Dissociative Experiences In Iranian Depressed Patients.

In the present study, 229 major depressive disorder (MDD) patients (57.6% female; 42.4% male) were selected by convenience sampling and examined for rate of dissociative experiences. Research tools were Dissociative Experiences Scale (DES) and demographic questionnaire. Group difference examinations were performed for gender, settlement region (place of residence), and chief complaints using standard t-test, analysis of variance, and Chi-square tests as appropriate. Ordinal regression was implemented for model building. The average age of the sample was 36.78 ± 10.73. Of which, 150 (65.5%) lived in the urban and 79 (34.5%) in the rural areas. The chief complaint of the 146 patients (63.8%) was psychiatric symptoms specific to MDD, and the remaining 83 patients (36.2%) had physical symptoms. The average DES score was 10.59 ± 13.59; and a significant mean DES score differences (P < 0.01) between patients' referred to physician for physical versus psychological complaints (physical: 23.61 ± 14.39; psychological: 3.19 ± 4.5) and geographic settlements (rural: 19.58 ± 15.13; urban: 5.86 ± 9.86) were observed. This study highlights the presence of subtype within MDD patients with significant dissociative tendencies. Given the relationship between trauma history and dissociation, this subgroup could be considered as probable cases with childhood history of abuse, lending to use dissociation as a defense mechanism. Given the evidence for promising results of trauma-focused psychotherapy in treating such patients, paying proper attention to childhood history of depression especially with somatization may minimize pain and suffering of these individuals overtime.

Randomized controlled trial of aripiprazole versus risperidone for the treatment of amphetamine-induced psychosis.

BACKGROUND: Lifetime prevalence of amphetamine-induced psychotic disorder is reported as being up to 23% for methamphetamine (MA) abusers. Approximately 25% of those with a baseline DSM-IV diagnosis of substance-induced psychosis are diagnosed with primary psychosis at one-year follow-up. Evidence on the treatment of amphetamine psychosis is very limited. OBJECTIVES: To investigate the efficacy of risperidone versus aripiprazole in treatment of amphetamine-induced psychotic symptoms. METHODS: In a double-blind study, 45 participants were randomly allocated to either aripiprazole 15 mg or risperidone 4 mg daily over a six-week trial. Positive and negative symptoms of psychosis were assessed using the Scale for Assessment of Negative Symptoms (SANS) and the Scale for Assessment of Positive Symptoms (SAPS) at baseline and completion of the trial. RESULTS: SANS and SAPS scores decreased significantly in both groups. Mean SAPS score reduction in risperidone and aripiprazole group was 16.20 and 10.80, respectively, after trial course (p < 0.001). Mean SANS score reduction in risperidone and aripiprazole group was 9.35 and 11.25, respectively (p = 0.08). CONCLUSIONS: Both aripiprazole and risperidone were effective for patients diagnosed with amphetamine-induced psychotic disorder. However, risperidone had the greater effect on positive psychotic symptoms while patients with negative symptoms may respond better to aripiprazole. There is a case for further studies evaluating the efficacy of atypical antipsychotics in this disorder.

Compared to an active control condition, in persons with multiple sclerosis two different types of exercise training improved sleep and depression, but not fatigue, paresthesia, and intolerance of uncertainty.

BACKGROUND: In persons with multiple sclerosis (MS), physical activity favorably impacts on psychological well-being. The aims of the present study were to investigate the influence of physical activity on depression, fatigue, sleep, paresthesia, and personality traits (intolerance of uncertainty), and to explore, if endurance training or coordinative training are superior to an active control condition. METHODS: 92 female individuals with MS (mean age: 37.36 years; mean EDSS: 2.43) took part in this intervention study. Participants were randomly assigned either to endurance training, coordinative training, or to an active control condition. At baseline, 4 weeks, and 8 weeks later at the end of the study, participants completed questionnaires on sleep, depression, fatigue, paresthesia and intolerance of uncertainty. Exercise training interventions took place three times/week for 45 min/session. Participants in the active control condition also met with the same duration and frequency. RESULTS: Sleep complaints and symptoms of depression decreased over time, but more so in the exercising groups, compared to the active control group. No changes over time and between groups were observed for fatigue, paresthesia, and intolerance of uncertainty. CONCLUSIONS: Both endurance and coordinative exercising had the potential to favorably impact on some aspects of cognitive-emotional processing, while also an active control condition appeared to have a positive impact.

Trauma-focused cognitive behavioral therapy a clinical trial to increase self-efficacy in abused the primary school children.

BACKGROUND: Child abuse and violence toward children has become a complex phenomenon in nowadays societies leaving hurt children with numerous complications such as lowered self-efficacy. Hence, this study was conducted to assess the effect of trauma-focused cognitive behavioral therapy (TF-CBT) in physically abused children self-efficacy. MATERIALS AND METHODS: This study was a randomized clinical trial. From this statistical population of all abused children aged 9-12 in Kermanshah in 2016-2017, 40 were divided into intervention and control groups randomly. Tools used in this study were Maurice self-efficacy questionnaire and child abuse questionnaire. Data analysis was done using Chi-square test, paired t-test, and independent t-test. RESULTS: It was revealed that the mean difference between two groups was not meaningful before intervention. After TF-CBT in intervention group, self-efficacy mean scores of social (17.95 vs. 24.20) and emotional (15.05 vs. 19.05) domains showed meaningful differences, whereas academic self-efficacy mean score did not change significantly (14.10 vs. 14.65) (P < 0.086). In control group, social (16.20 vs. 15.55), emotional (13.90 vs. 14.35), and academic (13.40 vs. 13.90) mean self-efficacy scores were not of significant difference (P > 0.001). CONCLUSIONS: TF-CBT can be used as an appropriate therapy intervention to improve social and emotional self-efficacy in abused children.

