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BACKGROUND: Major depressive disorder is one of the most common psychiatric disorders, which is associated with a high disease burden. Current treatments using antidepressants have limitations, so using medication with neuromodulating and anti-inflammatory properties alongside them could be helpful. In a clinical trial, we studied the effectiveness of empagliflozin, a blood sugar-lowering drug, as an adjunctive therapy to reduce the severity of depression symptoms. METHODS: A number of outpatients with moderate to severe depression (Hamilton Depression Rating Scale (HDRS) > = 17) who were not under related medication or had not taken medication for at least the last two months, had an age range of 18-60 years and had written informed consent to enter the study (N = 90) were randomly divided into two groups receiving placebo or empagliflozin (10 mg daily) combined with citalopram (40 mg daily) based on permuted block randomization method in an 8-week randomized, double-blind, placebo-controlled clinical trial. They were evaluated using the HDRS in weeks 0, 4, and 8. RESULTS: HDRS scores were equal to 28.42(± 3.83), 20.20(± 3.82), and 13.42(± 3.42) in the placebo group during weeks 0,4, and 8, respectively. These scores were 27.36(± 3.77), 13.76(± 1.40), and 7.00(± 1.13), respectively, for the group treated with empagliflozin. Compared to the control group, patients treated with empagliflozin using repeated-measures ANOVA showed greater improvement in reducing the severity of depression symptoms over time (p value = 0.0001). CONCLUSIONS: Considering the promising findings in this clinical trial, further study of empagliflozin as adjunctive therapy in MDD with larger sample sizes and longer follow-ups is recommended.
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Compuestos de Bencidrilo , Citalopram , Trastorno Depresivo Mayor , Glucósidos , Humanos , Antidepresivos/uso terapéutico , Citalopram/uso terapéutico , Trastorno Depresivo Mayor/tratamiento farmacológico , Método Doble Ciego , Quimioterapia Combinada , Resultado del Tratamiento , Adolescente , Adulto Joven , Adulto , Persona de Mediana EdadRESUMEN
BACKGROUND: Attention Deficit Hyperactivity Disorder (ADHD) constitutes a prevalent behavioral problem. The present study examined the parent-child relationship model and investigated strategies to cope with behavioral problems in children with ADHD. METHODS: This descriptive study selected 300 children with ADHD using convenience sampling. The data collected using the child behavior checklist, the parent-child relationship scale (PCRS), the Billings and Moos Coping Checklist, the socioeconomic status questionnaire, the general health questionnaire-28 (GHQ-28) and a demographic checklist were analyzed in SPSS-25 and LISREL 8.8. RESULTS: According to the results of the path analysis on the relationship model among parent-child relationship domains, coping responses and children's behavioral problems, parent-child dependency domain (B = 0.22) in the direct path, disease duration (B = 0.085) in the indirect path, and conflicts in the domain of parent-child relationship (B = 0.366) in both direct and indirect paths had the most positive causal effect on behavioral problems. Furthermore, intimacy in the said domain (B = -0.42) had the most negative causal effect in both direct and indirect paths. The extent to which parents used coping responses via the direct path had a positive causal effect on behavioral problems (B = 0.12). Based on the path analysis test findings in the relationship model among positive parent-child relationship, coping responses and children's behavioral problems, the positive parent-child relationship score had the most negative causal effect via the direct path (B = -0.56). Conversely, the child's age had the highest positive causal effect via the indirect path (B = 0.1) on behavioral problems in children. CONCLUSION: Based on findings, there is a causal and significant relationship between the parent-child relationship and the extent to which coping responses are used. It is recommended that training programs be developed to strengthen communication skills, coping responses and problem-solving techniques in parents.
