Comparison the Effects of Gabapentin and Oxazepam on Sleep Quality, Anxiety, and Pain in Unstable Angina Patients Admitted to Coronary Care Unit of Hazrat Rasool Akram Hospital.

Background: This study aimed to compare the efficacy of gabapentin and oxazepam on sleep quality, the severity of anxiety, and pain level in patients admitted to the coronary care unit (CCU). Materials and Methods: This double-blind randomized clinical trial was done on the patients with unstable angina (UA) admitted to the CCU of Hazrat Rasool Akram Hospital in Tehran. A total of 56 patients were entered the study and randomly divided into two groups of 26. The first group was given a gabapentin capsule at a dose of 300-1200 mg/day, and the second group was given 10-20 mg of oxazepam tablets per day until hospitalization in the CCU. On the first and 4th days of hospitalization, Groningen sleep quality score (GSQS), Beck Anxiety Inventory, and severity of pain experienced by Visual Analogue Scale were recorded, and the mean frequency of chest pains was calculated in 24 h during the first 4 days. The amount of drug (morphine) prescription in CCU also compared between the two groups. Results: There was no significant difference in GSQS scores between both groups. The mean score of Beck's anxiety scale did not differ significantly between the two groups. However, the incidence of chest pain was significantly lower in the gabapentin-receiving group than in the oxazepam-receiving group (<0.001). The days that the patients experienced chest pain were significantly less in the gabapentin-receiving group than in the oxazepam-receiving group (<0.001). Conclusion: The results of our study showed that gabapentin compared to oxazepam could significantly reduce chest pain in patients with UA.

Vitamin D deficiency and depression in obese adults: a comparative observational study.

BACKGROUND: Amongst the contributing factors of depression, vitamin D deficiency has increasingly drawn attention in recent years. This paper seeks to examine the association between serum vitamin D level and depression in patients with obesity. METHODS: In this comparative observational study, serum 25-hydroxyvitamin D [25(OH)D] levels were compared between obese individuals with depression (n = 174) and those without depression considering the effect of potential confounders. Participants were selected from males and females aged 18 to 60 years old visiting the outpatient obesity clinic of Rasoul-e Akram hospital, Tehran, Iran. The diagnosis of depressive disorder was made based on the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) criteria. Additional clinical and laboratory data were collected from hospital electronic records. Mann-Whitney U test (nonparametric), Student's t-test (parametric), and Chi-squared test were used to analyze the differences between the two groups. To examine age and gender differences in the relationship between vitamin D deficiency and depression, stratified analyses were conducted by age and gender groups. RESULTS: The mean 25(OH) D levels were significantly different between depressed and non-depressed groups (20 ± 15 vs. 27 ± 13, P <  0.001). Vitamin D insufficiency/deficiency was detected in 78 and 67% of the depressed and non-depressed groups, respectively, which was significantly different (P = 0.03). The associations between depression and the serum 25(OH) D levels were observed regardless of gender and age. The overall average vitamin D levels were not significantly different between total males and females (22 ± 13 vs. 23 ± 14, P = 0.49). The average level of vitamin D was higher in the older age group (40-60 years) compared to younger participants (18-39 years) (26 ± 15 vs. 21 ± 13, P = 0.004). CONCLUSION: The present study provides additional evidence for the hypothesis that low vitamin D serum concentration is associated with depression in obese adults, and highlights the need for further research to determine whether this association is causal.

The Impact of Depression, Personality, and Mental Health on Outcomes of Total Knee Arthroplasty.

BACKGROUND: Precise assessment of preoperative mental health and psychological determinants may be useful in identifying patients at risk for poor postoperative outcomes of total knee arthroplasty (TKA). The aim of this study was to investigate the influence of psychological status and physical and mental health on the outcome of patients undergoing TKA. METHODS: Fifty-two patients undergoing unilateral TKA were assessed preoperatively with Oxford Happiness Inventory, Eysenck Personality Inventory, 12-item short form health survey (SF-12), and Knee Injury and Osteoarthritis Outcome Score (KOOS) for evaluating depression, personality traits, physical and mental health, and function, respectively. At 1 year after surgery, health-related quality of life (HRQL) and function were assessed using the SF-12 and KOOS. RESULTS: HRQL and function of all personality traits increased significantly after TKA, without significant difference among them. Extroversion and neuroticism did not have significant correlation with subjective well-being, HRQL, and function before and after surgery. Subjective well-being and the baseline physical and mental health scores were correlated strongly and directly with postoperative physical component summary, mental component summary, and KOOS scores and their improvement. Among many factors that significantly affected the outcomes of TKA, the only independent predictor of physical, mental, and functional outcome was depression. CONCLUSIONS: Outcomes of surgery were not significantly different among diverse personality traits. Patients with less depressive symptoms and higher baseline mental and physical scores had significantly greater improvement in HRQL after surgery. The only independent factor affecting the physical, mental, and functional outcome was depression.

