Iranian Journal of Psychiatry
Year:2016 | Volume:11 | Issue:1|Papers Count:9

Objective: Attention-Deficit/Hyperactivity Disorder (ADHD) is one of the most common behavioral disorders in children effecting the families and society. This systematic review examined the literature on the role of lead exposure in children with ADHD symptoms. Articles were analytically compared, focusing on the methodology used to assess exposure and adverse effects on children with ADHD.Method: Using the search strategy from six databases (Pub Med, PsycINFO, Web of Science, SID, IRAN Medex, IRAN DOC), hand searching in key journals, list of references of selected articles and gray literature, without time and language limitation, articles up to May 2014 were entered into this review. In this review, 1, 387 articles were acquired at the primary search. Study selection and quality assessment processes were done based on Cochrane library guidelines. After assessing the quality and inclusion and exclusion criteria, 18 articles were selected and entered into the data synthesis.Results: Blood Lead level (BLL) of less than 10μg/dL in children has been attributed to at least one type of ADHD i.e., Combined / Inattentive / Hyperactive-Impulsive. The results of this study revealed that in 16 out of the 18 studies, a significant association was found between BLL and one of the types of ADHD.Conclusion: Based on the findings of this study, even the BLL of less than the action level of 10μg/dL, chosen by Centers for Disease Control and Prevention (CDC), may affect children with ADHD.

Objective: Schizophrenia and other psychoses have devastating personal and social impacts and many efforts have been devoted to study prodromal syndromes for psychosis in order to achieve earlier detection and interventions. However, only few studies have been performed in developing countries on this subject, and there is a dearth of evidence in the Iranian population. In this study, we focused on conversion rate to psychosis and changes in prodromal symptoms in a group of first-degree relatives of patients with schizophrenia and to compare the conversion rate in those with and without prodromal symptoms as assessed by the Structured Interview for Prodromal Syndromes (SIPS) and Scale of Prodromal Symptoms (SOPS).Method: Participants were the first-degree relatives of hospitalized patients with schizophrenia at Roozbeh Hospital, Tehran, Iran. At baseline, a trained psychiatrist interviewed the participants using the SIPS and the SOPS and assigned them to high- or low-risk groups either based on the presence of prodromal criteria or seeking mental health services. After 12 months, the same examiner re-evaluated the participants in order to determine the changes in their symptoms and identify the probable transitions to psychosis.Results: One hundred participants, 50 participants within each of high- or low-risk groups, were recruited at baseline. Eight participants dropped out of the study. At the follow-up, the rate of transition to full psychosis among high-risk group was 13% (95% CI [0.029, 0.23]), whereas none of the low-risk participants developed psychosis. None of the high-risk participants demonstrated attenuation in their prodromal states after a one-year follow-up. In contrast, of the 50 low-risk participants, three experienced prodromal symptoms for psychosis during this period. High-risk participant’s illustrated higher severity in almost all of the SOPS items compared to the low-risk participants at both baseline and follow-up evaluations.Conclusion: Prodromal syndrome for psychosis based on the SIPS and the SOPS was a predictive factor for transition to psychosis after a 12- month period in a group of first-degree relatives of patients with schizophrenia admitted to a psychiatric hospital in Iran. Conducting further studies on this at-risk population is highly recommended in order to provide practical methods for early screening and therapeutic interventions.

Objective: Medically unexplained symptoms are physical symptoms, which cannot be explained by organic causes. This study aimed to investigate mental health in patients with medically unexplained physical symptoms.Method: One hundred outpatients who were admitted to the Electro Diagnosis Clinic of Imam Khomeini hospital, Ahvaz/Iran, participated in this study. Data were collected using physical examination, paraclinical examinations, and SCL-90-R, and analyzed through multivariate analysis of variance (MANOVA), Chi-square test and Fisher’s exact test.Results: The findings revealed significant differences between clients with medically explained and unexplained symptoms in obsessive compulsive and somatization (p<0.05). Differences in depression, anxiety, phobia, psychosis, aggression and paranoia were not significant (p>0.05).Conclusion: The present study suggested an association between some psychological problems and somatic symptoms. Therefore, screening for psychological impairments can improve clinical outcomes.

Objective: Standards of care and treatment of premenstrual syndrome (PMS) vary. Non-drug psychosocial intervention therapy is recommended for women with any kind of discomfort or distress caused by PMS. The current study examined the effectiveness of group cognitive-behavioral therapy on the symptoms of PMS at a girls’ dormitory of North Khorasan University of Medical Sciences.Method: In this quasi-experimental study, 32 female students with PMS who were majoring in nursing and midwifery and residing in the dormitory were selected using the convenience sampling method and were assigned to experimental and control groups. The Standardized Premenstrual Symptoms Screening Tool was used as the research tool. Eight sessions of cognitive-behavioral group therapy were held for the students Results: There was a significant difference in psychological symptoms before and after cognitive-behavioral therapy (p=0.012). Furthermore, cognitive-behavioral therapy was effective on social interferences caused by PMS symptoms (p=0.012).Conclusion: Group cognitive-behavioral therapy effectively alleviates PMS symptoms in female college students.

