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1.
Neuropsychobiology ; 81(3): 192-203, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-34979513

RESUMO

BACKGROUND: Levetiracetam is an anticonvulsant with a low side effect profile and favorable properties for individuals with bipolar I disorder during their manic phase. Despite initial promising results until about 2008, it appears that this track of research has not been followed-up. To counter this, we tested the influence of adjuvant levetiracetam on acute mania, compared to placebo. More specifically, we performed a randomized, double-blind, placebo-controlled clinical trial among inpatients with bipolar disorder I during their acute phase of mania. METHODS: A total of 72 inpatients (mean age: 33.98 years; 23.6% females) with diagnosed bipolar disorder I and during their acute manic phase were randomly assigned either to the adjuvant levetiracetam (250 mg to a maximum of 1,500 mg) or to the placebo condition. Standard medication was lithium at therapeutic dosages. At baseline, participants completed a series of self-rating questionnaires covering sociodemographic information and subjective sleep. Subjective sleep was re-assessed 24 days later at the end of the study. Experts rated participants' acute state of mania with the Young Mania Rating Scale at baseline and at day 12 and day 24. Participants' cognitive performance was assessed at baseline and at day 24 at the end of the study. RESULTS: Over time, mania scores significantly decreased (large effect size), but more so in the levetiracetam condition, compared to the placebo condition (medium effect size). Likewise, over time, subjective sleep improved (large effect size), but more so in the levetiracetam condition, compared to the placebo condition (large effect size). Over time, cognitive performance improved (large effect size), irrespective of the study condition. CONCLUSIONS: Compared to placebo, adjuvant levetiracetam to lithium improved symptoms of mania, as rated by experts, and subjective sleep quality. Adjuvant levetiracetam had no further favorable (or detrimental) impact on cognitive performance.


Assuntos
Antipsicóticos , Transtorno Bipolar , Adulto , Antipsicóticos/uso terapêutico , Transtorno Bipolar/diagnóstico , Transtorno Bipolar/tratamento farmacológico , Método Duplo-Cego , Feminino , Humanos , Levetiracetam/uso terapêutico , Lítio/uso terapêutico , Masculino , Mania , Escalas de Graduação Psiquiátrica , Resultado do Tratamento
2.
BMC Psychiatry ; 22(1): 581, 2022 09 01.
Artigo em Inglês | MEDLINE | ID: mdl-36050679

RESUMO

BACKGROUND: Infertility is among the most unpleasant experiences for couples struggling with it. Therefore, coping with its associated psychological burden has become a concern in many societies due to its negative impacts on couples' lives and intimacy levels. Lack of marital intimacy leads to unfortunate consequences such as dissatisfaction with marital relationships between spouses. Therefore, these people should be encouraged to find an effective solution to cope with infertility. Regarding the importance of the emotional relationship between infertile couples and the success rate of infertility treatment, this study aims to determine the effect of couple-centered counseling by the Gottman method on marital intimacy of infertile couples referred to the infertility ward of Fatemieh Hospital in Hamadan. METHOD: The sample of this quasi-experimental study included 60 infertile couples in the evaluation phase of treatment with primary infertility. We collected data in a referral infertility center in Hamadan (Iran) between December 2020 and May 2021. Marital intimacy was measured using Thompson & Walker's Marital Intimacy Questionnaire. At the beginning of the study, the intervention and control groups completed this questionnaire. The intervention group received Gottman couple-centered counseling based on GATHER principles in 8 sessions. The groups completed the questionnaires 4 weeks after the last intervention session again. If the distribution was normal, the ANCOVA test was used to evaluate the differences between the two groups. Intra-group comparisons were performed using paired t-test, and intergroup comparisons were performed using an independent t-test. RESULTS: The mean score of female intimacy increased significantly after the intervention (P = 0.009). There was no significant difference in socio-demographic characteristics between groups (P < 0.05), both of which were adjusted in ANCOVA. After the intervention, the mean marital intimacy scores were significantly higher in women participating in the intervention group (from 75.6 (±10.63) to 78.86 (±7.87)). In addition, after the ANCOVA test, the difference was statistically significant (P = 0.009; MD: 3.74, CI: 0.95 and 6.52). The mean score of male marital intimacy increased after the intervention (from 78.93 (±10.21) to 78.9 (±9.79)), although the difference was not statistically significant (P = 0.54; MD: -0.58, CI: - 2.51 and 1.34). CONCLUSION: The findings support the effective role of Gottman's couple-centered counseling in increasing marital intimacy by raising couples' awareness about the principles of proper relationships between them. This outcome suggests that counseling with couples, especially in critical life situations, can improve their relationship in the infertility treatment process and prevent emotional divorce and other negative impacts on their lives. TRIAL REGISTRATION: IRCT Registration Number IR.UMSHA.REC.1399.535, registered on 21/09/2020.


