Association of Recalled Childhood Sex-Typed Behavior with Sexual Orientation and Gender Identity in Iranian Adult Males and Females.

Same-sex sexual attraction in both males and females has been associated with childhood sex-atypical behavior. Gynephilic females recall behaving in a manner that is less female-typical and more male-typical compared to cisgender androphilic females, whereas androphilic males recall behaving in a manner that is less male-typical and more female-typical compared to cisgender gynephilic males. In addition, male and female ambiphilic individuals exhibit intermediate levels of childhood sex-atypicality. In this study, we examined recalled childhood sex-typed behavior among Iranian cisgender gynephilic males (n = 236), cisgender ambiphilic males (n = 51), cisgender androphilic males (n = 191), transgender androphilic males (n = 60), cisgender androphilic females (n = 243), cisgender ambiphilic females (n = 96), cisgender gynephilic females (n = 32), and transgender gynephilic females (n = 122). Both cisgender androphilic males and cisgender gynephilic females recalled elevated childhood sex-atypicality, scoring intermediate between cisgender gynephilic males and cisgender androphilic females. Male and female ambiphilic participants scored intermediate between their other- and same-sex attracted cisgender counterparts. Transgender androphilic males exhibited hyper-feminized childhood behavior, scoring even more female-typical than cisgender androphilic females. Transgender gynephilic females recalled behaving as male-typical as cisgender gynephilic males. Consistent with previous research, our findings from Iran - a non-Western, Middle Eastern culture - provide cross-cultural support for the universality of childhood sex-atypicality as a normative developmental precursor of monosexual or ambisexual same-sex attraction in both males and females who are cisgender and transgender.

Occupational Preferences, Childhood Behavior, and Openness: The Role of Sex, Sexual Orientation, and Gender Identity in Iran.

Previous research suggests that both same-sex attraction and the personality trait "openness" are associated with sex-atypical preferences and behaviors. Here, we examined the links between adulthood occupational preferences, childhood play behavior, and openness among Iranian cisgender gynephilic males (n = 228), cisgender ambiphilic males (n = 48), cisgender androphilic males (n = 178), transgender androphilic males (n = 58), cisgender androphilic females (n = 226), cisgender ambiphilic females (n = 94), cisgender gynephilic females (n = 31), and transgender gynephilic females (n = 121) from Iran. Cisgender and transgender same-sex attracted males and females exhibited sex-atypical occupational preferences with the latter group showing even more sex-atypicality than the former. The personality trait openness did not differ between cisgender groups. Transgender androphilic males had a significantly higher mean score for openness compared to cisgender androphilic females and transgender gynephilic females, whereas transgender gynephilic females had a significantly lower mean score compared to cisgender androphilic males. In both males and females, childhood sex-atypicality, same-sex attraction, and openness were associated with sex-atypical occupational preferences. Our findings from Iran provides cross-cultural support for interconnectedness of childhood and adulthood sex-atypicality, openness, and same-sex attraction in males and females who are cisgender and transgender.

Cognitive rehabilitation in bipolar spectrum disorder: A systematic review.

Background and objectives: Neurocognitive deficits in bipolar disorder (BD) have a negative impact on the quality of life, even during the euthymic phase. And many studies conducted to improve cognitive deficits in bipolar disorder. This systematic review aims to summarize studies on cognitive rehabilitation (CR) conducted in bipolar patients and evaluate its impact on neurocognitive deficits. The primary objective is to explore how CR interventions can enhance cognitive functioning, treatment outcomes, and overall quality of life in this population. Methods: A comprehensive search was conducted on PubMed, Google Scholar, Scopus, Embase, and PsycINFO databases from 1950 to 2023, following the 2015 PRISMA-P guidelines, using search terms related to BD and CR. Results: The initial search yielded 371 titles across the five databases. After applying inclusion and exclusion criteria through screening, a total of 23 articles were included in the study. The selected articles evaluated verbal memory, attention, executive functions, and social cognition. Conclusion: The findings suggest that CR can be an effective treatment approach for bipolar patients, aimed at enhancing their cognitive abilities, treatment outcomes, and overall quality of life. The primary finding of this study indicates that cognitive-behavioral therapy (CBT) protocols, skill training, and homework exercises, which offer a daily structure, social support, and opportunities for exchanging coping strategies, are more effective in enhancing cognitive functions. However, it is important to acknowledge the notable limitations of this review. Firstly, we did not assess the methodological rigor of the included studies. Additionally, there was a lack of detailed analysis regarding specific cognitive rehabilitation approaches that adhere to core CR principles, resulting in increased heterogeneity within the reviewed studies.

