Effects of Mindful Parenting Training on Clinical Symptoms in Children with Attention Deficit Hyperactivity Disorder and Parenting Stress: Randomized Controlled Trial.

BACKGROUND: Children with attention deficit hyperactivity disorder (ADHD) are at risk of impairment in multiple domains. This study aimed to investigate the effectiveness of mindful parenting training in reducing clinical symptoms in children with ADHD and parenting stress of their parents. METHODS: This randomized clinical trial was conducted on 2 groups (experimental and control) in 3 phases (pretest, posttest, and 8 weeks' follow-up). Sixty children with ADHD, who had been referred by the child psychiatrist in the Iranian city of Kashan in the second half of the year 2016, were selected along with their mothers. The mothers were assigned to one of the 2 groups via permuted blocked randomization. The mothers completed the parenting stress index-short form (PSI-SF 36) and the Swanson, Nolan, and Pelham Parent and Teacher rating scale (SNAP-IV). All the children in both groups received pharmacotherapy with either risperidone or Ritalin. The intervention group received 8 sessions (1 session each week, each session lasting 90 minutes) of mindful parenting training based on the Kabat-Zinn protocol. The data were analyzed using SPSS, version 20, via the t test, χ2 test, repeated measures analysis of variance, and nonparametric Friedman test. RESULTS: This study showed a reduction in parenting stress, negative parent-child interactions, and children's problematic characteristics in the mindful parenting training group compared with the control group in the posttest and follow-up. Our results also demonstrated a significant improvement in ADHD symptoms in the experimental group by comparison with the control group in the posttest and follow-up. CONCLUSION: Mindful parenting training was effective in reducing parenting stress and ADHD symptoms in our intervention group. Trial Registration Number: IRCT2016021026505N1.

Effect of vitamin D supplementation on depression in elderly patients: A randomized clinical trial.

BACKGROUND & AIMS: Treatment of depression in elderly population is a crucial issue. The effect of vitamin D supplementation on treatment of depression in older adults was investigated in this clinical trial. METHODS: It was an 8-week, randomized clinical trial of vitamin D supplementation and placebo in the treatment of depression in 3 psychiatric clinics. The study sample included 78 older adults aged over 60 years with moderate to severe depression. Subjects were randomly allocated to receive 50,000 U vitamin D3 pearl weekly for 8 weeks or placebo (39 subjects in each group). Main outcome measures comprised Geriatric Depression Scale-15 (GDS-15) questionnaire and 25-hydroxyvitamin D3 [25(OH)D3]. The analysis utilized Mann Whitney U test, Wilcoxon signed ranks test, chi-square and multiple regression analysis. RESULTS: The mean baseline 25(OH)D3 concentration was 22.57 ± 6.2 ng/ml in vitamin D group and 21.2 ± 5.8 ng/ml in placebo group (p = 0.16). The Vitamin D increased to 43.48 ± 9.5 ng/ml in vitamin D and 25.9 ± 15.3 ng/ml in placebo group. The depression score decreased from 9.25 to 7.48 in vitamin D group (p = 0.0001), while there was a non-significant increase in depression score in placebo group. The multiple regression analysis showed that the vitamin D group and the score of depression before study were the variables that could explain 81.8% of depression score after intervention. CONCLUSION: The findings indicated that vitamin D supplementation can improve the depression score in persons aged 60 and over.

An epidemiological study of obsessive-compulsive disorder among high school students and its relationship with religious attitudes.

BACKGROUND/OBJECTIVE: Considering the importance of mental health in adolescents, we studied the prevalence of obsessive-compulsive disorder (OCD) in this age group and determined its relationship with their religious attitudes. METHODS: In this survey, 293 students at different grades were selected using a multiphasic cluster sampling method. Subjects were asked to complete demographic, Yale-Brown scale, and religious attitude questionnaires. Those with scores higher than the cutoff value were interviewed by a psychiatrist, based on the DSM-IV criteria. Data were analyzed by chi2 and Student's t-test. RESULTS: The prevalence of OCD was 8.87% (5.1% in boys and 3.75% in girls). The majority of patients with OCD were from urban regions and had a positive family history in their first- or second-degree relatives. Nonetheless, there was no relationship between OCD and religious attitudes. CONCLUSION: The prevalence of OCD found in our study was higher than many of those reported earlier. Religious attitudes could only affect the contents of obsession and compulsion.

Effectiveness of cognitive behavioral therapy and fluoxetine on sexual function of women with obsessive compulsive disorder: A double-blind randomized controlled trial.

