Association of MGLL Intronic C>T Single Nucleotide Polymorphism (rs782440) with Borderline Personality Disorder: A Case-Control Study.

OBJECTIVE: From the perspective of etiology, borderline personality disorder (BPD) is a multifactorial and complex disorder, hence our understanding about the molecular basis and signaling of this disorder is extremely limited. The purpose of this study was evaluating the relationship between BPD and the Monoacylglycerol lipase (MGLL) polymorphism rs782440 in the population of Hamadan, Iran. MATERIALS AND METHODS: In this case-control study, 106 participants including 53 patients with BPD and 53 healthy control subjects were selected by psychiatrists in the Department of Psychiatry at Farshchian Sina Hospital in Hamadan. The BPD patients were selected based on the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) form for diagnosing BPD patients. For genotyping, polymerase chain reaction (PCR) was used to amplify the desired region including the (MGLL) intronic C>T single nucleotide polymorphism (SNP) (rs782440) and afterward the amplicon was sequenced using the Sanger sequencing method. To determine the genotype of these patients, their sequences were aligned with the reference sequence of MGLL through the CLC genomic workbench software. RESULTS: The results indicated that the frequency of TT in comparison to the CC genotype was significantly different (P=0.003) and the risk of BPD in change from the TT genotype to CC genotype was increased by 6.679%. Regarding the frequency of allele in this group, no significant difference was observed. CONCLUSION: This paper, has studied and reports for the first time, the association between MGLL SNP (rs782440) with BPD. The findings of the current research revealed that the TT genotype increases the risk of BPD compared to the CC genotype. Considering the lack of a suitable diagnostic biomarker for BPD, using this potential biomarker in the near future can be promising.

How common is attention deficit hyperactivity disorder (ADHD) in a cohort of children with functional constipation, and does ADHD treatment improve functional constipation?

Introduction: Attention deficit hyperactivity disorder (ADHD) is one of the most common neurodevelopmental disorders in children. Functional constipation is common in children and has a significant impact on the quality of their life, affecting both physical and emotional well-being. The aim of this study was to evaluate the frequency of ADHD in functional constipation patients and its treatment effect on constipation. Material and methods: In this clinical trial study, 80 children with simultaneous ADHD and functional constipation were allocated to two equal groups by the block randomization method. One group was treated only with ADHD drugs and the second group was treated for ADHD and functional constipation. Subsequently, the treatment outcome was evaluated in both groups. Results: The frequency of ADHD in functional constipation patients was 13.87%. The frequency of functional constipation recovery in the first and second group was respectively 2 (5%) and 39 (97.5%) (p < 0.001). ADHD treatment has no significant effect on the recovery of constipation. There was no statistically significant relationship between the response to treatment with age, sex and duration of having ADHD and constipation. Conclusions: In patients with simultaneous ADHD and functional constipation, ADHD treatment did not influence the recovery of functional constipation and vice versa.

Effectiveness of Repetitive Transcranial Magnetic Stimulation (rTMS) Add-On Therapy to a Standard Treatment in Individuals with Multiple Sclerosis and Concomitant Symptoms of Depression-Results from a Randomized Clinical Trial and Pilot Study.

BACKGROUND: Compared to the general population, persons with multiple sclerosis (MS) are at increased risk of suffering from major depressive disorder (MDD). Repetitive Transcranial Magnetic Stimulation (rTMS) was used successfully to treat individuals with MDD. Here, we conducted a randomized clinical trial and pilot study, and tested the effectiveness of rTMS adjuvant to a standard pharmacological treatment among persons with MS, compared to a sham condition. MATERIALS AND METHODS: A total of 40 persons with MS (mean age: 32 years; 42.5% females; median EDSS score: 4) and with moderate to severe symptoms of depression were randomly assigned to the rTMS or to the rTMS sham condition, always as adjuvant intervention to the standard treatment with sertraline, a selective serotonin reuptake inhibitor (SSRI). rTMS consisted of 10 sessions each of 37.5 min; the sham condition was identical to the active condition except for the absence of rTMS stimuli. At the beginning and two weeks after the end of the study, participants reported on their fatigue, while experts rated the severity of participants' depressive symptoms (Montgomery-Asberg Depression Rating Scale; MADRS), cognitive performance (Montreal Cognitive Assessment; MoCA), and degree of disability (Expanded Disability Status Scale; EDSS). RESULTS: Data were analyzed per intent-to-treat. Scores for depression, fatigue, and EDSS declined significantly over time (large effect sizes), but more so in the rTMS condition than in the sham condition (large effect sizes for the time by group-interactions). Compared to the sham condition, scores for depression were significantly lower in the rTMS condition. Scores for cognition improved over time in both study conditions (large effect size). CONCLUSION: Compared to a sham condition, adjuvant rTMS to a standard pharmacological treatment ameliorated typical MS-related symptoms (depression; fatigue; EDSS scores). Results from this pilot study suggested that rTMS might be routinely applied in persons with MS displaying symptoms of depression and fatigue.