The effect of considering eye movement time in evaluating the efficiency of attentional networks.

The attention network test (ANT) is a tool for assessing the executive, alerting, and orienting components of attention. However, conflicting findings exist regarding the nature and correlation between attention networks. This study aims to investigate the influence of eye movement time on the assessment of attention network efficiency. Forty male students, with an average age of 20.8 ± 1.3 years, participated in the study. The revised attention network test was conducted concurrently with the recording of the electrooculogram signal. The electrooculogram signal was used to estimate eye placement time on target stimuli. Considering eye movement time for calculating the score of each network was proposed as a novel method. The study explored the nature of attention networks and their relationships, and revealed significant effects for attention networks with and without considering the eye movement time. Additionally, a significant correlation is observed between the alerting and orienting networks. However, no significant correlation is found between attention networks using the proposed method. Considering eye movement time alters the assessment of attention network efficiency and modifies the correlation among attention networks.

Attitudes and Beliefs Towards Transgender Individuals Among Residents of Mashhad, Iran in 2020.

A growing number of studies show that transgender people are at higher risk for psychiatric morbidities. This increased vulnerability can result from the discrimination, violence, and other forms of stigma transgender people experience. Several studies have assessed the stigma by studying the public attitudes and beliefs towards transgender people. Using the Genderism and Transphobia Scale, we evaluated how citizens of a metropolitan city in Iran think and feel about transgender people. A total number of 1202 participants, with a mean age of 41.57 years ± 13.41 (27.4% cisgender men and 72.6% cisgender women), were recruited via a random cluster sampling. Demographic data and socioeconomic status were collected for all the participants. The findings showed a notable level of transphobia. Participants identifying as men, being single, personally acquainted with a transgender individual, possessing a higher education, and having a higher socioeconomic standing displayed significantly more positive views towards transgender people. Iranian transgender people, living under a theocratic state, experience more challenges compared to those live in Western countries. Our findings demonstrate that educational level accounted for much of the variance in transgender attitudes. Therefore, representing transgender issues in social media can educate the general population and positively change attitudes and behaviors.

The effect and efficiency of attentional networks and the brain electrophysiology.

The attention networks test (ANT) is frequently utilized to evaluate executive, alerting, and orienting attentional components. Additionally, it serves as an activation task in neuroimaging studies. This study aimed to examine the relationship between attention networks and brain electrophysiology. The study enrolled 40 right-handed male students (age = 20.8 ± 1.3 years) who underwent the revised attention network test, while their electroencephalogram signals were recorded. The study aimed to explore the effects of attention networks and their efficiencies on brain electrophysiology. The results indicated that the P3 amplitude was modulated by the conflict effect in the central (p-value = 0.014) and parietal (p-value = 0.002) regions. The orienting component significantly influenced P1 and N1 latencies in the parietal and parieto-occipital regions (p-values < 0.006), as well as P1 and N1 amplitude in the parieto-occipital region (p-values = 0.017 and 0.011). The alerting component significantly affected P1 latency and amplitude in the parietal and parieto-occipital regions, respectively (p-value = 0.02). Furthermore, N1 amplitude and the time interval between P1 and N1 were significantly correlated with the efficiency of alerting and orienting networks. In terms of connectivity, the coherence of theta and alpha bands significantly decreased in the incongruent condition compared to the congruent condition. Additionally, the effects of attention networks on event-related spectral perturbation were observed. The study revealed the influence of attention networks on various aspects of brain electrophysiology. Specifically, the alerting score correlated with the amplitude of the N1 component in the double-cue and no-cue conditions in the parieto-occipital region, while the orienting score in the same region correlated with the N1 amplitude in the valid cue condition and the difference in N1 amplitude between the valid cue and double-cue conditions. Overall, empirical evidence suggests that attention networks not only impact the amplitudes of electrophysiological activities but also influence their time course.

