Iranian Journal of Psychiatry
Volume:18 Issue: 4, Autumn 2023

Limited studies have yet evaluated the effectiveness of topiramate in the treatment of amphetamine and methamphetamine addiction. Therefore, the aim of this study was to investigate the effectiveness of topiramate in the treatment of patients with this disorder.

In this randomized, double-blind, placebo-controlled clinical trial, 52 patients with amphetamine and methamphetamine use disorder, within the age range of 16-60 years, were randomly divided into an intervention group (n = 26) and a placebo group (n = 26). The intervention group was treated with topiramate tablets with a starting dose of 50 mg, which was gradually increased to the target dose of 200 mg. The control group was treated with placebo. The duration of drug intervention in this clinical trial was 12 weeks, and all participants were evaluated before the intervention and 2, 4, 6, 8, 10, and 12 weeks after beginning the intervention. The Beck Depression Inventory, drug use temptation questionnaire, urine test, and side effects questionnaire were used as outcome measures to assess the patients. The data were analyzed using chi-square, independent t-test, and analysis of variance with repeated measurements.

There was no significant difference between the intervention and placebo groups in depression at the beginning of the treatment and at the 4th, 8th, and 12th weeks after the intervention (P > 0.05). The urine test also showed no significant difference between the two groups at any of the evaluation stages (P > 0.05). Although there was no significant difference between the two groups in the drug use temptation results at the beginning and the 2nd, 4th and 6th weeks (P > 0.05), the level of drug temptation in the intervention group was significantly lower than the placebo group in the 8th, 10th, and 12th weeks (P < 0.05).

Topiramate can be effective in reducing the desire to use amphetamine and methamphetamine. However, further studies are needed to confirm these results.

A growing body of research stresses the effect of time perspective (TP) on the genesis and maintenance of psychological disorders. However, the variations in the TP configuration of individuals with different disorders have not yet been completely investigated. We aimed to compare the differences in TP among patients with three common psychiatric disorders.

We recruited 30 patients with major depressive disorder (MDD), 30 with generalized anxiety disorder (GAD), and 30 with obsessive-compulsive disorder (OCD). Participants completed Zimbardo’s Time Perspective Inventory, Beck Depression Inventory, Generalized Anxiety Disorder Scale, Maudsley Obsessive Compulsive Inventory, and Structured Clinical Interview for DSM-5 (SCID-5). The one-way MANOVA was utilized for the comparison of TP dimensions among the three disordered groups.

The results showed that TP was significantly affected in all three clinical groups. The effect of the disorder on time perspective was significant for Past Negative (PN) (F (2, 84) = 11.86, P < 0.01), Past Positive (PP) (F (2, 84) = 6.66, P < 0.01), Present Fatalistic (PF) (F (2, 84) = 7.08, P < 0.01) and Future (F) (F (2, 84) = 26.40, P < 0.01), but not for Present Hedonistic (PH). The findings revealed that the MDD group scored the highest on PN, with the GAD group scoring higher than the OCD group. The GAD and OCD groups reported higher PP than the MDD group. In addition, the MDD group scored higher than both the GAD and OCD groups on PF. Finally, the GAD patients reported higher scores than both the MDD and OCD patients on the F dimension, while the OCD patients scored higher than the MDD patients.

Individuals with MDD tend to obtain higher scores in PN and PF time perspective, whereas those with GAD and OCD showed higher PP and F scores. These findings demonstrate the significance of examining TP in clinical patients and prompt further research into the association between TP and the disorders being studied. Perspectives on therapy are also explored.

Stress, anxiety, and depression affect the diabetic patient by causing symptomatic changes. Considering the destructive effects of psychological symptoms on the health status of diabetic people, our aim was to investigate the effectiveness of cognitive-behavioral therapy (CBT) in improving the psychological outcomes of diabetic patients.

