Association between Sleep Quality and Neutrophil to Lymphocyte Ratio and Platelet to Lymphocyte Ratio in Patients with Bipolar Disorder.

Background: Many patients with bipolar disorder (BD) experience sleep problems. Sleep abnormalities are associated with immune dysfunction, which may be reflected by hematological indices. Purpose: This study aimed to investigate the association between sleep quality and the neutrophil-to-lymphocyte ratio (NLR) and the platelet-to-lymphocyte ratio (PLR) in patients with BD. Methods: This cross-sectional study was performed at Imam Hossein Hospital, Tehran, Iran, from March to September 2023. Hospitalized patients newly diagnosed with BD were interviewed to complete questionnaires. Sleep quality and manic and depressive symptoms of the participants were assessed using the Pittsburg Sleep Quality Index (PSQI), the Young Mania Rating Scale (YMRS), and the Hamilton Depression Rating Scale (HDRS), respectively. Furthermore, blood samples were taken from each patient to investigate hematological indices. Continuous and categorical variables were compared between groups using an independent-sample t test and chi-square/Fisher's exact tests, respectively. The Poisson regression model was also used to investigate predictors of the PSQI score. Results: Of 305 patients included in the study, 78.7% and 21.3% were experiencing manic and depressive episodes, and 90.20% had poor sleep quality. The prevalence of poor sleep quality was significantly higher in depressed patients than in manic patients (100% vs. 87.5%; P = 0.003). Depressed patients had significantly higher platelet counts (mean difference [MD], 34.09 [95% CI, 9.35-58.83]; P = 0.007) and PLR (MD, 38.14 [95%CI, 10.25-66.02]; P = 0.008) and lower lymphocyte counts (MD, 266.04 [95% CI, [14.41-517.67]; P = 0.038) compared with manic patients. The Poisson regression model with adjustment revealed that men (risk ratio [RR], 1.113; P = 0.025), those with lower educational levels (RR, 1.164; P = 0.001), and those with higher HDRS scores (RR, 1.370; P < 0.001) had significantly deteriorated sleep quality. Conclusion: Most bipolar patients have poor sleep quality, particularly those with depressive episodes. Depressed patients had significantly higher platelet counts and PLR. Also, depressed patients with male sex, lower educational levels, and more severe depressive symptoms had poorer sleep quality.

The Effectiveness of Telephone-based Psychological Services to COVID-19.

Background: The COVID-19 pandemic has disrupted the delivery of mental health services, leading to the development of telepsychiatry. Aim: The present study investigates the effectiveness of telephone-delivered treatment for psychological disorders of COVID-19 survivors in Tehran, the capital of Iran. Methods: In this non-randomized controlled trial, 91 COVID-19 survivors, primarily residents were enrolled. Participants completed a baseline questionnaire and a psychological screening questionnaire. The intervention included the telephone-based psychological services provided by trained psychiatric residents. The Post-Traumatic Stress Disorder (PTSD) Checklist (PCL) was administered to assess the presence of PTSD symptoms. Symptoms of anxiety and depression were measured by the Patient Health Questionnaire. Results: The General Health Questionnaire (GHQ) adjusted mean difference was significantly lower in the intervention group than in the control group. There was a significant negative correlation between the Spost-GHQ score and history of going to the clinic and history of psychiatric disorders, but no relationship with the history of hospitalization. All participants completed the satisfaction form, with almost half of them being "satisfied" or "very satisfied" with the telehealth calls. Conclusion: Telephonic delivery of psychological services showed an effective way of providing evidence-based psychological support during the pandemic. This telehealth program can offer much-needed assistance to individuals with COVID-19 improving their psychological wellbeing.

Prevalence of depression among pregnant women and its correlation with the choice of delivery method.

Background: Caesarean section is usually limited to cases where natural vaginal delivery is not possible or poses a serious risk to the foetus and mother. Psychological health of mothers is likely to play an important role in the method of delivery. This study aims to investigate the prevalence of depression in pregnant women and its relationship with the choice of delivery method and other demographic parameters. Methods: In this descriptive cross-sectional study, 250 mothers referring to the hospitals of Shahid Beheshti University of Medical Sciences, Tehran, Iran, were selected, and their demographic information and level of depression was collected using a questionnaire. Statistical analysis was conducted to evaluate the correlation between depression, method of delivery and other associated parameters. Results: Among 250 pregnant women, 225 (90%) had no depression, 25 (10%) had mild depression and no moderate or severe depression was reported in any pregnant mother. Also, 146 (58.4%) were willing to have a caesarean section and 104 (41.6%) wanted to have a normal delivery. The choice of delivery method was not significantly associated with depression. Analyzes showed that increasing maternal age is associated with a greater tendency to caesarean delivery. The incidence and higher depression scores of mothers showed a significant association with the history of previous abortions. Conclusion: Although in this study no significant association was observed between depression in pregnant mothers and the choice delivery, due to the high prevalence of caesarean section in the country and its progression to higher percentages, it seems that the design and implementation of effective programs and interventions is required.

