Iranian Journal of Psychiatry
Year:2018 | Volume:13 | Issue:4|Papers Count:10

Objective: Metabolic syndrome (MetS) and depression are two important causes of disability in the elderly. The association between MetS and depressive symptoms in Iranian elderly is unclear. In this population-based study, we aimed at evaluating the relationship between MetS and its components with depression in Iranian elderly population. Method: This cross sectional study was derived from Amirkola Health and Ageing Project (AHAP). The participants of this study included 1560 elders over the age of 60 during 2012 and 2013. MetS was diagnosed based on Adult Treatment Panel III report and depressive symptoms according to Geriatric Depression Scale. Odds ratio (OR) and 95% confidence interval (CI) based on age and gender were estimated using regression logistic model. Results: Depressive symptoms were observed in 28. 7% of men and 46. 2% of women. Age-and gender-adjusted OR of depressive symptoms did not show a significant difference among the participants with or without MetS. A significant association between MetS components (including waist circumference, HDL-C, fasting blood glucose, triglyceride) and depressive symptoms was observed, but this association no longer existed after age and gender adjustment. Elevated blood pressure revealed a significant relationship with depressive symptoms in men only (OR, 0. 665; 95% CI, 0. 469-0. 943). Conclusion: Depressive symptoms were associated with blood pressure component but not MetS in the elderly population of Amirkola, Iran. This association highlights the relevance of norepinephrine signal and sympathetic nervous activity disturbance for the emergence of depressive symptoms in the elderly. Therefore, it is reasonable to consider depression in hypertensive patients, especially in men.

Objective: Prostaglandin I2 receptor plays a major physiologic role in the relaxation of arterial smooth muscle and vasodilation and possibly during migraine attacks. Therefore, in this study, the coding and noncoding exons and exon-intron boundaries of Prostaglandin I2 receptor gene were examined in patients with migraine headache and healthy controls and the potential effects of identified single nucleotide variations were evaluated using direct PCR-sequencing and in silico analysis. Method: In this study, the peripheral blood samples of 50 patients and 50 controls were examined to find any mutation in coding and noncoding exons and exon-intron boundaries of PTGIR gene. DNA was extracted and all the samples were amplified by polymerase chain reaction (PCR) and sequenced. Results: In this study, the patients had a mean age of 35. 235 ± 10. 99 years (range, 9– 60 yrs. ), and female to male ratio was 4: 1 in this group. The controls had a mean age of 35. 058 ± 11. 116 years (range, 8– 59 yrs. ), and female to male ratio was 3. 7: 1. 3 in this group. Two patients had mutations in exon 2. The first mutation was located in exon 2 (at amino acid position 251) of PTGIR gene at nucleotide position c. 866A > T, a synonymous variant described previously in the database. The second mutation was located in exon 2 c. 867G > A, which is a missense variant. Sequence analysis revealed high occurrence of previously reported intronic variants mostly in a homozygous statue. Conclusion: The data supported the hypothesis that mutations in PTGIR gene, particularly the mutation we described, should be considered even in cases of migraine. The presence of this mutation in patients with family history raises important issues regarding genetic counselling.

Objective: Psychosomatic attitudes may be rooted and grounded in the particular culture of the scientific community in each country. We conducted a qualitative research to understand the exclusive psychosomatic attitudes and psychosomatic medicine status of Iranian Psychiatrists. Method: This research was conducted using a qualitative content analysis based on Graneheim and Lundmanand method. All psychiatrists of Avicenna hospital, which is a teaching hospital of Mashhad University of Medical Sciences, were the target population of this study. Among them, 9 psychiatrists were selected by a non-random purposeful sampling method, and semi-structured interviews were used to collect data. Results: Results indicated that most psychiatrists do not have a proper understanding of the term “ psychosomatic medicine” , but they acknowledged the importance of an integrative approach in medicine. Biopsychosocial model, as a unified and integrated concept, can encompass all emerged categories and refers to the overall pattern in psychiatrists' attitude. Conclusion: Despite acknowledging the importance of a comprehensive approach to medicine and profound theoretical knowledge of psychiatrists, the practical application of biological, psychological, and social dimensions has not been considered equally. Thus, the scientific practical stand of this comprehensive approach requires more serious consideration by the medical community.

