OBJECTIVE: In the DSM-5's diagnostic criteria of somatic symptom disorders (SSD), the presence of psychological problems (i.e., excessive thoughts, feelings, or behaviors) is emphasized more than the absence of the medical causes of patients' bothersome symptoms. In this regard, the Somatic Symptom Disorder-B Criteria Scale (SSD-12) is a screening tool for assessing these psychological features in somatic symptom disorder. This study aimed to validate the Persian version of SSD-12 in the Iranian community (non-clinical) and clinical samples. METHODS: Data was gathered from 291 individuals in a community sample (aged 18 to 54, M-age = 36.62, SD = 10.56, 79.7% females) and from clinical setting, including 118 patients diagnosed with major depressive disorder (MDD, aged 18 to 60, M-age = 36.52, SD = 11.39, 75.8% females) and 120 patients diagnosed with somatic symptom disorders (aged 18 to 60, M-age = 35.17, SD = 8.77, 73.7% females). To assess the convergent validity of SSD-12 in the clinical samples, participants were asked to complete measures assessing anxiety, depression, somatic symptoms, health anxiety, and emotional regulation. RESULTS: Confirmatory Factor Analyses (CFAs) showed that the three-factor model of the SSD-12 reached acceptable fit in the community and clinical samples and yielded excellent internal consistency across the samples. Also, test-retest reliability analysis results were good in the community sample. Convergent validity could be shown in the clinical samples. A cut-off score greater than 14 was in the optimal state with a sensitivity of 70.83 and a specificity of 70.07. CONCLUSION: The current study provides evidence on the factor structure, reliability, and validity of the Persian SSD-12 in the Iranian community and clinical samples. A sum score of 14 can be recommended as the cut-off point. Further studies are needed to assess SSD-12 in different clinical populations and larger samples.
Depressive Disorder, Major , Medically Unexplained Symptoms , Depressive Disorder, Major/diagnosis , Female , Humans , Iran , Male , Psychometrics/methods , Reproducibility of Results , Somatoform Disorders/diagnosis , Somatoform Disorders/psychology , Surveys and Questionnaires
Background: Here, we aimed to investigate the therapeutic effects of Nigella sativa extract on serum brain-derived neurotrophic factor (BDNF) and depression score in patients with depression. Materials and Methods: This clinical trial was performed in 2021 in the hospitals of military forces in Tehran on 52 male patients with major depressive disorder treated with sertraline. We used the Depression, Anxiety, and Stress Scale-21 Items (DASS-21) questionnaire to assess the patients. Serum BDNF levels were measured by the enzyme-linked immunosorbent assay. Patients were then divided into two groups receiving 1000 mg N. sativa oil extract, daily, and placebo. Both groups received sertraline for at least 3 months. DASS-21 questionnaire and serum BDNF levels were measured after 10 weeks. Results: After treatments, we observed significantly decreased DASS-21 score (-11.24 ± 5.69) in the intervention group (P < 0.001) and placebo (-2.72 ± 6.19, P = 0.032), but patients in the intervention group had significantly lower scores (50.1 ± 6.8 vs. 58.2 ± 5.6, respectively, P < 0.001). Furthermore, patients in the intervention group had significantly decreased depression score (-5.5 ± 2.47, P < 0.001) and lower scores compared to the placebo (P < 0.001) (18.6 ± 2.7 vs. 23.4 ± 2.1 in intervention and placebo, respectively). We also observed significantly increased BDNF levels in the intervention group after the treatments (6.08 ± 3.76, P < 0.001) compared to the placebo group (29.4 ± 3.6 vs. 24.9 ± 2.1, P < 0.001). Serum BDNF levels had also significant reverse correlations with DASS-21 score (r = -0.35, P = 0.011) and depression score (r = -0.45, P = 0.001). Conclusion: The use of N. sativa resulted in decreased depression score and increase in serum BDNF levels that indicate the importance and efficacy of this drug.
