The Effect of Add-on Buprenorphine to Matrix Program in Reduction of Craving and Relapse Among People With Methamphetamine Use Disorder: A Randomized Controlled Trial.

BACKGROUND: Methamphetamine addiction is a global issue. Buprenorphine might have beneficial roles in reducing craving to methamphetamine use via altering neurotransmission signaling and dopaminergic system-related reward mechanisms. PROCEDURES: This clinical trial was performed in 2019 to 2020 in Khorshid Hospital, Isfahan, Iran. The study was conducted on patients with methamphetamine use disorder. The intervention group received sublingual buprenorphine for 8 weeks, and the other group also received placebo tablets. Patients were followed up and visited every month for the next 4 months. Both groups were treated simultaneously by matrix program for 2 months and observed for the next 4 months. Patients filled out the Cocaine Craving Questionnaire-Brief (CCQ-Brief) every week during intervention time (first 2 months) and every month during follow up visits (4 months). The Depression Anxiety Stress Scale (DASS-21) was also filled out before and after interventions for all of the patients. Data were analyzed using SPSS software using χ2, independent t test and repeated-measure analysis of variance tests. RESULTS: Our data indicated significantly lower CCQ-Brief scores in the intervention group compared with the placebo group (P < 0.05). It was also indicated that changes in CCQ-Brief scores were also significant among both groups (P < 0.001). We also showed that the anxiety, depression, and stress scores reduced significantly after interventions (P < 0.001). These scores were also significantly lower in the intervention group compared with placebo group (P < 0.05). CONCLUSIONS: Buprenorphine may be effective and may have positive potential roles in reducing methamphetamine craving. This drug is also helpful in reducing the anxiety, depression, and stress of patients with methamphetamine use disorders.

Comparison of Rapid Antidepressant and Antisuicidal Effects of Intramuscular Ketamine, Oral Ketamine, and Electroconvulsive Therapy in Patients With Major Depressive Disorder: A Pilot Study.

PURPOSE/BACKGROUND: This study was devised to compare the antidepressant and antisuicidal effects of oral and intramuscular (IM) ketamine versus electroconvulsive therapy (ECT). METHODS/PROCEDURES: In our pilot study, 45 patients with major depressive disorder (based on Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, criteria) in the age range of 18 to 70 years who were determined suitable candidates for ECT got randomly divided into 3 equal groups. Each group received one of these treatment modalities: 0.5 mg/kg of IM ketamine; 1 mg/kg of oral ketamine; and ECT in 6 to 9 sessions during 3 weeks. Depression and suicidal ideation scores were recorded using the Hamilton Depression Rating Scale and the Beck Scale for Suicidal Ideation, respectively, at baseline, 24 hours, 1 week, 2 weeks, and 3 weeks within the intervention. The measurements were repeated 1 week and 1 month after the end of the intervention as well. Vital signs and adverse effects were noted. Finally, satisfaction levels of patients for each method were recorded and compared between groups. FINDINGS/RESULTS: The Hamilton Depression Rating Scale and the Beck Scale for Suicidal Ideation scores significantly improved in all groups compared with baseline with no significant differences between the 3 groups. The adverse effects for ketamine-consuming groups such as dissociative symptoms were brief and transient, whereas memory loss for the ECT group remained up to 1 month in some patients. Ketamine-receiving groups preferred it more than ECT. IMPLICATIONS/CONCLUSIONS: Oral and IM ketamine probably have equal antidepressant in addition to more antisuicidal effects compared with ECT but had less cognitive adverse effects and higher preference by patients. Thereby, ketamine can be an alternative method in the treatment of patients with severe and/or suicidal MDD.

The process of risky sexual behaviors formation in women drug users: a protocol for a grounded theory study.

