دارو درمانی

The aim of this study was to compare the effect of medication and combined medication and ACT on anxiety, worry, experiential avoidance and psychological hardiness of women with GAD. This was a quasi-experimental study with pre-test and post-test design with experimental and control groups. The present study population consisted of all women with GAD in Fereydunshahr city in the summer of 2017. Thirty women were purposefully selected as a sample and randomly assigned to three equal groups (10 people in each group). Medication was prescribed for all affected women, for at least a five-week period, and in combined intervention group, 8 one-hour sessions of ACT was performed individually. The Spielberger State-Trait Anxiety Inventory (Spielberger et al., 1983), Penn State Worry Questionnaire (Meyer et al., 1990), Multidimensional Experiential Avoidance Questionnaire (Gámez et al., 2011) and Psychological Hardiness Questionnaire (Kobasa et al., 1982) were administered before and after treatment. Covariance analysis was used for data analysis. The results showed that both medication and combined interventions in the experimental groups decreased the mean scores of anxiety, worry, and experiential avoidance, and increased the mean scores of psychological hardiness. Also, there was a significant difference between the experimental and control groups in the variables of experimental avoidance and psychological hardiness (P <0.05), and combined medication and ACT were more effective in these variables. According to the findings of this study, combined medication and ACT are more effective than medication in reducing GAD-related symptoms and features in women.

Attention deficit/hyperactivity disorder was regarded as one of the most prevalent disorders in children and adolescents. The present study aimed to investigate and compare the effects of drug therapy and attentional play therapy on neurological soft signs (NSS) and hyperactivity in children with ADHD. Multiple etiologies were described for ADHD, encompassing a combination of genetic, neurological, and environmental factors; among them, toxins, malnutrition, drug or alcohol use in pregnancy, and premature birth are strongly emphasized. Recent studies suggested that the prefrontal cortex and premotor area may have a crucial role in ADHD due to their interconnections with different subcortical areas. Furthermore, neuroimaging findings have shown that ADHD children may be suffering from impairments of consecutive functions, decision-making, problem-solving, time perception, and working memory. They also had lower scores in sustained attention, shifting attention, and emotion processing.The NSS is defined as minor and subtle sensory-motor abnormalities, which may be regarded as normal in infantile and childhood stages of development, but they would be regarded abnormal if they continued afterward. The NSS are not explicitly related to dysfunctions of the brain areas and are classified into three categories, including sensory integration, motor coordination, and motor sequencing. Some studies proposed that NSS with hyperactivity, inattention, and developmental delay in speech may be viewed as the initial and subtle signs of ADHD. Other studies found that NSS in children with ADHD was concordant with developmental delay due to cytoarchitecture of the cortex. In addition, other studies showed that there was a significant relationship between NSS and motor abnormalities in ADHD children. They also found that NSS was a reliable predicting factor in functional deterioration in ADHD. This fact, in turn, may lead to appropriate diagnosis and intervention for ADHD children. Some children with ADHD may concomitantly suffer from other disorders including conduct disorder and oppositional disorder, making them more vulnerable in their interactions with peer groups. Drug therapy was regarded as one of the first-line treatments for ADHD children, and methylphenidate proved to be effective via boosting noradrenergic and dopaminergic pathways in the frontal lobe cortex. However, drug therapy may be more useful in alleviating ADHD signs, and there remain some behavioral and relational signs that should be treated as well. Play therapy is a behavioral therapeutic approach by which children may gain opportunities to express their feelings freely and find resolutions for their problems through confronting reality. Some recent studies emphasized the effectiveness of play therapy in ADHD children. Some forms of play therapy are concentrated on attentional plays, by which the child learns to expand his/her attention span and control his /her impulsive behaviors, which in turn lead to enhancement of their attentional control. Accordingly, ADHD is a disorder with multiple signs; and different therapeutic approaches were examined and utilized in its treatment. Since different approaches were shown to be effective to different degrees of effectiveness, the present study was designed to evaluate and compare the effectiveness of play therapy and drug therapy in ADHD children, with an emphasis on neurological soft signs as a reliable predictor in the course of therapy.

This study was a quasi-experimental study with a pretest, post-test, follow-up and control group. The sample was selected from children with ADHD in the fourth grade of elementary schools in 2016. Conners test and Cambridge Neurological Inventory (CNI (were used in data collection. Of 170 pupils who were diagnosed with ADHD, 100 students were selected randomly, and the Conners parent scale (CPRS-48) and the Cambridge Neurological Inventory (CNI) were administered to them. Then, according to the NSS scores and determination of cutting point and determining the two groups of NSS on high and low levels (scores above and below the cutting point), the participants of each group were randomly assigned into two experimental and one control groups (in a total of six groups), and attentional games and drug therapy administered on experimental groups, separately. The control group was on a waiting list during the intervention. The CNI was standardized in 1995 and was extensively sued to evaluate neurological soft signs. The inventory comprised 25 questions, with three subscales for motor coordination, disinhibition, and sensory integration. Recent studies reported that the internal consistency of the inventory was 0.83, and in the current study, the validity was calculated as 0.75, with a Cronbach’s alpha of 0.83. The pharmacotherapy consisted of injecting Methylphenidate in a psychiatric clinic. NOVARTIS in Switzerland manufactured the drug. Attentional play therapy consisted of 15 sessions, which were performed by a clinical psychologist. Since there were two treatment types and two levels of scores in CNI, data analysis was performed by ANOVA through SPSS-23.

