The effect of child-abuse on the behavioral problems in the children of the parents with substance use disorder: Presenting a model of structural equations.

Child abuse may potentially create the behavioral problems particularly in the children of parents with substance use disorder. Thus, the current study was conducted to investigate the effects of child abuse on the behavioral problems in the children of parents with substance use disorder using the emotional regulation and social skills as mediators. In this paper, the method of Structural Equation Modeling (SEM) was applied. The study population included 358 children of parents with substance use disorder whose parents had referred to the addiction treatment center in Kermanshah province, Iran (2017-2018). Conners Comprehensive Behavior Rating Scales (CBRS), Emotion Regulation Checklist (ERC), Social Skills Rating Scale (SSRS) Questionnaire, and Child Abuse Questionnaire were also used for data collection. IBM SPSS Amos 22 software was utilized for statistical analysis of the obtained data. The SEM was also analyzed to confirm fit of the model. The results showed a direct relationship between the child abuse and behavioral problems so that, the boys outperformed the girls in this regard. The findings also suggested a significant relationship between the family characteristics and behavioral problems. On the other hand, family characteristics and emotional regulation had direct and significant effects on improvement of the social skills (P < 0.001). The results revealed a direct effect of child abuse on the behavioral problems in the children of parents with substance use disorder. Thus, it is suggested to take a preventive approach toward child abuse in the children of parents with substance use disorder by employing a comprehensive program and intervention methods.

Blood lead concentration among oral/inhaled opium users: systematic review and meta-analysis.

Lead is a poisonous heavy metal with various known side effects. The effect of opium on raising blood lead concentration (BLC) has been investigated with no general agreement. In Iran, the number of lead poisoning cases has raised among the opium-addicted population. This systematic review and meta-analysis aim to combine the results of previous studies with the Iranian population to investigate the effect of opium on BLC. In this systematic review, PubMed/Medline, Web of Sciences, Embase, and Scopus were searched for studies using the Iranian population to compare the BLC of opium-addicted cases and non-addicted controls till January 2020. A random-effects model was used to pool the results. I-square test was used to assess the heterogeneity of the studies. The effect sizes were standardized mean differences (proxied by Hedges' g) followed by a 95% confidence interval. Of 417 initial articles, 13 studies met the inclusion criteria to be considered in the meta-analysis. The sample size of eligible studies ranged from 40 to 131 (mean 81.83, SD 27.6). All studies were focused on adults with mean age ranged from 33.5 to 65.15 years old (overall mean 49.0, SD 7.66). There were 13 studies included with 18 Hedges' g effect sizes. Using a random effect model, the pooled effect size was gw = 2.48 (95% CI: 1.58-3.39) and statistically significant in favor of opium-addicted participants. Moreover, heterogeneity was 96.6% (I2=96.6, Q(17) = 504.95, p < 0.001). For studies with large Hedges' g effect sizes (> 4) identified as outliers and removed from meta-analysis. The pooled Hedges' g effect size reduced to 1.39 (95% CI: 0.94-1.85), still highly significant in favor of higher levels of lead in the opium-addicted group. The funnel plot appeared symmetrical confirmed by Egger's test (t = 1.87, p = 0.088), indicating no publication bias present.

Elder abuse among Spanish and Iranian people: new methodological approach to the same old story.

Elder abuse continues to be a taboo, mostly underestimated, ignored by societies across the world. Recent systematic reviews and meta-analyses have revealed significant variations in the prevalence of elder abuse, with large geographic variations. This is the first study that compares the prevalence of elder abuse and risk factors between a European and Asian countries and using the same method. Cross-sectional surveys were conducted in Spain and Iran. Eight hundred forty subjects, aged 65 and over, were chosen randomly from patients in primary care health centres. Prevalence of abuse and subtypes and risk factors were obtained using structured interviews. To minimize the potential effects of selection bias, a propensity score matching was performed. Multiple correspondence analysis was used to evaluate the possible relationships among all the variables and to identify specific profiles. Five hundred thirty-two older people remained for the analysis after matching. The prevalence of abuse was 39.1% in Spain and 80.5% in Iran. Elder abuse and its subtypes are significantly more probable in Iran than in Spain. Out of every five elderly people questioned, two in Spain and four in Iran responded affirmatively to a question concerning elder abuse. Multiple correspondence analysis allows the differences between patterns of elder abuse between both populations to be visualized. Elder abuse is a prevalent problem in Spain and Iran. While some characteristics are shared in the pattern of abuse there are different profiles between the two countries. Detecting elder abuse should be a priority objective in clinical and forensic setting. Key points • This is the first study that compares the prevalence of elder abuse between a European and Asian country, using the same methodology. • Multiple correspondence analysis allows specific elder abuse profiles to be identified. • Elder abuse is significantly more likely to occur in Iran than in Spain. • Out of every five elderly people questioned, two in Spain and four in Iran responded affirmatively to a question concerning elder abuse.