BACKGROUND: Drug use is an important underlying factor in risky sexual behaviors. Risky sexual behaviors can lead to STIs and HIV/AIDS, especially in women. For better understanding of the relationship between drug use and risky sexual behaviors in women, it is necessary to identify the process of the formation of these behaviors that is a multidimensional process influenced by multiple socio-cultural factors. Therefore, the present study aims to explore the process of risky sexual behaviors formation in women drug users. METHODS: This is a grounded theory qualitative study with Corbin and Strauss approach. The participants of the study are women drug users with risky sexual behaviors who, using purposeful sampling method, will be selected from the Counseling and Harm Reduction centers for vulnerable women, the Drug Rehabilitation centers affiliated to the Isfahan University of Medical Sciences, Therapeutic Community Rehabilitation centers, Drop in Centers affiliated to the Welfare Organization, Medium-term Residential centers (women's camps), and Women's Empowerment centers in Isfahan, Iran. Sampling will continue using snowball method and the strategy of maximum variation in terms of the age, occupation, education, duration of the drug use, and type of the drug. During the sampling process, theoretical sampling will gradually replace purposeful sampling, so that sampling will proceed based on the emergence of the theory and for understanding of the concept and, then, the next participants will be selected. Sampling will continue until data saturation is reached. Data will be collected using individual semi-structured in-depth interviews, observation, field notes, and memo writing. Data will be coded as they are collected, and the analysis will be performed at three levels of open, axial, and selective coding and based on the constant comparative analysis. The four criteria of credibility, dependability, transferability and confirmability will be used to ensure the trustworthiness of the data. DISCUSSION: The findings of the present study are expected to provide a better understanding of the process of risky sexual behaviors formation in women drug users. The findings may also lead to the identification of the barriers and factors contributing to the formation of such behaviors and, finally, will promote the reproductive and sexual health of these women. This study can also provide the guide and the ground for designing and conducting further studies in the related areas through using various qualitative and quantitative methods.

Expression of Bcl-2 and Bax genes in peripheral blood lymphocytes of depressed and nondepressed individuals.

BACKGROUND: Involvement of the immune system is one of the issues raised in the pathophysiology of depression. BCL2 and BAX genes are related to immune system regulation. We investigated the BCL2 and BAX expression as a probable mechanism of immune system involvement in depression. MATERIALS AND METHODS: This case-control study was conducted on 28 patients with major depression (case) and 28 nondepressed individuals (control) within the age range of 18-55 years in the Isfahan University of Medical Sciences. Clinical interviews, based on the Diagnostic and Statistical Manual of Mental Disorders, were conducted to detect depression, and Beck's Depression Inventory was used to measure the severity of depression in the individuals. In addition, a real-time polymerase chain reaction was employed to compare the level of Bax and Bcl-2 gene expression in peripheral blood lymphocytes. The multivariate covariance analysis was used to explore the correlation between BCL2 and BAX gene expression and to control the effect of duration and severity of depression. RESULTS: The results showed that none of the variables including group membership, the duration of depression, and the severity of depression were not significantly correlated with the expression of BCL2 and BAX genes. Furthermore, there was no statistically significant relationship between the Bax and Bcl-2 genes expression in case and control groups (P > 0.05). CONCLUSION: Depression may have no impact on Bax and Bcl-2 gene expression in patients with major depression. Studies with larger sample size are recommended.

Association between sleep quality and postpartum depression.

BACKGROUND: The objective of this study was an investigation of the association between depression and sleep quality. MATERIALS AND METHODS: This cross-sectional study was performed on 360 delivered women that referred to thirty health-care centers in Ardabil, Iran. The Standard Pittsburgh Sleep Quality Index questionnaire was used to the investigation of sleep quality. We used the Edinburgh Postnatal Depression Questionnaire to assess postpartum depression. Logistic regression was used to examine the association of sleep quality with postpartum depression. RESULTS: Chance of depression in women with poor sleep quality was 3.34 times higher than those with good sleep quality (odds ratio = 3.34; 95% confidence interval: 2.04-5.48; P < 0.001). After controlling for some risk factors, an association observed between sleep quality and depression in postpartum women. CONCLUSION: we found an association between sleep quality in women who had given birth in the last 3 months and symptoms of postpartum depression.

