Effect of Transcranial Direct Current Stimulation on Craving, Cognitive Functions, and Serum Brain-Derived Neurotrophic Factor Level in Individuals on Maintenance Treatment for Opioid Use Disorder, A Randomized Sham-Controlled Trial.

OBJECTIVES: To investigate the effects of transcranial direct current stimulation (tDCS) on brain-derived neurotrophic factor (BDNF) levels, craving, and executive functions in individuals on maintenance treatment for opioid use. METHODS: We randomized 70 right-handed men aged 18-55 years into 2 groups: the intervention group and the sham group. The intervention was 10 sessions of 2 mA stimulation over 5 days. Each session in the sham group ended after 30 seconds. Craving was measured using the Desire for Drug Questionnaire (DDQ), Obsessive Compulsive Drug Use Scale (OCDUS), and visual analog scale (VAS). The measurements were taken before and after the intervention, as well as 2 months later. BDNF was measured before and after the intervention. Repeated-measures analysis of variance, the generalized estimating equation model, and independent t test were used for data analysis. RESULTS: The mean differences (95% confidence intervals) in pre and post craving scores in the intervention group were (12.71 [9.10 to 16.32], P = 0.167) for VAS, (1.54 [1.12 to 1.96], P = 0.012) for OCDUS, and (1.71 [1.27 to 2.15], P = 0.125) for DDQ. These measures in the control group were -0.44 (-1.19 to 0.30), 0.01 (-0.21 to 0.23), and 0.126 (-0.11 to 0.36), respectively. BDNF serum levels significantly increased after the intervention (difference, 0.84 [0.69 to 0.99], P < 0.001); however, this change was not significant in the generalized estimating equation model. The effect of tDCS on craving was significant in OCDUS, but not significant in VAS and DDQ. CONCLUSIONS: The tDCS reduces craving and improves executive functions in the short term. BDNF serum level was not associated with tDCS.

The Effect of Krocina™ on Decreasing Substance User Withdrawal Syndrome, Craving, Depression and Stress: A Double-Blind Randomized Parallel Clinical Trial.

INTRODUCTION: Due to the association between substance use abstinence with some psychological syndromes, the use of herbal medicines such as Crocus sativus L. have been considered as a proper approach to controlling withdrawal syndrome. The present study aimed to identify the effect of Krocina™ in reducing withdrawal symptoms, craving, depression, stress, anxiety and durability of treatment in the detoxification period and abstinence phase. METHODS: In a double-blind randomized parallel clinical trial, 72 opioid users passing the detoxification period who were referred to the Soroush Center during 2020, randomly categorized into the two groups. Motivational interviewing sessions and 15 mg of Krocina™ twice a day were provided for six weeks for the cases. The placebo group received pills with the same coating and motivational interviewing. Withdrawal symptoms, craving, depression, stress and anxiety were assessed at the start of the study and then weekly using the Clinical Opiate Withdrawal Scale, Obsessive-Compulsive Drug Use Scale, and the Depression Anxiety Stress Scales-21, respectively. SPSS-v16 was used for statistical analyses. RESULTS: Drug withdrawal symptoms and craving did not indicate a significant difference by Krocina™ intervention during the time (p > 0.05). Furthermore, depression, stress and anxiety were statistically similar between Krocina™ and placebo groups (p > 0.05). Moreover, we found similar findings between the two groups when analyzing only patients with negative urinary test (F = 0.03;p = 0.86). CONCLUSION: Our finding rejected the effectiveness of 30 mg/day of Krocina™ for six weeks as an effective substance for decreasing withdrawal symptoms, craving, depression, anxiety and stress at the detoxification period and abstinence phase.

Reaching consensus: a review on sexual health training modules for professional capacity building.

Background: Professional capacity building (PCB) is the focus point in health-related subjects.The present study was conducted to systematically review the existing sexual health training modules for health care providers. Methods: The following keywords were used to search: training, education, professional capacity, practitioner, sexual health, skill education, module, course, package and curriculum.The term MESH is referred to Medical Subject Headings and the following databases were investigated: MEDLINE, EMBASE, PubMed, Cumulative Index to Nursing and Allied Health Literature (CINAHL), The Cochrane Library and Web of Science, Scopus, Google Scholar, SID,Magiran, and Iranmedex. All articles from 1980 to 2015 were extracted. Online modules were excluded. Considering that lesson plan was the basis of instruction, the modules were selected based on the characteristics of the lesson plans. Results: A total number of 38 published training modules in the field of sexuality we redetermined. In total, more than half of the modules (58%) were designed for medical doctor sand allied health professionals and the remaining (42%) were for nurses and midwives. Almost all the modules (97%) were introduced and utilized in developed countries, and only 3% were disseminated in developing countries. Conclusion: There are invaluable modules to build professional capacity in the field of sexual health. As a number of modules have been designed for nurses and midwifes, as the first-line health care providers, the use of these groups in sexual counseling and empowerment for sexual health is essential. No sexual health training program was designed in Iran. Therefore, designing such modules according to Iranian culture is strongly recommended.

Gaining comprehensive data about sexual knowledge through surveys.