Levetiracetam as an Adjunctive Treatment for Mania: A Double-Blind, Randomized, Placebo-Controlled Trial.

BACKGROUND: Levetiracetam is an anticonvulsant with a low side effect profile and favorable properties for individuals with bipolar I disorder during their manic phase. Despite initial promising results until about 2008, it appears that this track of research has not been followed-up. To counter this, we tested the influence of adjuvant levetiracetam on acute mania, compared to placebo. More specifically, we performed a randomized, double-blind, placebo-controlled clinical trial among inpatients with bipolar disorder I during their acute phase of mania. METHODS: A total of 72 inpatients (mean age: 33.98 years; 23.6% females) with diagnosed bipolar disorder I and during their acute manic phase were randomly assigned either to the adjuvant levetiracetam (250 mg to a maximum of 1,500 mg) or to the placebo condition. Standard medication was lithium at therapeutic dosages. At baseline, participants completed a series of self-rating questionnaires covering sociodemographic information and subjective sleep. Subjective sleep was re-assessed 24 days later at the end of the study. Experts rated participants' acute state of mania with the Young Mania Rating Scale at baseline and at day 12 and day 24. Participants' cognitive performance was assessed at baseline and at day 24 at the end of the study. RESULTS: Over time, mania scores significantly decreased (large effect size), but more so in the levetiracetam condition, compared to the placebo condition (medium effect size). Likewise, over time, subjective sleep improved (large effect size), but more so in the levetiracetam condition, compared to the placebo condition (large effect size). Over time, cognitive performance improved (large effect size), irrespective of the study condition. CONCLUSIONS: Compared to placebo, adjuvant levetiracetam to lithium improved symptoms of mania, as rated by experts, and subjective sleep quality. Adjuvant levetiracetam had no further favorable (or detrimental) impact on cognitive performance.

Influence of adjuvant clonidine on mania, sleep disturbances and cognitive performance - Results from a double-blind and placebo-controlled randomized study in individuals with bipolar I disorder during their manic phase.

BACKGROUND: While the favorable effect of adjuvant clonidine in the treatment of acute mania has been observed already about 40 years ago, this line of treatment has not been further investigated. Here, we resumed this topic, and we tested the effect of adjuvant clonidine, an antihypertensive stimulating the alpha-2 central adrenergic receptor, on symptoms of mania, cognitive performance, and subjective sleep. To this end, we performed a randomized, double-blind and placebo-controlled clinical trial among inpatients with bipolar disorder I during their acute phase of mania. METHODS: A total of 70 inpatients (mean age: 37.40 years; 15.7% females) with diagnosed bipolar disorder I and during their acute manic phase were randomly assigned either to the adjuvant clonidine (0.2 mg/d to a maximum of 0.6 mg/d) or to the placebo condition. Standard medication was lithium at therapeutic dosages. At baseline, participants completed a series of self-rating questionnaires covering sociodemographic information and subjective sleep. Subjective sleep was re-assessed 24 days later at the end of the study. Experts rated participants' acute state of mania with the Young Mania Rating Scale at baseline and at day 12 and day 24. Participants' cognitive performance was assessed at baseline and at day 24 at the end of the study. RESULTS: Over time, mania scores significantly decreased (large effect size), but more so in the clonidine condition, compared to the placebo condition (medium effect size). Likewise, over time, subjective sleep improved (large effect size), but more so in the clonidine, compared to the placebo condition (medium effect size). Over time, cognitive performance improved (medium effect size), irrespective from the study condition. CONCLUSIONS: Compared to placebo, adjuvant clonidine to lithium improved symptoms of mania, as rated by experts', and subjective sleep quality. Adjuvant clonidine had no further favorable (or detrimental) impact on cognitive performance.

