Comparing the effectiveness of behavioral activation in group vs. self-help format for reducing depression, repetitive thoughts, and enhancing performance of patients with major depressive disorder: a randomized clinical trial.

BACKGROUND: Behavioral activation has gained increasing attention as an effective treatment for depression. However, the effectiveness of Behavioral Activation Group Therapy (BAGT) in controlled conditions compared to its self-help programs requires more investigation. The present study aimed to compare their effectiveness on depressive symptoms, repetitive negative thinking (RNT), and performance in patients with major depressive disorder (MDD). METHODS: In this randomized clinical trial, 40 patients diagnosed with Major Depressive Disorder (MDD) were recruited based on a structured clinical interview for DSM-5 (SCID-5). Participants were allocated to BAGT (n = 20) and self-help behavioral activation (SBA; n = 20) groups. BAGT received ten weekly sessions (90 min), while the SBA group followed the same protocol as the self-help intervention. Participants were evaluated at pre-treatment, post-treatment, and the 2-month follow-up using the Beck Depression Inventory-II (BDI-II), repetitive thinking questionnaire (RTQ-31), and work and social adjustment scale (WSAS). RESULTS: The results of a Mixed ANOVA analysis revealed that participants who underwent BAGT showed significant improvement in depression, rumination, work, and social functioning post-treatment and at the 2-month follow-up. However, the SBA group did not show significant changes in any outcome. The study also found that, based on clinical significance, 68% of the BAGT participants were responsive to treatment, and 31% achieved a high final performance status at the 2-month follow-up. DISCUSSION: BAGT was more effective than SBA in MDD patients. Participants' engagement with self-help treatment is discussed. TRIAL REGISTRATION: The present trial has been registered in the Iranian Registry of Clinical Trials Center (IRCT ID: IRCT20181128041782N1|| http://www.irct.ir/ ) (Registration Date: 04/03/2019).

Comparing the effectiveness of CBT and low-frequency rTMS in reducing symptom severity and depression and improving working memory in adults with OCD: a clinical trial.

OBJECTIVE: This study aims to compare the effectiveness of cognitive-behavioral therapy (CBT) and low-frequency (LF) repetitive transcranial magnetic stimulation (rTMS) in reducing symptom severity and depression and improving working memory in adults with obsessive-compulsive disorder (OCD). METHODS: This is a randomized clinical trial conducted on 24 adults with OCD, randomly assigned into two groups of CBT (n = 12, received CBT with exposure and response prevention (ERP) individually at 20 sessions) and rTMS (n = 12, received LF (1-Hz) rTMS over the right dorsolateral prefrontal cortex (DLPFC) at 10 sessions). They completed the Yale-Brown Obsessive Compulsive Scale, the Hamilton Depression Rating Scale, and two N-Back tasks before, immediately, and 1 month after interventions. RESULTS: Results showed a significant difference between the two methods in reducing the severity of OCD symptoms (p < 0.05) and depression (p = 0.002) immediately after interventions where the CBT with ERP was more effective, but no significant difference was found in terms of working memory (p > 0.05). No significant difference was found between groups in any study variables 1 month after interventions. CONCLUSION: Individual CBT with ERP is superior to LF rTMS for reducing the severity of symptoms and depression in OCD patients. However, there is no difference between them in improving working memory.

The effectiveness of group counseling based on Bandura's self-efficacy theory on sexual function and sexual satisfaction in Iranian newlywed women: A randomized controlled trial.