Assuntos
Infertilidade , Aconselhamento , Feminino , Hospitais , Humanos , Infertilidade/psicologia , Irã (Geográfico) , Masculino , Parceiros Sexuais/psicologia
3.
J Ethn Subst Abuse ; 21(1): 364-376, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-32497463

RESUMO

Substance use is a social harm. Promoting substance users readiness for treatment of substance use with a non-medical approach is important besides the medical approach. The current study aimed to determine the relationship between readiness for treatment of substance use and self-efficacy based on life skills. In this descriptive-analytical study, a number of 118 substance users in Hamadan city (Iran) were participated. The data collection tools were Stages of Change Readiness and Treatment Eagerness Scale (SOCRATES) and Drug Avoidance Self-Efficacy Scale (DASES). Analytical and descriptive tests were used for data analysis, at 95% significant level, using Statistical Package for the Social Sciences 16. The results of this study showed that the readiness for treatment of substance use had a significant relationship with the self-efficacy includes assertiveness and communication (Df:1; Pvalue<0.05). Self-efficacy based on life skills can be used to promote substance users readiness for treatment of substance use in educational interventions.


Assuntos
Usuários de Drogas , Transtornos Relacionados ao Uso de Substâncias , Humanos , Irã (Geográfico) , Autoeficácia , Transtornos Relacionados ao Uso de Substâncias/terapia
4.
Neuropsychobiology ; 78(2): 95-103, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30970367

RESUMO

BACKGROUND: Individuals with lichen planopilaris (LPP) typically present with hair loss and an irritated scalp, with signs and symptoms such as itching, erythema, scaling, and burning. Both hair loss and reddened skin may be visible also for other people. Therefore, it is conceivable that individuals with LPP might report a lower mental health status. Accordingly, in the present study, we compared dimensions of mental health between individuals with LPP and healthy controls. METHOD: A total of 38 individuals with LPP (mean age: 38.24 years, 47.4% females) and 58 gender- and age-matched controls took part in this study. They completed questionnaires covering dimensions of quality of life and self-esteem; experts rated participants' symptoms of depression and anxiety. Furthermore, dermatologists reported on the illness duration, the LPP activity index, and the severity of alopecia. RESULTS: Compared to healthy controls, individuals with LPP reported lower scores of self-esteem, physical functioning, and mental health and higher scores of role limitations (physical and emotional). Likewise, experts rated higher depression scores in individuals with LPP compared to controls. In individuals with LPP, a higher LPP disease activity and a higher severity of hair loss were associated with higher depression and lower quality-of-life scores. Further, a higher LPP activity index, a lower self-esteem, and higher anxiety scores predicted a poorer quality of life, while illness duration was statistically unrelated. CONCLUSIONS: Compared to controls, and irrespectively of the illness duration, individuals with LPP reported a lower quality of life and a lower self-esteem, and experts' ratings observed higher scores of depression. Experts treating individuals with LPP might pay special attention to the individuals' mental health status.


Assuntos
Alopecia/psicologia , Depressão/psicologia , Líquen Plano/psicologia , Qualidade de Vida , Autoimagem , Adulto , Alopecia/complicações , Ansiedade/complicações , Ansiedade/psicologia , Estudos de Casos e Controles , Depressão/complicações , Feminino , Humanos , Líquen Plano/complicações , Masculino , Adulto Jovem
5.
Arch Womens Ment Health ; 21(1): 65-73, 2018 02.
Artigo em Inglês | MEDLINE | ID: mdl-28721461

RESUMO

Ten to 15% of mothers experience postpartum depression (PPD). If untreated, PPD may negatively affect mothers' and infants' mental health in the long term. Accordingly, effective treatments are required. In the present study, we investigated the effect of detached mindfulness (DM) and stress management training (SMT) as adjuvants, compared to pharmacologic treatment only, on symptoms of depression in women with PPD. Forty-five primiparae (mean age: M = 24.5 years) with diagnosed PPD and treated with an SSRI (citalopram; CIT) took part in the study. At baseline, they completed questionnaires covering socio-demographic data and symptoms of depression. Experts rated also symptoms of depression. Next, participants were randomly assigned to one of the following study conditions: adjuvant detached mindfulness (CIT+DM); adjuvant stress management training (CIT+SMT); control condition (CIT). Self- and experts' ratings were completed at the end of the study 8 weeks later, and again at 8 weeks follow-up. Symptoms of depression decreased significantly over time, but more so in the CIT+DM and CIT+SMT group, compared to the control condition. The pattern of results remained stable at follow-up. In primiparae with PPD and treated with a standard SSRI, adjuvant psychotherapeutic interventions led to significant and longer-lasting improvements.