Influence of modafinil on early ejaculation - Results from a double-blind randomized clinical trial.

BACKGROUND: For men, early ejaculation is a serious health concern. Here, we tested the influence of modafinil (Profinil®) on early ejaculation. To this end, we performed a double-blind randomized clinical trial among men with early ejaculation. METHODS: A total of 46 men with early ejaculation (mean age: 37.35 years) and in stable marital relationships with regular weekly penile-vaginal intercourse were randomly assigned either to the modafinil (100 mg) or to the placebo condition. Compounds were taken about 4-6h before intended penile-vaginal intercourse. At baseline and four weeks later at the end of the study, participants completed a series of self-rating questionnaires covering early ejaculation. Female partners also rated their male partners' early ejaculation profile. RESULTS: Dimensions of early ejaculation improved over time, but only so in the modafinil condition, while no improvements were observed in the placebo condition. CONCLUSIONS: Among male adults in stable marital relationships with regular weekly penile-vaginal intercourse modafinil improved dimensions of early ejaculation, always compared to placebo. Given the strong effect of modafinil on cognitive-executive processes, it is conceivable, that modafinil acted both via physiological and cognitive-executive pathways.

Influence of Lisdexamfetamine Dimesylate on Early Ejaculation-Results from a Double-Blind Randomized Clinical Trial.

BACKGROUND: Among male sexual dysfunctions, erectile dysfunction and early ejaculation have the highest prevalence rates. Here, we tested the influence of lisdexamfetamine dimesylate (Vyas®) on early ejaculation. To this end, we performed a double-blind randomized clinical trial among males with early ejaculation. METHODS: A total of 46 males with early ejaculation (mean age: 35.23 years) and in stable marital relationships with regular weekly penile-vaginal intercourse were randomly assigned either to the lisdexamfetamine dimesylate condition (30 mg) or to the placebo condition. Compounds were taken about six hours before intended penile-vaginal intercourse. At baseline and four weeks later at the end of the study, participants completed a series of self-rating questionnaires covering early ejaculation. Female partners also rated participants' early ejaculation profile. RESULTS: Compared to the placebo condition, dimensions of early ejaculation improved over time in the lisdexamfetamine condition, though improvements were also observed in the placebo condition. CONCLUSIONS: Among male adults in stable marital relationships with regular weekly penile-vaginal intercourse, lisdexamfetamine dimesylate improved dimensions of early ejaculation. Given that improvements were also observed in the placebo condition, psychological factors such as increased attention to early ejaculation and favorable expectations of the compound should be considered.

Non-linear associations between retinal nerve fibre layer (RNFL) and positive and negative symptoms among men with acute and chronic schizophrenia spectrum disorder.

