Comparative executive function analysis: Cochlear implants and normal hearing in 7- to 11-year-old children from Iran.

OBJECTIVE: This study compares executive functioning in deaf children with cochlear implants and those with normal hearing. Individuals who lacked auditory stimulation during their early years might experience cognitive challenges that extend beyond just speech and language abilities. METHODS: The executive functioning abilities of a group of 32 children who were born deaf and received cochlear implants before the age of 7 were contrasted with those of 30 children with normal hearing. Both sets of children underwent assessments using the Tower of London, BRIEF, and Stroop tests. RESULTS: The average score on the Tower of London task reveals that children who received cochlear implants (4.03 ± 2.53) achieved lower scores than typically hearing children (8.37 ± 2.79). This group also exhibited higher errors in the Stroop test and slightly longer response times Additionally, in terms of emotional control assessed by the BRIEF, a higher score was recorded. Notably, significant differences between the two groups were identified for organizing materials (t(62) = -4.204, p = 0.00). The tests measuring phonemic fluency, categorical fluency, and working memory also revealed significant differences. CONCLUSIONS: The significant differences in data between both groups suggest the influence of cochlear implantation on cognitive functions. This emphasizes the importance of a holistic approach to supporting the overall development of these children.

Prevalence of anxiety and depression in adult patients with CHD.

INTRODUCTION: CHD are among the most common congenital defects. Due to the chronic nature of CHD, patients face various risk factors that threaten their mental health. However, a comprehensive understanding of the medical and social predictors of mental health issues in adults with CHD is lacking. This study aims to investigate the prevalence of anxiety and depression in adults with CHD. METHODS: This cross-sectional descriptive study focused on adults with CHD in Kerman, Iran. The participants completed demographic information alongside two psychological assessment tools: the Beck Anxiety Inventory (BAI) and the Depression Anxiety Stress Scales (DASS)-21. The data were analyzed using SPSS 26. FINDINGS: The mean age of the participants was 29.94 ± 12.36 years, and 63.8% were female. According to the DASS, 73.4% did not have depression, 61% did not have anxiety, and 76.2% did not have stress. In total, 19% had mild stress, and 4.8% had moderate stress. According to the BAI, 27.6% did not have anxiety. Individual characteristics were not significantly associated with depression. However, gender, age, and type of surgery were significantly associated with anxiety. Cyanosis was significantly associated with stress. CONCLUSION: The results show that mental disorders like depression, anxiety, and stress are highly prevalent in adults with CHD. The prevalence depends on individual factors such as age, gender, and disease severity. Therefore, it is recommended that mental disorders in this population be evaluated and treated accurately.

Latent classes of posttraumatic stress disorder among survivors of the Bam Earthquake after 17 years.

BACKGROUND: The purpose of this study was to identify latent classes of the severity of post-traumatic stress disorder (PTSD) among the survivors of the earthquake in Bam, south-eastern Iran, 17 years after the disaster. The most influential predictor variables of PTSD classes were also investigated. METHODS: Eight hundred survivors of the Bam earthquake who were at least four years old in that disaster were selected by multistage sampling. The PTSD Checklist-Civilian Version was used. Latent class analysis was performed to identify subgroups of people with different PTSD symptom profiles. Latent class regression analysis was used to explore the influence of demographic and traumatic variables on each class membership. RESULTS: We found three latent classes of PTSD, with the following profiles emerging: Low Symptom (56.6% of the participants), Moderate Symptom (23.5%), and Severe Symptom (19.9%). Old age [OR = 2.20, 95% CI = (1.46, 3.32)], physical injury [OR = 1.95, 95% CI = (1.24, 3.06)], being trapped under the rubble [OR = 1.81, 95% CI = (1.15, 2.86)], and death of a family member [OR = 1.86, 95% CI = (1.12, 3.09)] were positive risk factors for PTSD and increased the chance of being in classes having more severe symptoms. Having a high educational level was a negative risk factor [OR = 0.86, 95% CI = (0.67, 1.11)]. CONCLUSIONS: The severity of PTSD 17 years after the earthquake shows that natural disasters such as earthquakes have long-term consequences, and earthquake survivors must have psychological support and long term health care. After any catastrophic earthquake, governments should establish psychology and psychotherapy centers for earthquake victims, and these centers should support earthquake victims for a sufficiently long time.