Objective: We aimed to examine the validity and reliability of the empathy quotient (EQ) and systemizing quotient (SQ) in a Farsi-speaking population. Method: This study explores the factor structure and psychometric properties of the Farsi translations of the 22-item version of EQ and the 25-item version of SQ among 542 young university students. Results: Applying a cross-validation approach, a 14-item two-factor model and a 15-item four-factor model for the Farsi translations of the short versions of EQ and SQ, respectively, were extracted from the exploratory dataset using exploratory factor analysis (EFA). Confirmatory factor analysis (CFA) on the validation dataset confirmed the factor structures identified by EFA. In addition, acceptable internal consistency and test-retest reliability were demonstrated for the Farsi translations of the 14-item two-factor EQ model and the 15-item four-factor SQ model. Conclusion: The results suggested further evidence in favor of the multi-factorial constructs of the EQ and SQ and validity and reliability of the scales.

Objective: Somatic symptoms are one of the most prevalent complaints in both psychiatric and general population, and validated scales are required to assess these problems. The present study was conducted to determine psychometric properties of the Persian version of Screening for Somatic Symptom Disorders-7(SOMS-7) in an Iranian population. Method: This was a multi centric comprehensive study conducted in Psychosomatic Research Center of Isfahan University of Medical Sciences in collaboration with Department of Clinical Psychology of Philipp University of Marburg, Germany. This part of the study includes 100 patients with anxiety/mood disorders and 291 healthy individuals. All participants completed the Patient Health Questionnaire (PHQ-15) and Screening for Somatic symptom disorders 7(SOMS-7). Data were analyzed by Pearson and Spearman correlation coefficient, factor analysis, independent t test, and discriminant analysis using SPSS-20 software. Results: Reliability coefficient based on Cronbach’ s alpha was 0. 92 and 0. 94 (clinical vs. healthy sample). Validity index of the SOMS according to correlation between factor 1 and 2 with PHQ somatic subscale was. 51 and. 59, respectively. Score of 15. 5 as cut-off point was accompanied with sensitivity of 77% and specificity of 66%. Factor analysis extracted 2 factors in patients and 4 factors in healthy population. Conclusion: Findings of this study indicated that the Persian version of SOMS-7 has appropriate reliability and validity for the assessment of somatic symptoms disorder and evaluation of treatment effects in these patients.

Objective: In recent years, protecting the rights of hospitalized psychiatric clients became a key issue in relationship-building and collaborative caretaking. Despite its importance, a few researches have been conducted on assessing the attitudes and expectations of clients and nurses about this issue. This study aimed to compare the nurses and psychiatric clients’ attitudes towards rights of hospitalized clients. Method: In this cross sectional descriptive study, 60 nurses, and 100 clients, who were admitted to various wards of a psychiatric hospital in Shiraz, were included. Data were collected using 2 questionnaires that were designed for nurses (22 questions) and patients (29 questions) about the rights of patients. Data were analyzed by descriptive and inferential statistics. Results: The results revealed that most of nurses (55%) and clients (64%) agreed with active participation of the clients in healthcare decision-making. More than half of the clients agreed with the possibility of refusal/withdrawal of the proposed treatment or leaving the hospital despite medical advice. Only 38. 3% of nurses agreed with those rules in some clauses (P-value < 0. 001). Conclusion: To protect the rights of mentally ill clients, their family, and the society, we should identify weaknesses and shortcomings of the basic rights of this group and make suggestions for their improvement. A legal bill, which covers the rights of mentally ill clients, could be a turning point for improvement of the quality of care as well as increasing clients' satisfaction.

Objective: Postpartum depression (PPD) is a condition which may compromise both maternal and neonatal health. The present study was conducted to determine the prevalence of PPD and its association with demographic, socioeconomic, obstetric, and household food security status. Method: This cross sectional study was conducted in community health centers in west of Tehran. A total of 325 women were selected by stratified sampling method from community health centers. A sociodemographic questionnaire, USDA 18-item questionnaire, and Edinburgh Postnatal Depression Scale (EPDS) questionnaire were used for data collection. Data were analyzed using both descriptive and analytic analyses, such as chi-squared test and logistic regression in SPSS 22. Results: The prevalence of PPD and food insecurity among the studied population was 35. 4% and 34. 2%, respectively. The results of this study revealed a significant association among PPD and food insecurity (OR = 6. 690, CI = 3. 118-14. 353, p<0. 001), the levels of economic satisfaction (OR = 3. 419, CI = 1. 241-9. 420, P = 0. 017), pregnancy loss (OR = 1. 899, CI = 1. 006-3. 582, p = 0. 048), and pregnancy complications (OR = 1. 853, CI = 1. 083-3. 170, P = 0. 024). Conclusion: Based on the results of this study, household food insecurity may predispose mothers to PPD. Moreover, it was observed that mothers with poor economic satisfaction were more likely to be depressed. Histories of pregnancy loss and pregnancy complications were other risk factors for PPD.