BACKGROUND: Schizophrenia Spectrum Disorder (SSD) is a chronic psychiatric disorder with modest treatment outcomes. Changes in neuronal morphology may be associated with the symptomatology of SSD. In the present study, we compared the retinal nerve fibre layer thickness (RNFLT) of typically developed adults with that of individuals with SSD in both acute and chronic stages. METHODS: Fifteen healthy adult males (mean age: 36.40 years) and 30 individuals with SSD (mean age: 37.9 years) took part in the study. Among the latter, 15 had a chronic mean SSD for 15.33 years, while 15 were in an acute psychotic phase with a mean illness duration of 12.20 years. Experts rated positive and negative symptoms of SSD. Retinal nerve fibre layer thickness (RNFLT) of all participants was measured with optical coherence tomography (OCT). RESULTS: Compared to healthy controls, individuals with acute SSD had the lowest macula thickness in the right eye. For nerve fiber layer atrophy, participants with acute SSD showed the largest atrophy (right eye, inferior quadrant). For retinal thickness and macular volume cube, compared to healthy controls, participants with acute SSD had the lowest thickness in the subfield of the right eye. Non-linear associations were observed between RNFL and positive and negative symptoms: e.g., for macula central and subfoveal thickness (left and right eye) and for participants with both acute and chronic SSD, exclusively positive and exclusively negative symptoms (as opposed to prevalently negative with some positive symptoms or prevalently positive with some negative symptoms) were associated with lower volumes. In participants with acute SSD, a longer disease duration was associated with thicker RNFL, while in participants with a chronic SSD a longer disease duration was associated with a thinner RNFL. CONCLUSION: The present results confirm previous findings that specific neuronal morphological abnormalities can be observed among individuals with SSD. The non-linear associations between neuronal alterations and positive and negative symptomatology suggested that higher pronounced SSD severity appears to be particularly related to morphological changes. Disease duration and RNFL thickness were linearly associated, though, in opposite directions depending on the chronic or acute state.

Influence of Simvastatin as Augmentative Therapy in the Treatment of Generalized Anxiety Disorder: A Pilot Randomized, Placebo-Controlled Study.

BACKGROUND: Preliminary evidence is promising regarding the anxiolytic effects of statins in animal models of anxiety. Hence, this study aimed to evaluate the efficacy of simvastatin augmentation versus placebo in the treatment of patients with generalized anxiety disorder (GAD) with residual symptoms despite treatment with selective serotonin reuptake inhibitors (SSRIs). METHODS: A double-blind, 8-week controlled trial was conducted from August 2018 to December 2019 in an outpatient psychiatry clinic in Hamadan, Iran. A total of 138 patients with a diagnosis of GAD were assessed for eligibility. Of them, 84 patients who met the study criteria were randomly assigned either to the adjuvant simvastatin (20 mg/day) or to the placebo group. Standard medication consisting of SSRIs was consistent 2 months prior to and during the study. The severity of anxiety symptoms for each patient was assessed based on the Hamilton Anxiety Rating Scale (HAM-A) score at baseline, week 4, and week 8 after treatment. Additionally, blood lipid values were assessed at baseline and on completion of the study. RESULTS: Thirty-three out of 42 patients in the intervention group and 35 out of 42 patients in the control group completed the 8 weeks of the study period. Compared to the placebo group, in the simvastatin group cholesterol, triglycerides, and low-density lipoprotein significantly decreased, and high-density lipoprotein significantly increased over time. General linear model analysis demonstrated that although over time a higher decrease in mean HAM-A scores was observed in the intervention group compared to the control group, this difference was not statistically significant (p = 0.11). In addition, at the end of the study, the number of responders and remitters was comparable in the two groups. CONCLUSIONS: The results from this clinical study did not support the potential efficacy of adjunctive simvastatin in the treatment of patients with GAD. Thus, large-scale and long-term clinical trials are required to more accurately assess the potential efficacy of statins in the treatment of patients with anxiety disorders.

Serum oxytocin concentrations in current and recent suicide survivors are lower than in healthy controls.

BACKGROUND: Suicide and suicide attempts are dramatic events both for the individuals concerned and for their social circles. From a psychopathological perspective, suicidal behavior could be understood as a severe breakdown in relations with their social worlds. Oxytocin is a neuropeptide highly involved in the perception of facets of social relationship such as their quality feelings of belongingness, and mutual trust. Given this, we expected that serum oxytocin concentrations would be lower in current and recent suicide survivors than in healthy controls. METHODS: A total of 48 participants (mean age: 27 years; 62.5% females) took part in the study. Of these, 16 (62.5% females) survived a suicide attempt 12-24 h ago; 16 (62.5% females) had made a suicide attempt about 12 weeks ago, and 16 (62.5% females) were healthy age- and gender-matched controls. Blood samples were taken in the morning to assess serum oxytocin concentrations. Participants also completed questionnaires covering sociodemographic information and a scale assessing suicidal ideation. RESULTS: Compared to healthy controls, suicide survivors had significantly lower serum oxytocin concentrations, but these levels did not differ between current and recent suicide survivors. Compared to healthy controls and recent suicide attempters, current suicide attempters recorded significantly higher scores on the Beck scale for suicidal ideation. Across the sample as a whole, higher scores for suicidal ideation were associated with lower serum oxytocin concentrations. Serum oxytocin concentrations and scores on the Beck scale for suicidal ideation did not differ between females and males. CONCLUSIONS: Given that oxytocin is a neurobiological correlate of subjectively perceived quality of social interaction and social relationships, the results support the notion that suicide attempts are closely linked to suicide survivors' perceptions of the quality of their social lives. Speculatively, and based on the serum oxytocin concentrations, it also appears that 12 weeks after a suicide attempt, the survivor's perceived quality of social life has not significantly improved.