Assuntos
Depressão Pós-Parto/tratamento farmacológico , Atenção Plena/métodos , Paridade , Estresse Psicológico/terapia , Adulto , Depressão Pós-Parto/psicologia , Feminino , Humanos , Gravidez , Inquéritos e Questionários , Adulto Jovem
6.
Neuropsychobiology ; 76(1): 51-58, 2017.
Artigo em Inglês | MEDLINE | ID: mdl-29649810

RESUMO

BACKGROUND: Self-immolation (SI) is considered one of the most painful, dramatic, and at the same time most inexplicable methods of suicide, with a high social impact. Prevalence rates are particularly high in Iran, and in north-western Iran specifically. Here, we report sociodemographic, psychological, and psychiatric characteristics of patients attempting self-immolation (PSIs), compared to patients with accident burns (PABs). METHOD: Patients referred to the Burns Emergency Unit of the Besat Hospital (Hamadan, Iran) were enrolled in the present study between winter 2015 and summer 2016. After burn-related treatments and surgery, a thorough interview was undertaken covering sociodemographic characteristics, burn-related information, and psychiatric background. RESULTS: A total of 79 patients were enrolled. Among these, 19 (31.7%) had attempted suicide via SI. Compared to the PABs, the PSIs were predominantly females; they reported family and marital problems as the main triggers for SI. The psychiatric interviews indicated that PSIs often suffered from major depressive disorders, adjustment disorders, and bipolar disorders. The prevailing feelings reported were guilt and shame. A binary logistic regression showed that feelings of guilt and marital and family problems predicted SI. CONCLUSIONS: The prevalence of SI was surprisingly high. Marital and family conflicts as a proxy for highly distressing social interactions, along with female gender and feelings of guilt and shame were strongly associated with SI. Family and couple counseling specifically tailored to difficulties experienced by women might reduce the risk of SI.


Assuntos
Queimaduras/etiologia , Queimaduras/psicologia , Família/psicologia , Culpa , Estresse Psicológico , Tentativa de Suicídio/psicologia , Acidentes/psicologia , Transtornos de Adaptação/epidemiologia , Adulto , Transtorno Bipolar/epidemiologia , Queimaduras/epidemiologia , Queimaduras/cirurgia , Transtorno Depressivo Maior/epidemiologia , Feminino , Humanos , Entrevista Psicológica , Irã (Geográfico) , Modelos Logísticos , Masculino , Fatores de Risco , Fatores Sexuais , Vergonha , Fatores Socioeconômicos , Estresse Psicológico/epidemiologia
7.
Compr Psychiatry ; 77: 71-79, 2017 08.
Artigo em Inglês | MEDLINE | ID: mdl-28636896

RESUMO

BACKGROUND: Patients with psychiatric disorders have an exceptionally high risk of completed or attempted suicide. This holds particularly true for patients with major depressive disorders. The aim of the present study was to explore whether patients with major depressive disorders (MDD) and a history of suicide attempts differed in their early maladaptive schemas from patients with MDD but without such a history or from healthy controls. METHOD: Ninety participants took part in the study. Of these, 30 were patients with MDD who had made a recent suicide attempt; 30 were patients with MDD but no suicide attempts, and 30 were gender- and age-matched healthy controls. Participants completed questionnaires covering socio-demographic characteristics and the Young Schema Questionnaire (YSQ- RE2R) to assess early maladaptive schemas. Experts rated patients' MDD with the Montgomery-Asberg Depression Rating Scale. RESULTS: Patients did not differ in experts' ratings of symptoms of depression. Compared to healthy controls, patients with MDD recorded higher scores on maladaptive schemas such as recognition seeking, negativity/pessimism, and insufficient self-control. Compared to patients without suicide attempts and healthy controls, those who had made a suicide attempt had higher scores on dimensions such as failure, mistrust, emotional inhibition, social isolation, and abandonment/instability. CONCLUSION: Compared to healthy controls, patients with MDD had more pronounced maladaptive schemas, but this was more marked in patients with a history of suicide attempts. The results suggest that suicide attempts and poorer psychological functioning are related.


