The Effects of Demographic Characteristics, Memory Deficits, and Executive Functioning Impairments in Failure to Respond to Fluvoxamine among Patients with Obsessive-Compulsive Disorder in Iran.

Background: Identifying treatment-response predictors could help improve treatment protocols as well as appropriately tailoring them to each subject, leading to a more desirable and accelerated recovery in patients. Thus, the present study aimed to investigate the role of demographic characteristics, memory deficits, and executive functioning impairments in failure to respond to fluvoxamine among patients with obsessive-compulsive disorder (OCD). Methods: This 2-group design (treatment-responsive and treatment-resistant) experimental study explored 76 participants who had received fluvoxamine monotherapy for OCD for ≥6 months. The study participants were from Iran. Four data collection tools were used in this study (ie, Demographic Data Form, WMS-III, WCST, and Y-BOCS). The achieved data were analyzed in SPSS-16 by descriptive statistics, such as mean and standard deviation and frequency and percentages, as well as an independent samples t-test, a chi-square test, and a Fisher exact test at P <0.05. Results: The present study findings indicated that 56 (81.2%) out of 76 patients with OCD responded to fluvoxamine treatment. A significant difference between the study groups highlighted age as an influential factor in providing a positive therapeutic response to fluvoxamine (P=0.048). However, the groups did not significantly differ in terms of gender (P=0.272), marital status (P=0.753), educational level (P=0.332), disease duration (P=0.276), and occupational status (P=0.473). While there was no significant difference between the groups (P=0.639) in terms of memory deficits (P=0.639), the response rate to fluvoxamine treatment was significantly higher in those with a healthy executive functioning, compared with patients with impairments in this respect (P=0.043). Conclusion: The obtained data suggested that fluvoxamine has a favorable efficacy in the treatment of OCD, and especially in young patients with healthy executive functioning.

DNA Banking to Assess Genetic Influences on Schizophrenia.

Background: Schizophrenia is among the most prevalent psychiatric disorders globally, with a lifetime prevalence rate of 0.3% to 0.7%, characterized by the heterogeneous presence of positive, negative, and cognitive symptoms that affect all aspects of mental activity. We aimed to describe the genetics of schizophrenia to widening our understanding of the inheritance of this illness. Methods: This quasi-experimental study was conducted in Razi psychiatric hospital in Tehran province, Iran. Recruitment of the study samples was conducted in Tehran, Iran, among patients with schizophrenia and their families. For this purpose, individuals with schizophrenia in 40 families with at least 1 to 2 affected members were identified and selected based on a clinical interview conducted by a psychiatrist and according to the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition. The clinical and paraclinical data, drug and substance usage, and medical treatments were collected through a standardized clinical questionnaire. Besides, the Global Assessment Scale and the Positive and Negative Syndrome Scale were completed for all study participants. Results: A total of 22 families had a negative family history, and 1 affected member and the rest of the studied families had a positive family history and at least 2 affected members. In addition, genealogical data (family tree) and lymphoblastic cell categories were developed to examine genes, and subsequent research results will be reported in the future. Conclusion: As the research continues, the approach to sampling must be modified to ensure that the deoxyribonucleic acid bank is as extensively representative as possible of all schizophrenia cases.

Serum Vitamin D, Mania and Depression-Related Scores: A Comparison among Mixed Bipolar, Mania, and Healthy Subjects.

Objective: Manic and mixed episodes of bipolar disorder are important episodes of this disorder. The aim of the current study was to assess serum vitamin D (SVD) levels in patients with mania and mixed bipolar disorder, compared to healthy subjects. Method : The current cross-sectional study was conducted on 75 subjects, including healthy subjects (n = 25), patients with acute-phase mania (n = 25), and patients with mixed bipolar disorder (n = 25). The SVD levels were measured in all of the enrolled subjects. The Hamilton Depression Rating Scale (HDRS), Young Mania Rating Scale (YMRS), and Clinical Global Impression- Severity (CGI-S) were used to assess disease activity in patient groups. Data analysis was performed using SPSS version 18. For statistical analysis, analysis of variance (ANOVA), independent-sample t test, Pearson correlation, and Chi-square tests were utilized. P-values < 0.05 were considered statistically significant. Results: The results showed that the mean of SVD was significantly lower in mania and mixed bipolar patients compared to healthy subjects (P < 0.05). In addition, the number of subjects with SVD ≥ 20 ng/ml was higher in the healthy group compared to the patient groups (P < 0.05). Also, SVD was negatively correlated with the CGI-S (r = -0.311; P = 0.028), YMRS (r = -0.464; P = 0.001), and HDRS (r = -0.393; P = 0.005) in the total patient subjects. Conclusion: Prevalence of low SVD was considerably high in mania and mixed bipolar patients compared to healthy subjects. Additionally, meaningful negative correlations were found between SVD and disease activity-related variables including the HDRS, YMRS, and CGI-S.