Diminished functional properties of T regulatory cells in major depressive disorder: The influence of selective serotonin reuptake inhibitor.

The properties of CD4+CD25hi T regulatory cells (Tregs), and interleukin (IL)-2 pathway were investigated in major depressive disorder (MDD) patients treated with or without selective serotonin reuptake inhibitor (SSRI). The frequencies of FOXP3 and pSTAT5 in peripheral Tregs were found to be diminished in untreated patients (SSRI-) versus HCs (p < .001 for both), while their percentages were increased in treated patients (SSRI+) versus untreated patients (p < .001 and p = .04). The proliferation of CD4+ T cells was higher in SSRI-MDD patients versus HCs (p = .03). The SSRI-MDD patients showed a lower concentration of supernatant TGF-ß than HCs (p = .001), while the production of TGF-ß was enhanced in SSRI+MDD versus SSRI-MDD patients (p = .003). The number of CD45RA-expressing Tregs, the expression of JAK1 and JAK3, and the levels of IL-2 and IL-10 were similar between the patients and HCs. The study results showed that untreated patients have an impaired IL-2 signaling pathway and defective Tregs, and SSRI treatment may improve the Tregs function.

Sociocultural Attitudes towards Appearance, Self-Esteem and Symptoms of Body-Dysmorphic Disorders among Young Adults.

Background: Beauty and an attractive body shape are particularly important during early adulthood, as both are related to greater mating success, positive social feedback, and higher self-esteem. The media may further influence common features of beauty. We tested whether higher body-dysmorphic disorder (BDD) scores were associated with sociocultural attitudes towards appearance. Additionally, we expected that a link between higher BDD scores and higher perceived media pressure would be mediated by lower self-esteem (SE). Method: 350 young Iranian adults (mean age: 24.17 years; 76.9% females) took part in the study. Participants completed questionnaires covering sociodemographic data, sociocultural attitudes towards appearances, and SE, while experts rated participants for symptoms of body dysmorphic disorders. Results: Higher BDD scores were associated with higher scores for sociocultural attitudes towards appearance, while SE was not associated with BDD or sociocultural attitudes towards appearance. Higher scores for sociocultural attitudes towards appearance and media pressure predicted higher BDD scores, while SE had no influence. Conclusion: Among young Iranian adults, sociocultural attitudes towards appearances and BDD scores, as rated by experts', were related, while SE was not. The shared variance between symptoms of BDD and sociocultural attitudes towards appearance was low, suggesting that other factors such as mating and career concerns together with social feedback might be more important in explaining symptoms of body dysmorphic disorders.

Prenatal and Postnatal Hair Steroid Levels Predict Post-Partum Depression 12 Weeks after Delivery.