Comparisons of Voxel-Based Morphometric Brain Volumes of Individuals with Methamphetamine-Induced Psychotic Disorder and Schizophrenia Spectrum Disorder and Healthy Controls.

BACKGROUND: Several psychological and neurological pathways are described to explain the emergence and maintenance of psychiatric disorders, and changes in brain volumes and brain activity are observed as correlates of psychiatric disorders. In the present study, we investigated if and to what extent specific voxel-based morphometric brain volume differences could be observed among individuals with methamphetamine-induced psychosis (MAIP) and schizophrenia spectrum disorder (SSD) compared to healthy controls. METHODS: A total of 69 individuals took part in the present study. Of those, 26 were diagnosed with MAIP, 23 with SSD, and 20 were healthy controls. After a thorough psychiatric assessment, participants underwent brain volume measurement. RESULTS: Compared to healthy controls, participants with MAIP had smaller volumes for left caudate and left and right parahippocampal gyrus. Compared to healthy controls, participants with SSD had smaller volumes for the gray and white matter, left amygdala, left hippocampus, left parahippocampal gyrus, left putamen, and the total volume. Compared to individuals with MAIP, individuals with SSD had a lower white matter brain volume. CONCLUSIONS: The pattern of results suggests that individuals with MAIP and SSD showed specific and regional brain atrophies on the left hemisphere, always compared to healthy controls. Given the cross-sectional design, it remains undisclosed if specific and regional brain atrophies were the cause or the consequence of the psychiatric issues.

Dissociative Experiences In Iranian Depressed Patients.

In the present study, 229 major depressive disorder (MDD) patients (57.6% female; 42.4% male) were selected by convenience sampling and examined for rate of dissociative experiences. Research tools were Dissociative Experiences Scale (DES) and demographic questionnaire. Group difference examinations were performed for gender, settlement region (place of residence), and chief complaints using standard t-test, analysis of variance, and Chi-square tests as appropriate. Ordinal regression was implemented for model building. The average age of the sample was 36.78 ± 10.73. Of which, 150 (65.5%) lived in the urban and 79 (34.5%) in the rural areas. The chief complaint of the 146 patients (63.8%) was psychiatric symptoms specific to MDD, and the remaining 83 patients (36.2%) had physical symptoms. The average DES score was 10.59 ± 13.59; and a significant mean DES score differences (P < 0.01) between patients' referred to physician for physical versus psychological complaints (physical: 23.61 ± 14.39; psychological: 3.19 ± 4.5) and geographic settlements (rural: 19.58 ± 15.13; urban: 5.86 ± 9.86) were observed. This study highlights the presence of subtype within MDD patients with significant dissociative tendencies. Given the relationship between trauma history and dissociation, this subgroup could be considered as probable cases with childhood history of abuse, lending to use dissociation as a defense mechanism. Given the evidence for promising results of trauma-focused psychotherapy in treating such patients, paying proper attention to childhood history of depression especially with somatization may minimize pain and suffering of these individuals overtime.

Personality and Psychological Aspects of Cosmetic Surgery.

