The efficacy and safety of adding celecoxib to escitalopram for improving symptoms of major depressive disorder.

OBJECTIVE: There is growing evidence that adding non-steroidal anti-inflammatory drugs to some psychopharmacological treatments may help to improve symptoms in patients suffering from major depressive disorder. The present study examined the therapeutic efficacy of adding celecoxib to Ecitalopram and the safety of doing so. METHOD: In this double-blind randomized controlled trial, 60 patients with major depressive disorder were randomly assigned to either treatment with Ecitalopram plus celecoxib (intervention group) or Ecitalopram and placebo. All patients were evaluated blind to treatment group with the Hamilton Depression Rating Scale (HDRS) before the intervention as well at 4 and 8 weeks after initiating treatment. Chi-square and paired t-test were used to examine between-group differences at those assessment times. RESULTS: There was no significant difference in depressive symptoms between intervention and placebo groups at baseline. However, at 4 and 8 weeks after the beginning of treatment, there were significant between-group differences in HDRS scores, favoring the intervention group. No between-group differences were found in treatment-related side effects. CONCLUSIONS: Adding celecoxib to Ecitalopram may effectively improve symptoms of depression in patients suffering major depressive disorder without increasing the risk of drug-related side effects.

The association between major dietary patterns and severe mental disorders symptoms among a large sample of adults living in central Iran: Baseline data of YaHS-TAMYZ cohort study.

BACKGROUND: The diet's role in developing psychological disorders has been considered by researchers in recent years. OBJECTIVE: To examine the association between major dietary patterns and severe mental disorders symptoms in a large sample of adults living in Yazd city, central Iran. METHODS: This cross-sectional study used the baseline data of a population-based cohort study (Yazd Health study: YaHS). Dietary intakes were assessed by a multiple-choice semi-quantitative food frequency questionnaire (FFQ, Yazd nutrition survey called TAMYZ). Psychological assessments were also done by using the depression, anxiety, and stress scale-21 (DASS-21) questionnaire. Major dietary patterns were identified using principal component analysis (PCA). Analysis of covariance (ANCOVA) and logistic regression analyses were used to evaluate the relationship between dietary patterns and mental disorders symptoms. RESULTS: A total of 7574 adults were included in the current analysis. Four major dietary patterns were identified: "Sugar and Fats", "Processed Meats and Fish", "Fruits" and "Vegetables and Red Meat". After adjustment for all confounding variables, participants in the fifth quintile of "Fruits" dietary pattern which was highly correlated with dried fruits, canned fruits, fruit juice, olive, hydrogenated fats and fruits intake, had a lower odds of severe depression (OR=0.61, 95% CI: 0.45-0.81, p for trend=0.057), anxiety (OR=0.64, 95% CI: 0.50-0.80, p for trend=0.007), and stress, (OR=0.45, 95% CI: 0.30-0.68, p for trend=0.081). CONCLUSIONS: The intake of a dietary pattern high in dried fruits, canned fruits, fruit juice, olive, hydrogenated fats, and fruits might be inversely associated with depression, anxiety, and stress symptoms. Future prospective studies are needed to warrant this finding.

The effect of dietary approaches to stop hypertension (DASH) diet on attention-deficit hyperactivity disorder (ADHD) symptoms: a randomized controlled clinical trial.

