Investigating the effectiveness of cognitive behavioral group therapy on psycho-social and emotional adaptability and cognitive flexibility in people with multiple sclerosis in Hamedan, Iran.

INTRODUCTION: Multiple sclerosis is a chronic disease that profoundly impacts the patient's life. This study investigates the effectiveness of cognitive behavioral group therapy on psycho-social and emotional adaptability and cognitive flexibility in patients with multiple sclerosis in Hamedan city. METHODS: The current study was semi-experimental and was designed with a pretest-posttest and follow-up with a control group. The statistical population included all people suffering from MS who referred to the MS association in Hamedan, Iran, in 2022, among whom 30 people were selected by sampling and randomly assigned to two experimental and control groups (each group of 15 people). The experimental group received cognitive behavioral intervention during eight sessions of 90 min weekly. The control group did not receive any interventions. The subjects were re-evaluated after 2 months for follow-up. The data were collected using a psycho-social adaptability with illness scale questionnaire, Bell's emotional adjustment questionnaire, and cognitive flexibility inventory questionnaire. The data were analyzed using variance analysis with repeated measurements using SPSS-21 software. RESULTS: The results revealed that the cognitive behavioral therapy intervention significantly impacted the improvement of psycho-social and emotional adaptability and cognitive flexibility compared to the control group. This impact persisted until the follow-up stage. CONCLUSION: Cognitive behavioral therapy removes cognitive barriers related to attitude and self-management by increasing the information, which improves psycho-social and emotional adaptability, cognitive flexibility, and, consequently, self-care behaviors.

Balance-energy of resting state network in obsessive-compulsive disorder.

Stability of the brain functional network is directly linked to organization of synchronous and anti-synchronous activities. Nevertheless, impact of arrangement of positive and negative links called links topology requires to be well understood. In this study, we investigated how topology of the functional links reduce balance-energy of the brain network in obsessive-compulsive disorder (OCD) and push the network to a more stable state as compared to healthy controls. Therefore, functional associations between the regions were measured using the phase synchrony between the EEG activities. Subsequently, balance-energy of the brain functional network was estimated based on the quality of triadic interactions. Occurrence rates of four different types of triadic interactions including weak and strong balanced, and unbalanced interactions were compared. In addition, impact of the links topology was also investigated by looking at the tendency of positive and negative links to making hubs. Our results showed although the number of positive and negative links were not statistically different between OCD and healthy controls, but positive links in OCDs' brain networks have more tendency to make hub. Moreover, lower number of unbalanced triads and higher number of strongly balanced triad reduced the balance-energy in OCDs' brain networks that conceptually has less requirement to change. We hope these findings could shed a light on better understanding of brain functional network in OCD.

Gender and age differences in suicide attempt: A large population study in the West of Iran.

Present study was to evaluate the relationship between suicide attempt, gender and age. We used all of suicide attempt entered in Hamadan Suicide Registry Program (2016-2017). Finding revealed that suicide attempt was lower among elderly patients. Using poison and self-immolation was more common in elder patients. Suicide attempt in females against males was higher in married. In males the higher rate of suicide attempt was in autumn, while in females was in summer. Using of drug was more frequent in females, while self-harm was more common in males. Gender and age are important risk factors of suicide attempts.

Complexity of information processing in obsessive-compulsive disorder based on fractal analysis of EEG signal.

The human brain is considered as a self-organizing system with self-similarities at various temporal and spatial scales called "fractals". In this scale-free system, it is possible to decode the complexity of information processing using fractal behavior. For instance, the complexity of information processing in the brain can be evaluated by fractal dimensions (FDs). However, it is unclear how over-elaboration of information processing impacts the dimensionality of its fractal behavior. In this study, we hypothesized that FDs of electroencephalogram (EEG) in obsessive-compulsive disorder (OCD) should be higher than healthy controls (HCs) because of exaggeration of information processing mainly in the frontal regions. Therefore, a group of 39 OCDs (age: 34.76±8.22, 25 female, 3 left-handed) and 19 HCs (age: 31.94±8.22, 11 female, 1 left-handed) were recruited and their brain activities were recorded using a 19-channel EEG recorder in the eyes-open resting-state condition. Subsequently, fractal dimensions of the cleaned EEG data were calculated using Katz's method in a frequency band-specific manner. After the test of normality, significant changes in the OCDs as compared to the HCs were calculated using a two-sample t-test. OCDs showed higher FDs in the frontal regions in all frequency bands as compared to HCs. Although, significant increases were only observed in the beta and lower gamma bands, mainly at the high beta. Interestingly, neurophysiological findings also show association with severity of obsessive behaviors. The results demonstrate that complexity of information processing in the brain follows an intimate nature of structural and functional impairments of the brain in OCD.

