμού). Είναι πιστοποιημένο μέλος της Ελληνικής Εταιρείας Συμβουλευτικής. Έχει εκπαιδευτεί στο Κέντρο Ψυχαναλυτικών Ερευνών της Αθήνας, στο οποίο δραστηριοποιείται ενεργά σε διαλέξεις, ημερίδες, σεμινάρια, κλινικές βραδιές, εργαστήρια, καρτέλ, εποπτείες. Το πρόγραμμα του Κέντρου Ψυχαναλυτικών Ερευνών είναι εμπνευσμένο από το έργο της Section Clinique, της κλινικής διδασκαλίας η οποία ξεκίνησε την δεκαετία του ’70 στο Τμήμα Ψυχανάλυσης που ίδρυσε ο Jacques Lacan στο Πανεπιστήμιο Paris VIII.

Είναι αριστούχος απόφοιτος του τριετούς προγράμματος μετεκπαίδευσης Ψυχαναλυτική και Ψυχοδυναμική Συμβουλευτική Προσέγγιση, Τομέας Ψυχολογίας, CPS Arts & Psychotherapy.

Συμμετέχει σε κλινικές παρουσιάσεις, σε συνεργασία με το Ψυχιατρικό Τμήμα Ενηλίκων του Γενικού Νοσοκομείου Αθηνών "Γ. Γεννηματάς", ενώ εργάστηκε εθελοντικά στην Εταιρία EPAPSY - Association for Regional Development and Mental Health.

Είναι απόφοιτος του Παντείου Πανεπιστημίου και της Σχολής Σκηνοθεσίας Θεάτρου Ελεύθερο Σχήμα. Συνέχισε με μεταπτυχιακές σπουδές στο θέατρο στο Royal Holloway University of London (MA, Department of Drama & Theatre, pathway Playwriting) και στη συνέχεια στη Νέα Υόρκη, όπου διδάχτηκε την τεχνική The View Points System δίπλα στην Anne Bogart και το Siti Company, καθώς και την μέθοδο Suzuki Actors Training του Tadashi Suzuki.

Είναι μέλος της Εταιρίας Ελλήνων Σκηνοθετών.

Ασχολείται με την ψυχανάλυση και την ψυχοθεραπεία τα τελευταία δέκα χρόνια. Παράλληλα, ασχολείται με την συγγραφή θεατρικών έργων, γράφει ποίηση και σκηνοθετεί παραστάσεις. Το θεωρητικό του υπόβαθρο περιλαμβάνει όλες τις θεμελιωμένες ψυχοδυναμικές προσεγγίσεις, αλλά η κλινική του προσέγγιση είναι λακανικού προσανατολισμού. Ο άνθρωπος που θα αποφασίσει να μπει σε ανάλυση, θα μπει σε διαπραγματεύσεις με το ασυνείδητό του, την απόλαυσή του, το σύμπτωμα και την ασυνείδητη επιθυμία του.

Kountouraki Xristina is a Psychologist - Psychotherapist. She holds a degree in Psychology from Panteion University of Social and Political Sciences and is undergoing further training in Psychodynamic Psychotherapy for Children and Adults at the Interdisciplinary & Research Psychosocial Support for Children & Adults (DI.KE.PSY). She has also completed various postgraduate training programs and seminars.

Despoina Ntina is a Psychologist – Psychotherapist who offers online sessions for adults, children, and adolescents. She holds a degree in Psychology from the Aristotle University of Thessaloniki and a Master’s degree in Sport and Exercise Psychology from the University of Thessaly. Specializing in Cognitive Behavioral Therapy (CBT), she provides support for issues such as anxiety and mood disorders, panic attacks, phobias, and personality disorders. She also works with individuals on anger management, personal development, relationship difficulties, trauma recovery, and obsessive-compulsive symptoms. Despoina also supports individuals seeking guidance on matters related to sexuality, gender identity, and self-acceptance. Her approach is inclusive and respectful of each person's uniqueness, focusing on managing thoughts and behaviors that impact mental well-being. She offers a safe and affirming space for LGBTQ+ individuals to explore topics related to sexual orientation, gender expression and identity, and the challenges that may arise from social stigma or internal conflicts. Provides parental counseling, family support, and guidance on issues related to family dynamics and relationships. The goal is to enhance communication, manage conflicts, and support parents in their role. She offers online sessions in both Greek and English, ensuring flexibility and accessibility regardless of location. Over the past four years, she has worked with adults and children who have experienced domestic violence, as well as with minorities and members of the LGBTQ+ community.

