Investigating the Effects and Side Effects of Two Antipsychotic Drugs in the Treatment of Children and Adolescents with Tourette Syndrome: A Semi-experimental Research.

INTRODUCTION: Due to the high prevalence of Tourette's disorder among children and adolescents and its negative consequences, an appropriate and effective medical treatment with minimal complications is necessary. Therefore, this study was conducted to compare the effects of Aripiprazole and Risperidone on Tourette's disorders in children and adolescents. METHODS: The statistical population of this semi-experimental study was children and adolescents aged seven to eighteen years old. They were diagnosed with Tourette's disorder based on the DSM-V criteria by the clinical interview of a child and adolescent psychiatrist in the child Psychiatry clinic of Ibne- Sina's Psychiatric Hospital (Mashhad-Iran) in 2018. A total of forty participants were selected by the convenience sampling method, and they were randomly divided into two groups treated with medicines, Risperidone or Aripiprazole, for two months. Then, the demographic information questionnaire was completed. The Y-GTSS Scale was completed. The clinical Effect Rating Scale (CGI-Tics Scale) was completed. Calculation of body mass index and medical side effects complications were completed. The evaluation was carried out at the beginning and on the second, fourth, and eighth weeks, and the results were compared. The data were analyzed using SPSS software. 14, descriptive statistics, Chi-square, and variance analysis. RESULTS: The two groups were homogeneous in terms of demographic variables and body mass index. Despite the positive effect of both medicines, no significant difference was observed among the general scores of such disorders, the overall score of severity, Tourette's recovery, and BMI of these two groups at the intervals and the end of treatments. (p <0.05). Due to the low number of complications reported, statistical comparisons of the medical side effects were not made. CONCLUSION: According to the results, the two medicines, Aripiprazole and Risperidone, effectively improved the symptoms of Tourette's disorder and its overall severity. However, there were no significant statistical differences between them. Furthermore, in terms of the medical side effects, the statistical comparison between the two medicines was impossible due to the small number of complications.

A quantitative study on completeness rate of documentation in psychiatric medical records.

Background: Mental disorders are one of the leading causes of illness and disability worldwide. According to the World Health Organization (WHO), one in four people in the world will be affected by mental or neurological disorders during their lifetime. Regular evaluation of mental health outcomes plays an important role in making decisions about timely treatment of the patient. Studies show that a medical record does not provide enough information about the diagnosis, current symptoms, psychiatric medications, and side effects of current medications and treatments for ongoing health care. In this study, the completeness of paper-based psychiatric records was investigated. Aim: The current study aimed to explore the completeness rate of paper-based psychiatric medical records (PMRs) and to investigate the factors effective on documentation status. Setting: The study was conducted in Ebnesina and Dr. Hejazi Psychiatric Hospital and Education Center. The case hospital is a psychiatric teaching hospital, which has 900 beds. Materials and Methods: The completeness rate of PMRs was determined using descriptive statistics. Fleiss' Kappa agreement and effective factors on PMRs' documentation status were assessed. Results: In total, 83.65% (n = 312) of the PMRs had at least one documentation defect. A significantly higher level of documentation completeness rate between different psychiatric wards was observed. Conclusion: Based on our results, it is suggested to conduct regular evaluation and provide feedback to the health-care providers, and conduct training courses.

Prevalence of elimination disorders and comorbid psychiatric disorders in Iranian children and adolescents.

PURPOSE: Currently, there is a paucity of studies on the prevalence of Elimination Disorders among Iranian children and adolescents. Due to the ongoing need to monitor the health status of these children and adolescents, the present study aims to investigate the prevalence of Elimination Disorders and comorbid disorders in Iranian children and adolescents. METHODS: In this cross-sectional study, 29,781 children and adolescents age 6 to 18 years old were selected and studied from all the provinces in Iran. The sampling was carried out by employing a multistage cluster sampling method, and several clinical psychologists using semi-structured interviews collected the data. Furthermore, clinical psychologists collected demographic information (including information about gender, age, place of residence, education level, and parental education level). The collected data were analyzed using SPSS version 20. RESULTS: Generally, the prevalence of Elimination Disorders was found to be 5.4% covering both enuresis (p= 5.4, 95% CI = 5.1-5.7) and encopresis (p= 0.13, 95% CI = 0.09-0.2). The total prevalence of comorbid disorders was 38%, and among the comorbid disorders, Attention Deficit Hyperactivity Disorder (ADHD) (p= 11, 95% CI = 9.5-12.7) and Separation Anxiety (p= 10.6, 95% CI = 9.1-12.2) were the most prevalent. CONCLUSION: The prevalence of Elimination Disorders in Iranian children and adolescents is moderate compared to similar studies elsewhere. As for comorbid disorders, ADHD and Separation Anxiety were found to be the most prevalent disorders. Since Elimination Disorders coexist with psychiatric disorders in children, further studies of these comorbidities may give better insight into the treatment and prognosis of Elimination Disorders.

Intrathecal autologous bone marrow stem cell therapy in children with autism: A randomized controlled trial.