BACKGROUND: The dietary approaches to stop hypertension (DASH) diet have several components like high amounts of fruits, vegetables, low-fat dairy products, and vitamin C and low amounts of simple sugars that might improve attention-deficit hyperactivity disorder (ADHD) symptoms. We aimed to investigate the effect of a DASH diet on children (aged 6-12 years) with ADHD, for the first time. METHODS: Participants were randomized to receive a DASH or a control diet for 12 weeks. The severity of ADHD symptoms [determined by abbreviated 10-item Conner's scale (ACS), 18-item Swanson, Nolan and Pelham (SNAP-IV) scale and strengths and difficulties questionnaire (SDQ)] were assessed every four weeks. RESULTS: Eighty children completed the study. After adjustment for confounders, parent (- 4.71 for the DASH group vs. - 3 for the control group) and teacher-reported (- 5.35 vs. - 1.87) ACS scores, parent-, teacher-, child-reported hyperactivity (- 1.40 vs. - 0.66, - 1.95 vs. -0.63, - 1.60 vs. - 0.43, respectively), emotional symptoms (- 1.50 vs. - 0.45, - 1.42 vs. - 0.63, and - 1.09 vs. - 0.61, respectively), and total SDQ scores (- 3.81 vs. - 1.65, - 4.11 vs. - 1.23, - 4.44 vs. - 1.26, respectively), teacher-reported of conduct problems (- 1.42 vs. - 0.63), peer relationship problems (- 0.87 vs. - 0.07), and prosocial behaviors (1.36 vs. 0.08) assessed by the SDQ were significantly improved in the DASH group compared with the control group (P < 0.05). CONCLUSION: Adherence to a DASH-style diet might improve ADHD symptoms. Further RCTs which include participants from both sexes and with longer follow-up periods are needed to warrant current findings (The trial registration code: IRCT20130223012571N6; http://irct.ir/trial/12623 ). Trial registration Trial registration number: The trial was registered in the Iranian registry of clinical trials (registration code: IRCT20130223012571N6), URL: http://irct.ir/trial/12623 .

Fear of abortion and emotional divorce in women with minor thalassemia: a population-based study in Yazd, Iran.

BACKGROUND: Thalassemia is the most common genetic disorder in humans that can be controlled and treated by, premarital screening, prenatal diagnosis and abortion. Aortion can be a critical issue for many families based on the cultural and religious backgrounds and have different consequences for couples, such as emotional divorce. Therefore, the present study aimed to investigate the association between fear of abortion and emotional divorce in women with minor thalassemia in Yazd City, Iran. MATERIALS AND METHODS: This retrospective study was conducted on 61 women with minor thalassemia (case group) and 100 healthy women (control group), who referred to health centers in Yazd. The census sampling was applied to select the case group and multistage (cluster andsimple) random sampling was adopted to select the control group. Data were collected using Gutman Emotional Divorce Questionnaire and a researcher made scale for measuring fear of Abortion. Data were analyzed by SPSS using descriptive statistics and chi-square, independent t-test, Pearson correlation, and linear regression. RESULTS: The mean scores of emotional divorce (6.62 vs. 4.26) and fear of abortion (25.85 vs. 17.4) were higher in the case than control group (P ˂ 0.01). There was a positive and significant correlation between fear of abortion and emotional divorce in the case (P ˂ 0.05, r = 0.275) and control (P ˂ 0.05, r = 0.570) groups. Fear of abortion in the case group predicted 25% of the variance in emotional divorce. CONCLUSION: Given the high level of fear of abortion in women with minor thalassemia and its effect on increasing the emotional divorce, designing and implementing psychological interventions with ongoing follow-up are recommended for thalassemia carrier couples.

Hookah is the enemy of health campaign: a campaign for prevention of hookah smoking among youth.

Hookah smoking is now a serious health threat especially for adolescents. Implementation of planned interventions can help reduce hookah smoking. This study was conducted to investigate the effect of a campaign Hookah is the Enemy of Health Campaign (HEHC) based on the protection motivation theory to prevent hookah smoking among the youth in Sirjan city, in 2018. This was a pre- and post-intervention study. Participants were 280 male and female youth who were selected randomly through the health centers of Sirjan. The educational campaign was conducted during 3 months and participants were trained through interpersonal, group, organizational and community channels and mass media. Data were collected by filling out a questionnaire (containing 64 questions) by the participant before the intervention and 3 months after. Data were analyzed by descriptive statistics (frequency and percentage), chi-square and Wilcoxon signed-rank test by SPSS20 software. The prevalence of hookah smoking was 44.3% in the target group. There was a significant change in the mean scores of knowledge and perceived susceptibility, perceived severity, response efficiency, self-efficacy, rewards, fear and protection motivation after the HEHC (p < 0.05), but there was no significant difference in the structure of perceived cost (p > 0.05). Also, the prevalence of hookah smoking among the target group for those who had ever consumed decreased from 8.9 to 4% and for those who used it occasionally decreased from 35 to 19.4%. The HEHC was effective in reducing hookah smoking, raising knowledge and improving the constructs of the protection motivation theory among the youth of Sirjan.