Η Κολέσνικ Αλεξάνδρα είναι Ψυχολόγος και διατηρεί ιδιωτικό γραφείο στο Περιστέρι. Είναι πτυχιούχος Ψυχολογίας του Παντείου Πανεπιστημίου Κοινωνικών και Πολιτικών Επιστημών. Έχει κάνει μεταπτυχιακές σπουδές στην Κλινική και Κοινοτική Ψυχολογία (MSc Clinical and Community Psychology, University of East London), με κατευθύνσεις στην Οικογενειακή - Συστημική Θεραπεία, Γνωστική Θεραπεία και Θεραπεία Σχημάτων. Επίσης, είναι κάτοχος διπλώματος μετεκπαίδευσης στην Κλινική Ύπνωση με εξειδίκευση στην Βιοθυμική Ψυχοθεραπεία (Κέντρο Εφαρμοσμένης Ψυχοθεραπείας και Συμβουλευτικής/ General Hypnotherapy Standards Council) καθώς και στην Γνωσιακή - Συμπεριφορική Κλινική Υπνοθεραπεία (Κέντρο Ψυχοθεραπείας και Μοντέρνας Εφαρμοσμένης Ψυχολογίας). Επιπλέον, έχει εκπαιδευτεί στην θεραπεία EMDR (EMDR Europe Βασική Εκπαίδευση, Αθήνα, Ελλάδα, Πέννυ Παπανικολοπούλου PhD EMDR Europe Accredited Senior Trainer). Καταρτήθηκε στην αντιμετώπιση και στην πρόληψη των κινδύνων του διαδικτύου (Ψυχική Υγεία και Διαδίκτυο: Δυσλειτουργικές Συμπεριφορές στο Διαδίκτυο - Τρόποι Παρέμβασης και Πρόληψης, Ε.Κ.Π.Α.) και απέκτησε ειδίκευση στην αντιμετώπιση παιδιών με αναπηρία και με ειδικές μαθησιακές ανάγκες (Ειδίκευση στην Ειδική Αγωγή και Εκπαίδευση, Ε.Κ.Π.Α.). Παρακολούθησε πλήθος σεμιναρίων, εκπαιδευτικών προγραμμάτων και συνεδρίων όπως Εκπαιδευτικό Πρόγραμμα Ψυχιατρικής Παίδων και Εφήβων, Τμήμα Ψυχιατρικής Παίδων και Εφήβων, ΓΝΑ Σισμανόγλειο-Αμαλία Φλέμινγκ (2013-2014) και ετήσια προγράμματα «Κρίσεις και ρήξεις: εφηβεία, κοινωνία» και «Η ψύχωση στην εφηβεία», Τμήμα Ψυχιατρική Εφήβων και Νέων του Γενικού Νοσοκομείου «Γ. Γεννηματάς» (2010-2012). Πραγματοποίησε πρακτική άσκηση με ειδικότητα ψυχολόγου σε συνεργασία με τον Συμβουλευτικό Σταθμό για το AIDS (Νοσοκομείο Αφροδίσιων και Δερματικών Νόσων Ανδρέας Συγγρός), την Τηλεφωνική Γραμμή για το AIDS (ΚΕ.ΕΛ.Π.ΝΟ), καθώς και την Κινητή Μονάδα Πρωτοβάθμιας Περίθαλψης. Άσκησε πρακτική με ειδικότητα ψυχολόγου στο Εργαστήριο Διερεύνησης Ανθρώπινων Σχέσεων (Χάρις Κατάκη), με συστημική-οικογενειακή θεραπεία. Συμμετείχε στην εθελοντική εργασία με ειδικότητα Ψυχολόγου στις Μη Κυβερνητικές Οργανώσεις «Ένα παιδί, ένας κόσμος» και «Μαζί για το Παιδί». Έχει τριετή συνεργασία με το «Ψυχοδός» (Κέντρο ψυχοθεραπείας, συμβουλευτικής και προσωπικής ανάπτυξης), όπου διεξήγαγε ατομικές και ομαδικές συνεδρίες, καθώς και θεραπεία ζεύγους. Επιπλέον, είναι εισηγήτρια σεμιναρίων με θέματα ψυχολογίας (Μικροεκφράσεις προσώπου και ανίχνευση ψεύδους, Κλινική Ύπνωση, Μηχανισμοί άμυνας, Ενδοικογενειακή βία, Mindfulness, κτλ.).