PURPOSE: This study was conducted to determine the effect of training based on Bandura's Self-Efficacy Theory on sexual function and sexual satisfaction in newlywed women. METHODS: This randomized controlled trial was conducted on 96 newlywed women presenting to health centers in Zanjan, Iran, in 2016. The participants were assigned to an intervention and a control group using randomized blocking. The intervention group received six 90-minute sessions of sexual counseling based on Bandura's self-efficacy theory held once every week over six weeks. The Female Sexual Function Index (FSFI) and the Sexual Satisfaction Questionnaire were completed by the participants before and eight weeks after the intervention. The ANCOVA and independent t-test were used for data analysis. RESULTS: There were no statistically significant differences between the two groups in terms of sexual function (p = 0.169) and sexual satisfaction (p = 0.190) scores before the intervention. Eight weeks after the intervention and after adjusting for the baseline scores, the ANCOVA showed that the sexual function score was significantly higher in the intervention group than in the control group (mean difference = 1.8; 95% Confidence Interval = 0.2 to 3.4; p = 0.021); however, there were no statistically significant differences between the two groups in terms of sexual satisfaction (5.6; -0.1 to 11.4; p = 0.058). CONCLUSION: The results suggest the positive effects of sexual counseling on sexual function but not on sexual satisfaction, which may be due to the duration of the follow-ups and the limited number of the counseling sessions held.

Investigating the bacterial profiles of Lactobacillus, Bifidobacterium, Actinobacteria, Fusobacterium, Firmicutes, and Bacteroides in stool samples from patients with severe depression and healthy individuals.

Depression is a multifaceted mental health disorder with complex etiology and significant global burden. Recent research indicates that the gut microbiota plays a role in the pathophysiology of depression, highlighting the potential role of specific bacterial species in influencing mood and cognitive function. In this study, we aimed to investigate the presence, copy numbers, and Ct values of selected bacterial species in stool samples from depressed patients (n=50) compared to control subjects (n=50). Our findings revealed significant differences in the abundance of Fusobacterium spp., Bifidobacterium spp., Lactobacillus spp., Bacteroidetes phylum, Firmicutes phylum, and Actinobacteria spp. between the two groups. Dysregulation of the gut microbiota, characterized by decreased presence of beneficial bacteria (e.g., Bifidobacterium spp., Lactobacillus spp.) and altered abundance of potentially pathogenic bacteria (e.g., Fusobacterium spp.), may contribute to the development or exacerbation of depression. These findings support the emerging concept of the gut-brain axis and its role in mental health. However, further research is needed to better understand the underlying mechanisms and explore the therapeutic potential of microbiota-targeted interventions for depression. Understanding the intricate interplay between the gut microbiota and depression could pave the way for novel treatment strategies and personalized approaches in mental health care.

Awareness, attitude, and perceived anxiety about COVID-19 in the Iranian population: A cross-sectional questionnaire survey.

An emergence of mental health issues among the general population has been reported during the COVID-19 pandemic. This study aimed to estimate COVID-19 awareness, attitude, and perceived anxiety among the Iranian people. This is a cross-sectional web-based survey done on the community population of Iran. The sample population was recruited through purposive sampling. The study questionnaire was circulated through online platforms as a web link. A questionnaire used in previous research has been used after translation in a sample of 375 adults from Iran. The majority of the participants in the study have a favourable attitude towards hand washing, social distancing, self-quarantine/isolation, and governmental policies regarding COVID-19. Similarly, many people feel anxious about partying, traveling, meetings, online shopping, and social contact. Anxiety related to contracting COVID-19 infection is reported in a larger populace. Most (> 80 percent) of the participants agree with the need for mental healthcare during the COVID-19 pandemic. The Iranian population has a favorable attitude towards the prevention of COVID-19. High anxiety and a perceived need for mental healthcare need in the community necessitates amelioration of mental healthcare during this challenging time.

The Effect of Quantitative Electroencephalography-Based Neurofeedback Therapy on Anxiety, Depression, and Emotion Regulation in People with Generalized Anxiety Disorder.

