Analyzing the network of parent-rated ADHD symptoms before and 2 weeks after the onset of pharmaceutical treatment.

PROBLEM: Via a network analysis approach, following 2 weeks of the medication Ritalin, the present study investigated the quality of symptom interactions and the pattern of behavior changes to identify locations of functional weaknesses in the network interactions of symptomology. METHODS: Ritalin® prescribed for 112 children (aged 4-14) with attention deficit hyperactivity disorder (ADHD) as diagnosed by five child and adolescent psychiatrists. Their parents completed Swanson, Nolan, and Pelham-IV questionnaire (SNAP-IV) before and after Ritalin® onset as the pre and post-test, respectively. Then, the network analysis approach was used to discover the pattern of changes in symptom interactions. FINDINGS: The results indicated that in 2 weeks following its initiation, Ritalin significantly reduced restlessness and interactions between symptoms of impulsivity. "Inability to follow instructions" and "difficulty waiting their turn" symptoms were the most central symptoms of strength. Three symptoms, "Often has difficulty waiting their turn," "runs and climbs in situations where it is inappropriate" and "does not follow through on instructions," had the most expected influence. In the 14-day period of investigation, Ritalin® was effective in breaking some interactions and components of ADHD, but no significant mitigation of other components of the detected symptomatology network. CONCLUSION: Follow-up investigations using network analysis can clarify the dynamics of the network changes after initiation of medications.

Investigating Cognitive Functions in Methadone Users in Comparison with Methadone and Methamphetamine Users and Control Group.

Background: Cognitive impairment in drug users is a marker for predicting recurrence and poorer adherence to treatment. The purpose of this study was to compare the cognitive function in three groups of methadone users methadone maintenance treatment (MMT), compared to methadone and methamphetamine (MAMP) users (MMT + MAMP) and healthy people (control group). Methods: Three groups of 90 people including 30 users of MMT, 30 users of MMT + MAMP, and 30 healthy persons participated in this cross-sectional and purposeful study. The study was performed on outpatients of MMT Clinic of Psychiatric Hospital in Kerman, Iran. The demographic and related data questionnaire was filled out. In addition, Persian version of the Brief Assessment of Cognition in Schizophrenia (BACS) was used to assess cognitive function. Findings: The mean of total number of scores and all BACS subscales were significantly better in control group than the other two groups of patients. Moreover, not only the mean of total number of BACS was significantly different between two substance abuser groups, but also there was a significant difference between them on verbal memory, digit sequencing, and token motor test, with MMT + MAMP group performing worse than MMT group. Conclusion: Concomitant use of opioids and stimulant substance such as MAMP results in cumulative toxic effect of them on brain and cognitive functions.

Evaluation of the Prevalence of Drug Abuse and Smoking in Parents of Children with Attention Deficit Hyperactivity Disorder.

BACKGROUND: Attention deficit hyperactivity disorder (ADHD) affects 5% of children. In addition to pharmacotherapy, non-drug treatments such as appropriate parenting are also very important in the treatment of these children. Diagnosis and treatment of parents with psychiatric disorders and substance abuse and evaluation of the frequency of these disorders in parents is critical. METHODS: In this case-control study, 200 parents were studied. The target population included parents of 7 to 12 year-old children who referred to child and adolescent psychiatric clinics. The control group included parents of children who referred to child non-psychiatric clinics. The parents were evaluated via a demographic information form, and structured interviews based on the Diagnostic and Statistical Manual of Mental Disorders, 4th Edition (DSM-IV) for nicotine and drug addiction. Then, the Hamilton Anxiety Rating Scale (HAM-A) and Hamilton Depression Rating Scale (HDRS) was used to assess their anxiety and depression. FINDINGS: Among the studied parents, the comparison of drug abuse, smoking, and stress showed significant differences between the two groups. In terms of depression and ADHD, the difference between the case and control groups was not statistically significant. CONCLUSION: The higher prevalence of these disorders in parents of children with ADHD may indicate the possible role of this disorder in the etiology.

Validation of the Persian version of the brief assessment of cognition in schizophrenia in patients with schizophrenia and healthy controls.

AIMS: The Brief Assessment of Cognition in Schizophrenia (BACS) is designed for assessment of cognitive function in patients with schizophrenia. Versions of the BACS in English and other languages have been shown to be as sensitive to cognitive dysfunction as a standard test battery, with the advantage of brief administration and scoring time. The present study aimed to test the concurrent validity of the Persian version of the BACS (Persian-BACS). METHODS: A group of 50 patients with schizophrenia-spectrum disorders and a group of 50 healthy controls received the Persian-BACS in a first session, and in a second session a standard neurocognitive battery. RESULTS: Cronbach's alpha for the Persian-BACS was 0.74. All the Persian-BACS subscales were significantly correlated with the corresponding standard neurocognitive subscales and the Pearson correlation of the composite scores from the two instruments was 0.71. Moreover, a one-factor solution was found that accounted for 67.9% of the variance. Finally, the Persian-BACS demonstrated high ability to discriminate patients with schizophrenia from healthy controls. CONCLUSION: Good psychometric properties of the Persian-BACS suggest that it is a useful tool for assessing cognition in schizophrenic patients with Persian as their primary language.