BACKGROUND: In recent years, cosmetic surgery in Iran, which is provided almost entirely by the private sector, has gained popularity despite evidence of its potential risks. In most cases, cosmetic surgeries are done to increase self-satisfaction and self-esteem, thus seeking cosmetic surgery potentially shows an individual's psychological profile. Current evidence needs studies on the psychological profile of Asian cosmetic surgery patients. The present study investigates psychological profile and personality traits of people seeking cosmetic surgery in Iran. METHODS: The present prospective observational study was conducted with a sample of 274 randomly selected persons seeking cosmetic surgery (rhinoplasty, blepharoplasty, face/jaw implant, mammoplasty, and liposuction). All participants completed the validated and reliable the Global Severity Index (GSI)-Symptom Checklist-90-Revised (SCL-90-R)-and the short Neuroticism-Extraversion-Openness Five-Factor Inventory (NEO-FFI). RESULTS: The prevalence rate of psychiatric problems based on the GSI cut-off point (>63) of SCL-90-R was about 51 %, and interpersonal sensitivity and psychosis were the highest and lowest endorsed syndromes among the subjects, respectively. Openness had the lowest mean score; agreeableness and extroversion had the highest mean. CONCLUSION: The current study shows that understanding and psychological evaluation prior to surgery is necessary and screening can reduce the number of unnecessary surgeries and may enhance satisfaction with surgical results. LEVEL OF EVIDENCE IV: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.

The relationship between lifetime suicide attempts, serum lipid levels, and metabolic syndrome in patients with bipolar disorders.

OBJECTIVES: To assess the relationship between lifetime suicide attempts (SAs), serum lipid values, and metabolic syndrome (MetS) in patients with bipolar disorders (BPD). METHODS: Eighty patients with BPD took part in the study (M = 40.60 years). After psychiatric diagnosis, demographic data, SAs, and serum lipids were measured and MetS was calculated. RESULTS: 70% reported at least one suicide attempt. 52.5% suffered from MetS. Suicide attempters had higher cholesterol values. SAs were associated with a family history of suicide, current mood state, and lower educational level. SAs were unrelated to MetS. CONCLUSIONS: In patients with BPD, against expectations, the occurrence of SAs was associated with higher cholesterol values. Serum lipid values are not suitable as a biological trait marker to predict SAs.

Randomized controlled trial of aripiprazole versus risperidone for the treatment of amphetamine-induced psychosis.

BACKGROUND: Lifetime prevalence of amphetamine-induced psychotic disorder is reported as being up to 23% for methamphetamine (MA) abusers. Approximately 25% of those with a baseline DSM-IV diagnosis of substance-induced psychosis are diagnosed with primary psychosis at one-year follow-up. Evidence on the treatment of amphetamine psychosis is very limited. OBJECTIVES: To investigate the efficacy of risperidone versus aripiprazole in treatment of amphetamine-induced psychotic symptoms. METHODS: In a double-blind study, 45 participants were randomly allocated to either aripiprazole 15 mg or risperidone 4 mg daily over a six-week trial. Positive and negative symptoms of psychosis were assessed using the Scale for Assessment of Negative Symptoms (SANS) and the Scale for Assessment of Positive Symptoms (SAPS) at baseline and completion of the trial. RESULTS: SANS and SAPS scores decreased significantly in both groups. Mean SAPS score reduction in risperidone and aripiprazole group was 16.20 and 10.80, respectively, after trial course (p < 0.001). Mean SANS score reduction in risperidone and aripiprazole group was 9.35 and 11.25, respectively (p = 0.08). CONCLUSIONS: Both aripiprazole and risperidone were effective for patients diagnosed with amphetamine-induced psychotic disorder. However, risperidone had the greater effect on positive psychotic symptoms while patients with negative symptoms may respond better to aripiprazole. There is a case for further studies evaluating the efficacy of atypical antipsychotics in this disorder.

The prevalence of alcohol consumption and its related factors in adolescents: Findings from Global School-based Student Health Survey.