Predictors of completed suicide: Results from the suicide registry program in the west of Iran.

Suicide is a crucial public health problem with a serious harmful impact on individuals, families, and societies. Therefore, the current study aimed to evaluate the predictors of death or serious injury related outcome regarding this lethal phenomenon in Hamadan Province. In this registry-based study we used all of suicide attempt entered in Hamadan Suicide Registry Program from January 2016 to the end of 2017. Serious injury and death were considered as suicide worse outcome and its prognostic factors were examined using logistic regression model. From 2493 patients with suicide attempts in 5.61 % and 4.09 % of them, suicide behaviour led to serious injury and death, respectively. Males had 2.83 times higher odds of the worse suicide outcomes ([OR = 2.83, 95 % CI: 1.71, 4.68)], P < 0.001). Moreover, the odds of worse outcomes of suicide in individuals with low level of education, advanced age and with the history of suicidal ideation was significantly higher (P < 0.05). Among different suicide methods, the highest odds of suicide worse outcomes were related to self-immolation, falls, hanging, self-harm, poisoning, and drugs (P < 0.001). We found that the increase odds of suicide worse outcomes were associated with individuals advance age, low level of education, time of suicide attempt, previous history of suicidal ideation and choosing self-immolation, falls, hanging, self-harm, poisoning, and drugs as a suicide method.

Differential pattern of brain functional connectome in obsessive-compulsive disorder versus healthy controls.

Researchers believe that recognition of functional impairment in some of brain networks such as frontal-parietal, default mode network (DMN), anterior medial prefrontal cortex (MPFC) and striatal structures could be a beneficial biomarker for diagnosis of obsessive-compulsive disorder (OCD). Although it is well recognized brain functional connectome in OCD patients shows changes, debate still remains on characteristics of the changes. In this regard, little has been done so far to statistically assess the altered pattern using whole brain electroencephalography. In this study, resting state EEG data of 39 outpatients with OCD and 19 healthy controls (HC) were recorded. After, brain functional network was estimated from the cleaned EEG data using the weighted phase lag index algorithm. Output matrices of OCD group and HCs were then statistically compared to represent meaningful differences. Significant differences in functional connectivity pattern were demonstrated in several regions. As expected the most significant changes were observed in frontal cortex, more significant in frontal-temporal connections (between F3 and F7, and T5 regions). These results in OCD patients are consistent with previous studies and confirm the role of frontal and temporal brain regions in OCD.

Comparison of the Clusters and Non-Clusters Areas of Attempted Suicide Cases in Hamadan Province, Western Iran: Findings from a Pilot Study (2016-2017).

BACKGROUND: Suicide behaviors are complex and multifactorial problems that in the most of the societies are considered as the public health challenge. However, its underlying reasons and spatial pattern remain unclear in Hamadan Province, western Iran. STUDY DESIGN: Secondary analysis of existing data. METHODS: We assessed the spatial pattern pre-city regarding some influencing factors by scan-statistics and logistic regression to detect clusters areas and its comparison with other areas for the period of 2016-2017. All of the registered cases of attempted suicide in a quality registry system of suicide in Sina (Farshchian) Hospital affiliated to Hamadan University of Medical Sciences, Hamadan, Iran were enrolled. RESULTS: Two significant clusters were detected in study areas, formed with relative risk at 5.28 (P=0.001) and 6.33 (P=0.017), and with the centrality of Asadabad and Razan, respectively. Clusters and non-clusters areas were differed in terms of location (OR=0.15, 95%, CI: 0.07, 0.31), self-harms methods (OR=0.28, 95%, CI: 0.9, 0.88) and education. Residents of rural areas, illiterate people and non-drug user cases have more likely to be in a cluster. CONCLUSIONS: Clusters were not formed equally among cities of Hamadan Province. Accordingly, we suggest the implementation of appropriate, long-term and evidence-based educations for high-risk and vulnerable groups through the intersectoral interventions in different parts of Hamadan Province (considering the cluster and non-clusters areas) to avert deaths and related injuries from attempted suicide.