Patterns of substance use and initiation timing in adults with substance abuse: a comparison between those with and without attention deficit hyperactivity disorder.

Background: Attention deficit hyperactivity disorder (ADHD) is a prevalent psychiatric disorder in childhood and adolescence, persisting into adulthood in 60% of cases, with an adult age prevalence rate of 4%. substance use disorder (SUD) is a recognized comorbidity with significant social and financial implications, necessitating detailed investigation. Materials and methods: This longitudinal study focused on adults with SUD in addiction detention in two camps including Toska and Chitgar in the west and south of Tehran during 2021-2022. Participants underwent assessment using the Structured Clinical Interview for DSM Disorders (SCID) to identify individuals with SUD, excluding those with major mental problems. The remaining subjects were assessed by Conner's questionnaire. And positive cases underwent a comprehensive ADHD interview. The study comprised 50 individuals with ADHD and 90 without ADHD, allowing for a comparative analysis of the onset age of substance use and patterns across both groups. The substances examined included alcohol, cannabis, crack, methamphetamine, tramadol, methadone, opium, ecstasy, morphine, and hypnotics. Results: The study revealed a lower age of onset of substance use in the ADHD group. Furthermore, individuals with ADHD exhibited higher rates of alcohol, cannabis, methamphetamine, and tramadol use, while the non-ADHD group showed elevated usage of Ritalin, methadone, ecstasy, morphine, and hypnotics. Conclusions: Prompt diagnosis and treatment of ADHD regarding the lower onset age of substance use and a further range of high-risk substances, such as alcohol, methamphetamine, and crack, would be crucial. Additionally, based on these findings, policy recommendations should emphasize early ADHD screening and intervention strategies to mitigate the risk of substance use disorders, thereby addressing the associated social and financial burdens.

The prevalence of depression and anxiety in premenopausal and menopausal women: A cross-sectional study.

Background and Aims: Targeted research on physiological and psychological changes during menopause is crucial. Most studies have prioritized the investigation of psychological disorders during menopause, with a limited comparison of mental health among women in the various stages surrounding menopause. This study aims to explore the difference in depression and anxiety prevalence between women in premenopausal and menopause. Methods: This cross-sectional study was conducted on 242 female participants referred to Imam Hossein (AS) Educational and Therapeutic Hospital affiliated with Shahid Beheshti University of Medical Sciences. These 242 individuals were selected through accessible sampling. 122 individuals were placed in the menopausal group and 120 individuals in the premenopausal group. First, the medical history of all participants was taken, and then the Beck questionnaire was administered to examine the levels of depression and anxiety. The association between the occurrence and severity of depression and anxiety in menopausal and premenopausal groups was statistically analyzed. Results: In this study, the age range of the participants was 45-70, the overall prevalence of depression was estimated to be 33.5% and the overall prevalence of anxiety was estimated to be 54.2%. The prevalence of depression was 30.2% and 36.6% in the menopausal and premenopausal groups, respectively. The prevalence of anxiety was estimated to be 52.5% and 55.7% in the menopausal and premenopausal groups, respectively. No significant difference was observed between the two groups in terms of the occurrence and severity of depression and anxiety. Conclusion: our study found a higher incidence of depression during premenopause compared to menopause, possibly due to greater hormonal fluctuations. Despite this, there wasn't a significant confirmation of this hypothesis compared to other groups. Nonetheless, there's a higher prevalence of depression and anxiety among premenopausal women, emphasizing the need for screening and intervention, such as hormone therapy, to prevent severe outcomes.

Validity and Reliability Assessment of the Complete Persian Version of the Temperament Evaluation of Memphis, Pisa, Paris, and San Diego Auto-Questionnaire in an Iranian Population.