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Trastorno por Déficit de Atención con Hiperactividad , Problema de Conducta , Adaptación Psicológica , Humanos , Relaciones Padres-Hijo , Padres/educaciónRESUMEN
BACKGROUNDS: The study of the relationship between adult Attention deficit hyperactivity disorder (ADHD) and bipolar disorder has received more attention in recent years and there is limited information in this area. On the other hand, there is a significant comorbidity between ADHD and bipolar disorder with substance use disorder. In this study, we investigated the prevalence of comorbidity of adult ADHD and substance use disorder among a group of bipolar patients admitted to a psychiatric hospital. METHODS: One hundred fifty patients from a total of 200 consecutive patients who were referred to the emergency department of Roozbeh Psychiatric Hospital in Tehran, diagnosed with bipolar disorder based on the initial psychiatric interview and needed hospitalization, were evaluated again by an experienced faculty member psychiatrist by using a subsequent interview based on the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition(DSM-5). They were evaluated using the Structured Clinical Interview for DSM-5 (SCID-5) questionnaire to confirm the diagnosis of bipolar disorder and the comorbidity of adult ADHD and substance use disorder. RESULTS: From 150 patients diagnosed with bipolar disorder, 106 patients (70.7%) had adult ADHD. 89 patients (59.3%) had substance use disorder and 58 patients (38.7%) had both of these comorbidities with bipolar disorder. Comorbidity of adult ADHD was associated with the earlier onset of the first mood episode in bipolar disorder (p value = 0.025). There was no statistically significant relationship between substance use disorder and age of onset of the first episode. (P value = 0.57). CONCLUSIONS: Due to the limitations of studies on adult ADHD comorbidity with bipolar disorder, especially in hospital settings, as well as the increased risk of association with substance use disorder, further multicenter studies in this area with larger sample sizes can increase awareness in this regard.
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Trastorno por Déficit de Atención con Hiperactividad , Trastorno Bipolar , Trastornos Relacionados con Sustancias , Adulto , Trastorno por Déficit de Atención con Hiperactividad/diagnóstico , Trastorno por Déficit de Atención con Hiperactividad/epidemiología , Trastorno Bipolar/epidemiología , Trastorno Bipolar/terapia , Comorbilidad , Hospitales Psiquiátricos , Humanos , Pacientes Internos/psicología , Pacientes Internos/estadística & datos numéricos , Irán/epidemiología , Trastornos Relacionados con Sustancias/epidemiologíaRESUMEN
Social capital is a complex concept that is considered an effective factor in the development of societies. Considering the importance of burdens of psychiatric disorders in Iran, we studied the relationship between various dimensions of social capital of parents of children and adolescents and psychiatric disorders among them. In this cross-sectional study, 18,940 parents of children and adolescents aged 6 to 18 years old were randomly selected from all provinces of Iran and were evaluated by the Millon clinical multiaxial inventory-III (MCMI-III) and a modified version of Nahapiet and Ghoshal questionnaire. MCMI-III was designed as a self-report tool for investigating psychiatric clinical disorders and personality traits in the general population. Modified Nahapiet and ghoshal questionnaire has 20 items and measures four components of social capital included trust, values, communication, and collaboration. Validity and reliability of both questionnaires have been approved in Iran. In the regression model, the relationship between social capital components and clinical and sever clinical syndromes, in the form of regression weight and standard weight for trust was - 0.558 and - 0.062 with p value less than 0.0001, and for values was - 0.466 and - 0.057, respectively, with p value less than 0.0001. There was a reverse correlation between social capital components of parents of children and adolescents and psychiatric disorders in Iran. In regression statistical models, the two components of values and trust were negative predictors of psychiatric disorders. Considering the high prevalence of psychiatric disorders in Iran, it seems that the strengthening of cognitive and structural aspects of social capital of parents of children and adolescents is one of the effective factors in reducing the prevalence of these disorders among them.