Objective: Since the study of driving behavior is of great importance, we conducted this research to investigate the psychometric properties and the factorial structure of the Manchester Driver Behavior Questionnaire (DBQ) in Iranian drivers.Method: This cross – sectional research was performed on a sample of 800 drivers (of category D and C) aged 23- 75 who were referred to Imam Sajjad Centre for drug Addiction Diagnosis. Manchester Driver Behavior Questionnaire (DBQ), a demographic questionnaire, were conducted to the sample. To analyze data, we used factor analysis, internal consistency (Cronbach' s’a), split half, and test-retest using SPSS18 Software.Results: As a result of reliability analysis and exploratory factor analysis by principal component and Varimax rotation, we extracted six factors (willful violations, unintentional errors, advertent errors, deliberate mistakes, unintentional violation, and unintentional mistakes, respectively). The factors reliability ranged from 0.65 to 0.75. The test-retest correlations of the DBQ and split- half reliability were 0.56 and 0.77, respectively.Conclusion: The results revealed that the Persian version of the DBQ in category D and C drivers is a valid and reliable tool to assess driving behaviors in Iranian drivers.

Objective: A significant increase in violence in the world and its impact on public health and society can be an important reason to offer solutions to reduce or control anger. Studies have shown that specific food groups may be effective in controlling mental disorders such as depression, anxiety and anger. The purpose of this study was to determine the relationship between food intake and Body Mass Index on state-trait anger expression in female students of Shahid Beheshti University of Medical Sciences.Method: In this cross-sectional study, 114 female students were randomly selected from dormitories of Shahid Beheshti University of Medical Sciences. Body height and weight were measured using the scale and stadiometer, respectively. The required data for evaluating the relationship between state-trait anger expression and food consumption groups were collected using State-Trait Anger Expression Inventory-2 (STAXI-2) and Food Frequency questionnaires.Results: The results revealed a significant negative correlation between consumption of dairy product and trait anger (angry reaction), (P=0.015). This association remained significant after adjustment of confounding factors. No significant correlations were found between other food groups as well as BMI and state-trait anger expression.Conclusion: The higher intake of dairy products reduced state-trait anger expression. This result is consistent with the findings of many studies on the effect of dairy consumption on mental disorders. Therefore, consumption of dairy products can be a solution for reducing anger.

Objective: There are controversial reports about factors that affect recovery from stuttering. In the present study, the effect of hand dominancy, fine motor and inhibition control on late recovery from stuttering was investigated among a group of Kurdish-Persian children who stuttered in Iran.Method: Twenty-two Kurdish-Persian children aged 7-14 years who stuttered were followed for 6 years. Based on the evaluation of three experienced speech therapists and parental judgments, these children were classified into recovered or persistent groups. Data about fine motor control of hand and inhibition control were obtained, using Purdue Pegboard and Victoria Strop Color Word Tests, respectively. Risk factors including sex, age, and family history of stuttering, handedness, inhibitory control and fine motor control of hand were compared between the groups and modeled to predict recovery from stuttering using logistic regression.Results: From the 22 participants, 5 (22.7%) recovered from stuttering. The recovered and persistent groups did not show significant differences in the interference effect. By dividing the scores of the Purdue Pegboard tests to the right and left hand, we created a new Handedness Index (HI). HI was significantly higher in the recovered group. The score of right hand was higher than the left in the recovered group, but no difference was found between the two hands in the persistent group. Among the investigated risk factors, only HI could predict the recovery from or persistency of stuttering with 94% sensitivity and 84% specificity.Conclusion: Handedness Index can predict the recovery from stuttering significantly among children who stutter.

Objective: It has been recognized that sleep has an important effect on emotion processing. The aim of this study was to investigate the effect of previous night sleep duration on autonomic responses to musical stimuli in different emotional contexts.Method: A frequency based measure of GSR, PR and ECG signals were examined in 35 healthy students in three groups of oversleeping, lack of sleep and normal sleep.Results: The results of this study revealed that regardless of the emotional context of the musical stimuli (happy, relax, fear, and sadness), there was an increase in the maximum power of GSR, ECG and PR during the music time compared to the rest time in all the three groups. In addition, the higher value of these measures was achieved while the participants listened to relaxing music. Statistical analysis of the extracted features between each pair of emotional states revealed that the most significant differences were attained for ECG signals. These differences were more obvious in the participants with normal sleeping (p<10-18). The higher value of the indices has been shown, comparing long sleep duration with the normal one.Conclusion: There was a strong relation between emotion and sleep duration, and this association can be observed by means of the ECG signals.

When a literature review on pediatric obsessive-compulsive disorder (OCD) is performed, it is observed that there is a dearth of research on preschool period OCD cases. Although cognitive behavioral therapy is recommended as the first line of treatment in preschool OCD cases when patients do not show adequate response to CBT, psychopharmacological treatment offers an alternative. The first line used in psychopharmacological treatment is selective serotonin reuptake inhibitors (SSRI’s). However, no SSRI’s (or any other drug group) have been approved by the FDA for this age group. Moreover, studies related to psychopharmacology in preschool OCD are very limited in the literature, consisting mostly of case reports related to sertraline and fluoxetine. In those studies, it is reported that sertraline and fluoxetine are effective in preschool OCD and generally well-tolerated. In this paper, we discussed the treatment and six-month follow-up period of a 3.5 year-old (42 months) female diagnosed with OCD and for whom escitalopram was used. In the literature, there is a retrospective case series related to this subject consisting of eleven cases, where improvement in symptoms is reported with escitalopram treatment in the five of six cases diagnosed with OCD. As far as we could find in literature, our paper is the second report on this subject. Our case also included the youngest patient to receive escitalopram for preschool period OCD and report its benefits.