Long-term detoxification of opioid use disorder with opium tincture assisted treatment.

Introduction: Retention in treatment, craving, and relapse rate are important indicators of the success rate in addiction maintenance therapy as they evaluate the effectiveness of the therapy and make necessary adjustments to the treatment plan. However, the rate of continuation in the treatment process and the rate of craving in patients with opioid use disorder undergoing maintenance treatment with opium tincture have not been studied. The present study aimed to investigate the rate of relapse, craving, and psychiatric disorders in patients with opioid use disorder undergoing treatment of gradual detoxification with opium tincture. Methods: Ninety patients with opioid use disorder who underwent treatment with the gradual detoxification method using opium tincture in the form of Congress 60 for 11 months were enrolled in the study. The level of craving based on the Desire for Drug Questionnaire (DDQ) and patients' self-report of drug use, the level of anxiety, depression, and sleep quality of patients were evaluated using the Beck Anxiety Inventory (BAI), Beck Depression Inventory (BDI), and Pittsburgh Sleep Quality Index (PSQI), respectively. Also, suicidal thoughts were assessed by Beck Scale for Suicidal Ideation and quality of life by the World Health Organization Quality of Life Questionnaire (WHOQOL-BREF). Results: The study found that the treatment resulted in a relapse rate of 16.7% for relapse. We also found that all sub-scales of the desire for drug questionnaire (DDQ), depression, and anxiety were significantly lower at the end of the study compared to its beginning. Additionally, quality of life and sleep significantly increased at the end of the study. All areas of craving, anxiety, and depression significantly decreased in all follow-up sessions that took place 1, 5, and 11 months after the start of treatment. Moreover, sleep disorders were improved considerably at the end of the treatment. Conclusion: The current study presented a low relapse rate of Iranian patients with opioid use disorder under structured treatment of gradual detoxification with opium tincture in a one-year follow-up period. Opium tincture under the Congress 60 protocol may help to control carving, decrease psychological disorders, improve quality of life, and consequently, lower relapse rate.

A Comparison between Single and Double-Dose Intravenous Ketamine Administration in Bipolar Mood Disorder: A Double-Blind Controlled Clinical Trial.

Objective: As glutamatergic system dysfunction is involved in bipolar depression pathophysiology, the glutamate receptor modulators such as Ketamine have been applied as complementary medication for mood stabilizers. While the treatment is currently just the intravenous injection of a single dose, and there is no robust conclusion on Ketamine effectiveness or its side effects in bipolar patients, this study aimed to consider single- and double-dose intravenous injections of Ketamine in bipolar patients compared to the placebo. Method : In a randomized, double-blind controlled clinical trial, 30 patients diagnosed with bipolar I and II disorders according to DSM-IV-TR (SCID-I) were randomly divided into three groups: the first group received an intravenous injection of Ketamine (0.5 mg/kg) and placebo with a three-day interval, the second group received two doses of Ketamine (0.5 mg/kg) in the same interval, and the third group received two placebo injections. Patients were assessed for depression, anxiety, and mania at various time points, including before the injection, 60 minutes after the injection, on the first, third, fifth, seventh, and 14th day, as well as at the end of the first month using the Hamilton Depression Rating Scale, Beck Anxiety Inventory, and Young Mania Scale, respectively. Data were analyzed using ANOVA and Repeated measure tests. Results: The mean age of patients was 36.8 ± 7.9 years, with 18 females (60%) and 12 (40%) males. Depression and anxiety showed significant differences in both the single- and double-dose Ketamine groups over time (P < 0.01). Moreover, mania displayed significant changes during the study time in the single- and double-dose Ketamine groups, as well as the in the control group. However, during the study time, there were no significant differences observed in depression, anxiety, and mania among the three groups (P = 0.198, P = 0.416, and P = 0.540, respectively). Patients did not indicate any side effects during the study. Conclusion: Intravenous Ketamine administration may relieve depressive manifestations in bipolar patients. The findings suggest that a double dose of Ketamine does not lead to greater improvement than a single dose.