BACKGROUND: Alcohol consumption has become very common among adolescents in recent years and its prevalence varies in different countries. This study aimed to investigate the prevalence of alcohol consumption and related factors in adolescents aged 11 to 16 years. METHODS: This descriptive cross-sectional study was performed on 288385 adolescents (girls, 53.9% of total) aged 11 to 16 years. In the present study, the GSHS data (2003-2018) available to public on the websites of the US Centers for Disease Control and Prevention (CDC) and WHO was used. To investigate the factors affecting alcohol consumption, univariate and multivariate logistics models with 95% confidence limits were used. RESULTS: The overall prevalence of alcohol consumption in adolescents was 25.2%, which was 28.3% and 22.4% in boys and girls, respectively. Among the surveyed countries, the highest prevalence was in Seychelles (57.9%) and the lowest in Tajikistan (0.7). Multivariate analysis showed that the Age for 16 and more than 16 years old (OR = 3.08,95%CI: 2.54-3.74), truancy for more than 10 days (OR = 1.24, 95%CI: 1.08-1.43), loneliness at sometimes of the times (OR = 1.04, 95%CI: 1.01-1.07), insomnia at most of the times (OR = 1.85, 95%CI: 1.70-2.01), daily activity (OR = 1.03, 95%CI: 1.00-1.07), bullied for 1-9 Days in a month (OR = 1.24, 95%CI: 1.09-1.40), cigarette (OR = 4.01, 95%CI: 3.86-4.17), used marijuana for more than 10 days in a month (OR = 5.58, 95%CI: 4.59-7.78), had sex (OR = 2.76, 95%CI: 2.68-2.84), and suicide plan (OR = 1.48, 95%CI: 1.42-1.54) were important factors affecting drinking alcohol. (Table 4). In this study, the sensitivity, specificity, positive predictive value, and negative predictive value were 42.79%, 93.96%, 70.80%, and 82.75. CONCLUSIONS: According to the results of the present study, the prevalence of alcohol consumption among teenagers was high. Therefore, it is suggested that demographic, family, and psychological factors should be taken into consideration in health programs for the prevention and treatment of alcohol consumption in adolescents.

Association Between Biological Lead Concentrations and Autism Spectrum Disorder (ASD) in Children: a Systematic Review and Meta-Analysis.

Studies have been conducted in different countries of the world to illustrate a link between autism spectrum disorder (ASD) and lead (Pb) in different specimens such as hair, blood, and urine. Therefore, we carried out a systematic review and meta-analysis to determine the association between Pb concentration in biological samples (blood, urine, and hair) and ASD in children through case-control and cross-sectional studies. In this systematic review, PubMed, Web of Sciences, Scopus, and Google Scholar were searched for relevant studies from January 2000 to February 2022. A random-effects model was used to pool the results. The effect sizes were standardized mean differences (proxied by Hedges' g) followed by a 95% confidence interval. Pooling data under the random effect model from blood and hair studies showed a significant difference between the children in the ASD group and the control group in blood lead level (Hedges' g: 1.21, 95% CI: 0.33-2.09, P = 0.01) and hair level (Hedges' g: 2.20, 95% CI: 0.56-3.85, P = 0.01). For urine studies, pooling data under the random effect model from eight studies indicated no significant difference between the children in the ASD group and control group in urinary lead level (Hedges' g: - 0.34, 95% CI: - 1.14,0.45, P = 0.40). Moreover, the funnel plot and the results of the Egger test for the blood and urine samples showed no publication bias, while, for the hair samples, the funnel plot illustrated the existence of publication bias.

Nomophobia (No Mobile Phone Phobia) and Psychological Health Issues among Young Adult Students.

BACKGROUND: Smart phone use has become a part of people's everyday life. However, when the lack of using the smart phone to establish and maintain electronic communication is related to psychological distress, such a behavior may be considered a modern-age phobia, or nomophobia (no mobile phone phobia). The aims of the present study were to investigate among a sample of young adults the associations between scores for nomophobia and symptoms of depression, anxiety, stress, insomnia, and obsessive-compulsive disorders. METHODS: A total of 537 students (mean age: 25.52 years; 42.3% females) participated in the study. They completed a booklet of self-rating questionnaires covering sociodemographic information and symptoms of nomophobia, depression, anxiety, stress, insomnia, and obsessive-compulsive disorders. RESULTS: Higher scores for nomophobia were associated with higher scores for depression, anxiety, and stress, but not with scores for insomnia and obsessive-compulsive disorders. The regression model confirmed that symptoms of anxiety predicted nomophobia. CONCLUSIONS: The present results support the assumption that nomophobia appears to be a mood disturbance related to stronger associations with symptoms of anxiety and, to a lesser extent, with symptoms of depression and stress. By contrast, nomophobia appeared to be unrelated to insomnia and symptoms of obsessive-compulsive disorders.

Evaluation of some toxic metals in breast milk samples with dietary and sociodemographic characteristics: a case study of Kermanshah, Western Iran.