Assuntos
Adaptação Psicológica , Transtorno Depressivo Maior/psicologia , Vergonha , Isolamento Social/psicologia , Tentativa de Suicídio/psicologia , Adulto , Estudos de Casos e Controles , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Autocontrole , Inquéritos e Questionários , Adulto Jovem
8.
Med J Islam Repub Iran ; 31: 60, 2017.
Artigo em Inglês | MEDLINE | ID: mdl-29445689

RESUMO

Background: 3,4- methylenedioxymethamphetamine (MDMA) is a chemical derivative of amphetamine that can induce learning and memory impairment. Due to the effect of neurotrophins on memory and learning, the impact of MDMA was evaluated on the brain - derived neurotrophic factor (BDNF), neurotrophin- 4 (NT-4), and tropomyosin- related kinase B (Trk- ß) expression in the hippocampus. Methods: In this study, 20 adult male Wistar rats (200-250 g) received saline (1 mL) or 10 mg/kg of MDMA intraperitoneally as single or multiple injection for 2 consecutive days per week for 2 months. Expression of BDNF, Trk-ß, and NT4 were assessed using Western blotting and RT PCR methods. Results: Our results revealed that the expression of BDNF, Trk- ß, and NT4 proteins and genes significantly decreased in MDMA groups compared to the sham group (p<0.05). Furthermore, the acute group showed the lowest expression of these proteins. Conclusion: The results of the present study suggest that ecstasy administration may downregulate the expression of BDNF, Trk- ß, and NT-4 in hippocampus, which is more extensive in case of acute treatment. It seems that in the chronic group, hippocampus was able to compensate the ecstasy- induced neurotoxicity.

9.
Neuropsychobiology ; 73(4): 224-32, 2016.
Artigo em Inglês | MEDLINE | ID: mdl-27299900

RESUMO

OBJECTIVE: There is some evidence that repetitive transcranial magnetic stimulation (rTMS) is an effective method of treating patients suffering from obsessive-compulsive disorder (OCD). Here, we tested the hypothesis that rTMS has a positive impact both on symptom severity and cognitive performance in such patients. Specifically, short-term verbal processing speed and flexibility were assessed. METHOD: Ten patients suffering from refractory OCD and treated with standard medication were randomly assigned either to a treatment-first or to a sham-first condition. At baseline and after 2 and 4 weeks, symptom severity (experts' ratings) and cognitive performance (auditory perception, visual perception, short-term memory, and processing speed) were assessed. After 2 weeks, the treatment condition switched to the sham condition, and the sham condition switched to the treatment condition. RESULTS: Under treatment but not under sham conditions, symptom severity reduced. Moreover, cognitive performance improved in parallel. CONCLUSIONS: rTMS is a safe and efficient treatment for patients suffering from refractory OCD; symptoms and cognitive performance improved in parallel.


Assuntos
Cognição , Transtorno Obsessivo-Compulsivo/terapia , Estimulação Magnética Transcraniana , Adulto , Atenção , Percepção Auditiva , Estudos Cross-Over , Feminino , Humanos , Masculino , Memória de Curto Prazo , Transtorno Obsessivo-Compulsivo/psicologia , Percepção Visual , Adulto Jovem
10.
Neuropsychobiology ; 74(2): 115-124, 2016.
Artigo em Inglês | MEDLINE | ID: mdl-28334708

RESUMO

OBJECTIVE: Whereas there is growing evidence that repetitive transcranial magnetic stimulation (rTMS) favorably impacts on symptoms of obsessive-compulsive disorders (OCD), less is known regarding the influence of rTMS on cognitive performance of patients with OCD. Here, we tested the hypothesis that rTMS has a positive impact both on symptom severity and executive functions in such patients. METHODS: We assessed 10 patients diagnosed with OCD (mean age: 33.5 years) and treated with a standard medication; they were randomly assigned either to a treatment-first or to a sham-first condition. Symptom severity (experts' ratings) and executive functions (Wisconsin Card Sorting Test) were assessed by independent raters unaware of the patients' group assignments at baseline, after 2 and 4 weeks. After 2 weeks, treatment switched to sham condition, and sham condition switched to treatment condition. RESULTS: Under treatment but not under sham conditions, symptom severity decreased. Performance on the executive function test increased continuously with every new assessment and was unrelated to rTMS treatment. CONCLUSION: Whereas the present study confirmed previous research suggesting that rTMS improved symptoms of OCD, rTMS did not improve executive functions to a greater degree than sham treatment. More research is needed to investigate the effect of rTMS on executive functions in patients with OCD.