BACKGROUND: Within three to six months after delivery, 13%-19% of women suffer from post-partum depression (PPD), understood as a dysfunctional adaptation to the postpartum condition and motherhood. In the present cross-sectional study, we compared the hair steroid levels of women 12 weeks before and after delivery and with or without PPD. METHOD: The present study was a cross-sectional study conducted twelve weeks after delivery. At that time, 48 women (mean age: 25.9 years) with PPD and 50 healthy controls (mean age: 25.2 years) completed questionnaires on depressive symptoms. Further, at the same time point, 6 cm lengths of hair strands were taken, providing samples of hair steroids 12 weeks before and 12 weeks after delivery in order to analyze hair steroids (cortisol, cortisone, progesterone, testosterone, and dehydroepiandrosterone (DHEA)). RESULTS: Compared to those of women without PPD, hair steroid levels (cortisol, cortisone, progesterone) were significantly lower in women with PPD both before and after delivery. Lower prenatal cortisone and progesterone levels predicted higher depression scores 12 weeks after delivery. Lower prenatal levels of cortisol and progesterone and higher levels of DHEA, and postnatal lower levels of cortisol, cortisone, and progesterone, along with higher levels of DHEA predicted PPD-status with an accuracy of 98%. CONCLUSIONS: PPD is associated with blunted hair cortisol, cortisone, and progesterone secretions both pre- and postpartum. Such blunted steroid levels appear to reflect a stress responsivity that is less adaptive to acute and transient stressors. It follows that prenatally assessed low hair cortisol and progesterone levels, along with high DHEA levels, are reliable biomarkers of post-partum depression 12 weeks after delivery.

Omega-3-polyunsatured fatty acids (O3PUFAs), compared to placebo, reduced symptoms of occupational burnout and lowered morning cortisol secretion.

BACKGROUND: Occupational burnout is both a serious health concern at both public and individual levels. Treatment options are psychopharmacological, psychological and physical activity-related interventions. Here, we tested whether, compared to placebo, omega-3-polyunsaturated fatty acids (O3PUFAs) have a positive impact on burnout and morning cortisol secretion. METHOD: A total of 43 individuals (mean age: 38.4 years, 76.7% females) took part in the present double-blind and placebo-controlled intervention. Participants were randomly assigned either to the O3PUFA or to the placebo condition. At baseline and again eight weeks later, participants completed the Maslach Burnout Inventory and collected morning saliva samples for analysis of the cortisol awakening response (CAR). RESULTS: Emotional exhaustion and depersonalization decreased, and sense of personal accomplishment increased over time, but more so in the O3PUFA condition than in the placebo condition. Likewise, CAR decreased over time, but again more so in the O3PUFA condition than in the placebo condition. CONCLUSIONS: The present pattern of results suggests that, compared to placebo, administration of daily omega-3-polyunsaturated fatty acids for eight consecutive weeks positively influences both psychological and physiological markers of occupational burnout.

Does rTMS on brain areas of mirror neurons lead to higher improvements on symptom severity and empathy compared to the rTMS standard procedure? - Results from a double-blind interventional study in individuals with major depressive disorders.

BACKGROUND: A key feature of major depressive disorders is the lack of emotional processing such as empathy. To counter this, we tested, if brain stimulation on areas rich of mirror neurons on the left inferior parietal lobe (lIPL) might improve emotional processing, including empathy, compared to a standard brain stimulation on the left dorsolateral prefrontal cortex (lDLPFC). METHODS: Twenty inpatients (mean age: 38.9 years; 55% females) with severe major depressive disorders and stable treatment of sertraline at therapeutic dosages were randomly assigned to either the rTMS condition on areas of mirror neuron stimulation, that is, the left inferior parietal lobe (rTMS-lIPL), or to the left dorsolateral prefrontal cortex (rTMS-lDLPFC; control condition). Interventions lasted for two consecutive weeks (2 × 5 interventions of 30'). At baseline and at the end of the study, patients completed questionnaires on current mood state and emotion regulation. In parallel, experts rated patients' depression severity. RESULTS: Mood improved over time, but more so in the control condition, compared to the rTMS-lIPL condition (medium-large effect sizes). Emotion regulation improved over time; specifically, empathy improved, but only in the rTMS-lIPL condition, compared to the control condition. Symptoms of depression decreased over time, but more so in the rTMS- lIPL condition. CONCLUSIONS: The pattern of results suggests that among inpatients with severe major depressive disorders, and compared to a standard procedure of rTMS, rTMS targeting on areas rich of mirror neurons appeared to improve emotion regulation, and specifically empathy, while there was no advantage on acute mood.