Objective: Verbal fluency tests (VFTs) are widely used in clinical practice and research to assess executive functions and are highly sensitive to frontal lobe lesions. However, using VFTs in different cultures and languages needs further considerations. The aim of this study was to provide a Persian (Farsi) version of verbal fluency with preliminary normative data. Method: In the first phase, 50 healthy native Persian-speaking individuals completed 1-minute VFT for all 32 letters in Persian to find letters with highest frequency. In the second phase, 100 healthy participants (50 females) were recruited into 5 age groups that were matched by gender and education. Participants were instructed to do 1-minute VFT for the 3 selected letters (phonemic VFT) and 3 categories (animal, supermarket, and fruit) (semantic VFT). For data analysis, one-way ANOVA was performed. Results: In the first phase, 3 letters (Pe standing for /P/, Meem for /M/ and Kaaf for /K/) had the highest frequency in word production (12 in average) and had been chosen for Persian phonemic VFT. Participants were assessed with the 3 selected letters (/P/: 12. 28± 3. 607, /M/: 12. 54± 3. 907, and /K/: 12. 48± 3. 708) and 3 semantic categories (animal: 21. 67± 5. 119, supermarket: 21. 19± 4. 907, and fruit: 19. 58± 4. 439) with 1-minute time limitation for each test. The results showed that education was significantly (p<0. 01) associated with the performance in the phonemic but not semantic scores, while age was not correlated with either of the tests. No significant effect of gender was observed. Conclusion: Based on our results, we recommend Persian letters Pe, Meem, and Kaff that have the highest frequency in word production among others to be used for neuropsychological assessments and future studies in the Persian language. This is the same logic behind selecting F, A, and S in the English version. Although the norms obtained in this study are preliminary, these results can be useful in clinical evaluation with considerations about age and educational levels. Moreover, the findings of this study can be used as an initial step for more comprehensive normative studies.

Objective: Domestic violence is the most common form of violence against women and a major health problem worldwide. The aim of this study was to examine the relationship between demographic factors and domestic violence during pregnancy through meta-analysis. Method: This meta-analysis study was conducted in Iran. All the articles published during 2001 up to Jun 2018 were extracted independently by 2 trained investigators from domestic and foreign databases including, Science Medlib, SID, Web of Science, PubMed, Science Direct, Irandoc, Medline, Scopus, Magiran, and Google Scholar with keywords and their compounds. The results of studies pooled using the random effects model Cochran and I2 tests were used to check heterogeneity. Data were analyzed using Stata Ver. 11. 2. Results: A total of 28 articles with the sample size of 15 020 people were included in the study. The findings of the meta-analysis showed that low level of maternal education (OR: 1. 68) (CI 95%: 1. 15, 2. 46), low education level of the spouse (OR: 1. 73) (CI 95%: 1. 31, 2. 29), unemployment of the husband (OR: 1. 61) (CI 95%: 1. 05, 2. 48), and smoking of the husband (OR: 2. 51) (CI 95%: 1. 64, 3. 84) were important factors in the increase in domestic violence during pregnancy. Having 3 children or fewer (OR: 0. 30) (CI 95%: 0. 16, 0. 56) and enough and regular visits to physicians to receive adequate prenatal care (OR: 0. 31) (CI 95%: 0. 16, 0. 57) were deterrent for violence during pregnancy. Conclusion: Based on our findings, level of education, unemployment, prenatal care, smoking, and number of children are associated with violence during pregnancy. Thus, paying attention to these factors and controlling them can reduce violence during pregnancy and its adverse consequences.

Methylphenidate, a stimulant, is prescribed commonly in the treatment of attention deficit hyperactivity disorder (ADHD) in children and adults. Methylphenidate is generally considered a safe medication, however, some rare adverse effects, such as psychotic symptoms, may occur with its therapeutic or high doses. Additionally, this medication has a potential of abuse, especially among teenagers. There are several published cases regarding methylphenidate-induced psychosis in young adults. However, psychosis due to methylphenidate has been rarely reported in the elderly. This case presents psychotic manifestations due to methylphenidate in a 65-year-old female who was taking this medication for ADHD. She consumed 3 to 4 methylphenidate hydrochloride tablets per day for several months and thought that they were sleeping pills. Antipsychotic medication was initiated and methylphenidate was discontinued which resulted in improvement of her psychosis. Alternative diagnoses, including bipolar mood disorder with psychotic feature or mood disorder due to general medical condition, were ruled out because her psychotic symptoms appeared after taking several methylphenidate tablets and disappeared after discontinuation of this medication.