Efficacy of illness perception focused intervention on quality of life, anxiety, and depression in patients with myocardial infarction.

BACKGROUND: Myocardial infarction (MI) is one of the major causes of death and disability worldwide, which can reduces quality of life in patients. Some disabilities are depression and anxiety which delay returning to work. The aim of this study was to evaluate the effect of illness perception focused intervention on quality of life, anxiety, and depression in MI patients. MATERIALS AND METHODS: A randomized controlled trial study of 48 recently hospitalized MI patients was conducted (24 in intervention group and 24 in control group). Intervention group was trained to understand the disease by a mental health counselor in three half-an-hour sessions for three consecutive days. Data were collected from three questionnaires: hospital anxiety and depression scale, the World Health Organization Quality of Life Questionnaire (short form), and Illness Perceptions Questionnaire Brief at admission, 1.5, and 3 months postdischarge. Data were analyzed with ANOVA repeated measure. RESULTS: The mean duration of returning to work was 28.7 ± 8.1 days in intervention groups and 46 ± 7.6 days in control group which was statistically significant (P < 0.001). Moreover, anxiety, depression, and illness perceptions score were significantly decreased in intervention groups which were 8.3 ± 3.3, 6.8 ± 3.5, and 36.5 ± 5 in intervention groups and 15.8 ± 2.1(P < 0.001), 17.1 ± 2.3 (P < 0.001), and 41.9 ± 4 (P < 0.001) in control group, respectively. Mean of quality of life subscales scores just physical health subscale showed a significant reduction after 3 months in the control group. CONCLUSION: Training MI patients to understand the disease in three half-an-hour sessions for 3 consecutive days can decrease the duration of returning to work, anxiety and depression, and increase illness perceptions which can make a better outcome.

The Effect of Buprenorphine on Methamphetamine Cravings.

BACKGROUND: Methamphetamine (METH) abuse and dependence present a major global problem. We investigated the efficacy of adding buprenorphine in reducing METH cravings during treatment with the Matrix program. METHODS: This was a randomized, double-blind, controlled clinical trial of 40 men between the age of 18 and 40 years who were referred to the addiction treatment center at Noor Hospital from December 2012 to September 2013. All of the selected subjects participated in the Matrix program and were randomly assigned into 2 groups and given either buprenorphine or a placebo. A 4-month intervention program with buprenorphine or a placebo was arranged for each group. Demographic variables of the 2 groups, descriptive indices from the cocaine craving questionnaire-brief (CCQ-Brief), the ratio of urine tests positive for METH, and the frequency of drug complications were regularly evaluated in both groups every 2 weeks and, if not possible, by the third or fourth week. All analyses were performed by SPSS20 using analysis of covariance, χ, and t tests. RESULTS: The average of indices from the cocaine craving questionnaire-brief score, except the 2 initial measurements, was significantly lower in the intervention group in all measurements (P < 0.05). Apart from weeks 3 and 28, the ratio of positive tests was significantly different in all measurements in both groups (P < 0.05). CONCLUSIONS: Buprenorphine augmentation, in comparison with the placebo, significantly reduced the craving to use METH during treatment with the Matrix program.

Validity, reliability, and factor analysis of Persian version of quality of life questionnaire for irritable bowel syndrome (IBS-QOL-34).