Executive functions, selective attention and information processing in patients with obsessive compulsive disorder: A study from west of Iran.

Obsessive-compulsive disorder (OCD) is associated with cognitive dysfunction. Deeper and wider knowledge of the cognitive components of these patients can play an important role in better understanding of this disorder. This study aimed to compare executive function, selective attention and information processing in OCD patients and healthy controls. The current study was performed on 54 patients meeting DSM-5 criteria for OCD and 54 healthy subjects who matched with patients in gender, age, marital and educational status. The cognitive functions were assessed by The Stroop test, Wisconsin Cart Sorting Test (WCST), Paced Auditory Serial Addition Test (PASAT) and the Yale-Brown Obsessive-Compulsive Scale (Y-BOCS). The performance of the OCD group was significantly worse than the healthy group in comparison with the all subscales of the Stroop and WSCT tests. Also, functions in information processing among two groups were statistically significant for 3- and 2-second PASAT. The results demonstrated that OCD patients have deficits in several aspects of cognitive functions. Hence, the treatment of these patients can be contributed by paying more attention to these deficits.

Cognitive Process in Patients With Obsessive-Compulsive Disorder: A Cross-Sectional Analytic Study.

INTRODUCTION: In recent studies, deficit in cognitive process has been investigated as one of the etiological hypotheses in a wide range of Obsessive-Compulsive Disorder (OCD). This research aimed to compare cognitive process in patients with OCD and healthy groups. METHODS: In the current cross-sectional analytic study, 43 patients with OCD and 43 healthy individuals matched with gender, age, educational and marital status were selected by convenience sampling method and assessed by Wisconsin Cart Sorting Test (WCST), Paced Auditory Serial Addition Test (PASAT) and Yale-Brown Obsessive Compulsive Scale (Y-BOCS). The obtained data were analyzed with Chi-square, Independent t test, Mann-Whitney U test and Pearson correlation in SPSS version16. RESULTS: There was no difference between the patients with OCD and the healthy group in demographic characteristics (P>0.05). There was a significant differences between two group on the all subscale of WCST test and PASAT3, PASAT2 tests (P<0.01). These findings indicate that the OCD patient's performance in cognitive process was significantly worse than the healthy controls. CONCLUSION: The findings indicate that individuals with OCD suffer from a deficiency in various aspects of cognitive processes. Therefore, paying attention to these deficiencies can make an important contribution to the treatment of these patients.

Orexin A induced antinociception in the ventral tegmental area involves D1 and D2 receptors in the nucleus accumbens.

Previous studies have shown that there are functional interactions among the lateral hypothalamus (LH), ventral tegmental area (VTA) and the nucleus accumbens (NAc), implicating pain modulation in the central nervous system. It has been shown that the LH-VTA orexinergic projecting neurons play an important role in mediating the suppression of nociception in animal models. However, little is known about the function of intra-VTA orexin receptors and involvement of D1/D2 receptors within the NAc in this antinociception. In the present study, we investigated the effect of direct administration of orexin A into the VTA, and examined the role of intra-accumbal dopamine receptors in tail-flick test as a model of acute nociceptive responses in rats. Adult male Wistar rats were unilaterally implanted by two separate cannulae into the VTA and NAc. The results showed that intra-VTA orexin A (0.055, 0.55, 5.5 and 55ng/0.3µl saline) could induce antinociception in a dose-dependent manner. In two separated supergroups, rats received intra-accumbal infusions of D1 and D2 receptor antagonists, SCH-23390 and sulpiride (0.125, 0.25, 1 and 4µg/rat) prior to intra-VTA orexin A (5.5ng/rat) administration respectively. Antinociceptive responses of drugs are represented as maximal possible effect in 5, 15, 30, 45 and 60min after their administrations. Our findings showed that intra-accumbal SCH-23390 and sulpiride dose-dependently prevented intra-VTA orexin-induced antinociception. Nevertheless, this effect is more potent in animals that received D2 receptor antagonist. It is supposed that orexin A can induce the antinociception through activation of orexinergic receptors which activate the dopaminergic inputs to the NAc in rats.