Effect of Rivastigmine (Acetyl Cholinesterase Inhibitor) versus Placebo on Manic Episodes in Patients with Bipolar Disorders: Results from a Double Blind, Randomized, Placebo-Controlled Clinical Trial.

BACKGROUND: To treat patients with bipolar disorders (BPD) during the acute phase, the standard procedure is to administer lithium or sodium valproate. To further optimize treatment, acetylcholinesterase inhibitors such as donepezil and galantamine have gained increased interest, though with conflicting results. In the present randomized, double-blind, placebo-controlled clinical trial, we investigated whether, and to what extent, adjuvant rivastigmine might improve symptoms of mania in patients with BPD during the acute manic phase. METHODS: A total of 70 patients with BPD in an acute state of mania (mean age 33.8 years; 24% females) took part in this study. After a thorough clinical interview, standard treatment consisted of 20mg/kg/day of sodium valproate; next, patients were randomly assigned either to the adjuvant rivastigmine or to the placebo condition. The study duration was 24 days. The dose of rivastigmine was 1.5 mg for the first 7 days and 3 mg from day 8 to day 24. Experts blind to the patients' study condition rated patients' mania scores, symptom severity, and symptom improvements at baseline (except symptom improvements) and 4, 8, 12, and 24 days after the beginning of this study. RESULTS: Symptoms of mania improved over time, but more so in the adjuvant rivastigmine compared to the placebo condition. Greater improvements were observed from day 8 on. CONCLUSIONS: The pattern of results from the present randomized, placebo-controlled, double-blind study suggests that adjuvant rivastigmine, a cholinesterase inhibitor, improved symptoms of mania among a larger sample of inpatients with BPD and in the acute manic state. However, the improvements were modest, and the results should be replicated and above all balanced against side effects.

Influence of adjuvant Coenzyme Q10 on inflammatory and oxidative stress biomarkers in patients with bipolar disorders during the depressive episode.

Bipolar disorder (BPD) is a severe and chronic mental disease with high rates of social and functional disability. To explain the emergence and maintenance of BPD, increasing attention has been focused on dimensions of inflammation and oxidative stress (OTS). Coenzyme Q10 (CoQ10) is known for its anti-oxidant and anti-inflammatory effects; accordingly, the aim of the present study was to investigate, if compared to placebo, adjuvant CoQ10 might favorably impact on serum levels of inflammatory and OTS biomarkers in patients with BPD during their depressive phase. A total of 89 BPD patients, currently in a depressive episode were allocated by block randomization either to the adjuvant CoQ10 (200 mg/day) condition or to the placebo condition. At baseline and 8 weeks later at the end of the study, serum levels of total antioxidant capacity (TAC), total thiol groups (TTG), catalase activity (CAT), nitric oxide (NO), malondialdehyde (MDA), tumor necrosis factor-alpha (TNF-α), interlukin-6 (IL-6), and IL-10 were assessed. 69 patients completed the 8-week lasting study. Compared to baseline and to the placebo condition, serum levels of TTG and TAC significantly increased, and TNF-α, IL-10, and NO statistically decreased over time in the adjuvant CoQ10 condition. No statistically significant changes were observed for CAT, MDA, and IL-6. The pattern of results suggests that compared to placebo and over a time lapse of 8 weeks, adjuvant CoQ10 favorably impacted on OTS and inflammatory biomarkers in patients with BPD during the depressive episode. Thus, CoQ10 might be considered a safe and effective strategy for treatment of patients with BPD during their depressive phase.

Risky Behaviors and Health-Promoting Behaviors in Young Adults: An Epidemiological Study.