BACKGROUND: Quality of life (QOL) improvement is the main objective of treating patients with irritable bowel syndrome (IBS). This study aimed to assess the validity, reliability, and factor analysis of IBS-QOL-34 questionnaire as a common transcultural instrument for Iranian IBS patients. MATERIALS AND METHODS: Two hundred and forty patients with IBS (based on gastroenterologists' diagnosis according to ROM III criteria) were referred to Digestive Health Clinic in Psychosomatic Research Center have been selected in this study. Aside with IBS-QOL-34, MOS 36-item short-form health survey (SF-36) and IBS severity index (IBSSI) questionnaires were completed by the cases for determination of correlation coefficients; the data were analyzed using descriptive statistics, factor analysis, Cronbach's alpha, Pearson correlation coefficient by Statistical Package for Social Sciences (SPSS) software, version 18. RESULTS: Total reliability of the questionnaire was reported by using Cronbach's alpha as 0.95, ranging from 0.65 to 0.90. Correlation coefficients of concurrent implementation of IBS-QOL with SF-36 and IBSSI resulted in -0.61 and 0.64, respectively. Exploratory factor analysis using varimax rotation identified eight principle components, which will determine QOL at 67% variance. CONCLUSION: According to the results, IBS-QOL-34 questionnaire has good psychometric properties in the research community and can be safely used as a valid tool to assess QOL of patients with IBS for healthcare and therapeutic purposes.

Is there any association of anxiety-depressive symptoms with vascular endothelial function or systemic inflammation?

BACKGROUND: Studies have shown the association of mood disorders and endothelial dysfunction, and increased risk of cardiovascular disease; however, mediatory mechanisms are not entirely clarified in this regard. We investigated the relationship between depression/anxiety symptoms with systemic inflammation and endothelial function. MATERIALS AND METHODS: This cross-sectional study was performed in 2011 on employees of an oil company located in the Isfahan city (central Iran). Participants were selected with clustered random sampling. Anxiety and depression were evaluated by Hospital Anxiety Depression Scale (HADS). Systemic inflammatory status was evaluated by measuring sensitive C-reactive protein (high sensitive-CRP). To evaluate the endothelial function flow-mediated dilation (FMD) was measured. RESULTS: During the study period, 254 participants (mean age = 51.4 ± 6.1 years) were evaluated. No significant relationship was found between high sensitive-CRP or FMD and any of the variables of anxiety or depression. In multivariate analysis, by controlling the possible confounding factors, no association was found between anxiety score, depression, or the overall score of HADS with high sensitive-CRP or FMD. After the separate analysis of patients with and without diabetes, depression score was correlated inversely with FMD among patients with diabetes (r = 0.525, P = 0.021). CONCLUSION: According to the results, in the studied population, there was no relationship between anxiety/depression with systemic inflammation or endothelial dysfunction, while in individuals with diabetes, depression was associated with endothelial dysfunction. In this regard more cohort studies are recommended.

Brain-derived Neurotrophic Factor and High Sensitive C-reactive Protein in Bipolar Depression and Unipolar Depression: The Practical Usage as a Discriminatory Tool.

Objective: Brain-derived neurotrophic factor (BDNF) and high sensitive C-reactive protein (hs-CRP) have been reported to play roles in depression and bipolar disorder (BD). However, the probable discriminatory properties of these biologic markers are less investigated. We aimed to assess the serum BDNF and hs-CRP levels among Iranian patients with major depressive disorder (MDD) and BD during a depressive episode and investigate the optimum cut-off point for differential diagnosis of BD and MDD. Methods: We recruited 30 patients with MDD, 30 with BD in depressive mood and 30 healthy comparators. Blood sample was taken from each participant to measure BDNF and hs-CRP levels. We also used receiver operating characteristic (ROC) curve analysis to find an optimal cut-off point for differentiating MDD from BD according to pre-defined variables. Results: The mean age of total study population was 37.3 ± 5.0 years (males: 49%). BDNF was significantly lower in patients with BD, followed by MDD subjects and healthy controls 541.0 ± 601.0 pg/ml vs. 809.5 ± 433.3 pg/ml vs. 1,482.1 ± 519.8, respectively, p < 0.001). The area under curve of ROC curve analysis for BD versus MDD was 0.704 (95% confidence interval: 0.564-0.844, p = 0.007). We also found that the BDNF cut-off value of 504 could appropriately distinguished BD from MDD (sensitivity: 73%, specificity: 70%). No significant association were identified in terms of hs-CRP levels. Conclusion: Patients suffering from BD had lowest BDNF levels compared to MDD or healthy adults and this biomarker could play a practical role differentiating MDD from BD. Several studies are required confirming our outcomes.