Does celecoxib with sodium valproate have an augmentation effect on acute mania in bipolar disorder? A double-blind controlled clinical trial in Iran.

Inflammatory processes in the brain play a role in acute mania etiopathogenesis. There is little evidence indicating the efficacy of celecoxib adjuvant therapy in treatmenting of manic episodes of bipolar disorder. Therefore, this clinical trial aimed to assess the celecoxib effect on treating acute mania. In a double-blind, placebo-controlled trial, 58 patients meeting the criteria for acute mania were enrolled. After considering eligibility, 45 patients were included in the study and randomly divided into two groups. The first group (23 patients) received sodium valproate 400 mg/day along with celecoxib 400 mg/day, and the second group (22 patients) received sodium valproate 400 mg/day and a placebo. The subjects were evaluated by the Young Mania Rating Scale (YMRS) at the beginning of the study and 9, 18, and 28 days following the initiation of the medication. Evaluation of baseline factors indicated a significant difference in age ( P = 0.01) and psychiatric history ( P = 0.02) between the two groups. However, other factors were similar between groups ( P ≥ 0.05). Comparing the YMRS score between celecoxib and placebo groups revealed no significant difference on days 0, 9, 18, and 28. However, the YMRS score at the end of the study decreased by 16.05 ± 7.65 in the intervention group ( P < 0.001) and 12.50 ± 5.98 in controls ( P < 0.001) compared to the baseline, the trend of change was not significant between the two groups during the time of the study ( F = 0.38; P = 0.84). Although celecoxib adjuvant therapy indicated no considerable side effects, a longer treatment duration may be needed to detect its beneficial effects for treating acute mania in bipolar patients. Trial registration: Iran clinical trial register: IRCT20200306046708N1.

The Effect of Adding Curcumin to Sertraline in the Treatment of Severe Major Depressive Disorder: A Randomized, Double-Blind Clinical Trial.

OBJECTIVES: Major depressive disorder (MDD) is a chronic and debilitating disease influenced by inflammatory processes in the brain. Some evidence has represented the adding curcumin as a complementary regime to the standard medication in treating depressive symptoms. However, limited clinical trials have been conducted on the antidepressants effects of curcumin in MDD patients. Therefore, this study aimed to investigate the effectiveness of curcumin in the treatment of MDD. METHODS: In a randomized, double-blind clinical trial, 45 severe MDD patients referred to the psychiatric clinic of Ibn-e-Sina Hospital, Mashhad, Iran, during 2016 were selected. Patients were randomly divided into 2 groups who received sertraline plus curcumin or placebo at a dose of 40 mg/d for 8 weeks. The patients were evaluated using Beck Anxiety and Depression Surveys at the beginning of the study, fourth, and eighth weeks by a psychiatry resident. The data analyzed aiding SPSS software. RESULTS: While depression and anxiety significantly decreased during the 8 weeks of the study, there was no significant difference between the 2 groups (P > 0.05). However, the anxiety score was lower in the intervention group. Moreover, no severe adverse events were observed in all patients. CONCLUSIONS: Adding 40 mg/d of SinaCurcumin to sertraline as a routine medical regimen did not improve the depression and anxiety levels in severe MDD patients. However, the anxiety score was lower in the intervention group than in the placebo receiver, which suggests curcumin may have a more effect on anxiety.

Efficacy and safety of palmitoylethanolamide as an adjunctive treatment for acute mania: A randomized, double-blind, placebo-controlled trial.