Before conducting an analysis of the variance, the assumption of homogeneity of variances was tested, and it was confirmed. The analysis of variance revealed that there was a significant difference between the groups of high and low NSSs and between the attentional plays and drug therapy groups as well. In other words, drug therapy was more effective on children who had high scores of NSSs, while attentional therapy was more effective on children who had low scores of NSS. A review of the findings of the post-test and follow-up phases showed that there were some differences in the dependent variables in experimental and control groups. Furthermore, it was found that there were differences among the groups in the pre-test, post-test, and follow up phases, suggesting an interaction effect between neurological soft signs and the type of treatment (P=0.000).

An essential suggestion of this study was that drug therapy and attentional play therapy had differential effects on NSSs, depending on severity of NSS. An significant finding of this study was that drug therapy was more effective on ADHD with higher neurological soft signs, while attentional play therapy was more effective on ADHD with lower NSS. The authors have not found previous studies with the same findings. Hence, this may be the first time a study revealed differential effects of play therapy and drug therapy on ADHD with different levels of neurological soft signs. The fact that methylphenidate was more effective on ADHD with a higher score of NSS suggested that motor coordination, motor integration, and continuous motor activities were potentially more possible to be altered with drugs. It was recently found that long-term prescription of methylphenidate may have a positive effect on cortical development of white matter, cingulate, and cerebellum. Moreover, according to new neuropsychological findings, ADHD was postulated as a neurodevelopmental disorder in which brain consecutive functions may be impaired; however, these consecutive functions were shown to be effectively improved after the prescription of methylphenidate. Another finding of this study was that attentional play therapy concentrated on attentional skills and decreased both ADHD signs and mild forms of neurological soft signs.

This research is a clinical trial with the trial ID 4N20171228038109, which was conducted with the aim of investigating the effectiveness of paroxetine on the clinical symptoms of social anxiety, depression, fear of negative evaluation, and quality of life in patients with social anxiety disorder. The statistical population of this research included all those who referred to psychological service centers and private psychiatric offices with the diagnosis of social anxiety disorder in the city of Mashhad. They were selected in a purposeful and available manner and randomly placed in groups. The tools for measuring research variables were evaluated before, after and 3 months after group treatment with Paroxetine drug. The statistical analysis of the data of the current research by using the statistical method of analysis of variance with repeated measurements shows that, in general, paroxetine has a significant effect (p < 0.05) on the dependent variables. Drug treatment has been significantly effective on most of the sub-components of the dependent variables in the post-test stage, and only in the mean scores of the psychological sub-components, social relations, satisfaction with the life situation, no significant difference can be seen, but in the follow-up stage It has not had a statistically significant effect. In the control group, no significant difference can be seen in the three stages of the test.

Attention deficit hyperactivity disorder (ADHD) in adulthood is one of the disorders which make persons in trouble in this period. Inattention, hyperactivity and impulsivity are three main symptoms but hyperactivity changes to restlessness in adulthood. The goal of the present study was to review medical and psychological treatments in this disorder. A number of 55 review and research articles were chosen to report. Findings show that medical drugs reduce the main symptoms and indirectly the intra and interpersonal problems too. Psychological treatments in combined with medical treatments and with focus on intra and interpersonal and comorbidities are effective in reducing the symptoms. The present study shows that combination of medical and psychological treatments are the necessary cures in adult ADHD.

Attention Deficit/ Hyperactive Disorder (ADHD), as a neurodevelopmental disorder, accompanied not only with some special behavioral symptoms, but also deficits in cognitive functioning. Current research aimed to compare the effectiveness in improving executive functions (EF) in children with ADHD of cognitive-­motor rehabilitation (CMR) and drug therapy approaches. This was a semi-experimental study with post-test and follow-up assessments, comparing three groups in a single-blind design. 48 ADHD children were selected using criterion sampling, matched for ADHD severity, and randomly assigned to either cognitive-­motor rehabilitation (n= 16), drug therapy (n= 16) and active control (n=16) groups. All the participants were tested by Stroop color-word, Tower of London (TOL), Wechsler Coding tests, and a 3 sub-scale short-form of the WISC-R tests, and their parents rated them on child syndrome inventory-4 (CSI-4). The data were analyzed using MANOVA and paired t-tests with Bonferroni corrections as post hoc tests. CMR showed effective and enduring effects on the participant's performance on EF components including response inhibition, planning, and speed processing and only the improvements in speed processing returned significantly to lower levels at follow-up. In addition, despite the better performance of CMR group compared to drug therapy group, the changes were not statistically significant. Altogether, the results indicate that CMR is an effective approach in the treatment of ADHD, and it can be used as a complementary technique to drug therapy.