This study aimed to investigate the concentration of some toxic metals (gold (Au), cadmium (Cd), chromium (Cr), mercury (Hg), nickel (Ni), lead (Pb), tin (Sn), and vanadium (V)) and arsenic (As) in breast milk based on demographic characteristics and the diet of mothers. In this cross-sectional study, 100 lactating mothers from Kermanshah, Western Iran, were included. The mean age of the participants was 29.5 (ranging from 16 to 43 years) with a mean BMI of 26.9 (± 3.81) kg (range: 17.0-39.1). The results of the pairwise correlation coefficient of trace elements illustrated that correlation was mostly positive and weak to moderate. A few exceptions of strong correlations were Cr-Ni (r = 0.82), Au-As (r = 0.64), Cr-V (r = 0.64), and Ni-V (r = 0.58). Moreover, results indicated that BMI (p = 0.008), cooking oil (0.042), and potato intake (p = 0.010) affected the trace element levels significantly. The concentrations of V (p = 0.044), Sn (p = 0.036), Au (p < 0.001), and As (p < 0.001) in the breast milk of women was affected by the BMI. The results of univariate linear regression analysis showed that the concentration of Pb in the milk of mothers who use cosmetics was significant (p < 0.05). Since the lifestyle of lactating women, such as cosmetics usage can impact the content of some elements in breast milk, they should be educated in this part.

Maternal sleep deprivation affects extinction and reinstatement of methamphetamine reward memory in male offspring: Role of the D1-like and D2-like dopamine receptors.

Maternal sleep-deprivation (MSD) has been shown to induce stress, hyperactivity, and risk taking behavior in the offspring; howbeit, it is not yet clear whether it may also affect vulnerability to psychostimulant abuse in the offspring. We aimed to determine whether MSD affects extinction and reinstatement of methamphetamine (METH) reward memory in the offspring and also to evaluate the possible role of dopamine D1-like and D2-like receptors in these processes. Thirty-day-old male offspring born to control and sleep-deprived dams (during the third week of pregnancy) were trained to acquire METH-induced place preference (2 mg/kg., i.p.). METH reward memory was then reinstated following an 8-day period of extinction. The offspring received SCH 23390 (0.03 or 0.1 mg/kg, i.p.) or sulpiride (20 or 60 mg/kg, i.p.) as antagonists of dopamine D1-like and D2-like receptors, respectively, either immediately after each daily extinction session or prior to the reinstatement session. MSD postponed METH extinction and facilitated METH reinstatement in the offspring. SCH 23390 facilitated METH extinction and decreased reinstatement of the extinguished METH preference. Sulpiride in the offspring from sleep-deprived dams facilitated METH extinction, but it did not affect reinstatement of the extinguished METH reward memory. It seems that MSD may enhance vulnerability to METH abuse in the offspring. Furthermore, both dopamine D1-like and D2-like receptors may mediate METH extinction in the offspring born to the sleep-deprived dams; however, only the dopamine D1 receptor may play an important role in reinstating the extinguished METH reward memory in the offspring.

REM sleep deprivation before extinction or reinstatement alters methamphetamine reward memory via D1-like dopamine receptors.

We aimed to determine whether REM sleep deprivation (RSD) affects extinction and reinstatement of methamphetamine (METH) reward memory in male rats and also to evaluate the possible role of dopamine D1-like and D2-like dopamine (DA) receptors in these processes. Male rats were trained to acquire METH-induced place preference (2 mg/kg, i.p.). METH reward memory was then reinstated following a 10-day extinction period. The animals underwent a 72-hour sleep deprivation episode by multiple platforms method (in separate groups), either before the extraction or before the reinstatement of METH reward memory. The animals received SCH 23390 (0.01 or 0.05 mg/kg, i.p.) or sulpiride (20 or 60 mg/kg, i.p.) as antagonists of D1-like and D2-like DA receptors, respectively, either immediately following each daily extinction session or before the reinstatement of METH-seeking behavior. The RSD episode postponed extinction and facilitated reinstatement of METH reward memory. Administration of SCH 23390, but not sulpiride, facilitated METH extinction and decreased reinstatement of the extinguished METH-seeking behavior. Moreover, locomotor activity was not affected by METH and/or the RSD paradigm. The results would seem to suggest that the D1-like, but not the D2-like, DA receptors may be involved in the extinction and reinstatement of the extinguished METH reward memory in RSD animals. Nonetheless, more investigations are needed to elucidate the exact mechanisms involved.