Objective: The Temperament Evaluation of Memphis, Pisa, Paris, and San Diego - Auto-questionnaire (TEMPS-A) assesses five affective temperaments and has been translated into 32 languages. A 35-item short version is available in Persian, but the complete version is not yet translated. This study aimed to assess the validity and reliability of the complete Persian version of the TEMPS-A in an Iranian population. Method : This descriptive study translated the TEMPS-A questionnaire from English to Persian using a standard forward-backward method. The translation was evaluated for face and content validity by 10 psychiatry specialists, with quantitative content validity assessed through content validity ratio (CVR) and content validity index (CVI) calculations. The Persian TEMPS-A was completed twice, with a two-week interval, by 30 individuals out of the 319 medical staff of Imam Hossein Hospital in Tehran, Iran, who participated in the study, and its reliability was evaluated using Cronbach's alpha. The questionnaire was then distributed to the entire sample (n = 319) for the analysis of temperament frequencies and statistical indices by a statistician. Results: The Persian version of the TEMPS-A, consisting of 110 items across five factors (depressive, cyclothymic, hyperthymic, irritable, and anxious), demonstrated excellent reliability with Cronbach's alpha values of 0.910, 0.909, 0.911, 0.910, and 0.909, respectively. The questions related to cyclothymic and hyperthymic temperaments exhibited the highest and lowest correlation coefficients with the general scale, respectively. Most subscales in the Persian TEMPS-A version showed correlation coefficients ranging from 0.28 to 0.68. An ANOVA with Cochrane's test revealed a significant difference in the mean scores of the questionnaire items (P < 0.001), with a grand mean score of 1.73 across all questions. Conclusion: The Persian version of the TEMPS-A, consisting of 110 items, showed good internal consistency and a strong correlation with the original version. This suggests that it is suitable for use in temperament studies among the Iranian population.

Can l-carnitine reduce post-COVID-19 fatigue?

A significant number of patients infected with the new coronavirus suffer from chronic fatigue syndrome after COVID-19, and their symptoms may persist for months after the infection. Nevertheless, no particular treatment for post-disease fatigue has been found. At the same time, many clinical trials have shown the effectiveness of l-carnitine in relieving fatigue caused by the treatment of diseases such as cancer, MS, and many other diseases. Therefore, it can be considered as a potential option to eliminate the effects of fatigue caused by COVID-19, and its consumption is recommended in future clinical trials to evaluate its effectiveness and safety.

Prevalence of anxiety and depression among engineering students consuming cannabis.

Objective: Drug abuse is common among patients with mental disorder. The use of cannabis is likely to be associated with mental-health issues. The aim of this study is to investigate the prevalence of anxiety and depression among cannabis user in engineering college and associated demographic factors. Methods: In this study, 100 cannabis-consuming engineering students of (XXX) were selected by snowball sampling. After confirmation of cannabis use and individual selection according to DSM-5 criteria, Beck anxiety and depression inventories were used to access prevalence and severity of anxiety and depression among the participants. Demographic information such as age, gender, education and town of residence were also filled in a research questionnaire for analysis. Results: The overall frequency of people with anxiety in the population of cannabis users was 60% and the overall frequency of people with depression was 33%. The frequency of cannabis users was highest in the age range of 24-25, in men and participants with diploma. The prevalence and severity of anxiety and depression was not significantly associated with age, gender, education and town of residence among the participants, p > 0.05. Conclusion: Due to the higher frequency of anxiety and depression disorders in cannabis users in this study compared to the general population, cannabis use is likely to be associated with anxiety and depression.

COVID-19 and Acute Kidney Injury: A Systematic Review.

Introduction: Acute kidney injury (AKI) has been associated with an increased mortality rate among hospitalized patients with Coronavirus disease 2019 (COVID-19). The current review aimed to evaluate the symptoms, complications, and treatments performed to manage AKI in patients with COVID-19. Methods: We searched PubMed/Medline, Web of Science, and Embase for the relevant scientific literature published up to February 1, 2022. The following keywords were used: "COVID-19", "SARS-CoV-2", and "Acute kidney injury". Results: Forty-four studies with a total number of 114 COVID-19 patients with AKI (Mean age: 53.6 years) were included in our systematic review. The most common comorbidities in patients with COVID-19 suffering from AKI were the history of diabetes, hypertension, and hyperlipidemia. Twelve out of the 44 included studies reported a history of chronic kidney disease (CKD) in this group of patients. Focal segmental glomerulosclerosis (FSGS) and acute tubular necrosis (ATN) were the most common pathological evidence. The average length of hospital stay was 19 days, and the average duration of need for mechanical ventilation was 3 days. Conclusions: The current systematic review shows that AKI frequently complicates the course of COVID-19 hospitalizations and is associated with increased severity of illness, prolonged duration of hospitalization, and poor prognosis. Given the extent of the adverse impact of AKI, early detection of comorbidities and renal complications is essential to improve the outcomes of COVID-19 patients.