Forced swim stress but not exogenous corticosterone could induce the reinstatement of extinguished morphine conditioned place preference in rats: involvement of glucocorticoid receptors in the basolateral amygdala.

Addiction is a common psychiatric disease and stress has an important role in the drug seeking and relapse behaviors. The involvement of basolateral amygdala (BLA) in the effects of stress on reward pathway is discussed in several studies. In this study, we tried to find out the involvement of glucocorticoid receptors (GRs) in the BLA in stress-induced reinstatement of extinguished morphine-induced conditioned place preference (CPP) in rats. The CPP paradigm was done in adult male Wistar rats weighing 220-320 g, and conditioning score and locomotor activity were recorded by Ethovision software. Animals received effective dose of morphine (5mg/kg) daily, during the 3-day conditioning phase. In extinction phase, rats were put in the CPP box for 30 min a day for 8 days. After extinction, animals were injected by corticosterone (10 m/kg) or exposed to forced swim stress (FSS) 10 min before subcutaneous administration of ineffective dose of morphine (0.5mg/kg) in order to reinstate the extinguished morphine-CPP. To block the glucocorticoid receptors in the BLA, after stereotaxic surgery and placing two cannulae in this area bilaterally, animals received GR antagonist mifepristone (RU38486; 0.3, 3 and 30 ng/0.3 µl DMSO per side) prior to exposure to FSS then each animal received ineffective dose of morphine (0.5mg/kg) as drug-induced reinstatement. The results revealed that physical stress (FSS) but not exogenous corticosterone can significantly induce reinstatement of extinguished morphine-CPP, and intra-BLA mifepristone prevents the stress-induced reinstatement. It can be proposed that stress partially exerts its effect on the reward pathway via glucocorticoid receptors in the BLA.

Inhibitory effects of forced swim stress and corticosterone on the acquisition but not expression of morphine-induced conditioned place preference: involvement of glucocorticoid receptor in the basolateral amygdala.

Addiction is a common chronic psychiatric disease which represents a global problem and stress has an important role to increase drug addiction and relapse. In the present study, we investigated the effects of physical stress and exogenous corticosterone on the acquisition and expression of morphine-induced conditioned place preference (CPP). Also, we tried to find out the role of glucocorticoid receptors (GRs) of basolateral amygdala (BLA) in this regard. In the CPP paradigm, conditioning score and locomotion activity were recorded by Ethovision software. Male adult rats received forced swim stress (FSS) as a physical stress or corticosterone (10 mg/kg; ip) as a dominant stress hormone in rodents, 10min before morphine injection (5 mg/kg; sc) during three conditioning days (acquisition) or just prior to CPP test in the post-conditioning day (expression). In FSS procedure, animals were forced to swim for 6 min in cylinder filled with water (24-27 °C). To evaluate the role of glucocorticoid receptors in the BLA, different doses of mifepristone (RU38486) as a GR antagonist were injected into the BLA (0.3, 3 and 30 ng/side) during 3-day conditioning phase before FSS or injection of corticosterone in morphine-CPP paradigm. The results showed that FSS and corticosterone reduce the acquisition but not expression of morphine-induced CPP. Moreover, blockade of GRs in the BLA could diminish the inhibitory effects of FSS or corticosterone on the acquisition of morphine-induced CPP. It seems that stress exerts its effect on reward pathway via glucocorticoid receptors in the BLA.

Intrahippocampal administration of D2 but not D1 dopamine receptor antagonist suppresses the expression of conditioned place preference induced by morphine in the ventral tegmental area.