AIM: Palmitoylethanolamide is an endogenous fatty acid amide with neuroprotective and anti-inflammatory actions. We performed a randomized, double-blind, placebo-controlled clinical trial to investigate the efficacy and safety of palmitoylethanolamide combination therapy in acute mania. METHODS: Patients in the acute phase of mania were assigned into two parallel groups given either lithium (blood level of 0.8-1.1 mEq/L) and risperidone 3 mg plus palmitoylethanolamide 600 mg or placebo twice per day for 6 weeks. All participants were assessed with the Young Mania Rating Scale (YMRS), Hamilton Depression Rating Scale (HDRS), and Extrapyramidal Symptom Rating Scale (ESRS) at baseline and at weeks 1, 2, 4, and 6. RESULTS: A total of 63 patients (32 in palmitoylethanolamide and 31 in placebo groups) completed the trial. We found a significant effect for time×treatment interaction on the YMRS score (F = 5.22, d.f. = 2.34, P= 0.004) from baseline to study end point. Results from independent t test showed a significantly greater decrease in YMRS scores in the palmitoylethanolamide group, compared with the placebo group, from baseline to weeks 4 and 6 (P= 0.018 and P= 0.002, respectively). There was no significant difference between palmitoylethanolamide and placebo groups based on ESRS scores or ESRS changes in scores (P>0.05). CONCLUSIONS: Our findings provide preliminary evidence that palmitoylethanolamide is an effective adjunctive medication that improves manic symptoms and overall clinical status in acute episodes of mania. However, larger sample sizes and more extended follow-up therapy are needed in future studies to confirm our findings.

The Epidemiology of Gender Dysphoria in Iran: The First Nationwide Study.

Gender dysphoria (GD) is defined as a persistent and distressful incongruence between one's gender identity and one's at-birth-assigned sex. Sex reassignment has been religiously accepted for transgender individuals in postrevolutionary Iran since 1987; however, very little is known about how many individuals seek and receive such treatment annually. This study provides the first nationwide effort to assess the prevalence of GD in Iran as a function of diagnosis. The medical records of all transgender individuals referred to the Iranian Legal Medicine Organization between March 2012 and March 2017 were reviewed. All individuals diagnosed with GD were contacted. A total of 839 medical records meeting study criteria were received and evaluated. The prevalence of transgender individuals was estimated to be 1.46 per 100,000 Iranians with a transwoman (TW)/ transman (TM) ratio of 1:2. The mean age of individuals with GD at the time of referral was 25.22 (SD = 6.25) years for TW and 25.51 (SD = 5.66) years for TM. The findings are twofold. First, gender dysphoria is less prevalent in Iran than has been reported in Western countries. Second, the sex ratio is skewed toward at-birth-assigned females, which differs from what has been reported in Western countries. These findings have been interpreted in light of Iran's legal system, which is based on Islamic penal codes. These findings are of utmost importance for both health providers and legislators, as it can illustrate a more accurate picture of the transgender population in Iran.

Oxcarbazepine versus sodium valproate in treatment of acute mania: a double-blind randomized clinical trial.

Oxcarbazepine as an anticonvulsant has been suggested as an effective drug in affective disorders. The present study was designed to compare the efficacy of oxcarbazepine and sodium valproate in the treatment of acute mania in the Iranian population. In a double-blind, randomized clinical trial, hospitalized bipolar patients in the acute manic phase who were admitted to Ibn-e-Sina psychiatric hospital in Mashhad city (north-eastern part of Iran) were enrolled. The diagnosis was confirmed using Structured Clinical Interview for DSM-IV-TR. Patients were then randomly allocated into two groups taking oxcarbazepine (900-2400 mg/day) and sodium valproate (about 20 mg/kg/day) for 6 weeks. Young Mania Rating Scale (YMRS), Clinical Global Impression Scale (CGI-S), and adverse effects of drugs were assessed at baseline and after 3 and 6 weeks. Mania symptoms based on mean scores of YMRS and CGI-S significantly decreased from baseline to endpoint in both treatments (P < 0.01). However, there was no significant difference between the two groups in terms of reduction of symptoms during times (P = 0.715 and P = 0.446, respectively) and adverse events (P > 0.05). This study confirmed the previous findings that indicate the efficacy of oxcarbazepine as same as sodium valproate. Moreover, its adverse effects resemble sodium valproate in the treatment of acutely manic patients.