Assuntos
Função Executiva , Transtorno Obsessivo-Compulsivo/psicologia , Transtorno Obsessivo-Compulsivo/terapia , Estimulação Magnética Transcraniana , Adulto , Estudos Cross-Over , Feminino , Humanos , Masculino , Testes Neuropsicológicos , Resultado do Tratamento , Adulto Jovem
11.
Eur Arch Psychiatry Clin Neurosci ; 266(8): 695-702, 2016 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-26984349

RESUMO

Given that antidepressants (ADs) work slowly, there is interest in means to accelerate their therapeutic effect and to reduce side effects. In this regard, thiamine (vitamin B1) is attracting growing interest. Thiamine is an essential nutrient, while thiamine deficiency leads to a broad variety of disorders including irritability and symptoms of depression. Here, we tested the hypothesis that adjuvant thiamine would reduce depression, compared to placebo. A total of 51 inpatients (mean age: 35.2 years; 53 % females) with MDD (Hamilton Depression Rating Scale score (HDRS) at baseline: >24) took part in the study. A standardized treatment with SSRI was introduced and kept at therapeutic levels throughout the study. Patients were randomly assigned either to the thiamine or the placebo condition. Experts rated (HDRS) symptoms of depression at baseline, and after 3, 6, and 12 weeks (end of the study). Between baseline and the end of the study, depression had reduced in both groups. Compared to placebo, adjuvant thiamine improved symptoms of depression after 6 week of treatment, and improvements remained fairly stable until the end of the study, though mean differences at week 12 were not statistically significant anymore. No adverse side effects were reported in either group. Results suggest that among younger patients with MDD adjuvant thiamine alleviated symptoms of depression faster compared to placebo. Importantly, improvements were observed within 6 weeks of initiation of treatment. Thus, thiamine might have the potential to counteract the time lag in the antidepressant effects of ADs.


Assuntos
Antidepressivos/uso terapêutico , Transtorno Depressivo Maior/tratamento farmacológico , Tiamina/uso terapêutico , Complexo Vitamínico B/uso terapêutico , Adulto , Método Duplo-Cego , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Escalas de Graduação Psiquiátrica , Fatores de Tempo , Resultado do Tratamento
12.
Compr Psychiatry ; 69: 71-7, 2016 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-27423347

RESUMO

BACKGROUND: There is limited evidence on the long-term outcomes for patients with bipolar I disorder (BP-I-D) and treated with ECT. Therefore, we asked whether mania scores and cognitive performance at the end of ECT treatment (baseline/BL) predicted mania scores, cognitive performance, recurrence, treatment adherence, and mood (depression; hypomania) two years later (follow-up/FU). METHOD: 38 patients with BP-I-D undergoing ECT at baseline were followed up two years later. A brief psychiatric and cognitive assessment (Mini Mental State Examination; short-term verbal memory test) was performed; patients completed questionnaires covering recurrence, treatment adherence, and mood (depression; hypomania). RESULTS: High cognitive performance at BL predicted high cognitive performance at FU; low mania scores at BL predicted low mania scores at FU. By FU, cognitive performance had increased and mania scores decreased. Mania scores and cognitive performance at BL did not predict recurrence, or adherence to medication, or mood (depression; hypomania). CONCLUSIONS: The pattern of results suggests that after two years of successful treatment of acute mania with ECT, cognitive impairment, measured by MMSE and a short-term verbal memory test, is not impaired and mood symptom recurrence seems to be improved. Mania scores and cognitive performance at the end of ECT treatment predicted neither mood (depression; hypomania), nor recurrence, or adherence to medication two years later.


Assuntos
Transtorno Bipolar/psicologia , Cognição , Eletroconvulsoterapia , Adulto , Transtorno Bipolar/terapia , Feminino , Seguimentos , Humanos , Masculino , Adesão à Medicação/psicologia , Pessoa de Meia-Idade , Testes Neuropsicológicos , Recidiva , Resultado do Tratamento
13.
Int J Psychiatry Clin Pract ; 19(3): 168-73, 2015.
Artigo em Inglês | MEDLINE | ID: mdl-25969160

RESUMO

OBJECTIVE: The aim of the present study was to provide further evidence of (1) metabolic syndrome and blood lipid profile differences between suicide attempting and non-attempting patients with bipolar disorder (BPD) I and to assess these differences (2) as a function of acute depressive or manic phase. METHODS: Fifty inpatients (mean age: 36.14 years 48% males) with BPD I took part in the study. After recruitment, patients were clustered in four groups: 13 suicide attempters (SAs) assessed during a manic phase, 12 SAs assessed during a depressive phase, 15 non-SAs assessed during a manic phase, and 10 non-SAs assessed during a depressive phase. Body mass index (BMI), metabolic syndrome, blood pressure, blood lipids (cholesterol, high- and low-density lipids, and triglyceride), and fasting blood sugar were assessed. RESULTS: Neither metabolic syndrome, blood lipid values, fasting blood sugar, nor BMI or blood pressure differed between the SAs and non-SAs, or between patients in an acute manic phase and those in a depressed phase. The overall prevalence of metabolic syndrome was 26.0%. CONCLUSION: Among patients with BPD I neither the occurrence of metabolic syndrome nor lipid values or fasting blood sugar are reliable biomarkers of suicidal behavior during either acute depressive or manic phase.