Factors Associated with the Involvement of Women Drug Users in Risky Sexual Behaviors: A Narrative Review.

Background: Drug use is known as an important underlying factor in the occurrence of risky sexual behaviors. The present study was conducted to identify the factors associated with the involvement of women drug users in risky sexual behaviors. Materials and Methods: This review was conducted by searching databases of ISI Web of Science, Scopus, Science Direct, Cochrane, PubMed, Scientific Information Database (SID), the Iranian Magazine Database (Magiran), the Iranian Research Institute for Information Science and Technology (IranDoc), and the Iranian Medical Articles Database (IranMedex) and searching through the Google Scholar engine. All the articles published in English and Persian using the keywords including substance use, drug users, addiction, substance use disorders, substance-related disorders, sexual risks, high-risk sexual behavior, HIV risk behavior, unsafe sex, unprotected sex, and risky sex were searched from January 2000 to December 2020. After reviewing the articles, out of 110 articles, 21 articles were selected for final evaluation. Results: Factors related to the involvement of women drug users in risky sexual behaviors were divided into five categories: individual factors, factors related to drug use, inter-personal relationships, gender discrimination, and socio-economic factors. Conclusions: The results can be used in the field of women's social harms in finding strategies and designing the necessary interventions to prevent risky sexual behaviors in women drug users in different societies and cultural contexts. Also, the results can be used by all researchers who want to study the relationship between these factors and the involvement of women drug users in risky sexual behaviors.

Importance of gabapentin dose in treatment of opioid withdrawal.

AIM: The aim of the study was to evaluate the efficacy of gabapentin (1600 mg/d) as an adjunctive to methadone-assisted detoxification in the treatment of opioid withdrawal symptoms. DESIGN: This was a 3-week open-label study (as second phase) following a double-blind, placebo-controlled study with 900 mg/d of gabapentin (as first phase of this study). SETTING: The study was conducted at a specialized outpatient clinic for the treatment of patients with addictive disorders. PARTICIPANTS: The study subjects were composed of 27 patients addicted to opiate who met the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision criteria for opioid dependency, randomly selected among outpatients referred to our clinic. INTERVENTION: Subjects received adjunctive treatment with gabapentin (1600 mg/d) in addition to methadone-assisted detoxification for 3 weeks. MEASUREMENTS: Subjective Opiate Withdrawal Scale (SOWS) with a total score of 0 to 64 was administered at 6 time points during the study. FINDINGS: The total SOWS score was significantly decreased after the intervention. Compared to our previous trial, an almost significant difference was observed in total SOWS scores between groups treated with gabapentin 1600 and 900 mg/d at the end of the intervention period (P = 0.06). Gabapentin with a dose of 1600 mg/d was significantly superior to a dose of 900 mg/d in decreasing severity of coldness, diarrhea, dysphoria, yawing, and muscle tension. CONCLUSIONS: Add-on gabapentin with a dose of 1600 mg/d is effective in reducing some of the withdrawal symptoms in patients addicted to opiate undergoing methadone-assisted detoxification.

Depression literacy and the related factors among a group of hospitals' staff in Iran.