Comparison of Psychopathologic Characteristics between Individuals Undergoing Methadone Maintenance Treatment, Opioid Dependents, and Control Group.

Background: Methadone maintenance treatment (MMT) can theoretically reduce the psychosocial harms of opioid dependency. The increasing number of MMT clinics in Iran during the last two decades was not accompanied by a reduction in addiction rates. Therefore, this study was conducted to compare the psychopathological characteristics of individuals on MMT, opioid dependents, and a control group in the Iranian population. Methods: This cross-sectional study was conducted in Mashhad to evaluate the psychopathological profile of 99 participants (33 opioid-dependent individuals [ODI], 33 MMT clients, and 33 controls) using the Symptom Checklist-90-Revised (SCL-90-R) questionnaire and demographic form. Parametric and non-parametric tests were used to compare the mean score of symptoms between the three groups. The Spearman correlation test was used to test the correlation of psychological features with age and dependency duration. Findings: There was no significant difference between MMT clients and ODI regarding the Global Severity Index (GSI) and nine items of the SCL-90-R questionnaire. However, a significant difference was found between the controls and two other groups (P<0.001). Paranoid ideation in the ODI was more frequent compared to MMT clients significantly (P=0.015). Psychological characteristics had a direct correlation with dependency duration and an inverse correlation with age (P<0.05). Conclusion: Psychopathologic features observed in the dependent patients and MMT clients were significantly higher than in the control group. It seems that the psychopathology profile in MMT clients was not better than dependent individuals in Iran.

Accommodative and convergence anomalies in patients with opioid use disorder.

CLINICAL RELEVANCE: Considering the significant relationship between opioid abuse and some accommodative and convergence disorders, opioid use should be considered in the differential diagnosis and will directly affect the management plan. BACKGROUND: To determine the prevalence of accommodative and convergence anomalies and their related factors in a population of male young adults with opioid use disorder (OUD). METHODS: This cross-sectional study was conducted using a convenience sampling method in 2019. The study sample included male young adults with OUD who had been referred to a specialised drug-dependence rehabilitation centre in Mashhad, Iran. The diagnosis of OUD was made by a psychologist based on the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) criteria. All patients underwent complete optometric examinations. RESULTS: Eighty male young adults with OUD were included in this study. The mean age of participants was 30.5 ± 3.9 years (age range 19 to 35 years). The prevalence of accommodative and convergence disorders was 33.75% (95% CI: 23.55-45.19) and 25.00 (95% CI: 15.99-35.94), respectively. Accommodative insufficiency (22.5%, 95% CI: 13.91-33.21) had a higher prevalence than accommodative excess (3.75%, 95% CI: 0.78-10.57) and accommodative infacility (7.50%, 95% CI: 2.80-15.61). Convergence insufficiency (18.75%, 95% CI: 10.89-29.03) had a higher prevalence compared to convergence excess (3.75%, 95% CI: 0.78-10.57) and basic exophoria (2.50%, 95% CI: 0.30-8.74). According to the multiple logistic regression, a significant inverse relationship was observed between pupil size with accommodative insufficiency (OR = 0.45), accommodative infacility (OR = 0.67), and convergence insufficiency (OR = 0.55). CONCLUSION: The results of the present study showed a higher prevalence of some accommodative and convergence disorders in OUD patients compared to the prevalence reported in previous studies conducted on the normal populations with a similar age range.

Efficacy of repetitive transcranial magnetic stimulation in patients with obsessive-compulsive disorder: a pilot study.