Karatza Eugenia is a Psychologist and Existential – Systemic Psychotherapist with experience in the treatment of adolescents, adults, and couples, as well as in parent counseling. She maintains a private practice in Pefki. She studied Psychology at the University of Crete and subsequently completed a six-year training in Existential – Systemic Psychotherapy at the ANTISTIXI Psychotherapeutic Institute, under the supervision of Psychiatrists/Child Psychiatrists/Psychotherapists Mr. Dimitris Karagiannis and Ms. Eleni Karagianni. Concurrently, she has specialized in learning disabilities, providing assessment and intervention with scientifically validated tools such as WISC-V, DTLA-3/4, L-a-T-O, and the Mathematical Proficiency Test for children aged 4–16 years. She regularly attends conferences and training seminars related to psychotherapy, relationship dynamics, and contemporary psychological approaches. As a psychotherapist, she holds a profound interest in how each individual relates to themselves and to others, and how through this relationship new paths of development and meaning can be discovered. Her approach is based on the principles of Existential and Systemic Psychotherapy, viewing the individual as a unity extending across the three temporal dimensions of past, present, and future. She believes that through connection, the possibility for deeper understanding, internal coherence, and the creation of new meaning in life emerges. She works with adults, adolescents, couples, and families seeking understanding, balance, and authenticity in their relationships and way of living.

Η Καράμπελα Νικολία MSc είναι μέλος του Συλλόγου Ελλήνων Ψυχολόγων με άδεια ασκήσεως επαγγέλματος αναγνωρισμένη τόσο από το Αγγλικό, όσο και από το Ελληνικό Κράτος (Αριθμός πράξης χορήγησης Αδείας: 4624/2006, Νομαρχία Αθηνών). Οι παρεχόμενες υπηρεσίες στο ιδιωτικό της γραφείο αφορούν την κλινική αξιολόγηση και την ψυχοθεραπεία παιδιών, εφήβων, ενηλίκων καθώς και τη συμβουλευτική γονέων, και στοχεύουν στην αντιμετώπιση και ψυχολογική διαχείριση συμπτωμάτων, όπως άγχος, φοβίες, κρίσεις πανικού, κατάθλιψη, ψυχοσωματικά συμπτώματα, διατροφικές διαταραχές και διαταραχές ύπνου, διαταραχές λόγου, όπως τραυλισμός και επιλεκτική αλαλία (κυρίως σε παιδιά), θέματα συμπεριφοράς, αυτοεκτίμησης και εικόνας σώματος και εαυτού, δυσκολίες στο σχολικό περιβάλλον (για παιδιά και εφήβους) ή στο εργασιακό περιβάλλον (για τους ενήλικες) και γενικότερα δυσκολίες στις διαπροσωπικές, οικογενειακές ή ερωτικές σχέσεις. Είναι κάτοχος Μεταπτυχιακού Διπλώματος στην Αναπτυξιακη Νευροψυχολογία στο πανεπιστήμιο ΕSSEX της Αγγλίας. Από το 2007 ως το 2011 μετεκπαιδεύτηκε στην οικογενειακή συστημική θεραπεία στο Αθηναϊκό Κέντρο Μελέτης του Ανθρώπου (ΑΚΜΑ) και από το 2019 στα πλαίσια της δια βίου εκπαίδευσης, συνεχίζει την εξειδίκευση της στη λακανική ψυχανάλυση στην Ακαδημία Κλινικών Σπουδών της Αθήνας (ΑΚΣΠΑ). Έχει αποκτήσει κλινική εμπειρία σε ένα ευρύ φάσμα διαταραχών και συμπτωμάτων σε δημόσιες και ιδιωτικές δομές  μεταξύ των οποίων το Ψυχιατρικό Τμήμα του Νοσοκομείου του Ελληνικού Ερυθρού Σταυρού (Κοργιαλένειο - Μπενακειο) (2005-2006), κέντρα ειδικών θεραπειών (2007-2015), την Ψυχοκοινωνική Υπηρεσία του Δήμου Παλαιού Φαλήρου (2012-2013), Δημοτικά Σχολεία στα πλαίσια Ψυχολογικής Στήριξης παιδιών με ψυχοσυναισθηματικές δυσκολίες (2013-2018). Παράλληλα διατηρεί το ιδιωτικό της γραφείο από το 2006, αναλαμβάνοντας πλήθος περιστατικών.