The ventral tegmental area (VTA) as a major source of dopamine neurons projecting to cortical and limbic regions has a crucial role in reward and addiction. The current study assessed the role of D1 and D2 receptors within the dorsal hippocampus (CA1) in the expression of conditioned place preference (CPP) by intra-VTA morphine in the rats. In the present study, 160 adult male albino Wistar rats weighing 220-290g were bilaterally implanted by two cannulae into the CA1 and VTA. The CPP paradigm was done and animal displacement, conditioning score and locomotor activity were recorded. For blocking the dopamine D1/D2 receptors in the dorsal hippocampus, SCH23390 (0.02, 0.05, 0.2 and 0.5µg per side) or sulpiride (0.25, 0.75, 1.5 and 3µg per side) were microinjected into the CA1, just 5min before the CPP test on the post-conditioning day. All animals received intra-VTA morphine (1µg per side) during 3-days conditioning phase. Our results showed that sulpiride (1.5 and 3µg) but not SCH23390 in the dorsal hippocampus significantly decreased the expression of CPP induced by intra-VTA morphine (p<0.001). Intra-CA1 administration of these antagonists alone, in all doses, could not induce CPP. We suggest that D2 receptors in the CA1 region of hippocampus have a key role in the expression of CPP induced by morphine at the level of the VTA and there is a relationship between dopaminergic D2 receptors and opioidergic systems in these areas in reward circuit.

The Role of Resilience and Age on Quality of life in Patients with Pain Disorders.

The quality of life (QOL) has been defined as ''a person's sense of well-being that stems from satisfaction or dissatisfaction with the areas of life that are important to him/her''. Age was also significantly associated with several functional limitations such as illness, and physical restrictions. The concept of ''resilience'' refers to successful adaptation that unfolds within a context of significant and usually debilitating adversity or life stress. The ability to adapt to pain may play an important role in maintaining the QOL. In this study, we investigated the role of resilience and age in various domains of quality of life such as physical, psychological, social and environmental domains. In this study, 290 adult patients (146 men, 144 women) completed the Connor-Davidson Resilience Scale and the WHOQOL-BREF questionnaire. Moreover, we illustrated several demographic variables. The results were analyzed using SPSS version 19.0 and means, descriptive correlation and regression were calculated. Our data revealed that resilience and age could significantly anticipate the QOL and physical aspect (P<0.001). In psychological, social and environmental domains resilience but not the age could significantly predict this domains. In addition, it is noticeable that the effect of resilience on the prediction of QOL is much more obvious in the psychological domain.. In conclusion, resilience is more important factor than the age in prediction of life quality (QOL) in persons suffering from chronic pain.

Prediction of Quality of life by Self-Efficacy, Pain Intensity and Pain Duration in Patient with Pain Disorders.

The quality of life (QOL) has been defined as "a person's sense of well-being that stems from satisfaction or dissatisfaction with the areas of life that are important to him/her". It is generally accepted that pain intensity and duration have a negative impact on the QOL. One specific type of control is "self-efficacy", or the belief that one has the ability to successfully engage in specific actions. The ability to adapt to pain may play an important role in maintaining the QOL. In this study, we investigated the role of self-efficacy, pain intensity, and pain duration in various domains of quality of life such as physical, psychological, social and environmental domains. In this study, 290 adult patients (146 men, 144 women) completed coping self-efficacy and the WHOQOL-BREF Questionnaire. Moreover, we illustrated numerical rating scale for pain intensity. The results were analyzed using SPSS version of 19.0 and means, descriptive correlation, and regression were calculated. Our data revealed that self-efficacy but not the pain duration could significantly anticipate the QOL and its four related domains (P<0.001). In addition, it is noticeable that the effect of self-efficacy on the prediction of QOL is much more obvious in the psychological domain. However, the pain intensity could predict all of the QOL domains (P<0.001) except social and environmental ones. In conclusion, to predict the quality of life (QOL) in person suffering from chronic pain, self-efficacy and pain intensity are more important factors than the pain duration and demographic variables.