BACKGROUND: Having a proper approach to depression requires having sufficient depressive literacy in the affected person. AIMS: This study aimed to evaluate the level of depression literacy among hospital staff affiliated to Isfahan University of Medical Sciences (IUMS) and to reveal the risk factors and knowledge gaps. METHODS: This was a cross-sectional study with 760 participants from university hospital staff at IUMS who were selected by a census method from April 2018 to December 2018. The data regarding depression signs and symptoms, anti-depressant drugs safety, non-medical treatment efficacy, etc. were collected using the Depression Literacy Questionnaire (D-Lit-22) and were analysed by SPSS-20, using the Pearson correlation coefficient, independent Samples t-test and analysis of variance (ANOVA) (p ⩽ .05). RESULTS: The mean age of participants was 35.33 ± 8.00 years old and 77.6% of them were female. The mean of the total score of depression literacy was 11.62 ± 3.53. Depression Literacy score was significantly higher in those with higher education levels, female gender and clinical staff (p < .001). The inability to distinguish depression from other mental disorders as well as having wrong beliefs about suitable treatment approaches were the most considerable gaps in depression literacy. CONCLUSION: Male gender, low level of academic education and working in non-medical wards are the main factors associated with lower depression literacy in our studied sample. The poor differentiation of depression and wrong beliefs in depression treatment modalities were the largest gaps which require more educational programmes.

Can Vitamin B6 Help to Prevent Postpartum Depression? A Randomized Controlled Trial.

BACKGROUND: A low level of vitamin B6 may theoretically cause symptoms of depression. AIMS: To investigate the effect of vitamin B6 on the prevention of postpartum depression (PPD) among mothers at risk for PPD. METHODS: This single-blind, placebo-controlled clinical trial was conducted on 81 pregnant women who were at risk of PPD from February to July 2016 at six selected health centers in Isfahan, Iran. A simple random sampling method was adopted. Forty cases and 41 controls received 80 mg vitamin B6 and placebo, respectively from the 28th week until the end of pregnancy. The risk of PPD was assessed as the main inclusion criteria using a structured clinical interview using hospital anxiety-depressive scale (HADS), social support appraisals scale (SS-A), and Holmes and Rahe life change and stress evaluation questionnaire (HRLCSEQ). The Edinburgh postpartum depression scale (EPDS) was used to assess the rate of depression prior to and 1.5 months after the intervention (end of pregnancy). Data were analyzed using SPSS 20 and statistical tests (Chi-square, independent t-test, Mann-Whitney's, and Exact Fisher Test). RESULTS: Forty-three subjects were assigned to each group and the final analysis comprised 81 subjects (40 in the case and 41 in the control groups), the mean age of the case and control groups being 5.8 ± 29.6 and 4.6 ± 28.2, respectively. The mean depression score was 10.4 ± 1.4 in the case and 9.3 ± 4.2 in control groups (P = 0.34) before and 4.2 ± 2.7 in the case and 10.4 ± 3.4 in control groups (P < 0.001) after intervention. CONCLUSIONS: Vitamin B6 has a positive effect on reducing postpartum depression scores among mothers at risk for PPD. These may be clinically useful for preventing PPD in high-risk women.

Citalopram and metacognitive therapy for depressive symptoms and cognitive emotion regulation in patients with major depressive disorder: A randomized controlled trial.

BACKGROUND: Metacognitive therapy (MCT) is a new psychotherapy for depression. This study was conducted to compare the effectiveness of citalopram and MCT on major depressive disorders (MDDs). MATERIALS AND METHODS: A total of 36 patients with MDD were randomly assigned into three groups of citalopram (n = 12), MCT (n = 16), and control (n = 8). MCT group received ten sessions of metacognition therapy. Citalopram group received 20-40 mg citalopram, and the control group did not receive any interventions. Outcomes were measured using the Beck Depression Inventory-II, Metacognition Questionnaire-30, and Cognitive-Emotion Regulation (CER) Questionnaire. Data were analyzed with ANCOVA using SPSS version 18. RESULTS: Depression score reduction was significant in both citalopram and metacognitive groups (P < 0.05). However, there was only a statistically significant difference between MCT and control group in CER and metacognition. CONCLUSION: MCT and citalopram both are effective in symptom reduction in MDD. Furthermore, MCT could lead to more improvement in metacognition, depression symptoms, and CER than citalopram, when treating MDDs.

Intelligence Quotient, Anxiety, and Depression in Congenital Hypothyroid Children at School Age.