Assuntos
Transtorno Bipolar/sangue , Transtorno Bipolar/fisiopatologia , Lipídeos/sangue , Síndrome Metabólica/sangue , Tentativa de Suicídio/estatística & dados numéricos , Adulto , Transtorno Bipolar/epidemiologia , Glicemia/metabolismo , Pressão Sanguínea/fisiologia , Índice de Massa Corporal , Feminino , Humanos , Masculino , Síndrome Metabólica/epidemiologia , Pessoa de Meia-Idade , Adulto Jovem
14.
Neuropsychobiology ; 70(1): 29-35, 2014.
Artigo em Inglês | MEDLINE | ID: mdl-25171133

RESUMO

BACKGROUND: In patients suffering from bipolar disorders (BPD), we explored to what extent oral loading of sodium valproate (SV) leads to more rapid symptom improvement compared to intravenous loading and oral maintenance administration. METHODS: Ninety patients (mean age: 35.00 years) with BPD and currently in an acute manic state were randomly assigned to one of three study conditions: oral loading (20 mg/kg oral single-dose SV on the first day, then 10-15 mg/kg SV daily, divided dose), intravenous loading (20 mg/kg SV intravenous injection on the first day, then 10-15 mg/kg orally, divided dose), or oral maintenance administration (15-20 mg/kg SV daily from the beginning) over the first 7 days of treatment. SV plasma levels, side effects and symptoms were evaluated at baseline and on days 1, 3, and 7 after commencing treatment. RESULTS: There were significant Time-by-Group interactions for symptom improvements, symptom severity, and SV plasma levels, with positive values in the oral and intravenous loading conditions, compared to the oral maintenance condition. Post hoc analyses showed that oral and intravenous conditions led to similar improvements. CONCLUSIONS: Both oral and intravenous loading of SV led to quicker and more efficient improvement and SV plasma levels as compared to an oral maintenance regimen.


Assuntos
Administração Intravenosa , Administração Oral , Antimaníacos/administração & dosagem , Transtorno Bipolar/tratamento farmacológico , Ácido Valproico/administração & dosagem , Adulto , Análise de Variância , Antimaníacos/sangue , Transtorno Bipolar/sangue , Esquema de Medicação , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Escalas de Graduação Psiquiátrica , Fatores de Tempo , Resultado do Tratamento , Ácido Valproico/sangue , Adulto Jovem
15.
Neuropsychobiology ; 69(4): 235-42, 2014.
Artigo em Inglês | MEDLINE | ID: mdl-24993832

RESUMO

OBJECTIVES: In light of the high prevalence of sleep disorders in patients suffering from posttraumatic stress disorder (PTSD), this study sought to compare the effect of prazosin and hydroxyzine on sleep quality in this patient group. METHODS: A total of 100 patients suffering from PTSD were assessed (mean age = 35.51 years, SD = 6.41; 28% females). Next, they were randomly assigned to one of three treatment groups: prazosin (33 patients), hydroxyzine (34 patients) or placebo (33 patients). The trial lasted for 8 weeks. The patients' sleep quality was assessed using the Pittsburgh Sleep Quality Index. Items taken from the Mini International Neuropsychiatric Interview were used to operationalize PTSD. RESULTS: Compared to controls, patients treated with prazosin and hydroxyzine reported improved sleep and less nightmares. Improvement was greatest in patients treated with prazosin compared to hydroxyzine and placebo. Improvement in sleep was associated with an amelioration of their PTSD symptoms. CONCLUSION: Both prazosin and hydroxyzine can be used to treat psychopharmacological sleep disorders and nightmares in patients suffering from PTSD, also leading to reductions in PTSD symptoms.