Prevalence of complicated grief and related factors in elderly individuals in Sabzevar City, Iran.

AIM: Although often undiagnosed and untreated, prolonged grief and its conversion to complicated grief (CG) can lead to functional impairment. Given the impact of CG on mortality and quality of life in elderly individuals, this study aimed to determine the prevalence of CG and its related factors among the elderly in the city of Sabzevar in Iran. METHODS: The subjects of this cross-sectional study were elderly individuals aged 60 years and older who lived Sabzevar in 2019. Participants were randomly selected in two stages. First, the grief experience of 823 elderly individuals was investigated. Second, the 247 individuals who met the inclusion criteria and had experienced grief were assessed for CG. Data were collected with a demographic information questionnaire, the Brief Grief Questionnaire, and the Geriatric Depression Scale. RESULTS: The prevalence of CG among the participants who had experienced grief was 18.6%. Significant differences in CG prevalence were observed among participants according to age, gender, marital status, occupation, and relationship to the deceased person (P < 0.05). The prevalence of CG was also significantly associated with the deceased person's age, gender, and cause of death; the participant being the deceased's primary caregiver and the participant being with the deceased at the time of death(P < 0.05). Furthermore, CG was significantly higher in people with mild or severe depression than in non-depressed participants (P = 0.01). The odds of CG and sub-threshold CG incidence were 2.94 times higher in women than in men and 3.64 times higher in participants with severe depression than in non-depressed participants. CONCLUSION: Complicated grief is relatively prevalent among the elderly, and it is associated with age, gender, marital status, depression status, and some variables related to the deat time of the deceased. Given the negative effects of CG on individuals and the community, appropriate planning is needed to reduce its incidence in elderly individuals who have experienced grief.

Impact of opium dependency on clinical and neuropsychological indices of multiple sclerosis patients.

The aim of this study was to determine the effect of opium on clinical and neuropsychological parameters in multiple sclerosis (MS) patients with substance dependency. A cross-sectional study was conducted on MS patients in Rafsanjan, Iran. Forty opium-addict MS patients (10 males and 30 females) aged between 18 and 50 years were compared with 40 MS patients with no addiction. Word-Pair Learning, Mini-Mental State Examination (MMSE), Wisconsin Card-Sorting Test (WCST), Depression, Anxiety, Expanded Disability Status Scale (EDSS), Fatigue, and the Multiple Sclerosis Functional Composite (MSFC) were measured and compared in the two groups. The comparison of two groups showed a significant increase trait anxiety (P < 0.001), fatigue (P = 0.009) and significant decrease in the executive function (P = 0.003), MMSE (P = 0.003), and working memory (P < 0.001) in addicted MS. It indicates the better efficiency of processing in the non-addicted MS patients. The MSFC z-score also was significantly higher in the non-addicted group (P < 0.001). The opium addiction has a negative impact on the clinical and neuropsychological outcome in MS patients.

Aloysia citriodora Palau (lemon verbena) for insomnia patients: A randomized, double-blind, placebo-controlled clinical trial of efficacy and safety.