The influence of mindfulness-based stress reduction (MBSR) on stress, anxiety and depression due to unwanted pregnancy: a randomized clinical trial.

BACKGROUND: Individuals with unwanted pregnancies often experience high levels of anxiety, stress and depression that associated with maternal-neonatal outcomes. Mindfulness training is a safe and acceptable strategy to support mental health before parturition. PURPOSE: The main objective of present study was to evaluate the influence of eight-week application of mindfulness-based stress reduction on stress, anxiety and depression caused by unplanned pregnancy. METHOD: In this study, 60 women with unwanted pregnancy before 32 weeks of gestational age were selected and randomly divided into two groups. Intervention group received MBSR sessions, practice at home and the recorded sound. Mental health was evaluated before intervention and at the end of the eight sessions by standard stress, anxiety and depression DASS-21 questionnaire. Data were analyzed using Chi-square, Mann-Whitney U and Wilcoxon tests. FINDINGS: In order to compare pre-test and post-test scores in each group, the Wilcoxon Test was used. The results revealed that the participants in the intervention group reported a significant decrease in mean scores of stress, anxiety and depression compared to baseline (P = 0.0). Whereas no significant decrease in mean stress, anxiety and depression score were found in control group. P-value was estimated to be 0.346, 0.212 and 0.343 respectively. CONCLUSIONS: The mindfulness program has effectively reduced stress, anxiety and depression. Further research is needed to investigate the mechanisms and effects of mindfulness on maternal-neonatal outcomes.

Drug use and pattern of injuries sustained by drivers involved in road traffic crashes.

OBJECTIVE: Road traffic crashes are one of the global public health concerns and remain at high priority in many countries. Driving under the influence of drugs increases the risk of crashes through altering the driver's mental state and reactions. This study was conducted to determine the relationship between driving pattern and substance abuse among drivers in Kerman, a city in Iran, in order to enable policy makers to make the necessary decisions in planning and executing guidelines. METHODS: The population of this descriptive study was drivers involved in road traffic crashes admitted to the emergency department of Shahid Bahonar university hospital in summer 2019. After obtaining demographic information, type of vehicle, type of collision and pattern of serious injury, 222 eligible drivers were tested for tramadol, cannabis, amphetamine, methamphetamine, morphine and methadone using one step urine test strips. Chi-square test, Fisher's exact test, Whitney-Mann and Kruskal-Wallis tests and one-way Anova test was performed using SPSS version 22. RESULTS: The statistics showed that most drivers were male (90.5%), married (63.5%), age group (18-30) and had positive urine test (76.6%). In addition to uniqueness of dual-drug detection among male drivers (7.7%), the most common substances detected were methadone and morphine with 34.7% and 27.5% respectively. The most common injuries were lower limb and hip injuries mostly among motorcyclists. The results indicated that characteristics of being under 30's, married, school dropout, self-employed and motorcyclist had significant relationship with substance use. CONCLUSIONS: Substance use, especially methadone, has undoubtedly a significant role in both road traffic crashes and resulted injuries. The high rate of injuries on drivers influenced by methadone in traffic crashes needs to be screened and prevented. It is recommended to not only authoritatively deal with the excessive supply of methadone in the community but also restricting the driving of people receiving methadone treatment.

Prevalence and Predictors of Post-Traumatic Stress Disorder and Depression Among Survivors Over 12 Years After the Bam Earthquake.