BACKGROUND: Delivery of sexual health services rely on rigorous facts extracted from surveys, but often those facts cannot be available due to the lack of culturally-sensitive questionnaires. OBJECTIVE: our aim was to show the validity and reliability of the Persian version of the Acquisition of Sexual Information Test (ASIT), a measure selected due to its assemblages with Iranian culture. MATERIALS AND METHODS: Forward-backward procedure was applied to translate the questionnaire. Cross-sectional study was carried out and psychometric properties of the Iranian version were tested in a thirty sample of reproductive-age women. Face validity was assessed by qualitative and quantitative methods. Content validity was also assessed by calculating two quantitative indicators as content validity index (CVI) and content validity ratio (CVR). Reliability was assessed by test-retest analyses. RESULTS: Impact score was 1.5, the majority of participants (83.3%) stated that the overall level of questionnaire was high but some of the questions were irrelevant to sexual knowledge. Many questions (90%) gained a CVR less than 0.56, and all of them gained CVIs lower than 0.7. Correlation in test-retest reliability was 0.85. CONCLUSION: sexual knowledge questionnaire seems to be culturally inappropriate for Iranian women. Although, we need survey data for assessing the evidence-based needs for sexual health and best practice, but the questions addressing various dimensions of sexuality must be culturally sensitive, comprehensive and appropriate. Our findings suggest that ASIT as a well-known measure should be used in Iranian population with caution.

Quality of Life in Methadone Maintenance Treated Patients in Iran.

BACKGROUND: Measurement of life quality as an index of health status has a widespread application in health care domain. OBJECTIVES: The current study aimed to determine the quality of life of referents to addiction cessation centers of Iran. PATIENTS AND METHODS: In this cross-sectional study, 988 addicts who had referred to addiction cessation centers in Shahroud were studied through SF-36 questionnaire. The data were analyzed using linear regression in structural equation modeling and STATA 12 statistical software. RESULTS: The mean ± SD age of the participants was 41.2 ± 11.8 years. Most of the referents used smoking followed by eating method of opium abuse. The mean ± SD score of life quality was 67.8 ± 17.2, the mean ± SD score of life quality in physical health dimension was 76.9 ± 26.7, and the mean ± SD score in mental health dimension was 64.5 ± 18.4. Univariate analysis showed a significant relationship between life quality and gender, place of residence, education, occupation, marital status, and income (P ≤ 0.05). However, in multivariate analysis a significant relationship was observed only between gender, socioeconomic status, and quality of life score. CONCLUSIONS: Although most studies have reported low and weak quality of life in addicts, the findings of this study shows that the life quality score of addicts is rather good. It seems that the maintenance treatment that addicts receive in addiction cessation centers has been effective in improving the quality of life of the patients. Hence, expanding methadone treatment centers can play a leading role in the improvement of life quality in addicts.

Psychopathy in Iran: a cross-cultural study.

Few cross-cultural studies have assessed psychopathy and none have included a sample from non-western countries. This study investigated the factor structure of the Psychopathy Checklist: Screening Version (PCL:SV) in an Iranian sample, and compared the results with a western sample. Three hundred fifty-one Iranian prisoners were compared with 405 participants of the standardization sample of the PCL:SV. Confirmatory factor analysis and item response theory method were used for data analysis. The Iranian data fitted well with the hierarchical three-factor model of psychopathy and neither two- nor four-factor models showed an adequate fit. Differential item functioning existed across samples, with discriminatory power of factor 1 (arrogant and deceitful interpersonal style) being lower in the Iranian sample that for factor 2 (deficient emotional experience) being greater in the Iranian sample than the standardization sample. Deficient emotional experience might be the most significant factor in diagnosing psychopathy, regardless of the studied culture. Other factors appear to be relatively culture-specific.

Neurological soft signs in mentally disordered offenders.

The study used the Neurological Evaluation Scale to assess neurological soft signs in 351 offenders and 80 healthy comparison subjects. Offenders were also interviewed using the Structured Clinical Interview for DSM-IV and the Hare Psychopathy Checklist. Neurological signs were significantly increased in offenders compared with healthy subjects. Offenders with repeated misdemeanors had higher rates of neurological signs than those with a single felony. Neurological scores were significantly predicted by lifetime diagnoses of psychotic, anxiety, and substance use disorders. Each diagnostic category was associated with a distinct pattern of neurological abnormalities.

Psychiatric morbidity among sentenced prisoners: prevalence study in Iran.

BACKGROUND: Information on psychiatric morbidity of prisoners has almost entirely been based on research in Western countries and it is uncertain whether these research findings are applicable to other settings. AIMS: The primary objective was to investigate the prevalence of psychiatric disorders in Iranian prisoners. METHOD: Through stratified random sampling, 351 prisoners were interviewed using the clinical version of the Structured Clinical Interview for DSM-IV Axis I Disorders and the Psychopathy Checklist: Screening Version. RESULTS: The majority (88%) of prisoners met DSM-IV criteria for lifetime diagnosis of at least one Axis I disorder and 57% were diagnosed with current Axis I disorders. Opioid dependence (73%) had the highest prevalence among lifetime diagnoses, whereas major depressive disorder (29%) was the most common current diagnosis. Psychopathy was recorded in 23%. Prevalence rates of psychiatric disorders were significantly different among offence categories. CONCLUSIONS: The results suggest that a substantial burden of psychiatric morbidity exists in the prison population of Iran, with treatment challenges that appear to be different from those observed in inmates in Western countries.