Lioliou Isidora is a Forensic Psychologist - Psychotherapist and maintains a private practice in Athens. Since 2025, she has been listed as an expert witness by decision of the Greek Judicial Authority and can provide assistance in adult cases. She is a graduate of the Department of Psychology at Panteion University of Social and Political Sciences, with postgraduate studies in Forensic Psychology (MSc in Forensic Psychology) from the University of Bedfordshire. She possesses significant experience, having worked in various institutions and organizations in Greece and abroad, and has served as a Psychotherapist and assistant psychologist in therapeutic support groups for vulnerable populations, as well as in prisons and rehabilitation centers for former inmates in Greece, Germany, and the United Kingdom, offering support and assistance to these vulnerable groups. The psychotherapeutic method used is Cognitive Behavioral Therapy (CBT). Sessions can also be held in English. Sessions can also be held in English.

Kyriakou Thomai is a Psychologist - Psychotherapist who maintains a private practice in Marousi and Argos. She also collaborates with the Center for Speech, Language, and Learning "Spell" as a Family Counselor and Psychoeducator and is the co-founder of the company "Morfogenesis," which provides counseling, training, support, guidance for individuals and groups, and training through seminars in workplace environments. She holds a degree in Psychology from the Open University of England, focusing on developmental psychology and the role of the father in the Greek family. Subsequently, she completed postgraduate studies in Psychology at the same university, specializing in criminology, prevention, and semiotic analysis. Throughout her career, she specialized as a family and group therapist in the Synthetic - Systemic approach at the Laboratory of Human Relations and as a couple therapist in the Emotionally Focused Therapy direction at the EFT Greek Network. Additionally, she recently completed the Gestalt Coaching in Business & Organizations Program to enhance her awareness of workplace issues and conditions, which are highly relevant in today's era. With children, she works psychotherapeutically using the Therapeutic Play method and is a Certified Play Therapist from Play Therapy Greece. To date, she has continuously updated and further educated herself on scientific topics related to psychology, psychotherapy, and education, considering their contribution essential to her professional practice. Finally, her extensive studies, experience, and collaborators enable her to work psychotherapeutically with individuals at different life stages, concerns, and needs. She works with adults, couples, families, and groups addressing issues such as the management of negative or intense emotions, low self-esteem, the creation and maintenance of functional relationships, and existential matters.

Dr Kanellakis Spyridon is a Psychologist with private practices in Ilioupoli and Kolonos. He graduated in Psychology from the National and Kapodistrian University of Athens, holds a postgraduate diploma in School of Medicine & Therapeutics from the University of Aberdeen, and a PhD from Harokopio University. His practice handles cases across the full spectrum of psychology.