PURPOSE: The Bam earthquake was one of Iran's worst natural disasters. As a reason of limited sample size, prevalence and risk factors of PTSD and depression were still unclear after a huge earthquake in Bam. PATIENTS AND METHODS: A total of 1500 participants selected from the survivors by multistage sampling. Instruments included the demographic questionnaire, the PTSD Checklist-Civilian Version and the Beck Depression Inventory-2. Bivariable and multivariable logistic regressions were used to analyze the data. RESULTS: The prevalence rates of PTSD and depressive symptoms were 38.7% (n = 581) and 40.1% (n=597), respectively. The most commonly occurring symptoms of PTSD were distress at reminders (73.7%), fear of recurrence (70.3%) and sleep disturbance (68.4%). Age (OR=1.5, 95% CI= [1.03, 1.74], P < 0.001) and being injured (OR=1.68, 95% CI= [1.09, 2.61], P=0.02) are positive risk factors of PTSD. The risk factors for depressive symptoms were old age (OR= 1.46, 95% CI= [1.02, 1.64], P < 0.001), female gender (OR=1.42, 95% CI=[1.14, 1.77], P=0.002), and death of work colleagues (OR=4.03, 95% CI= [1.54, 6.54], P=0.005). CONCLUSION: Professional and effective mental health services should design programs in order to aid the psychological wellbeing of the population focusing on older adults, females, those who lost work colleagues, and those who lost their family members.

The Efficacy of Probiotics for Treatment of Bipolar Disorder-Type 1: A Randomized, Double-Blind, Placebo Controlled Trial.

Objective: Bipolar disorders are among the most common chronic mental disorders. Despite the recent improvement in controlling psychiatric disorders, treatment of bipolar disorders remains a challenge. The aim of this study was to determine the effect of consuming probiotics in patients with bipolar disorder-type 1 compared to the placebo group. Method : This was a permuted blocked randomized clinical trial conducted in Shahid Beheshti mental hospital in Kerman, Iran, from October 2017 to October 2018. Two psychiatrists diagnosed and hospitalized all 38 patients with type 1 bipolar disorder based on the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). Using blind randomized blocking method size 4, patients were divided into 2 groups of placebo and probiotic. Young Mania Rating Scale (YMRS) and Hamilton's Depression Rating Scale (HDRS) were completed at the beginning, week 4, and week 8 of the study by a psychiatry resident. Independent t test, Mann-Whitney and repeated measures ANOVA tests were used. Data were analyzed using SPSS software version 20. Results: There was no significant difference between the 2 groups in age, sex, and severity of mania and depression. Consumption of probiotics reduced the scores of YMRS and HDRS over time in the probiotic group more than the placebo group, but it was not significant. Conclusion: Consumption of probiotics had non-significant effects on improvement and treatment of bipolar type 1 patients. It is suggested that future studies be conducted with different probiotic microbial strains and longer period of treatment.

Bam Earthquake Survivors' Mental Health Status 12 Years after the Earthquake: A Population-Based Study.

BACKGROUND: Mental health is one of the characteristic benchmarks of public health. This research aimed to evaluate mental health of survivors of the Bam earthquake which occurred in 2003 twelve years after the earthquake in fall of 2015. METHODS: The statistical population of this cross-sectional study were people over 16 years of age who were present at the time of the earthquake in the city of Bam. The sample of the study consisted of 1500 people selected from the survivors by multistage sampling. The general health questionnaire-28 was used as a screening tool for mental disorders. The independent sample test, ANOVA test, Welch test, one-sample t test and the multiple logistic regression test were used to analyze the data. The analysis of data in the current study was carried out using the SPSS-18 software. RESULTS: Using the GHQ Likert scoring method, the results showed 52% of the people surveyed were suspected of having mental disorders (49.93% of men and 54.27% of women). Somatization and anxiety is more frequent than severe depression in respondents. The obtained statistics revealed that the prevalence of mental disorders amplified with loss of close relatives and age (odds ratio [OR] =1.457 and 1.828 respectively). The results also indicated that widows and divorcees (66.66%), illiterates and drop-outs (57.48%) and the elderly (77.12%) had the highest average in terms of having mental disorders. CONCLUSION: The results of this study showed more than half of the Bam earthquake survivors are suspected to be suffering from mental disorders. Since natural disaster-related mental illness effects can last for many years, comprehensive screening programs at regular intervals are required. Mental health services should be available to the elderly and people at risk in order to ensure restoration of mental health after a catastrophe.