Assuntos
Fármacos do Sistema Nervoso Central/uso terapêutico , Hidroxizina/uso terapêutico , Prazosina/uso terapêutico , Sono/efeitos dos fármacos , Transtornos de Estresse Pós-Traumáticos/tratamento farmacológico , Adulto , Fármacos do Sistema Nervoso Central/efeitos adversos , Sonhos/efeitos dos fármacos , Sonhos/fisiologia , Feminino , Humanos , Hidroxizina/efeitos adversos , Entrevista Psicológica , Masculino , Testes Neuropsicológicos , Prazosina/efeitos adversos , Sono/fisiologia , Transtornos do Sono-Vigília/tratamento farmacológico , Transtornos do Sono-Vigília/fisiopatologia , Transtornos de Estresse Pós-Traumáticos/fisiopatologia , Resultado do Tratamento
16.
J Clin Med ; 12(7)2023 Mar 27.
Artigo em Inglês | MEDLINE | ID: mdl-37048608

RESUMO

BACKGROUND: Compared to the general population, persons with multiple sclerosis (MS) are at increased risk of suffering from major depressive disorder (MDD). Repetitive Transcranial Magnetic Stimulation (rTMS) was used successfully to treat individuals with MDD. Here, we conducted a randomized clinical trial and pilot study, and tested the effectiveness of rTMS adjuvant to a standard pharmacological treatment among persons with MS, compared to a sham condition. MATERIALS AND METHODS: A total of 40 persons with MS (mean age: 32 years; 42.5% females; median EDSS score: 4) and with moderate to severe symptoms of depression were randomly assigned to the rTMS or to the rTMS sham condition, always as adjuvant intervention to the standard treatment with sertraline, a selective serotonin reuptake inhibitor (SSRI). rTMS consisted of 10 sessions each of 37.5 min; the sham condition was identical to the active condition except for the absence of rTMS stimuli. At the beginning and two weeks after the end of the study, participants reported on their fatigue, while experts rated the severity of participants' depressive symptoms (Montgomery-Asberg Depression Rating Scale; MADRS), cognitive performance (Montreal Cognitive Assessment; MoCA), and degree of disability (Expanded Disability Status Scale; EDSS). RESULTS: Data were analyzed per intent-to-treat. Scores for depression, fatigue, and EDSS declined significantly over time (large effect sizes), but more so in the rTMS condition than in the sham condition (large effect sizes for the time by group-interactions). Compared to the sham condition, scores for depression were significantly lower in the rTMS condition. Scores for cognition improved over time in both study conditions (large effect size). CONCLUSION: Compared to a sham condition, adjuvant rTMS to a standard pharmacological treatment ameliorated typical MS-related symptoms (depression; fatigue; EDSS scores). Results from this pilot study suggested that rTMS might be routinely applied in persons with MS displaying symptoms of depression and fatigue.

17.
Iran J Child Neurol ; 17(2): 55-61, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-37091474

RESUMO

Objectives: Anxiety is a significant health issue in mothers who give birth to unhealthy neonates. Different studies have investigated the relationship between anxiety and alpha-amylase. According to the necessity for psychological care of mothers whose infants are hospitalized in intensive care units and consequently the anxiety that is imposed on mothers due to the condition, this study aims to assess anxiety in these mothers and the relationship between this anxiety and salivary alpha-amylase. Materials & Methods: This study was a cross-sectional study conducted at Besat Hospital in Hamadan in 2021. Thirty mothers were enrolled in the study through a census method sampling. The Hamilton questionnaire measured maternal anxiety during the children's hospitalization period. Salivary alpha-amylase samples were taken from all mothers according to the scientific method, and mothers' salivary alpha-amylase levels were measured. All the gathered data were analyzed using SPSS 21 software. The significant level was considered 0.05 in all comparisons. Results: The mean age of the 30 mothers was 29.27+6.24 years. The mean score of maternal anxiety was 16.27 + 6.78, and the mean salivary amylase level was 33.02 ± 16.22 U / ml. Fourteen mothers obtained low anxiety scores, 14 had moderate anxiety, and two had severe anxiety. No significant relationship was found between the mean of salivary alpha-amylase at the three levels and anxiety. There was no significant relationship between anxiety level with parent location, age, mother's level of education, infant gender, and child rank. Conclusion: According to the results of the present study, there was no significant relationship between the level of alpha-amylase and the level of anxiety in mothers of neonates admitted to the neonatal intensive care unit (NICU), so further researches in similar groups that are in anxious conditions seem necessary.