The Correlation between Methadone Dosage and Comorbid Psychiatric Disorders in Patients on Methadone Maintenance Treatment.

BACKGROUND: Methadone Maintenance Treatment is a useful method for opioid dependents, which results in harm reduction and increased quality of life in opioid dependents. The prevalence of psychiatric disorders in addicts is higher than in the general population which can interfere with the course and treatment of substance dependents and decrease the efficacy of treatment. METHODS: This descriptive, cross-sectional study was aimed to determine the correlation between psychiatric disorders and methadone dosage. It was performed on 154 patients of Kerman Shahid Beheshti Hospital's Methadone Clinic during a six month period from Dec 2010 to Jul 2011. The study population was chosen by convenience sampling. The searching tools were Socio-Demographic Questionnaire, psychiatric structured interview based on DSM-IV-TR, Beck Depression Inventory, Young Mania Rating Scales, and Anxiety and Depression Rating Scales. FINDINGS: Significant correlations were observed between increased methadone dosage and antisocial personality disorder. In addition, significant positive correlations were observed between increased methadone dosage and Hamilton anxiety scores, Hamilton depression scores and Young Mania scores. CONCLUSION: High methadone dosage may be a marker of coexisting psychiatric disorders in patients on methadone maintenance treatment which indicates the necessity of devoting further attention to this group. Psychiatric services should be open and accessible to the patients, especially those who seek treatment voluntarily. Early diagnosis and treatment of patients with coexisting psychiatric disorders may increase the efficacy of methadone maintenance treatment.

Attention deficit hyperactivity disorder (ADHD) and conduct disorder in children of drug dependent parents.

BACKGROUND: Attention deficit hyperactivity disorder and conduct disorder are amongrelatively prevalent disorders during childhood and adolescence.Considering the negative impact of the parents' drug dependency andbipolar disorder, the present study aimed to determine the prevalence ofADHD and conduct disorder in children of drug-dependent and bipolar parents. METHODS: In this case-control study, the case group included two groups ofpatients with drug dependency and bipolar disorder hospitalized inShahid Beheshti hospital in Kerman who had 7 to 11-year-old children.The control group included healthy individuals without any drugdependency or other psychiatric disorders. Data were collected usingRutter scale Form A (parents' form) and a demographic questionnaire.Data were analyzed with ANOVA, Chi-square and Tamhane's post-hoc test. FINDINGS: Rutter's abnormal scores were generally 7.11% in children of drugdependent parents, 14% in children of bipolar parents and 1.6% in childrenof healthy parents demonstrating no significant difference. The frequencyof conduct disorder in the bipolar and drug dependent group was higherthan the healthy group, but the difference was not significant. Thefrequency of ADHD was 8.9% in the drug dependency group and 1% inthe control group which shows a significant difference. CONCLUSION: Drug dependency in parents may be a leading factor to mentaldisorders such as ADHD and conduct disorder in children.

Post-traumatic stress disorder in bam-survived students who immigrated to Kerman, four months after the earthquake.

BACKGROUND: The 6.3 Richter earthquake in Bam killed 26,000 and injured 30,000 people, and destroyed 85% of houses according to the literature. Children are affected more than others by disasters. In this study, we assessed the rate of post-traumatic stress disorder and psychological problems in survived Bam students in Kerman four months after the earthquake and their relations with demographic factors, family loss, house destruction, and body injury. METHODS: A group of 433 students attended this cross sectional study. Watson post traumatic stress disorder questionnaire and Symptom Checklist-90 were applied for students older than 15 years of age and Yule post-traumatic stress disorder and Rutter (parents' version) questionnaires were used for students younger than 15. Multiple regression analysis was used to assess the effects of variables on psychopathologies. RESULTS: Post-traumatic stress disorder was detected in 36.3% of the students older than 15 years of age and 51.6% of the students younger than 15. Behavioral problems were present in 31.3% of the children and the mean score of Global Symptom Index was 1.13+/-0.59. Body injury and living with family were correlated with post-traumatic stress disorder and Symptom Checklist-90 items in students older than 15. Female sex was correlated with post-traumatic stress disorder and behavioral problems in students younger than 15. CONCLUSION: The prevalence of post-disaster post-traumatic stress disorder was high in children. Younger age, female gender, living apart from family, geographic living conditions, being in the center of stress or not after the earthquake, body injury, and loss of family members form the basis for developing post-disaster psychopathology. Due to incomplete presence of post-traumatic stress disorder criteria or high rate of overlooking post-traumatic stress disorder in children, the disorder may be misdiagnosed or remain undiagnosed in them, which warrants more consideration.