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Trastornos Mentales , Capital Social , Adolescente , Niño , Estudios Transversales , Humanos , Trastornos Mentales/epidemiología , Trastornos Mentales/psicología , Padres , Reproducibilidad de los ResultadosRESUMEN
In this population-based survey, we have evaluated the lifetime prevalence of tic disorders and related sociodemographic factors and comorbidities of them. The data obtained from face-to-face interviews with 29,885 children and adolescents aged 6-18 years. We used the multistage cluster sampling method and a cross-sectional design. Tic disorders and other psychiatric disorders were assessed using the Persian version of the Kiddie Schedule for Affective Disorders and Schizophrenia-Present and Lifetime Version (K-SADS-PL). The lifetime prevalence of tic disorders was 1.5% (95% CI (1.3-1.7%)). The highest prevalence was in the age range of 15-18 years old with 1.9% (95% CI (1.6-2.3%)).57.7% (95% CI 51.8-63.3%) of patients with tic disorders had comorbidity with other psychiatric disorders. Increasing the prevalence of tic disorder with increasing age among Iranian children and adolescents, emphasizes the need to pay more attention to use of pharmacological and non-pharmacological treatments and increase education to families in this regard.
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Trastornos de Tic , Adolescente , Niño , Comorbilidad , Estudios Transversales , Humanos , Irán/epidemiología , Prevalencia , Trastornos de Tic/diagnóstico , Trastornos de Tic/epidemiologíaRESUMEN
The current study aimed to evaluate the effects of exercise on negative and cognitive symptoms and simultaneous evaluation of brain and hippocampus volume in patients with schizophrenia. Forty patients with schizophrenia were randomly divided into two groups. The intervention group, in addition to pharmacological treatment, underwent a multi-session exercise program for 8 weeks. At the beginning and end of the study, patients were assessed for cognitive status and negative symptoms using the Mini-Mental State Examination (MMSE) and Positive and Negative Syndrome Scale (PANSS), respectively. Total brain volume and hippocampus volume were also measured using magnetic resonance imaging. Overall, mean MMSE score significantly improved over time, but this improvement was greater in the intervention group (29%) compared to the control group (11%). The same was true for the PANSS negative score (21.5% vs. 53.5%). Absolute hippocampus volume during these 8 weeks, in exercise and control groups, increased from 6.24 to 7.11 and 6.44 to 6.59, respectively. The greater increase in volume obtained in the intervention group was statistically significant (p = 0.003). Exercise may be associated with improved cognitive function and negative symptoms in patients with schizophrenia; however, additional studies are warranted. [Journal of Psychosocial Nursing and Mental Health Services, 60(5), 37-43.].
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Disfunción Cognitiva , Esquizofrenia , Cognición , Disfunción Cognitiva/terapia , Terapia Combinada , Ejercicio Físico , Humanos , Esquizofrenia/tratamiento farmacológico , Resultado del TratamientoRESUMEN
BACKGROUND: Studies have shown that health care workers (HCWs), as front liners of the coronavirus (COVID-19) pandemic, are at high risk for psychological symptoms, but few studies have compared these symptoms in infected and non-infected HCWs. This study compares psychological symptoms among these two groups. METHODS: In this cross-sectional study, 938 HCWs from various medical fields working in the leading general hospitals of Alborz province, Iran, were selected using a multistage sampling method. The participants had contact with COVID-19 patients. Post-traumatic stress disorder-8 (PTSD-8) is a validated questionnaire that we used to evaluate PTSD symptoms along with its subscales, including intrusion, avoidance, and hypervigilance. Also, the Depression, Anxiety, and Stress Scale-21 questionnaire was used to assess the severity of the aforementioned conditions in HCWs. Multivariate logistic regression was used to compare psychological symptoms in infected and non-infected HCWs. RESULTS: Among 938 included HCWs, 55 had a history of confirmed COVID-19 infection. Prevalence of stress, anxiety, depression, intrusion, hypervigilance, and avoidance among infected HCWs were significantly higher in comparison to non-infected HCWs. In the multivariate logistic model, history of COVID-19 infection among HCWs was associated with a significantly increased risk of anxiety, depression, stress, intrusion, hyper-vigilance, and avoidance. CONCLUSION: The present study showed that the HCWs with COVID-19 infection were at a high risk of displaying psychological symptoms. Therefore, it is also necessary to develop psychological support and interventions for HCWs, especially those who got infected with the virus.