Aloysia citriodora (A. citriodora) has a long history of traditional use for sedation and treatment of insomnia in different societies. This study was carried out to assess the efficacy of A. citriodora in patients with insomnia. One hundred patients were randomly divided into two groups of A. citriodora (total essential oil 1.66 mg/10 ml and total amount of flavonoid in terms of quercetin 3.22 mg/10 ml of the syrup) and placebo. They were advised to use 10 cc of the syrups; an hour before the bedtime for a period of 4 weeks. Participants were assessed using Pittsburgh Sleep Quality Index (PSQI) and Insomnia Severity Index (ISI) questionnaires at the baseline and then 2 and 4 weeks after the enrollment. Mean scores of global PSQI and its four components including sleep latency, habitual sleep efficiency, daytime dysfunction, and subjective sleep quality and also ISI score in the A. citriodora group improved significantly after 4 weeks of treatment when compared with the placebo group (p < 0.001, for all of them). Also, improvement of global score of PSQI and ISI was observed in the intervention group as compared with the placebo group, 2 weeks after the enrollment (p < 0.001). The results of this study showed that oral intake of A. citriodora can be suggested as a complementary treatment for patients with insomnia.

Anxiety leads to up-regulation of CD36 on the monocytes of chronic hepatitis B-infected patients.

Introduction It has been hypothesized that mental disorders including depression and anxiety can affect immune responses. The study was done to evaluate the relation between depression and anxiety and expression levels of CD36, CD68, and CD9 on peripheral blood monocytes of chronic hepatitis B (CHB) patients. Methods Sixty CHB patients were selected with various ranges of depression and anxiety. Depression and anxiety were evaluated using a standard questionnaire by an expert psychiatrist according to BECK's Depression Inventory II and Hamilton Anxiety Rating Scale, respectively. The levels of CD36, CD68, and CD9 on the peripheral blood monocytes have been performed using flow cytometry technique. Results The results demonstrated that levels of CD36 were significantly increased on the peripheral blood monocytes of CHB patients when compared with CHB patients with no anxiety. Expression levels of CD68 and CD9 were not significantly altered on the CHB patients with various ranges of anxiety. Expression levels of CD36, CD68, and CD9 were also not significantly altered on the CHB patients with various ranges of depression. Discussion It seems that anxiety induces inflammation in the CHB patients by induction of alteration in several molecules including up-regulation of CD36. CD36 plays important roles in the induction of tissue damage; hence, it may be hypothesized that anxiety may participate in the induction of some hepatitis B complications.

ASC provides a potential link between depression and inflammatory disorders: A clinical study of depressed Iranian medical students.

Background and aims AIM2 is a component of inflammasomes which can activate caspase-1 via an adaptor protein (ASC) after pathogen-associated molecular pattern (PAMP) or danger-associated molecular pattern (DAMP) recognition. Activation of caspase-1 is a trigger for the induction of IL-1 and IL-18 which are important pro-inflammatory cytokines. Furthermore, IL-1ß, which can regulate inflammatory responses, has also been associated with depression. Previous studies revealed that patients suffering from depression may also have altered immune responses, but the mechanisms underlying this correlation are unclear. Thus, the aim of this study was to determine the mRNA levels of AIM2 and ASC in the peripheral blood mononuclear cells (PBMCs) isolated from Iranian medical students suffering from depression. Materials and methods The participants used for the study included 38 Iranian medical students diagnosed with depression and 43 non-depressed students as a control group. The mRNA levels of AIM2 and ASC were evaluated by quantitative real-time polymerase chain reaction (PCR) using ß-actin as a housekeeping gene for the normalization of expression. Results The results showed that mRNA levels of AIM2 were similar in both groups. However, ASC levels were significantly increased in PBMCs isolated from individuals with elevated depressive symptoms when compared to non-depressed participants. Conclusions Based on the current results, it appears that ASC transcript expression may be a surrogate marker for depression and may represent a link between depression and the altered immune responses observed in these categories of individuals with elevated depressive symptoms.

The Attitude of Medical Students Toward Death: A Cross-Sectional Study in Rafsanjan.