The main goal of this paper is focused on comparison of influence of drug therapy and neurofeedback training on reduction of anxiety symptoms and life quality of generalized anxiety disorder (GAD) patients. For this purpose، 16 visitors in one of psychiatry centers in Tehran were studied who received GAD diagnosis and did not suffer other psychological disorders according to psychiatrist visit and diagnostic criteria within fourth edition of statistical and diagnostic guide revised text of psychological disorders)DSM-IV-TR ((8 persons in neurofeedback training and 8 ones in drug therapy). Patients in both groups were surveyed and studied in pre-test and post-test steps through GAD seven-question scale (GAD-7) and life quality questionnaire (PWI-A). Persons in neurofeedback training group received fifteen 30-minute sessions (three sessions per week) on alpha wave increase and those in drug therapy were treated under supervision of physicians by anti-anxiety drugs (SSIRs) for one year. Record and training of alpha wave activity was accomplished in O1 or O2 and patients received audio feedback for increase of alpha range up to higher than determined threshold. Wilcoxon and Mann Witney tests were applied for descriptive analysis of data. Research findings show that neurofeedback training led to increase of alpha wave in the receiver group. In addition، influence of neurofeedback training on reduction of GAD symptoms in this group is considerably higher than that of drug therapy group. There was no meaningful difference between the two groups on change of patients'' life quality index.

In recent years, experts in the field of obsessive-compulsive disorder are trying to measure and compare the validity and efficiency of psychological interventions and drug therapy. In this regard, a meta-analysis integrating results of different researches demonstrates the effect size of treatments. This study aims to study the impact of psychological interventions and drug therapy on reducing symptoms of obsessive-compulsive patients. For this purpose, 40 accepted researches were selected and meta-analysis was performed on them. Research instrument was a checklist of meta-analysis.The effect size of psychological interventions on reducing obsessive-compulsive symptoms was 1/88(p ≤ 0.001) and for drug therapy 1/11 (p ≤ 0.001). According to Cohen's effect size, psychological interventions and drug therapy have a high impact on reducing symptoms of obsessive-compulsive disorder.

This research aimed to investigate the effectiveness of brief group couple therapy (BGCT), traditional treatment and drug therapy on marital adjustment in patient with substance abuse. A sample was selected comprised of 75 men with their wives that were referring to substance abuse treatment clinics in Shiraz. The couples were assigned to 3 groups: BGCT drug therapy, traditional treatment drug therapy, and only drug therapy. All group members were pretested, post-tested and fallowed-up by interview, laboratory rapid test and dyadic adjustment scale (DAS). The result showed that "BGCT", in comparison with traditional treatment and only drug therapy, has significant effect on marital adjustment in patient with substance abuse in post test and follow up. We can conclude that "BGCT" has more effect on increasing marital adjustment in men with substance abuse.

Essential Hypertension is the third cause of death and one of the most important causes of chronic disability in the world that its course can be chronic and progressive quality of life of patients in different aspects of their affect. The purpose of present study is to determine the effect of Hope Therapy and Drug Therapy on improvement of Quality of Life in the patients with Essential Hypertension. The present research is a quasi-experimental study that performed in Heart center of Medical University of Isfahan between April 2007 and April 2008. 40 Patients with Essential Hypertension were assigned in 2 groups as experimental group who received Hope Therapy and control group with Drug Therapy. Data were collected in this study by demographic questionnaire and short form of quality of life questionnaire. Questionnaire were completed by both groups in three stages before, after and three months after the intervention (follow-up phase) then analyzed. Results showed that Hope Therapy was more effective than Drug Therapy on improvement of Quality of Life in the patients with Essential Hypertension in post test and follow-up phase. Hope Therapy is effective on improvement of Quality of Life in the patients with Essential Hypertension. The results suggest a team work approach consist of Psychologists and Heart Professional can be useful for treatment of Quality of Life in the patients with Essential Hypertension.

The aim of this study was to examine the impact of Systemic- Behavioral Couple Therapy (SBCT) on family functioning and self- esteem in women with dysthymia disorder. An experimental design with repeated measures was applied in this study. The sample was selected from 78 married depressed women, referred to some of the psychiatric and consulting centers in Tehran; from them 39 couples met the criteria, 20 couples were randomly selected, and assigned to couple therapy or medication groups. The women in couple therapy group participated in a 10-weekly sessions of systemic-behavioral couple therapy together with their husbands. The women of pharmaco therapy group were put on antidepressant drugs prescribed by psychiatrist. Assessment instruments were Family Assessment Device (FAD) and Rosenberg Self-esteem Scale. Participants in both groups were tested before treatment, just before the sixth session, after tenth session, and two months after termination. ANOVA with repeated measures was used to analyze the data. The findings showed that the systemic-behavioral couple therapy was significantly effective in improving family functioning, and increased self- esteem in women with dysthymia disorder. The results suggest that SBCT, in addition to increased marital satisfaction, is a useful intervention for improvement of family functioning and self- esteem in depressed women. Theoretical and clinical implications will be discussed.