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COVID-19 , Ansiedad , Estudios Transversales , Personal de Salud , Humanos , Irán , SARS-CoV-2RESUMEN
Separation Anxiety Disorder(SAD) is one of the earliest anxiety disorders. The effect of this disorder on the performance of children and adolescents reveals the need for awareness of the prevalence and comorbidity of this disorder in each region. This study is a cross-sectional analytical study implemented in all provinces of Iran. The instrument used in this study is the Persian version of the Kiddie Schedule for Affective Disorders and Schizophrenia-Present and Lifetime Version(K-SADA-PL) questionnaire. The total number of participants was 29,699. The overall prevalence of SAD was 5.3%. The comorbidity rate of 65.3% was found between SAD and other psychiatric disorders. Specific phobia and oppositional defiant disorder had the highest comorbidity with this disorder in the studied population. The more prevalence of separation anxiety disorder in the age range of 6-9 years old highlights the need for early detection of this disorder and targeting screening programs in childhood and adolescence.
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Ansiedad de Separación/epidemiología , Adolescente , Ansiedad de Separación/diagnóstico , Niño , Comorbilidad , Estudios Transversales , Femenino , Humanos , Masculino , PrevalenciaRESUMEN
OBJECTIVE: The evident central role of inflammation, oxidative stress, and metabolic derangement in pathophysiology of negative symptoms of schizophrenia has opened new insights into probable pharmacological options for these symptoms. Pioglitazone is an antidiabetic agent with anti-inflammatory and antioxidant properties. In this study, we evaluated the efficacy of pioglitazone as an adjunct to risperidone for reduction of negative symptoms in schizophrenia. METHODS: In this randomized, double-blind, placebo-controlled trial, 40 patients with chronic schizophrenia and a minimum score of 20 on the negative subscale of Positive and Negative Syndrome Scale (PANSS) were randomly allocated to receive risperidone plus either pioglitazone (30 mg/day) or placebo for 8 weeks. Patients' symptoms and adverse events were rated at baseline and weeks 2, 4, 6, and 8. The difference between the two groups in decline of PANSS negative subscale scores was considered as the primary outcome of this study. RESULTS: At the study endpoint, patients in the pioglitazone group showed significantly more improvement in PANSS negative subscale scores (p < 0.001) as well as PANSS total scores (p = 0.01) compared with the placebo group. CONCLUSION: These findings suggest the probable efficacy of pioglitazone as an augmentation therapy in reducing the negative symptoms of schizophrenia.