AIM: Attitude toward death is one of the most important factors that can influence the behavior related to the health profession. It is thought that physicians are afraid of death more than other groups of specialist. Therefore, this study aimed to evaluate the attitudes of the medical students of Rafsanjan University of Medical Sciences toward death. MATERIALS AND METHODS: This study is a cross-sectional study on 308 medical students of Rafsanjan University of Medical Sciences in the academic year of 2015. Attitudes were assessed through the questionnaire of death attitude profile-revised. The collected data were analyzed upon arrival to a computer with SPSS version 14, and descriptive and inferential statistical methods. RESULTS: Attitude toward death was investigated in the 5 dimensions including the fear of death, death avoidance, approach acceptance, neutral acceptance, and escape acceptance. The results showed that the mean and standard deviations of fear of death, death avoidance, natural acceptance, approach acceptance, and escape acceptance were 3.76 ± 1.15, 3.54 ± 1.33, 5.14 ± 0.86, 4.66 ± 0.95, and 3.73 ± 1.25, respectively. It was found that people who have had the experience in dealing with death had less escape of the death attitude. CONCLUSION: Totally, the results of this study demonstrated that the medical students had good attitudes through 5 dimensions of attitudes toward death. This is probably due to the religious beliefs and also dealing with dying patients. However, it is recommended that training programs should be provided for students in the field of attitudes toward death.

Comparative efficacy of methylphenidate and atomoxetine in the treatment of attention deficit hyperactivity disorder in children and adolescents: A systematic review and meta-analysis.

BACKGROUND: The aim of this study was to directly compare efficacy of atomoxetine and methylphenidate in treatment of children and adolescents 6- 18 years. METHODS: All published, randomized, open label or double blind trials, comparing the efficacy of methylphenidate with atomoxetine in treatment of children diagnosed with ADHD, using DSM-IV criteria were included in this study; ADHD Rating Scale-IV-Parent Version: Investigator Administered and Scored (ADHDRS) scores was used. The standardized mean difference (SMD) was used as a measure of effect size. RESULTS: Eleven studies were included with a total of 2,772 participants. The meta-analysis did not find a significant difference in the efficacy between methylphenidate and atomoxetine (SMD= 0.09, 95% CI -0.06, 0.25) (Z= 1.18, p= 0.24). Sub group analysis showed a significant standardized mean difference favoring OROS methylphenidate (SMD= 0.31, 95% CI 0.16, 0.47 (Z= 3.91, p< 0.0001); immediate release methylphenidate was not superior to atomoxetine (SMD= -0.05, 95% CI -0.20, 0.10) (Z= 0.68, p= 0.49). Open label trials did not make a difference in the standardized mean difference (SMD= 0.10, 95% CI -0.02, 0.23) (Z= 1.17, p= 0.09). There was significant heterogeneity among the studies (p= 0.003, I2= 63%). Subgroup analysis demonstrated that heterogeneity was because of the open label trials (p= 0.009, I2= 79%). CONCLUSION: Atomoxetine and methylphenidate showed comparable efficacy in the treatment of children and adolescents with ADHD. However, Osmotic (Controlled) Release Oral (Delivery) System (OROS) methylphenidate is more effective than atomoxetine in treatment of ADHD in children and adolescents that is suggested as a first-line treatment in ADHD. Moreover, comparing the immediate release (IR) methylphenidate to atomoxetine did not lead to the benefit of IR methylphenidate.

The effect of depression and anxiety on expression levels of toll like receptor signaling molecules in chronic HBV infected patients.