INTRODUCTION: Generalized Anxiety Disorder (GAD) is one of the most common anxiety disorders that has significant adverse effects on social functioning, occupational/academic performance, and daily living. This study aimed to evaluate the effect of Quantitative Electroencephalography (QEEG)-based Neurofeedback (NFB) therapy on anxiety, depression, and emotion regulation of people with GAD. METHODS: This research is a quasi-experimental study with a pre-test/post-test/follow-up design and a control group. The study participants were 29 college students with GAD living in Zanjan City, Iran, who were selected using a convenience sampling method. Then, they were randomly divided into two groups of intervention (n=15) and control (n=14). The protocol of NFB therapy was designed based on the QEEG method. The intervention group received QEEG-based NFB therapy for 8 weeks (20 sessions, 2 sessions per week, each session for 45 min), while the control group received no intervention. The samples were surveyed and measured by using a 7-item GAD scale, Emotion Regulation Questionnaire (ERQ), 21-item Depression, Anxiety, and Stress Scale (DASS), and Structured Clinical Interview for DSM (SCID) before and after the intervention and then at a 3-month follow-up. The collected data were analyzed in SPSS software V. 22 using univariate ANCOVA and repeated measures ANOVA. RESULTS: The within-subjects effect of time (pre-test, post-test, and follow-up) was statistically significant (P=0.031). The intervention group showed significant changes in the post-test and follow-up phases in comparison with the control group. The anxiety and depression levels of patients reduced significantly (P=0.001), and their emotion regulation improved (P=0.001) after the intervention, and they remained unchanged in the follow-up period. CONCLUSION: QEEG-based NFB therapy can reduce anxiety and depression and improve emotion regulation in patients with GAD.

Effect of Stress Management Counseling on Self-Efficacy and Continuity of Exclusive Breastfeeding.

Background: Self-efficacy is an important motivational factor that can be affected by physiological responses such as stress. Objective: The study aimed to determine the effect of stress management counseling on self-efficacy and continuity of exclusive breastfeeding in mothers. Materials and Methods: This randomized controlled trial was carried out on 46 pregnant women recruited at three Childbirth Preparation Centers of Zanjan (Iran) in 2018. The eligible women were allocated into two intervention and control groups according to the block design. Stress management counseling was carried out individually in four sessions, twice a week at 35 and 36 weeks of gestation. The control group only received routine cares. The self-efficacy and continuity of exclusive breastfeeding were measured monthly up to 4 months after childbirth. Results: Breastfeeding self-efficacy showed a statistically significant difference between the two study groups at 1 and 4 months after childbirth (p = 0.001). More women in the control group terminated exclusive breastfeeding compared to those in the intervention group (16 (72.7%) versus 8 (34.8%), p = 0.013). Conclusion: The results showed that integration of stress management counseling in breastfeeding education package can improve the self-efficacy and continuation of breastfeeding in mothers.

Comparing the Efficacy of Anodal, Cathodal, and Sham Transcranial Direct Current Stimulation on Brain-Derived Neurotrophic Factor and Psychological Symptoms in Opioid-Addicted Patients.

INTRODUCTION: Today, addiction to opioids is a serious problem all over the world. Unfortunately, the consumption of these drugs and the number of addicted people have drastically increased. This research aimed at comparing the efficacy of anodal, cathodal, and sham transcranial Direct Current Stimulation (tDCS) on the Brain-Derived Neurotrophic Factor (BDNF) and psychological symptoms in opioid-addicted patients. METHODS: Thirty opioid-addicted patients were selected based on the Diagnostic and Statistical Manual of Mental Disorders, the Fifth Edition, through the convenience sampling method. They were then randomly assigned to 3 groups (10 in each group). The subjects were evaluated before and after tDCS by their serum level of BDNF, desires for drug questionnaire, and depression anxiety stress scale. The data were analyzed by the Kolmogorov-Smirnov test, one-way analysis of variance, as well as the Bonferroni test. RESULTS: Stimulating the Dorsolateral Prefrontal Cortex (DLPFC) led to a significant change in increasing the level of BDNF (P=0.031) and reducing the degree of depression (P=0.018), anxiety (P=0.001), stress (P=0.012), and decreased the level of craving (P=0.001) in opioid-addicted patients. There was no significant difference between active stimulation groups (anodal left/cathodal right and anodal right/cathodal left). The stimulation of the right DLPFC (group B) significantly increased BDNF in comparison with the sham group (sham tDCS) and decreased anxiety and craving. Nonetheless, no change was observed in depression and stress. The stimulation of the left DLPFC (group A) significantly reduced depression, anxiety, stress, and craving compared with the sham group, while there was no change in BDNF. CONCLUSION: In addition to the conventional treatments of opioid-addicted patients, tDCS is an effective complementary treatment.