Co-administration of probiotic and vitamin D significantly improves cognitive function in schizophrenic patients: A double-blinded randomized controlled trial.

AIM: Manipulation of the intestinal microbiome and supplying vitamin D can attenuate psychiatric symptoms in schizophrenic patients. The current study tried to evaluate the effects of probiotic/vitamin D supplementation on the cognitive function and disease severity of schizophrenic patients. METHODS: In the present study, 70 patients (aged 18-65) with schizophrenia were recruited. Participants were randomly allocated to the placebo (n = 35) and intervention (probiotic supplements+400 IU vitamin D, n = 35) groups. Severity of disease and cognitive function (primary outcomes) were evaluated by Positive and Negative Syndrome Scale (PANSS) and Montreal Cognitive Assessment (MoCA) tests, respectively. Moreover, lipid profile, body mass index (BMI), gastrointestinal (GI) problems, serum C-reactive protein (CRP), and erythrocyte sedimentation rate (ESR) were evaluated as secondary outcomes. RESULTS: A total of 69 patients completed the study. The MoCA score was increased by 1.96 units in the probiotic-containing supplement group compared to the placebo (p = 0.004). Also, the percentage of subjects with MoCA score ≥ 26 rose significantly in the intervention group (p = 0.031). Moreover, TC (p = 0.011), FBS (p = 0.009), and CRP (p < 0.001) significantly decreased in the supplement group compared to the placebo. Although the probiotic supplement reduced PANSS score by 2.82 units, the difference between the study groups was not statistically significant (p = 0.247). CONCLUSION: Co-administration of probiotics and vitamin D has beneficial effects on the improvement of cognitive function in schizophrenic patients.

The effect of escitalopram in treating mild to moderate depressive disorder and improving the quality of life in patients undergoing coronary artery bypass grafting - a double-blind randomized clinical trial.

Introduction: Chronic depression and anxiety can be a risk factor for coronary aArtery bypass grafting (CABG) and is an emerging factor after coronary artery disease when the patient is admitted to the hospital and after surgery. We aimed to assess the effect of Escitalopram in treating mild to moderate depressive disorder and improving the quality of life in patients undergoing CABG. Methods: In this randomized clinical trial, 50 patients undergoing CABG referred to Tehran Heart Hospital from January 2021 to May 2021 and were suffering from mild to moderate depression were randomly assigned to one of the two groups of Escitalopram or placebo. The level of depression was assessed based on Beck's depression inventory and the quality-of-life status and its domains were assessed based on the SF-36 questionnaire in 2 groups. Measurements were obtained at baseline and at four and eight weeks after treatment. Chi-square, Fisher's exact, paired, and Wilcoxon tests or ANOVA were used as appropriate. Results: There was no significant difference between the level of depression between the two study groups at baseline (P=0.312). There was no significant difference between the quality of life and its domains in the two study groups at baseline (P=0.607). However, the most important effect of Escitalopram was reducing depression scores in the intervention group at weeks 4 and 8 after treatment compared to the placebo group (P<0.001). The quality of life and its domains were significantly higher in the Escitalopram group eight weeks after treatment (P=0.004). The amount of drug side effects at 2 and 4 weeks after treatment had no significant difference between the groups (P>0.05). Conclusion: Escitalopram was effective in treating mild to moderate depressive disorder and improving quality of life in patients undergoing CABG. Clinical trial registration: https://irct.behdasht.gov.ir/, identifier IRCT20140126016374N2.

Pregnenolone as an adjunct to risperidone for treatment of women with schizophrenia: A randomized double-blind placebo-controlled clinical trial.

There have been few studies of pregnenolone therapy in schizophrenia and those that exist have been subject to several critical limitations, thus yielding inconsistent results. We attempted to assess the therapeutic effect of pregnenolone in a patient sample as homogeneous as possible. In this randomized double-blind clinical trial, 82 female inpatients with chronic schizophrenia, who had discontinued their antipsychotic medications for at least one week in case of any oral antipsychotic medication or a month for any depot antipsychotic medication, received risperidone plus either pregnenolone (50 mg/day) or placebo for 8 weeks. Inclusion criteria were acute illness with a baseline Positive and Negative Syndrome Scale (PANSS) negative subscale score of ≥20. Exclusion criteria were the presence of severe depression or other concomitant psychiatric disorders. Primary outcome was defined as the difference in the PANSS total score change from baseline to week 8 in the pregnenolone group compared to the placebo group. No significant difference was found in the PANSS total score changes between the two arms (mean difference (CI 95%) = -9.41 (-20.24 to 1.41); p = 0.087). Significant differences were initially found for PANSS negative change scores (mean difference (CI 95%) = -2.61 (-5.03 to -0.19); p = 0.035) and general psychopathology change scores (mean difference (CI 95%) = -5.93 (-11.37 to -0.48); p = 0.033). However, these findings did not survive Bonferroni correction for multiple testing. While this trial may suggest a potential effect of pregnenolone on schizophrenia symptoms, further studies are warranted.