Spiritual Care for Cancer Patients in Iran.

BACKGROUND: Studies have shown that a return to spirituality is a major coping response in cancer patients so that therapists can adopt a holistic approach by addressing spirituality in their patient care. The present study was conducted to develop a guideline in the spiritual field for healthcare providers who serve cancer patients in Iran. MATERIALS AND METHODS: Relevant statements were extracted from scientific documents that through study questions were reviewed and modified by a consensus panel. RESULTS: The statements were arranged in six areas, including spiritual needs assessment, spiritual care candidates, the main components of spiritual care, spiritual care providers, the settings of spiritual care and the resources and facilities for spiritual care. CONCLUSIONS: In addition to the development and preparation of these guidelines, health policy-makers should also seek to motivate and train health service providers to offer these services and facilitate their provision and help with widespread implementation.

The frequency of personality disorders in patients with gender identity disorder.

BACKGROUND: Co-morbid psychiatric disorders affect prognosis, psychosocial adjustment and post-surgery satisfaction in patients with gender identity disorder. In this paper, we assessed the frequency of personality disorders in Iranian GID patients. METHODS: Seventy- three patients requesting sex reassignment surgery (SRS) were recruited for this crosssectional study. Of the participants, 57.5% were biologically male and 42.5% were biologically female. They were assessed through the Millon Clinical Multiaxial Inventory II (MCMI- II). RESULTS: The frequency of personality disorders was 81.4%. The most frequent personality disorder was narcissistic personality disorder (57.1%) and the least was borderline personality disorder. The average number of diagnoses was 3.00 per patient. CONCLUSION: The findings of this study revealed that the prevalence of personality disorders was higher among the participants, and the most frequent personality disorder was narcissistic personality disorder (57.1%), and borderline personality disorder was less common among the studied patients.

Mood disorders insight scale: Validation of Persian version.

BACKGROUND: Lack of insight in patients with bipolar I disorder has been associated with poor course and clinical outcome and compromised therapeutic compliance. Therefore, it is important to evaluate insight and use more specialized scales such as Mood Disorder Insight Scale (MDIS) in these patients. Our objective in this study was to assess validity and reliability of Persian version of MDIS. MATERIALS AND METHODS: A hundred forty five bipolar patients were selected from Iran Hospital of Psychiatry. They were interviewed by The Persian Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorder, 4th edition's (DSM-IV) axis I disorders (SCID-I) and the Scale to Assess Unawareness of Mental Disorder (SUMD). The translated version of MDIS in Persian was subsequently completed by patients. RESULTS: The internal consistency was satisfactory (Cronbach alpha coefficients = 0.8). The test-retest reliability (coefficient alpha) was 0.95 (p < 0.01). Construct validity and concurrent validity were supported by factor analysis and Spearman rank correlation between MDIS and SUMD (0.85). CONCLUSIONS: Persian version of the MDIS could be a useful instrument for assessing insight in patients with bipolar I disorder.

Folie à deux and delusional disorder by proxy in a family.

This report presents a 52-year-old woman who was admitted to nephrology ward with hypernatremia. She shared a persecutory delusion of poisoning with her 22-year-old daughter and did not feed her 8-year-old son due to her delusion.

Clinical and course indicators of bipolar disorder type I with and without opioid dependence.

BACKGROUND: The existing evidence about the clinical situations of the bipolar patients with opioid dependence is scarce. The present study was carried out to compare the clinical features and course of the bipolar disorder type I regarding the two subgroups of opioid dependent and non-dependent. METHODS: There were 178 adult patients with bipolar disorder type I consecutively referred to the Iran Hospital of Psychiatry, Tehran, Iran, from January 2008 to January 2009 who enrolled in the study. The Persian Structured Clinical Interview for DSM-IV axis I disorders (SCID-I), HDRS-17, and Y-MRS were administered for all patients. Other clinical information was gathered through the face-to-face interviews with the probands and the hospital records. The T test, Chi square test and logistic regression were used to analyze the data. RESULTS: The mean age of probands were 33.6 ± 11.1 years old and they were mostly male. Among the evaluated indices, the factors gender, anxiety disorders comorbidity, non-adherence, and positive family history were different significantly and independently from the other studied factors between opioid dependent and non-dependent bipolar patients. CONCLUSIONS: Despite some differences, the opioid dependent and non-dependent bipolar patients did not have any significant difference regarding most of the examined clinical and course indices.