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Antipsicóticos/uso terapéutico , Risperidona/uso terapéutico , Esquizofrenia/tratamiento farmacológico , Psicología del Esquizofrénico , Tiazolidinedionas/uso terapéutico , Adulto , Antipsicóticos/efectos adversos , Enfermedad Crónica , Método Doble Ciego , Quimioterapia Combinada , Femenino , Humanos , Irán , Masculino , Pioglitazona , Escalas de Valoración Psiquiátrica , Tiazolidinedionas/efectos adversos , Factores de Tiempo , Resultado del TratamientoAsunto(s)
Ansiedad/epidemiología , COVID-19/terapia , Depresión/epidemiología , Personal de Salud/estadística & datos numéricos , Hospitales de Enseñanza , Estrés Psicológico/epidemiología , Adulto , Factores de Edad , Técnicos Medios en Salud/psicología , Técnicos Medios en Salud/estadística & datos numéricos , Ansiedad/psicología , Depresión/psicología , Femenino , Personal de Salud/psicología , Humanos , Irán/epidemiología , Masculino , Cuerpo Médico de Hospitales/psicología , Cuerpo Médico de Hospitales/estadística & datos numéricos , Salud Mental , Personal de Enfermería en Hospital/psicología , Personal de Enfermería en Hospital/estadística & datos numéricos , Prevalencia , Factores Sexuales , Estrés Psicológico/psicologíaRESUMEN
RATIONALE: Changes in the density and diversity of gut microbiota in chronic use of methamphetamine have been mentioned as contributors to psychotic and anxiety symptoms, sleep problems, and loss of appetite. OBJECTIVE: In this placebo-controlled clinical trial, we investigated the effect of the probiotic Lactobacillus Acidophilus in improving psychiatric symptoms among hospitalized patients with chronic methamphetamine use along with psychotic symptoms. METHODS: 60 inpatients with a history of more than 3 years of methamphetamine use, were randomly assigned to one of two groups receiving either a probiotic capsule or placebo along with risperidone for 8 weeks based on a simple randomization method. In weeks 0, 4, and 8, patients were evaluated using the Brief Psychiatric Rating Scale (BPRS), Beck Anxiety Inventory (BAI), Pittsburgh Sleep Quality Index (PSQI), Simple Appetite Nutritional Questionnaire (SANQ), and Body Mass Index (BMI). RESULTS: Compared to the control group, patients receiving probiotics had better sleep quality, greater appetite, and higher body mass index (there were significant interaction effects of group and time at Week 8 in these variables (t = -3.32, B = -1.83, p = .001, d = 0.89), (t = 10.50, B = 2.65, p <.001, d = 1.25) and (t = 3.40, B = 0.76, p <.001, d = 0.30), respectively. In terms of the improvement of psychotic and anxiety symptoms, there was no statistically significant difference between the two groups. CONCLUSIONS: The use of probiotics was associated with improved sleep quality, increased appetite, and increased body mass index in patients with chronic methamphetamine use. Conducting more definitive clinical trials with larger sample sizes and longer-term follow-up of cases is recommended.
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Trastornos Relacionados con Anfetaminas , Anorexia , Ansiedad , Metanfetamina , Probióticos , Trastornos del Inicio y del Mantenimiento del Sueño , Humanos , Masculino , Adulto , Femenino , Probióticos/administración & dosificación , Ansiedad/tratamiento farmacológico , Trastornos del Inicio y del Mantenimiento del Sueño/tratamiento farmacológico , Metanfetamina/efectos adversos , Anorexia/psicología , Trastornos Relacionados con Anfetaminas/psicología , Risperidona/uso terapéutico , Risperidona/administración & dosificación , Persona de Mediana Edad , Método Doble Ciego , Resultado del Tratamiento , Psicosis Inducidas por Sustancias , Adulto Joven , Antipsicóticos/uso terapéutico , Antipsicóticos/administración & dosificación , Anfetamina , Trastornos Psicóticos/tratamiento farmacológicoRESUMEN
Background: During the COVID-19 pandemic, Health Care Workers (HCWs) were more vulnerable than ever to Burnout and Suicidal thoughts due to stressful work conditions. This study, investigated the level of Burnout and Suicidal thoughts among HCWs during the fourth wave of the pandemic in Alborz Province in Iran and compared it with the conditions at the beginning of the pandemic. Methods: A total of 305 HCWs from 3 referral hospitals for COVID-19, including 155 men and 150 women, participated in the study. A cross-sectional study was carried out with a sample of HCWs dealing with COVID-19 patients using the available sampling method. The results of this online survey, which was conducted from June 7 to July 5, 2021 (at the end of the Fourth Wave of the COVID-19 Pandemic in Iran), have been compared with the conditions of the First Wave of the Pandemic (from February 24 to April 27, 2020). The participants were evaluated by the Beck Scale for Suicidal Ideations (BSSI) and Maslach Burnout Inventory (MBI). Results: The mean age of the participants was 36.34 ± 7.37. The means of Suicide Index (SI), Emotional Exhaustion (EE), Depersonalization (DP), and Personal Accomplishment (PA) scores were 0.76 ± 1.74, 19.94 ± 4.69, 4.92 ± 1.51, and 31.30 ± 5.88, respectively. SI and PA were significantly higher in workers other than nurses and physicians and EE was higher among workers with night shifts (p value<0.05 in all indices). Age had a significant and negative correlation with EE (p value<0.01) and DP (p value<0.05) and a significant and positive correlation with PA (p value<0.01). Conclusion: This study showed a high level of SI and Burnout indices among HCWs in the fourth wave of the pandemic in Iran. Paying attention to the factors affecting the development of social capital and creating health policy changes may be effective in reducing Burnout indices and high Suicide index among HCWs.