BACKGROUND: Many studies who evaluated the outcome of the congenital hypothyroidism (CH) screening reported some intellectual and behavioral deficit despite early diagnose and treatment. The aim of the present study was to compare the intellectual and behavioral adjustment of CH children with controls. METHODS: This study was conducted among a group of 135 children aged 8--12 years in Isfahan, including transient and permanent congenital hypothyroidism (TCH and PCH) and a matched group of their classmate. Demographic characteristics collected using a designed data collecting form completed by parents. Intellectual quotient (IQ) was evaluated using Wechsler Intelligence Scale for Children aged 6--16 years (WISC-III). Depression and anxiety were evaluated using The Children's Depression Inventory (CDI) and the Multidimensional Anxiety Scale for Children (MASC), respectively. The SPSS software version 20.0 was used for data analysis. Nonparametric tests (Mann--Whitney) were used to investigate the association between variables. A significant level of less than 0.05 was considered in all analyzes. RESULTS: There was no significant difference in the IQ scores between PCH and TCH groups (P = NS). However, neither of them had intellectual disability (defined as IQ <70). IQ scores were significantly lower in PCH comparing to controls (P < 0.001). Total IQ and verbal IQ were significantly differenct between TCH and control group (P = 0.007 and P = 0.001). No significant difference was found in anxiety and depression scores between CH children and controls. CONCLUSIONS: There is no significant difference in anxiety and depression scores between congenital hypothyroidism children and controls, although IQ scores in children with congenital hypothyroidism is lower than controls.

Psychological profiles of risk for antenatal depression and anxiety in Iranian sociocultural context.

BACKGROUND AND AIM: Mental health issues including depression and anxiety are common in pregnancy worldwide. This study aimed to identify factors associated with mental disorders in a sample of Iranian pregnant women. MATERIALS AND METHODS: A cross-sectional study was conducted among pregnant women referred to a prenatal-care clinic in an urban area, Isfahan, Iran. The questionnaires in this study included the General Health Questionnaire and additional structured questionnaires exploring sociodemographic, obstetric, and economic risk factors and empowerment for decision-making regarding pregnancy, parenting, financial authority, trust, and confidence in health-care staff. Regression analysis was performed to assess the impact of the number of variables on the likelihood of the presence of mental health problems. RESULTS: Overall, 54.2% and 11.7% of the women had anxiety and depression, respectively. No statistically significant associations were reported between anxiety and depression and obstetric characteristics such as gestational age, parity, abortion, previous infertility, unwanted pregnancy, and the screening test results. According to the logistic regression analysis, the predictors of depression and anxiety were acknowledging psychological changes in pregnancy and empowerment for decision-making regarding pregnancy and parenting and financial authority (P < 0.05). CONCLUSIONS: probably, women's empowerment on becoming aware of psychological changes during pregnancy and making decisions on pregnancy, parenting, and financial authority is the factor affecting the mental health of pregnant women.

The effect of assisted reproduction treatment on mental health in fertile women.

INTRODUCTION: The process of assisted reproductive treatment is a stressful situation in the treatment of infertile couples and it would harm the mental health of women. Fertile women who started infertility treatment due to male factor infertility have reported to experience less stress and depression than other women before the assisted reproductive process but considering the cultural and social factors and also the etiology of the assisted reproductive process, it could affect the metal health of these women. Therefore, this study was conducted to evaluate the mental health of fertile women who undergo assisted reproductive treatment due to male factor infertility. MATERIALS AND METHODS: This study was a prospective study on 70 fertile women who underwent assisted reproductive treatment due to male factor infertility. The exclusion criterion was to stop super ovulation induction. To assess mental health, anxiety and depression dimensions of the general health questionnaire were used. Before starting ovulation induction and after oocyte harvesting, the general health questionnaire was filled by women who were under treatment. Data were analyzed using multi-variable linear regression, paired t-test, and Chi-square. RESULTS: The results showed that the mean score of depression and anxiety before ovulation induction and after oocyte harvesting were not significantly different; but the rate of mental health disorder in the depression dimension was significantly decreased after oocytes harvesting (31.7% vs. 39.7%). Also, there was a significant relation between the level of anxiety and depression before ovulation induction and after oocyte harvesting (P < 0.05). The anxiety level after oocyte harvesting had a positive and significant correlation with the economic situation (P < 0.05). CONCLUSION: This study revealed that the process of assisted reproductive treatment does not affect the mental health in fertile women independently, but these women start assisted reproductive process with high levels of depression and anxiety. Therefore, prior to the assisted reproductive treatment mental health consultation is needed.