BACKGROUND: Obsessive compulsive disorder (OCD) is a mental health concern due to its various negative consequences, especially in sexual function. Therefore, the treatment of sexual dysfunction in women with OCD is important in order to improve the patient's marital function and mental health. OBJECTIVES: To compare the sexual behavior and sexual and marital satisfaction in women with obsessive-compulsive disorder (OCD) before and after treatment with fluoxetine and cognitive behavior therapy. METHODS: This randomized clinical trial was conducted at psychiatric and psychological counseling centers in Kashan (Iran) from January 2, 2014, to December 29, 2014. Fifty-eight women with OCD were included in the study. In order to compare the effectiveness of pharmacological treatment (fluoxetine) and psychological treatment, cognitive behavior therapy (CBT), 58 female patients with OCD (diagnosed based on DSM-IV-T criteria) were randomized equally to either fluoxetine (at a dose of 60-80 mg daily for 3 months) or CBT (10 45-minute sessions). OCD and sexual behavior status of the patients before and after the intervention was assessed with the Yale-Brown Obsessive Compulsive Scale (Y-BOCS) and Female Sexual Function Index (FSFI) questionnaire, respectively. The data were analyzed using SPSS version 22. To compare changes between the two groups, an independent T-test was used. Finally, the effects of all potential factors on treatment outcome were analyzed using factorial ANCOVA. RESULTS: The mean score for OCD in the fluoxetine group was 25.6 ± 4.8 at the beginning of the experiment and 18.79 ± 4.26 at the end of the study, while in the CBT group it was 25.6 ± 4.8 and 18.79 ± 4.26, respectively. No significant differences were found between two groups regarding obsession score changes. These scores in fluoxetine group were 58.1 and 52.8, respectively (p=0.046). There was a significant difference between the two groups in terms of sexual performance (p=0.003). CONCLUSION: In this study, our findings demonstrate a significant reduction in symptom severity of OCD after treatment with fluoxetine and CBT, indicating CBT can be an alternative for fluoxetine therapy in such patients. Therefore, both pharmacotherapy and CBT can be used for this purpose in clinical practices, but more studies are needed. CLINICAL TRIAL REGISTRATION: The trial was registered at the Iranian Registry of Clinical Trials (http://www.irct.ir) with the Irct ID: IRCT2013091014619N1. FUNDING: The authors received no financial support for the research, authorship, and/or publication of this article.

Stigma and its determinants among male drug dependents receiving methadone maintenance treatment.

BACKGROUND: The stigma attached to substance use is considered as a barrier to treatment, resulting in continued dependence and harmful consequences for the health of drug abusers and society. METHODS: In the current study, stigma and its relation with patient characteristics and secrecy was examined in people who were in treatment of drug dependency. Participants were 144 patients from two referral methadone treatment centers who completed a survey containing questionnaires about stigma, secrecy and other measures of drug use. RESULTS: Patients reported high levels of self-stigma and moderate levels of stigma-related rejection and perceived stigma as well as commonly using secrecy, as a way of coping. More experiencing of self -stigma was associated with unemployment, positive history of IV drug use, incarceration and heroin consumption, compared to opium use. IV drug users and unemployed persons also reported more contacts with stigma- related rejection. No association was found between stigma and previous history of treatment for substance abuse. CONCLUSION: Findings indicate stigma in individuals who are in the treatment for substance dependence and highlight the need for more studies to clarify all aspects of drug use stigma.

The association of postpartum maternal mental health with breastfeeding status of mothers: a case-control study.

BACKGROUND: Maternal health status might have an important effect on breastfeeding, growth, and general health of the infants. OBJECTIVES: This study was conducted to assess the association between maternal mental health and breastfeeding status of mothers in Kashan province. PATIENTS AND METHODS: This case-control study was conducted on 458 mothers in two groups of unsuccessful breastfeeding (case) and successful breastfeeding (control) attending Kashan province health clinics. In this study, the GHQ questionnaire and clinical interview were employed to collect data. The data were statistically analyzed using Chi-square and Fisher's exact tests. RESULTS: It was found that mothers of the case group had a greater susceptibility to depression than those of the control group, that is, breastfeeding status was directly associated with susceptibility to depression (P = 0.001, OR = 5.48). Furthermore, there was a significant association between basic characteristics such as maternal occupational status (P = 0.04) or their educations (P = 0.006) with breastfeeding. Besides, clinical interview revealed that mixed depression and anxiety disorder was the most prevalent type of psychological disorder in the case group. CONCLUSIONS: Screening depression during pregnancy and postpartum period appeared to be necessary and it should be incorporated into prenatal and postnatal care due to its influence on mothers' successful breastfeeding.

Evaluation of emotional intelligence and job satisfaction in employees of kashan hospitals.

BACKGROUND: Job satisfaction and emotional intelligence are two important variables in organizational behavioral studies, and are key factors in promoting the efficiency of organizations. OBJECTIVES: The present study was conducted in order to determine the job satisfaction and emotional intelligence of employees of Kashan hospitals in 2011. MATERIALS AND METHODS: This cross-sectional study was performed on 121 employees of Kashan hospitals who were selected using random stratified method. In this study, Bar-on emotional intelligence and job satisfaction questionnaires were used. The data were analyzed using statistical methods such as odds ratio, Chi-square and Fisher's exact test. RESULTS: The majority of employees (76%) had moderate emotional intelligence while 88.2% of them had moderate job satisfaction. In this study, there were no significant relations between emotional intelligence and variables such as sex, education, and marital and job status (P > 0.05) but significant relations were found between the age and emotional intelligence (P = 0.01). Furthermore, there was no significant relation between job satisfaction and demographic variables. Moreover, no significant relation was found between the emotional intelligence and job satisfaction (P > 0.05). CONCLUSIONS: As the majority of the staff had average level of job satisfaction and emotional intelligence and others were lower than average, it seems necessary for authorities to explore the reasons for job dissatisfaction to prevent job burnout, depression and developing a sense of helplessness in the staff. It is also recommended to hold educational workshops for the staff especially who are younger than 40 years to promote their emotional intelligence.