Comparison of urine trace element levels in tramadol addiction alone and its co-abuse with cigarette and opium in Western Iran.

Tramadol is an opioid pain medication used to treat moderate to severe pain. Tramadol consumers tend to co-abuse some other substances such as opium, cigarettes, alcohol, and cannabis and each of these substances may impair trace elements homeostasis in the body. Therefore, this case-control study aimed to compare the urinary concentration of some essential and toxic elements in tramadol addiction alone and its co-abuse with cigarette and opium in Western Iran. For this purpose, urine samples were collected in two groups of tramadol (n = 72) and control subjects (n = 62) from March to November 2020. The case group was divided into three groups: tramadol alone, tramadol + opium, and tramadol + cigarettes. Moreover, ICP-MS (Agilent 7900) was used to measure trace element concentrations in the urine samples. Based on our results, Fe was the only element markedly higher among controls as compared to tramadol users (p < 0.001). Moreover, the concentration levels of As appeared to be the same among both groups, but the levels of other elements including Ca, Cd, Cr, Mn, Cu, Zn, Co, Ni, Se, and Pb were all significantly higher among tramadol users as compared to control group. The rank-based regression analysis illustrated that no contribution of sex and age effect was found by the regression model on the levels of all 12 studied elements. While, smoking was found to affect the levels of Fe (ß = 0.163, P = 0.025) and Co (ß = 0.411, p < 0.001) so that smoking reduced Fe levels but elevated Co concentration levels. Abuse of tramadol along with cigarettes and opium increased the concentration of some heavy metals in urine samples compared to the control group. However, these results showed no significant effect of age, sex, smoking habit, and amount of tramadol usage on the levels of trace elements.

Multivariate statistical evaluation of heavy metals in the urine of opium individuals in comparison with healthy people in Western Iran.

The current study aimed to evaluate the levels of some toxic and essential elements (Pb, Cd, Cu, Ti, Ni, Cr, Co, Fe, Ca, Hg, Mn, Se, and Zn) in the urine of opium-addicted compared to non-addicted cases. In this study, 126 participants were recruited and their fasting urine samples were collected (63 opium-addicted and 63 non-addicted subjects served as the reference group). ICP-MS was utilized to detect the concentration of trace elements. Results exhibited that the concentration of all elements than Ni, Cu, and Zn was markedly different between the addicted and non-addicted groups. Compared to controls, the Cd, Cr, Co, Hg, Mn, Pb, Se, and Ti levels were higher among opium-addicted cases (p < 0.05) whereas the Fe and Ca concentrations were higher among controls (p < 0.05). Robust regression analysis showed no statistically significant effect of gender on element levels. It revealed that age was associated with the levels of Ni and Cu only and also the route of administration was related to the urinary levels of Co, Cr, Hg, and Mn. In conclusion, results confirmed that it is opium consumption that affects the concentration levels of most elements.

The prevalence of people who inject drugs among those with HIV late presentation: a meta-analysis.

BACKGROUND: One of the most important routes of HIV transmission is through injections of drugs, and this group, due to unawareness of their infection, causes the spread of HIV. The coexistence of other opportunistic infections and diseases with HIV among people who inject drugs (PWID) imposes healthcare costs and is associated with high morbidity/mortality rates. Early detection of HIV among PWID is essential to prevent and control the spread of the disease. OBJECTIVES: This study aimed to determine the prevalence of PWID among those with late presentation (LP). METHODS: Three electronic databases of PubMed, Scopus, and Web of science were searched using appropriate keywords. Besides the prevalence data reported for PWID among LP, the other outcomes of interest were LP defined as having CD4 count < 350 cells/µL or HIV or advanced disease defined with CD4 count < 200 cells/µL or HIV at the time of diagnosis. RESULTS: Of the 160 studies found, only eight met the inclusion criteria. Among those presented late, 36.5% were PWID (95% CI = 24.88-48.17). Compared with men who have sex with men (MSM), HIV-infected PWID had a higher risk of LP [OR = 1.51; 95% CI = 0.96-2.06]. CONCLUSION: The results of this study show that HIV is diagnosed late in the majority of PWID when CD4 is less than 350 cells/µL. Targeted interventions/strategies are highly required to reduce LP among HIV-infected PWID.