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INTRODUCTION: Treatment of mood and cognitive symptoms of patients with bipolar disorder is associated with many complications and is generally not associated with therapeutic satisfaction. In this clinical trial, we evaluated the effectiveness of spironolactone in controlling mood and cognitive symptoms, sleep quality, appetite, and body mass index in patients with bipolar disorder in manic episodes. METHODS: Sixty inpatients with bipolar disorder in manic episodes were treated with spironolactone/placebo in an 8-week randomized, double-blind, placebo-controlled clinical trial. They were evaluated using the Young Mania Rating Scale (YMRS), mini-mental state examination (MMSE), Pittsburgh sleep quality index, Simplified Nutritional Appetite Questionnaire, and body mass index in weeks 1, 4, and 8. RESULTS: For cognitive impairment (MMSE), there were significant interaction effects of group and time at week 8 (B = -1.60, SE = 0.69, t = -2.33, p = .021) such that individuals in the spironolactone group experienced more improvement in their cognitive performance. For manic symptoms (YMRS), there were no significant interaction effects of group and time at week 8 (B = -2.53, SE = 1.46, t = -1.73, p = .085). CONCLUSIONS: Considering the promising findings in this clinical trial, further study of spironolactone as adjunctive therapy in bipolar disorder in manic episodes with larger sample sizes, multicenter settings, and longer follow-ups are recommended.
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Trastorno Bipolar , Humanos , Trastorno Bipolar/diagnóstico , Método Doble Ciego , Quimioterapia Combinada , Manía/tratamiento farmacológico , Escalas de Valoración Psiquiátrica , Espironolactona/uso terapéutico , Resultado del Tratamiento , Ácido Valproico/uso terapéuticoRESUMEN
Background: Stigma can be seen as a mark of disgrace that can lead to the separation of one person from another. In this qualitative study, we assess the status of stigma among in front-line health care workers (HCWs) during the first wave of the COVID-19 pandemic in Iran. Subjects and methods: The participants were selected from frontline HCWs related to COVID-19 in Imam Ali and Imam Hossein referral hospitals in Alborz province, Iran. Study was conducted between May and June 2020. The 32-item checklist Consolidated Criteria for Reporting Qualitative Research (COREQ) was used to report this qualitative study. Interview questions were prepared based on the grounded theory method. The thematic approach was used to analyze the data content. Data analysis was based on open and axial coding and after implementing the codes in MAXQDA software. Results: The results of this study included 4 themes, 8 categories and 33 sub-categories. Themes included extrinsic and intrinsic elements of stigma, perplexity and stigma removal requirements. Extrinsic elements included "creating blame and shame" and "discrimination" categories. Intrinsic elements included "the desire to be avoidance," "feeling depressed and frustrated" and "feeling anxious and scared" categories. Perplexity included "feeling loss" category. Stigma removal requirements included "factors causing stigma" and "protective agents against stigma" categories. Conclusion: Low public awareness on COVID-19 and inadequate public care, limited personal protective equipment and inadequate facilities for HCWs along with lack of appreciation for their efforts, lack of proper psychiatric/psychological counseling to identify and treat symptoms associated with mental health and the limitations of training to maintain mental health skills are considered to be factors in the formation of stigma among HCWs related to COVID-19. Health policymakers should implement coherent strategies related to increasing public awareness and providing personal protection needs and counseling care for HCWs in relation to COVID-19.