18.
J Inj Violence Res ; 15(1)2023 Jan 07.
Artigo em Inglês | MEDLINE | ID: mdl-36609357

RESUMO

BACKGROUND: Physical and sexual harassment has extensive psychological consequences on people's lives. Therefore, the using of a valid measure to identify this unpleasant experience in people can be useful both in determining the starting point of interventions related to victims and in general screenings in the society. In this regard, due to the lack of native and multidimensional measures to investigate this phenomenon, the aim of this study was to design and validation of the psychosexual harassment questionnaire. METHODS: The research method was applied in terms of purpose and descriptive in terms of nature. The study population included all university students aged 18 to 30 in Hamadan province from 2021-2022. From this population, a sample of 600 participants was selected based on a multi-stage cluster sampling method according to the population of the studied cities. The measures were a 27-item researcher-made psychosexual harassment questionnaire and the Ryff Psychological Well-being Scale. RESULTS: The results showed that the factor load was 27 items appropriate and 2 items inappropriate which were removed from the questionnaire. Finally, four factors including sexual harassment, physical harassment, sexual-virtual harassment, and verbal harassment were identified, in total, four factors could explain 58% of the variance of psychosexual harassment. Based on this, the four identified factors explained 33, 12, 8, and 5 percent of the variance of the structure of the psychosexual harassment construct, respectively. The adequacy of Kaiser-Meyer-Olkin sampling and Bartlett sphericity test (7332.2132) was calculated to be significant at the level of 0.001. The overall reliability of this questionnaire was calculated based on Cronbach's alpha coefficient equal to 0.91 and the reliability of physical, sexual, sexual-virtual and verbal harassment dimensions equal to 0.90, 0.88, 0.81, and 0.82, respectively. CONCLUSIONS: As a result, given the validity and reliability of this measure, researchers can use this measure to determine the level of four cases of abuse expressed. Also, due to having a nominal table and its interaction with each of the four dimensions of the measure, followed by obtaining very accurate and detailed information from the subject, clinicians can use this measure for clients and patients, especially in the category of disorders.

19.
Sci Rep ; 13(1): 10423, 2023 06 27.
Artigo em Inglês | MEDLINE | ID: mdl-37369689

RESUMO

Stability of the brain functional network is directly linked to organization of synchronous and anti-synchronous activities. Nevertheless, impact of arrangement of positive and negative links called links topology requires to be well understood. In this study, we investigated how topology of the functional links reduce balance-energy of the brain network in obsessive-compulsive disorder (OCD) and push the network to a more stable state as compared to healthy controls. Therefore, functional associations between the regions were measured using the phase synchrony between the EEG activities. Subsequently, balance-energy of the brain functional network was estimated based on the quality of triadic interactions. Occurrence rates of four different types of triadic interactions including weak and strong balanced, and unbalanced interactions were compared. In addition, impact of the links topology was also investigated by looking at the tendency of positive and negative links to making hubs. Our results showed although the number of positive and negative links were not statistically different between OCD and healthy controls, but positive links in OCDs' brain networks have more tendency to make hub. Moreover, lower number of unbalanced triads and higher number of strongly balanced triad reduced the balance-energy in OCDs' brain networks that conceptually has less requirement to change. We hope these findings could shed a light on better understanding of brain functional network in OCD.


Assuntos
Imageamento por Ressonância Magnética , Transtorno Obsessivo-Compulsivo , Humanos , Imageamento por Ressonância Magnética/métodos , Encéfalo/diagnóstico por imagem , Mapeamento Encefálico/métodos , Biometria , Vias Neurais
20.
Int J Psychiatry Clin Pract ; 16(3): 197-204, 2012 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-22873719

RESUMO

OBJECTIVE: Borderline personality disorder (BPD) is defined as a pervasive pattern of instability in emotion, mood and interpersonal relationships, with a comorbidity between PBD and depressive disorders (DD). A key competence for successful management of interpersonal relationships is emotional intelligence (EI). Given the low EI of patients suffering from BPD, the present study aimed at investigating the effect on both emotional intelligence and depression of training emotional intelligence in patients with BPD and DD. METHODS: A total of 30 inpatients with BPD and DD (53% females; mean age 24.20 years) took part in the study. Patients were randomly assigned either to the treatment or to the control group. Pre- and post-testing 4 weeks later involved experts' rating of depressive disorder and self-reported EI. The treatment group received 12 sessions of training in components of emotional intelligence. RESULTS: Relative to the control group, EI increased significantly in the treatment group over time. Depressive symptoms decreased significantly over time in both groups, though improvement was greater in the treatment than the control group. CONCLUSION: For inpatients suffering from BPD and DD, regular skill training in EI can be successfully implemented and leads to improvements both in EI and depression. Results suggest an additive effect of EI training on both EI and depressive symptoms.


Assuntos
Transtorno da Personalidade Borderline/terapia , Transtorno Depressivo/terapia , Inteligência Emocional , Psicoterapia/métodos , Adulto , Análise de Variância , Transtorno da Personalidade Borderline/complicações , Transtorno da Personalidade Borderline/psicologia , Transtorno Depressivo/complicações , Transtorno Depressivo/psicologia , Emoções , Expressão Facial , Feminino , Humanos , Pacientes Internados , Relações Interpessoais , Masculino , Escalas de Graduação Psiquiátrica , Autorrelato , Resultado do Tratamento
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