Predictors of substance abuse among risky drivers: The role of personality characteristics and mental health.

BACKGROUND: Regarding the high prevalence of substance abuse and its serious complications, the necessity of assessing factors assuming to make tendency toward substance abuse is justifiable. MATERIALS AND METHODS: The statistical population consisted of all car drivers referred to traffic department in 2015 in Kermanshah. In this descriptive study of correlation type, 846 risky drivers from referrals to traffic department were randomly selected. Data were analyzed through NEO personality inventory, general health questionnaire, and discriminant analysis. RESULTS: Discriminant analysis was used to analyze data. Standard coefficients of discriminant function revealed that depression, social functionality, physical symptoms, neurosis, and anxiety symptoms were of the highest role in discriminant function while agreeableness and conscientiousness had the least role in discriminant function and its success. The discriminant analysis also showed that linear combination of above variables is able to explain about 75.5% of variance of difference between two groups (P < 0.0001). CONCLUSIONS: Regarding the results of this study, it is proposed that the role of personality characteristics as well as mental health in tendency toward substance abuse could be appreciated and included in preventive and treatment programs held for people with methamphetamine abuse.

Comparison of trauma-focused cognitive behavioral therapy and theory of mind: Improvement of posttraumatic growth and emotion regulation strategies.

BACKGROUND: Assessing various therapeutic methods with the intention to decrease the problems relevant to abused children is of high significance. Accordingly, the present study seeks to compare the effectiveness of trauma-focused cognitive behavioral therapy (TF.CBT) with an emphasis on the theory of mind on posttraumatic growth and emotional regulation strategies in abused children. MATERIALS AND METHODS: This quasi-randomized clinical trial study was done on 39 abused children who referred to welfare organization centers in Ahvaz - Iran. After randomized allocation, the TF. CBT and theory of mind method were implemented for two groups. Before and after the interventions, posttraumatic growth and emotional regulation strategies were assessed with using Kilmer's posttraumatic growth inventory and Garnefski emotional regulation questionnaire. RESULTS: The study findings indicated that the mean of the posttraumatic growth and adaptive and maladaptive emotional regulation strategies in the TF.CBT group was significantly higher than that of other study groups (P < 0.001). CONCLUSION: TF.CBT can lead to increased levels of posttraumatic growth and improve emotional regulation strategies in abused children. Theory of mind method can also be effective in improving emotional regulation strategies.

Demographic and mental history-related data predicted occurrence of psychosis in metamphetamine users.

Methamphetamine use is increasing worldwide, and the occurrence of psychosis further complicates treatment. This holds also true for Iran. The aim of the present study was to investigate possible predictors of metamphetamine-induced psychosis. 237 methamphetamine users (70.9% with psychosis; mean age: M=33.41 years) took part in the study. A psychiatric interview was performed covering socio-demographic and illness-related information. Male gender, low education, unemployment, being single, a history of mental disorders, and a higher number of previous hospitalizations predicted the occurrence of psychosis, while age and duration of metamphetamine use were excluded from the equation. Socio-demographic and mental illness-related dimension seemed suitable to predict occurrence of psychosis among metamphetamine abusers.

Mini Mental State Examination (MMSE) in First Episode of Psychosis.

OBJECTIVE: Neurocognitive deficits are now recognized as part of the fundamental disturbances and are a major determinant of functional outcome in psychosis. A cross-sectional association between cognitive deficits and poor social and occupational outcomes has been demonstrated; and treatment of cognitive impairment at the time of the first episode may have the potential to change functional outcomes of the illness. We conducted this study to evaluate cognitive function in first episode of psychosis by the Mini Mental State Examination (MMSE). METHOD: Sixty two patients with first episode of psychosis were selected and underwent psychiatric interview and took MMSE test. Statistical analysis was done using SPSS-18 software. RESULTS: According to MMSE scale, 47 patients (75.8%) showed definite cognitive impairment, 8(12.9%) showed possible impairment, and 7(11.3%) showed no cognitive impairment. According to MMSE subscale, registration (69.4%) and recall (77.3%) were the most impaired cognitive areas. CONCLUSIONS: The results of the current study indicate significant cognitive impairment in patients with first episode of psychosis. We recommend future studies with larger sample size and control group for further evaluation of cognitive function as early treatment of cognitive impairments may have important implications in the course of illness.

Trazodone in methandone induced erectile dysfunction.

OBJECTIVE: Based on findings of previous studies, those men on Methadone Maintenance Therapy (MMT) have a high prevalence of Erectile Dysfunction(ED), related to hypogonadism and depression. We conducted this study to evaluate the efficacy of Trazodone (an antidepressant which can improve sexual function) on this sexual dysfunction. METHOD: A structured interview was administered by the clinical staff. The interview contained questions about the subjects' socio-demographic characteristics, their drug use and sexual behavior. In addition to the socio-demographic survey, erectile function was assessed using erectile dysfunction (ED) intensity scale. Of the 157 subjects, 95 suffered from ED. The subjects were informed about the study. Then, seventy five patients voluntarily received 50mg of Trazodone for four days, and the dosage was increased to100 mg and maintained for 6 weeks. Fifty five patients who completed the treatment course were assessed by ED questionnaire again at the end of study. Statistical analysis was performed using Stata 8 software. RESULTS: The prevalence of ED was 60.5% in our sample. The mean erectile dysfunction (ED) intensity scale was 12.21, and 16.78 before and after the treatment course respectively. (P<0.05) ED severity had no significant relation with age and type of substance dependency (P>0.05); but it had a significant relation with duration of Methadone therapy and Methadone daily dosage. (p<0.05) CONCLUSION: Trazodone may be effective in the treatment of methadone induced ED. Further studies with control groups and greater sample sizes are warranted.