BACKGROUND: Obsessive-compulsive disorder (OCD) is a common disabling psychiatric disorder. Considering the lack of an acceptable treatment response in many patients, several efforts have been made to increase the efficacy of therapy. We aimed to evaluate the efficacy of repetitive transcranial magnetic stimulation (rTMS) on the supplementary motor area in the treatment of patients with drug-resistant OCD and examine changes in brain function. METHODS: This quasi-experimental study was performed on 12 patients who were referred to outpatient clinics of Ibn-e-Sina psychiatric hospital and were diagnosed with OCD according to the clinical and diagnostic criteria of Diagnostic and Statistical Manual of Mental Disorders (DSM-5). All patients received 20 rTMS sessions in their right supplementary motor region. Main outcomes were assessed using quantitative electroencephalography (qEEG) and the Yale-Brown Obsessive Compulsive Scale (Y-BOCS) before and after the intervention. In addition, Y­BOCS was completed after 10 rTMS sessions and after the 6­week follow-up. Data were analyzed with SPSS. RESULTS: Ten of 12 patients completed this study, of whom 7 (70%) were female. The mean age was 36.66 ± 10.28 years. Y­BOCS overall score significantly decreased over time during the course of study compared to baseline (P < 0.05). A significant decrease in beta wave activity of the parietal and occipital regions was seen in posttreatment qEEG, compared with baseline (P < 0.05). CONCLUSIONS: rTMS over the supplementary motor area at 20 sessions could effectively improve Y­BOCS score and decrease beta wave activity in parietal and occipital regions. Further studies are needed to approve these findings in a controlled design.

Temperament and character traits in substance use disorder in Iran: a case control study.

BACKGROUND: Patients with Substance use disorder have distinct personality traits, they were high score in novelty seeking (NS) and sensation seeking and lower in Self-directedness and higher in Self-transcendence, so we aim to investigate the relationships of temperament and characteristics with related some variables such as substance of choice. DESIGN AND SETTING: A case-control study enrolling 70 Substance use disorder patients and 70 controls was conducted at Mashhad University of medical sciences. METHODS: Using a case-control design, a group of 70 Substance use disorder patients and 70 controls was conducted at Mashhad university of medical sciences. All participation completed the 240 questions of Temperament and Character Inventory-Revised (TCI-R). Multivariate analysis of covariance (MANCOVA) was employed to compare the relationship between temperament and character traits and patterns of substance use. RESULTS: The scores of reward dependence, persistence, self-directedness, cooperativeness, and self-transcendence were significantly lower in the case group compared to healthy individuals (P < 0.05). In contrast, the score of novel seeking was significantly higher in the case group (P < 0.05). On the other hand, harm avoidance was not significantly different between the two studied groups (P = 0.637). CONCLUSIONS: Higher NS in patients with substance use disorder is common and different traits, and temperaments would choose different substance combinations.

Effective Factors on the Recurrence of Bipolar Mood Disorder I in an Iranian Population Sample Using the Frailty Model with Bayesian Approach.

Objective: Bipolar I disorder is one of the most frequent mental disorders characterized by manic or mixed +/- depressive episodes. Drug treatment has been proved to diminish next episodes, but many other factors are important for exacerbating the conditions. This study aimed to investigate the effective factors on the time and number of episodes in these patients by applying the shared frailty model. Method : In this retrospective longitudinal study, the information of 606 patients with bipolar I disorder, admitted for the first time in Ibn-e-Sina psychiatric hospital in Mashhad from the beginning of 2007 until the end of 2009 were used. These patients were followed up until the end of 2018 for readmission. The Cox model with gamma frailty and Bayesian approach were used to determine the effective factors of frequent recurrences. Results: History of head trauma, substance abuse, and legal conflict had a positive impact on recurrences, while age had a negative effect on recurrences and the risk of recurrence was higher in younger people (P < 0.05). The variance estimation of frailty effect was 0.97 that indicates a correlation between the recurrence intervals of bipolar I patients, owing to a heterogeneity among patients. Conclusion: Based on the results, a higher risk of recurrence of bipolar I disorder was found in younger patients and those with a history of head trauma, substance abuse, and legal conflicts. Further investigations are required to account for the genetic factor and psychosocial exposure during critical periods applying this model.