Objective: Health behaviors are defined as activities that affect either health status or disease risk. They can be divided into 2 categories: risky behaviors and health promoting behaviors. The growing body of evidence indicates that unhealthy behaviors often cluster in young individuals. Patterns of health-related behaviors are significantly different among countries and even among various regions of a certain country. Method : The present study was conducted to assess the youths' patterns of health attitude, health-related behaviors, and their mental and physical wellbeing. In this cross-sectional study, 800 university undergraduate students were selected using multistage cluster sampling method. Standard questionnaires were filled by students. Results: About 13.3% of students smoked regularly and 14.3% reported at least one occasion of drinking, and heavy drinking was quite prevalent. Of the students, 95% reported regular physical activity and exercise. Eating habits were not healthy among the majority of students, as there was a high consumption of fast food and salt, and only 23.9% had normal body weight. Self-care behaviors were not prevalent among the students (3.2% breast self-exam and 8.5% testicular self-examination). Conclusion: Many factors may affect positive and negative heath behaviors, including knowledge, beliefs and attitudes, legal constrains, social context, and economic status. However, lower health literacy leads to more negative health behaviors.

Influence of adjuvant omega-3-polyunsaturated fatty acids on depression, sleep, and emotion regulation among outpatients with major depressive disorders - Results from a double-blind, randomized and placebo-controlled clinical trial.

BACKGROUND: Extant literature shows that adjuvant omega-3-polyunsaturated fatty acids (O3PUFAs) to a standard antidepressant medication impacts favorably on symptoms of depression in participants with major depressive disorders (MDD). The aim of the present study was to investigate, if and to what extent compared to placebo adjuvant O3PUFAs had a favorable impact on symptoms of depression, anxiety, sleep and emotion regulation among outpatients with MDD. METHOD: A total of 50 outpatients (mean age: M = 42.46; 68% females) took part in this randomized, double-blind and placebo-controlled study. They were randomly assigned either to the O3PUFA- or to the placebo-condition. Standard medication was sertraline at therapeutic dosages. At baseline, six weeks and 12 weeks later at study completion participants completed questionnaires covering symptoms of depression, anxiety sensitivity, intolerance of uncertainty, sleep disturbances, and emotion regulation. In parallel, experts blind to participants' group assignment rated participants' depression with the Montgomery-Asberg Depression Scale. RESULTS: Symptoms of depression (self- and experts' ratings) decreased over time, but more so in the O3PUFA condition, compared to the placebo condition. Likewise, anxiety sensitivity, intolerance of uncertainty and sleep disturbances improved, but again more so in the O3PUFA condition. Further, regulation and control of emotions and perception of other's emotions improved over time, but more so in the O3PUFA condition. CONCLUSIONS: Among outpatients with MDD, and compared to placebo, adjuvant O3PUFAs to a standard medication improved not only symptoms of depression, but also dimensions of anxiety and sleep, and above all patients' competencies to regulate their emotions.

Evaluating the Effect of Coenzyme Q10 Augmentation on Treatment of Bipolar Depression: A Double-Blind Controlled Clinical Trial.

BACKGROUND: Bipolar disorder (BPD) is a chronic and recurrent mood disorder characterized by episodes of mania, hypomania, and major depression. Based on available evidence, mitochondrial dysfunction, oxidative stress, and inflammation have important roles in the pathophysiology of bipolar depression. More specifically, it seems that coenzyme Q10 (CoQ10), a mitochondrial modulator, as well as an antioxidant and anti-inflammatory agent, might be effective in modulating these pathophysiological pathways. Accordingly, the aim of this study was to investigate whether and to what extent, compared with placebo, adjuvant CoQ10 might improve symptoms of depression in patients with BPD. METHODS: A total of 69 patients with BPD with a current depressive episode were randomly assigned either to the adjuvant CoQ10 (200 mg/d) or to the placebo group. Standard medication consisting of mood stabilizers and antidepressants was consistent 2 months prior and during the study. Depression severity for each patient was assessed based on the Montgomery-Asberg Depression Rating Scale scores at baseline, fourth week, and eighth week of the study. RESULTS: Symptoms of depression decreased over time in both groups. Compared with the placebo group, adjuvant CoQ10 to a standard medication improved symptoms of depression after 8 weeks of treatment. In addition, at the end of the study, it turned out that more responders were observed in the CoQ10 group, compared with the placebo group. CoQ10 had minimal adverse effects and was well tolerated. CONCLUSIONS: The present pattern of results suggests that among patients with BPD, compared with placebo, adjuvant CoQ10 probably because of its antioxidant and anti-inflammatory properties can improve symptoms of depression over a period of 8 weeks.