BACKGROUND: Toll- like receptors (TLRs) play an important role in the recognition of DAMPs and PAMPs and induction of inflammation. Previous studies demonstrated that depression and anxiety can influence the expression levels of immune related molecules. Our previous study revealed that mRNA levels of IRAKIRAK4, TRAF3 and IRF7 were significantly decreased in chronic HBV infected (CHB) patients when compared to healthy controls. Therefore, the aim of this study was to evaluate the effects of depression and anxiety on the expression levels of these molecules in CHB patients. METHODS: Sixty CHB patients participated in this study and filled out the standard questionnaires; and the expression of IRAK4, TRAF3 and IRF7 were examined using Real-Time PCR techniques. RESULTS: The results of this study demonstrated that expression of IRAK4, TRAF3 and IRF7 did not differ between patients with various stages of depression and anxiety (all p>0.05). CONCLUSION: According to the results, it seems that declined expression of IRAK4, TRAF3 and IRF7 in CHB patients were not related to depression and anxiety, and other factors including genetic and immunoregulatory effects of HBV may be responsible for the declined expression of these molecules.

The adapter proteins of TLRs, TRIF and MYD88, are upregulated in depressed individuals.

BACKGROUND AND AIMS: TRIF and MYD88 are intracellular adaptor proteins for TLR signaling, and altered expression of these molecules can lead to defective or unregulated immune responses. Furthermore, previous studies revealed that depression may alter immune responses, but its mechanisms of action are unclear yet. There is a possibility that immunity and depression are linked through molecules such as TRIF and MYD88, thus, the aim of this study was to evaluate the mRNA levels of TRIF and MYD88 in the PBMCs isolated from depressed medical students. MATERIAL AND METHODS: The current study examined 38 depressed medical students studying in Iran and 43 healthy students from the same cohort as a control group. The mRNA levels of TRIF and MYD88 were examined in parallel with a housekeeping gene using real-time PCR. RESULTS: Our results demonstrated that expression of TRIF and MYD88 were significantly elevated in PBMCs isolated from depressed patients when compared to healthy subjects. CONCLUSIONS: Based on the current results, it seems that chronic inflammation in depressed patients correlates to the over expression of TRIF and MYD88 genes. Our results show a possible link between the reported increases of chronic inflammation in depressed individuals with unbalanced expression of genes that regulate immunity.

Metabolic syndrome: a population-based study of prevalence and risk factors.

The association between personal habits and metabolic syndrome (MetS) remains controversial. This study aimed to assess the prevalence of MetS among youths and its association with cigarette, tobacco, opium, and alcohol consumption in the Rafsanjan Youth Cohort Study (RYCS). The current cross-sectional study was based on data from RYCS, as part of the Rafsanjan Cohort Study (RCS). RCS is a branch of the prospective epidemiological research studies in Iran (PERSIAN). In the present study, 2843 youths aged 15-35 were included. MetS was diagnosed using the international diabetes federation (International IDF), National Cholesterol Education Panel- Adult Treatment Panel III (NCEP-ATPIII), and Iranian criteria (IDF Iranian). Binary logistic regression models were performed to estimate odds ratios (ORs) and confidence intervals (CIs). The prevalence of MetS was 7.67%, 7.14%, and 10.13% based on NCEP-ATPIII, IDF Iranian, and International IDF criteria respectively. The odds of MetS according to international IDF and Iranian IDF in the alcohol-drinking group in the last 12 months (OR: 1.51, 95%CI 1.02-2.21, OR: 1.66, 95%CI 1.11-2.48 respectively) were greater compared with the non-drinking group. The odds of having high TG in the alcohol-drinking group in the last 12 months was 1.53 times higher than the control group (OR = 1.53, 95% CI: 1.20-1.94). Furthermore, the odds of having high waist circumference (WC) according to IDF International was significantly higher in the tobacco-smoking group in the last 12 months and in the tobacco-smoking group in the last 12 months daily (OR: 1.23, 95%CI 1.01-1.49 and OR: 1.41, 95%CI 1.01-1.98 respectively) compared to the control groups. The prevalence of MetS was 7.67%, 7.14%, and 10.13% based on NCEP-ATPIII, IDF Iranian, and International IDF criteria respectively. The odds of MetS and high TG were greater in the alcohol-drinking group in the last 12 months compared with the non-drinking group. The odds of high WC in the last 12 months, were greater in the tobacco-smoking group compared with the non-smoking group. However, more longitudinal studies are needed to verify the associations observed in the current study.