INTRODUCTION: This study aimed to determine the safety and efficacy of treatment with autologous bone marrow mesenchymal stem cell (BMMSCs) compared with the routine treatment in children with autism spectrum disorder (ASD). METHODS: In this ethically approved randomized controlled trial, 32 ASD children aged 5-15 years were randomly assigned to receive either autologous BMMSC plus rehabilitation therapy and risperidone (intervention group) or rehabilitation therapy and risperidone (control group). Autologous BMMSCs were intrathecally injected in the intervention group twice in 4 weeks. Patients were assessed using childhood autism rating scale (CARS), Gilliam autism rating scale-second edition (GARS-II), and clinical global impression (CGI) at the baseline, as well as 6 and 12 months after intervention. RESULTS: Overall, 32 patients in two groups of intervention (n = 14) and control (n = 18) completed the study, of which 27 (84.4%) were male. Mean age was 9.50 ± 2.14 years. The improvements in CARS total score, GARS-II autism index, and CGI global improvement showed no significant differences between the groups over 12 months. However, the main effect for time*group interaction was significant regarding the CGI-severity of illness, showing a significantly more pronounced improvement in the intervention group (F = 6.719; P = .002). DISCUSSION: Intrathecal injection of autologous BMMSCs seems to be safe and feasible, but has limited clinical efficacy in treatment of children with ASD.

Efficacy of Violet oil, a traditional Iranian formula, in patients with chronic insomnia: A randomized, double-blind, placebo-controlled study.

ETHNOPHARMACOLOGICAL RELEVANCE: Violet oil is an ancient herbal drug which has been extensively used to treat insomnia in traditional Iranian Medicine clinics. Violet oil is an almond or sesame oil-based extract of Viola odorata, which is administered as nasal drops. This study aimed to evaluate the efficacy of Violet oil in the treatment of insomnia. METHODS AND MATERIALS: This study was conducted as a 3-arm double-blind randomized trial. A total of 75 patients with chronic insomnia were enrolled and randomly assigned to three groups in Traditional Iranian Medicine Clinic of Mashhad University of Medical Sciences, Mashhad, Iran. The treatment consisted of intranasal dropping of Violet oil, Almond oil or placebo (1% solution of Carboxymethyl cellulose) in each nostril every night before sleep for 30 days, i.e. three drops of the drug (including either Violet oil or Almond oil) or the placebo was used every night before the sleep. All the patients were asked to complete Pittsburgh Sleep Quality Index (PSQI) and Insomnia Severity Index (ISI) questionnaires before and after the intervention. RESULTS: There were no significant differences between patients in the three groups before the intervention (P > 0.05). However, there were significant differences between the three groups after the intervention in ISI scores (P<0.002) and PSQI scores (p<0.001). When comparing the pre- and post-treatment data, the ISI and PSQI scores improved significantly in all the three groups as follows: Violet oil (P<0.001), Almond oil (P<0.001) and placebo (P<0.001). The results also showed that the Violet oil had the most effect among the three groups. In addition, it was more effective on sleep quality than sleep quantity. CONCLUSION: Considering the effects of natural nasal drug on the improvement of sleep quality in insomniac patients, this study has proposed the use of Violet oil as a natural and herbal drug in a non-oral method without serious side effects for treatment of insomnia.

Effect of changing journal clubs from traditional method to evidence-based method on psychiatry residents.

INTRODUCTION: Journal club is a valuable educational tool in the medical field. This method follows different goals. This study aims to investigate the effect on psychiatry residents of changing journal clubs from the traditional method to the evidence-based method. METHOD: This study was conducted using a before-after design. First- and second-year residents of psychiatry were included in the study. First, the status quo was evaluated by standardized questionnaire regarding the effect of journal club. Then, ten sessions were held to familiarize the residents with the concept of journal club. After that, evidence-based journal club sessions were held. The questionnaire was given to the residents again after the final session. Data were analyzed through descriptive statistics (frequency and percentage frequency, mean and standard deviation), and analytic statistics (paired t-test) using SPSS 22. RESULTS: Of a total of 20 first- and second-year residents of psychiatry, the data of 18 residents were finally analyzed. Most of the subjects (17 [93.7%]) were females. The mean overall score before and after the intervention was 1.83±0.45 and 2.85±0.57, respectively, which showed a significant increase (P<0.001). CONCLUSION: Moving toward evidence-based journal clubs seems like an appropriate measure to reach the goals set by this educational tool.

Depression, anxiety and quality of life in caregiver spouses of veterans with chronic spinal cord injury.

OBJECTIVE: We were curious about the degree of anxiety and depression and their effect on the quality of life of the caregivers of veterans with spinal cord injury (SCI). METHODS: A convenience sample of 72 out of 120 caregiver spouses of veterans with spinal cord injury participated in our study. The Hospital Anxiety and Depression Scale (HADS) were considered as a measure of depression and anxiety. The World Health Organization Quality of Life BREF questionnaire (WHOQOL-BREF) was considered to evaluate the quality of life. To compare the caregivers, we enrolled 74 matched caregiver spouses of patients without spinal cord injury. RESULTS: The average age of the spouses was 44.7±6.5. The average time elapsed from the injury was 26.4±3.1 years. There was a significant difference in all domains of quality of life and depression between the caregivers and the control group, but there was not a significant difference in terms of anxiety. There was a negative correlation between depression and age, level of education and quality of life. CONCLUSION: Mental care support should be implemented for veterans and their spouses in addition to the provided facilities.