Prevalence of Mental Health Problems and Its Associated Factors Among Recovered COVID-19 Patients During the Pandemic: A Single-Center Study.

Introduction: The coronavirus disease 2019 (COVID-19), is profoundly affecting the mental health status. Although the burden of mental health problems has been reported in the general population and health care workers, little is known about the prevalence of mental health disorders among recovered COVID-19 patients and their associated factors. Methods: A cross-sectional telephonic-study of recovered COVID-19 patients with and without a history of hospitalization was conducted from April 20 to June 20, 2020, in Tehran, Iran. We assessed the anxiety symptoms, depression, and post-traumatic stress disorder (PTSD) among participants, using the Patient Health Questionnaire (PHQ-4) and PTSD checklist for DSM-5 (PCL-5). Logistic regression analyses were used to explore the risk factors associated with mental health problems. Results: A total of 602 individuals with a mean age of 53.2 years (SD: 14.7), completed the study. The rates of mental health symptoms among the respondents were 5.8% (95% CI: 4.2-7.8%) for anxiety, 5.0% (95% CI: 3.5-7.0%) for depression, and 3.8% (95% CI: 2.3-5.3%) for PTSD disorders. Moreover, being younger than 50 years and female gender was significantly associated with a higher probability of reporting anxiety (p < 0.01), and depression (p < 0.001 for being younger than 50 years, p < 0.02 for female gender). Conclusions: The current study indicated that patients with COVID-19 presented features of anxiety, depression, and PTSD. These results may help implement appropriate mental health intervention policies for those at risk and minimize the mental health consequences of the COVID-19.

Borderline personality disorder among cannabis users and its association with demographic variables

The abuse and chronic use of cannabis is associated with several physical and psychological adverse effects including depression and anxiety. Substance abuse is likely to be associated with increased frequency of borderline personality disorder. The aim of this study is to evaluate the prevalence of borderline personality disorder among engineering students, its severity and association with demographic variables.This descriptive cross-sectional study included 100 engineering students who were determined as cannabis abusers using DSM-5 criteria. These participants were evaluated for borderline personality disorder with borderline personality inventory (BPI) and based on the score were grouped as low probability of being a borderline personality, average probability of being a borderline personality and very likely to be borderline personality. Demographic information of the participants such as gender, age, town of residence and education were also collected in a research questionnaire for evaluation.Of 100 participants, 68% were males and 32% were females and the mean age of the participants was 24.1 ± 3.75 years. 54% participants had low probability, 37% had medium and 9% had high probability of borderline personality disorder. The incidence and severity of borderline personality disorder was not significantly associated with the gender, education, and area of residence p > 0.05, however it was significantly associated with the age, respectively.Our study showed that about 9% of the participants had high probability of borderline personality disorder regardless of their gender, education, and town of residence. Further studies with different age groups and larger sample size are required in this field. (AU)

El abuso y uso crónico de cannabis está asociado con varios efectos adversos físicos y psicológicos, incluyendo depresión y ansiedad. Es probable que el abuso de sustancias se asocie con una mayor frecuencia del trastorno límite de la personalidad. El objetivo de este estudio es evaluar la prevalencia del trastorno límite de la personalidad en estudiantes de ingeniería, su gravedad y asociación con variables demográficas.Este estudio transversal descriptivo incluyó a 100 estudiantes de ingeniería que fueron determinados como consumidores de cannabis utilizando los criterios del DSM-5. Estos participantes fueron evaluados para el trastorno límite de la personalidad con el inventario de personalidad límite (BPI) y, en función de la puntuación, se agruparon en baja probabilidad de ser una personalidad límite, probabilidad media de ser una personalidad límite y muy probable ser una personalidad límite. La información demográfica de los participantes, como sexo, edad, ciudad de residencia y educación, también se recopiló en un cuestionario de investigación para su evaluación.De 100 participantes, el 68% eran hombres y el 32% eran mujeres y la edad media de los participantes fue de 24,1 ± 3,75 años. El 54% de los participantes tenían baja probabilidad, el 37% media y el 9% alta probabilidad de trastorno límite de la personalidad. La incidencia y severidad del trastorno límite de la personalidad no se asoció significativamente con el género, la educación y el área de residencia p > 0,05, sin embargo, sí se asoció significativamente con la edad, respectivamente.Nuestro estudio mostró que alrededor del 9% de los participantes tenían una alta probabilidad de trastorno límite de la personalidad independientemente de su género, educación y ciudad de residencia. Se requieren más estudios con diferentes grupos de edad y un mayor tamaño de muestra en este campo. (AU)