Risk-Taking Behavior among Suicide Attempters.

BACKGROUND: Suicidal behavior is a major mental health concern both for the individual and for the public health. Among others, suicidal behavior is associated with impulsivity, risk taking, pain tolerance, and a state of overarousal. In the present study, we investigated if suicide attempters (SAs) reported higher scores for risk-taking when compared with healthy controls (HC) of the general population. METHODS: A total of 616 individuals (mean age: 27.07 years; 51.5% females) took part in the study; of those, 240 (39%) were individuals with a suicide attempt (SA) within a time lapse of one to three months, and 376 (61%) were healthy controls (HC). Participants completed a series of self-rating questionnaires covering sociodemographic information, risk-taking (Risk-Taking Questionnaire 18; RT-18), and suicidal behavior (Suicide Behaviors Questionnaire-Revised; SBQ-R). RESULTS: Compared with HCs, individuals with SA reported higher risk-taking and suicidal behavior scores. The risk-taking questionnaire yielded a four-factor solution: Thrill and sensation seeking; Cautious procedure; Cautious decision making; Impulsive behavior. Compared with HCs, SAs showed the highest scores for thrill and sensation seeking and impulsive behavior. CONCLUSIONS: Compared with healthy controls, individuals reporting a recent suicide attempt also reported a higher propensity to thrill and sensation seeking and impulsive behavior as a proxy of risk-taking behavior. The present results corroborate the notion that, among others, suicide attempts appeared to be less related to premeditation, but rather to impulsive and thus spontaneous behavior.

The prevalence of obsessive-compulsive disorder in patients with irritable bowel syndrome: A cross-sectional study.

BACKGROUND: Irritable bowel syndrome (IBS) is one of the most common gastrointestinal diseases, and obsessive-compulsive disorder (OCD) is one of the main causes of this disease. The present study was aimed to investigate the prevalence of OCD in patients with IBS. MATERIALS AND METHODS: The present research is a cross-sectional survey study. The research sample included 120 patients with IBS who referred to Imam Reza Hospital and gastrointestinal clinics in Kermanshah (Iran) in the 3 months of April, May, July in 2019 that were selected using the census sampling method, and demographic information, clinical and medical records were collected. Data analysis was performed using frequency, percentage, and Chi-square. RESULTS: Among the patients who were studied, 58 of them (48.3%) were women and 62 (51.7%) were men, the results showed that the prevalence of OCD in patients with IBS was 14.96 and the symptoms of washing, checking, skepticism and slowness-repetition had the highest prevalence, respectively. These symptoms were more common in women than in men. There was also a significant relation between OCD prevalence in patients with IBS and with female gender, age-range 30-21 years, single, and history of OCD in the patient's immediate family and close relatives (P < 0.05), but there was no significant relationship between OCD prevalence in patients with IBS and level of education, occupation, income status, and place of residence. CONCLUSION: Due to the high prevalence of OCD in patients with IBS, the interaction of gastroenterologists and psychiatrists to treat irritable bowel syndrome is very important.

Recurrent Events Model Application in Determining the Risk Factors of Bipolar Disorder Recurrence.

Objective: Recurrent events data is one of the most important types of survival data whose main feature is correlation between individual's observations. The aim of this study was to analyze the time to bipolar disorder (BD) relapse and determine the related factors using recurrent events models. Method : In this retrospective study, records of 104 BD patients with at least one relapse who were admitted for the first time (2001-2015) in Farabi hospital of Kermanshah were gathered to identify the factors influencing the time intervals between the recurrent survivals data using the Cox model with and without frailty (shared frailty), once with frailty gamma distribution and once with log-normal distribution frailty. All calculations were performed using R and SPSS software, versions 3.0.2 and 16 and the level of significance was considered at 0.05. Results: Among the employed models, Cox model with lognormal shared frailty showed better fit for BD recurrent survival data. According to results of Cox model with lognormal frailty, 2 factors (marital status and history of veteran) were identified to affect the time intervals between relapses. Conclusion: Because of the better fit of the models with the frailty effect on data, the correlation between the recurrent time intervals of each subject's relapse of BD was confirmed. Also, since the risk of subsequent relapses was less in married and veteran patients, marriage and emotional care supports can be considered as effective factors in reducing the risk of subsequent relapses of this disease.