Defective NF-kB transcription factor as the mediator of inflammatory responses: a study on depressed Iranian medical students.

BACKGROUND: NF-kB is a transcription factor that is a downstream target of several cell signaling systems including TLRs. Defective expression of the molecule can lead to inappropriate immune responses. Previous studies revealed that depression can affect immune responses, but its molecular mechanisms are yet to be fully understood. Thus, the main aim of this study was to identify if mRNA levels of NF-kB are changed in the PBMCs isolated from Iranian depressed medical students. METHODS: This cross-sectional study was done on 38 Iranian depressed medical students and 43 healthy students as a control group. The mRNA levels of NF-kB were assessed in parallel with beta-actin (as the housekeeping gene) using Real-Time PCR technique. RESULTS: Our results showed that mRNA levels of NF-kB were significantly decreased in isolated PBMCs from depressed patients compared to healthy controls. CONCLUSIONS: According to the results obtained in the present study, it seems that depressed patients are unable to appropriately express NF-kB at mRNA levels which may in turn lead to defective molecule expression.

Sprengel deformity and Klippel-Feil syndrome leading to cervical myelopathy presentation in old age.

Klippel-Feil syndrome is a rare condition characterized by the congenital fusion of two of the seventh cervical vertebrae. A 50-year-old woman presented with a 2-year history of neck pain and ataxia for 1 year. She had not urinary incontinence. She was referred to a neurosurgeon by a neurologist because of her progressive gait ataxia. Risk for brachial plexus injury because of compression or stretching by the clavicle accelerate with age. Therefore, the surgical approach of adults' patients with Sprengel's deformity can intend suitable surgical conclusions.

Gut Microbiota and Neuropsychiatric Disorders.

Numerous studies in humans and animals hypothesize that gut microbiota dysbiosis is involved in the development of behavioral and neurological diseases such as depression, autism spectrum disorder, Parkinson disease, multiple sclerosis, stroke and Alzheimer's disease. Some of the most salient works so far regarding the brain-gut axis are mentioned below. The current knowledge on the impact of gut microbiota on nervous system diseases is far from being directly used for pharmacologic or nutritional advice toward restoration of normal bodily functions. It seems that a more comprehensive approach should be followed so that the individual effect of each kind of intervention on the patient's somatic or psychological status is determined. Future research must address global need for regimens which could reestablish normal composition of gut microorganisms after each neuropsychological disorder.

Assessment of stress in patients with suicide attempts referred to the Emergency Poisoning Unit of Yazd in 2016.

Objective: Stress and life changes such as ageing, spouse's death, divorce, marriage, job loss, retirement, illness, interpersonal relationships and a history of suicide ideation or attempt may be considered risk factors for suicide attempts. This study aimed to investigate the relationship between stress and suicide. Design: Case-controlled and retrospective study. Participants: Patients referred to the Emergency Poisoning Unit of Yazd, were used as a case group and other admitted patients with various plans and etiologies were a control group, matched on age, gender, marital status and place of residence. Settings: Patients were asked to fill out a questionnaire including age, gender, economic status, marital status, place of residence, a background of suicide, and history of family members' suicide as well as the Holmes-Rahe scale. SPSS 16, chi-square and t-test were used for analyzing data. Results: Comparing the Holmes-Rahe stress scale's scores of the case group (312.9±84.60) and control group (224.62±85.57) showed a significant statistical difference (P<0.0001). Regarding stress intensity, the score in the case group showed 6% mild stress, 40% moderate stress, 54% severe stress, and in the control group, 13%, 61% and 26%, respectively. Holmes-Rahe stress scale score of stress intensity showed a significant statistical difference between groups (P<0.0001). Conclusion: The results of this study suggest that stress was associated with increased suicide attempts. Funding: None declared.