Validity, reliability and factor analysis of Persian version of schizophrenia quality of life scale.

CONTEXT: Exact measurement of quality of life (QOL) in schizophrenia patients for evaluation of the patient's deterioration and also to assess the efficacy of therapeutic Interventions has become a daily task, which requires accurate assessment tools. AIMS: This study was aimed to assess the psychometric properties of a Persian version of schizophrenia QOL scale (SQLS) as a common transcultural instrument. SETTINGS AND DESIGN: One hundred and fifty schizophrenia patients who referred to Psychiatric Clinic in Noor Hospital (Isfahan, Iran) have been selected using simple sampling method. SUBJECTS AND METHODS: Aside with SQLS, short form-36 general health (SF-36) and World Health Organization QOL-brief-26 (WHOQOL-BREF-26). Questionnaires were completed by the cases for determination of correlation coefficients. STATISTICAL ANALYSIS USED: The data were analyzed using descriptive statistics, factor analysis, Cronbach's coefficient alpha, Pearson correlation coefficient by Statistical Package for Social Sciences software, version 18 (SPSS-18). RESULTS: Total reliability of the questionnaire was reported by using Cronbach's coefficient alpha 0.84, reliability of individual relationships subscales was 0.91, signs 0/87, symptoms 0/72 and motivation/energy 0/61. Correlation coefficients of SF-36 with a total scale of SQLS and correlation coefficient of WHOQOL-BREF-26 with a total scale of SQLS were acceptable. Exploratory factor analysis using varimax rotation identified four principle components (interpersonal relationship, symptoms, signs, motivation, and energy), which will determine QOL at 52.7% variance. CONCLUSIONS: Persian version of the SQLS can be used as a simple, reliable and valid tool in Iranian population.

Effect of add-on valproate on craving in methamphetamine depended patients: A randomized trial.

BACKGROUND: Methamphetamine dependence lead to the compulsive use, loss of control, and social and occupational dysfunctions. This study aimed to compare the effect of valproate in reducing the craving in methamphetamine dependents. MATERIALS AND METHODS: This is a randomized, double-blind, controlled clinical trial on 40 men of 18-40 years old referred to Noor Hospital during December 2012-September 2013 in Isfahan, Iran. The subjects participated in matrix program and randomly were divided into two groups of valproate and placebo. A 4-months program of intervention with valproate or placebo was arranged for each group. The rate of craving to methamphetamine and positive methamphetamine urine tests were evaluated in both groups every 2 weeks using cocaine craving questionnaire-brief (CCQ-Brief) and urine test. After the 4 months (active treatment with valproate and placebo), the drug was tapered and discontinued within 10 days, and patients were introduced to self-help groups and monitored regularly on a weekly basis over another 3 months. Collected data were analyzed with SPSS 20 using analysis of covariance repeated measure, Chi-square, and t-test. RESULTS: CCQ score of the intervention group was significantly less than the placebo group (P < 0.001), except on weeks 1, 3, and 28. The ratio of a positive urine test for methamphetamine in the intervention group was significantly lower than the control group in all screenings except weeks 3 and 28. CONCLUSION: Adding valproate to matrix program in the treatment of methamphetamine dependence showed significant effect on the reduction of the craving to methamphetamine.