Methamphetamine, one of the most frequently used illicit drugs worldwide, can induce psychosis in a large fraction of abusers and it is becoming a major problem for the health care institutions. There is some evidence that genetic and epigenetic factors may play roles in methamphetamine psychosis. In this study, we examined methamphetamine-induced epigenetic and expression changes of several key genes involved in psychosis. RNA and DNA extracted from the saliva samples of patients with methamphetamine dependency with and without psychosis as well as control subjects (each group 25) were analyzed for expression and promoter DNA methylation status of DRD1, DRD2, DRD3, DRD4, MB-COMT, GAD1, and AKT1 using qRT-PCR and q-MSP, respectively. We found statistically significant DNA hypomethylation of the promoter regions of DRD3 (P = 0.032), DRD4 (P = 0.05), MB-COMT (P = 0.009), and AKT1 (P = 0.0008) associated with increased expression of the corresponding genes in patients with methamphetamine psychosis (P = 0.022, P = 0.034, P = 0.035, P = 0.038, respectively), and to a lesser degree in some of the candidate genes in non-psychotic patients versus the control subjects. In general, methamphetamine dependency is associated with reduced DNA methylation and corresponding increase in expression of several key genes involved in the pathogenesis of psychotic disorders. While these epigenetic changes can be useful diagnostic biomarkers for psychosis in methamphetamine abusers, it is also consistent with the use of methyl rich diet for prevention or suppression of psychosis in these patients. However, this needs to be confirmed in future studies. © 2016 Wiley Periodicals, Inc.
DNA Methylation/drug effects , Psychotic Disorders/genetics , Adult , Amphetamine-Related Disorders/genetics , Case-Control Studies , Catechol O-Methyltransferase/genetics , DNA Methylation/genetics , Dopamine , Epigenomics , Female , Genetic Predisposition to Disease/genetics , Humans , Male , Methamphetamine/adverse effects , Promoter Regions, Genetic/drug effects , Promoter Regions, Genetic/genetics , Proto-Oncogene Proteins c-akt/genetics , Psychotic Disorders/metabolism , Receptors, Dopamine D3/genetics , Receptors, Dopamine D4/genetics , Saliva , Transcriptome
OBJECTIVE: Bipolar disorder is strongly associated with suicidal ideations, attempts and commissions. Although several studies have been conducted on suicide risk factors in patients with bipolar disorder worldwide, a comprehensive study has not been reported from Iran. METHODS: Patients with bipolar disorder type I, hospitalized in Iran Hospital of Psychiatry since May 2008 to August 2011 were sequentially enrolled. Patients were evaluated using Demographic and Clinical Variables Questionnaire, the Structured Clinical Interview for DSM-IV axis I disorders (SCID-I), Young-Mania Rating Scale (Y-MRS), and Hamilton Depressive Rating Scale-7 (HDRS-7). One hundred patients were followed for 2 to 42 months (mean: 20.6 ± 12.5 months). RESULTS: Only one patient attempted suicide during the follow-up period. 33% of the patients had history of previous suicide attempts. Female gender, divorce, and early age at onset of the disease were independently correlated with suicide attempt. CONCLUSION: Suicide attempts rarely occur during systematic follow-up of patients with bipolar disorder type I. Larger samples and longer follow-ups are needed to confirm this finding. DECLARATION OF INTEREST: None.
OBJECTIVE: A rare phenomenon of Shared Psychosis Disorder occurring in the context of Bipolar I Disorder, in identical twins is reported. CASE PRESENTATION: Two identical twins with shared Psychotic Manic Syndrome were admitted and received antipsychotic and lithium as their treatment. Psychotic symptoms of primary case did not improve and her diagnosis changed into Schizophrenia. They had hypothyroidism at the same time. CONCLUSION: Completely shared manic syndrome along with the psychotic features shows a need for the criteria of shared syndromes to develop, including both psychotic and mood symptoms.