Vlaxou Georgia is a Systemic Psychotherapist who maintains a private practice in Marousi. She completed her clinical postgraduate studies in Psychiatry at the Medical School of Athens, National and Kapodistrian University of Athens, and continues her specialization in Systemic & Family Psychotherapy at the Institute of Education and Research in Systemic Psychotherapy SANE. She has additionally specialized in the therapeutic treatment of addictions and psychological trauma.

She provides individual psychotherapy for adults, counseling for parents, children, and adolescents, couples therapy, and group therapy. She specializes in managing anxiety, depression, addictions, and interpersonal difficulties. She has particular experience in managing psychological and intergenerational trauma, as well as supporting individuals who have experienced narcissistic abuse and dysfunctional relational dynamics, aiming to enhance self-regulation, self-esteem, and the capacity for healthy boundary-setting.

Specializations

Couples counseling – enhancing communication, conflict resolution & relationship restructuring

Parent counseling – support in the parenting role & cultivation of healthy family relationships

Anxiety, panic attacks & phobia management

Treatment of depression & mood disorders

Support for addiction issues (substances, alcohol, gambling)

Improvement of interpersonal relationships & boundary-setting

Processing of psychological trauma & intergenerational patterns

Recovery from narcissistic abuse & toxic relationships

Empowerment of self-esteem & personal identity

Maria Tsimpinou is a Psychologist - Psychotherapist who maintains a private practice in Glyfada, where she provides individual, group therapy as well as counseling for couples and families. She studied Applied Psychology at the University of Derby, U.K., graduating with "Excellent" honors. She specialized in Group Psychotherapy through the Hellenic Organization of Psychotherapy and Education in Group Analysis (H.O.P.E IN G.A), which is a full member of GAS & IAGP. She further pursued training in Couple & Family Therapy at the Group Analysis Organization, which is a full member of the EFPP for Couples & Family (European Federation for Psychodynamic Psychotherapy for Couples & Therapy). She has participated in numerous conferences and seminars on group and psychoanalytic approaches as well as systemic approaches from the National and Kapodistrian University of Athens (EKPA). She has volunteered at the Day Center for Psychological Support of Cancer Patients and their Families within the Society of Social Psychiatry of Prof. Sakellaropoulos. She provides psychotherapeutic support to families with relatives with disabilities in the OTE Group (PASESPA).

Vemvetsou Viky is a Mental Health Counselor - Psychotherapist and has maintained a private practice in Glyfada since 2010. She graduated from the American College of Greece (BSc in Psychology) and underwent training in the Psychiatric Department of the General Hospital for Thoracic Diseases of Athens "Sotiria." At the same hospital, she continued as a trainee Psychologist in the Pulmonary Rehabilitation program (COPD) of the 3rd Internal Medicine Department. She has attended annual seminars in Clinical Psychopathology (2005) and Philosophy and Methodology of Psychopathology (2006) at the 1st Psychiatric Clinic of the University of Athens at Aeginiteio Hospital. In 2010, she graduated from the 4-year Gestalt Psychotherapy training program (GF Athens). She has volunteered at the Athens Cancer Patients Association KEFI (individual sessions and volunteer training groups for the association), the "Together for Children" Union, supporting and operating the "11525 Together for Children Hotline" (individual sessions and counseling for children, adolescents, and parents), as well as at the "Estia Konstantinoupoleos" Nursing Home, conducting mental empowerment groups for the elderly. She is a regular member of the Hellenic Society of Gestalt Psychotherapy and the European Association for Gestalt Psychotherapy. Particularly sensitive to parenting issues (being a mother of three children), she voluntarily coordinates parent groups in schools and language centers. She continuously attends professional development seminars (trauma, abuse, crisis intervention, couples, group dynamics, loss, grief). She participates in conferences, festivals, and workshops promoting mental health in the community, is engaged in a 15-year study and supervision group, a 2-year Mindfulness group for therapists, and undertakes individual psychotherapy and supervision. She is trained in Storytelling and Mindfulness as tools for stress management. As a mental health professional, she values responsibility, volunteering, and aesthetics in diagnosis.