Saffron (Crocus sativus) versus duloxetine for treatment of patients with fibromyalgia: A randomized double-blind clinical trial.

OBJECTIVE: Saffron was found efficient and safe in treatment of neuropsychiatric disorders, in particular depression. We compared the efficacy of saffron with duloxetine in treatment of patients with fibromyalgia. MATERIALS AND METHODS: In this double-blind parallel-group clinical trial, outpatients with fibromyalgia were randomized to receive either saffron 15 mg or duloxetine 30 mg starting with 1 capsule per day in the first week followed by 2 capsules per day from week 2 until the end of week 8. Participants were men and women aged 18-60 years diagnosed with fibromyalgia based on the American College of Rheumatology 2010 criteria who also had a pain score≥40 based on visual analogue scale. Participants were excluded in case they had rheumatologic diseases, inflammatory/infectious/autoimmune arthritis, comorbid neuropsychiatric disorders except depressive disorders, pain due to traumatic injuries, drug history of duloxetine or saffron use, current use of psychoactive medications, recent use of muscle relaxants, steroids, opioid analgesics, benzodiazepines, anti-epileptics, or injective analgesics. Primary outcomes included differences in mean score changes from baseline to endpoint between the treatment arms for Hamilton Rating Scale for Depression, Fibromyalgia Impact Questionnaire, and Brief Pain Inventory. RESULTS: Socio-demographic characteristics and baseline scores were similarly distributed between the two treatment arms (2n=46). No significant difference was detected for any of the scales neither in terms of score changes from baseline to endpoint between the two treatment arms (Mean score changes: -4.26 to 2.37; p-values: 0.182-0.900) nor in terms of timetreatment interactions (p-values: 0.209-0.964). CONCLUSIONS: Saffron and duloxetine demonstrated comparable efficacy in treatment of fibromyalgia symptoms.

A Survey on Mental Health Status of Adult Population Aged 15 and above in the Province of Kerman, Iran.

INTRODUCTION: This research aims to determine the mental health status of population aged 15 and over in the province of Kerman in 2015. METHODS: The statistical population of this cross-sectional field survey consisted of residents of urban and rural areas of Kerman in Iran. An estimated sample size of 1200 people was chosen using systematic random cluster sampling. The access was provided by the contribution of Geographical Post Office of Kerman, Jiroft and Bam cities. The General Health Questionnaire-28 (GHQ-28) was used as the screening tool for mental disorders. The analysis of data in the current study was carried out using the SPSS-18 software. RESULTS: Using GHQ traditional scoring method, the results showed that 18.8% of the subjects showed to be at risk of mental disorders (22.9% of females and 14.8% of males). Urban areas (20.2%) were more at risk of mental disorders compared with rural residents (16%). Anxiety and somatization symptoms were more frequent than depression and social dysfunction among respondents. The obtained data revealed that the prevalence of mental disorders increased with age. The results also indicated that mental disorders were more common in certain subgroups; in particular women, those aged 65 years and above, the divorced and widowed, illiterate and unemployed adults. CONCLUSION: The results of this study showed that one fifth of the samples were suspected of psychiatric disorders and the prevalence of these disorders has decreased from 22.9% in 1999 to 18.8% in 2015; so, it is on the authorities and health managers of the province to maintain the essential elements for continuity of mental health services to people with mental disorders.

Systemic lupus erythematosus presenting with a fatal intestinal vasculitis: a case report.

This case report demonstrates fatal gastrointestinal vasculitis as a rare presentation of systemic lupus erythematosus. A 34-year-old woman presented with abdominal pain and diarrhea. Anti nuclear antibody was positive and high titre of anti-ds DNA antibody was also reported. Treatment with corticosteroid and supportive cares were started; however, her condition worsened. Eventually, she was considered as a candidate for diagnostic laparoscopy. Immediately after laparoscopy, she developed respiratory distress along with upper gastrointestinal bleeding. Soon after, the patient died because of disseminated intravascular coagulation .