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Objective: Spironolactone (C24H32O4S), a potent mineralocorticoid receptor (MR) inhibitor, is a potassium-sparing diuretic that is traditionally used to treat fluid build-up in the body or for its anti-androgenic properties. This study is a double-blind, placebo-controlled, randomized clinical trial assessing the beneficial effects of spironolactone in addition to risperidone in improving negative symptoms of schizophrenia. Method: 40 patients with chronic schizophrenia, aged 18-60 years, were assigned to two groups: risperidone + spironolactone or risperidone + placebo. Risperidone was administered to both the spironolactone and placebo groups with a dose up to 6 mg/day throughout the trial. Spironolactone (C24H32O4S) was ordered 100 mg/day for the full 8-week course of the study. Patients were rated on the Positive and Negative Syndrome Scale (PANSS) at four time points: baseline, weeks two, four, and eight. The PANSS negative subscale score was the main objective. Results: PANSS negative, positive, and total scores showed significantly greater improvements in the spironolactone relative to the placebo group from baseline to the trial endpoint (P (Cohen's d): 0.004 (0.96), 0.007 (0.90), and 0.042 (0.66), respectively). Similarly, ANOVA also presented significant time × treatment interaction effect for spironolactone on PANSS negative (F = 9.04; ηp2 = 0.19; df = 1.38; P = 0.002), positive (F = 3.43; ηp2 = 0.08; df = 2.72; P = 0.023), and total (F = 3.94; ηp2 = 0.09; df = 2.05; P = 0.022) scores. However, spironolactone did not cause significant decrease in the general psychiatric pathology score of PANSS. Conclusion: Our findings suggest the efficacy and safety of spironolactone as an adjunctive therapy to risperidone in improving the symptoms of schizophrenia.
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Throughout life, mechanisms such as damage and inflammation can alter the permeability of the blood-brain barrier(BBB). According to some studies, increasing the permeability of the blood-brain barrier can occur in a time-dependent manner following restraint stress. On the other hand, there have been reports of increased N-Methyl-D-Aspartate Receptor (NMDAR) -Ab seroprevalence in chronic stress conditions. The presence of antibody-secreting cells / memory B cells in the intrathecal area of the brain and their redistribution under various environmental stresses, which can be independent of the BBB status, are other points in this area that can emphasize the role of environmental stress in Anti NMDAR encephalitis.
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Encefalitis Antirreceptor N-Metil-D-Aspartato , Encefalitis Antirreceptor N-Metil-D-Aspartato/complicaciones , Autoanticuerpos , Barrera Hematoencefálica , Humanos , Receptores de N-Metil-D-Aspartato , Estudios Seroepidemiológicos , Estrés Psicológico/complicacionesRESUMEN
Introduction: Creutzfeldt-Jakob disease (CJD) as a prion disease is an untreatable type of progressive neurodegenerative encephalopathy. Although no definitive case has been reported yet, here we report a case that given the history, course of symptoms, and recent dental practice, it is highly probable that it was caused by dental procedures. Case Report: The patient was a 52-year-old woman who has had memory problems gradually with forgetting the names of family members since 6 weeks prior to the visit and shortly after the dental procedure. She experienced progressive visual hallucinations accompanied by a sharp decline in cognitive, verbal, and motor abilities in just a few weeks. Finally, the diagnosis of Creutzfeldt-Jakob was made for her based on the clinical history and typical brain MRI. Discussion: Clinical evidence of this patient, along with positive brain MRI results, indicates the risk of prion transfer through dental procedures. Paying attention to the neurological aspects of psychiatric manifestations and increasing the awareness of dentists about how to deal with and act on the potential dangers of prion transfer is of paramount importance.