This trial is a quasi-experimental type that uses a pretest-posttest design with a control group. A total of 62 people were selected based on the inclusion criteria and randomly divided into two experimental and control groups. All subjects in the intervention group underwent CBT training twice a week for eight sessions, while those in the control group did not receive this intervention. Before and following the intervention, the depression, anxiety and stress scale (DASS-42) was utilized to evaluate the psychological symptoms of all participants. The data were analyzed through analysis of covariance (ANCOVA) and SPSS-23 software.

There were no significant differences between the two groups in terms of age, gender, marital status, parenthood, and education level (P > 0.05, n = 30 in each group). Additionally, there was no significant difference between the mean DASS-42 scores before the intervention (P > 0.05). However, after the intervention, the experimental group exhibited reduced levels of depression, anxiety, and stress compared to the control group (P < 0.001). The values of Eta for depression, anxiety, and stress subscales were equal to 0.809, 0.669 and 0.776, respectively, which means that 80.9%, 66.9%, and 77.6% of the changes in these symptoms in the experimental group are related to the training received through the CBT approach.

It can be concluded that diabetic patients who suffer from psychological symptoms can benefit from the CBT approach to reduce their stress, anxiety, and depression levels.

As glutamatergic system dysfunction is involved in bipolar depression pathophysiology, the glutamate receptor modulators such as Ketamine have been applied as complementary medication for mood stabilizers. While the treatment is currently just the intravenous injection of a single dose, and there is no robust conclusion on Ketamine effectiveness or its side effects in bipolar patients, this study aimed to consider single- and double-dose intravenous injections of Ketamine in bipolar patients compared to the placebo.

In a randomized, double-blind controlled clinical trial, 30 patients diagnosed with bipolar I and II disorders according to DSM-IV-TR (SCID-I) were randomly divided into three groups: the first group received an intravenous injection of Ketamine (0.5 mg/kg) and placebo with a three-day interval, the second group received two doses of Ketamine (0.5 mg/kg) in the same interval, and the third group received two placebo injections. Patients were assessed for depression, anxiety, and mania at various time points, including before the injection, 60 minutes after the injection, on the first, third, fifth, seventh, and 14th day, as well as at the end of the first month using the Hamilton Depression Rating Scale, Beck Anxiety Inventory, and Young Mania Scale, respectively. Data were analyzed using ANOVA and Repeated measure tests.

The mean age of patients was 36.8 ± 7.9 years, with 18 females (60%) and 12 (40%) males. Depression and anxiety showed significant differences in both the single- and double-dose Ketamine groups over time (P < 0.01). Moreover, mania displayed significant changes during the study time in the single- and double-dose Ketamine groups, as well as the in the control group. However, during the study time, there were no significant differences observed in depression, anxiety, and mania among the three groups (P = 0.198, P = 0.416, and P = 0.540, respectively). Patients did not indicate any side effects during the study.

Intravenous Ketamine administration may relieve depressive manifestations in bipolar patients. The findings suggest that a double dose of Ketamine does not lead to greater improvement than a single dose.

Social anxiety refers to an excessive concern or fear about social situations. It seems that social media, which has become one of the most popular and effective tools for communication today, can be one of the contexts of social anxiety. Due to the lack of a Persian instrument to assess social anxiety in the context of social networks, the current study was undertaken to analyze the psychometric criteria of the Iranian version of the Social Anxiety Scale for Social Media Users (SAS-SMU). The SAS-SMU is a 21-item questionnaire designed by Alkis and colleagues (2017) to measure social anxiety emerging from the social media platforms.

In this study, a total of 842 participants within the age range of 11 to 82 years old (mean age 33.11 ± 12.134), 59% female) answered the questions in an online survey. The original version of the scale was translated into Persian using the back translation procedure. All participants completed a Demographic Questionnaire, the SAS-SMU, and the Beck Anxiety Inventory. In order to analyze the collected data, internal and external consistency, factor analysis, construct validity, and confirmatory factor analysis (CFA) were examined. A significance level of less than 0.05 was considered to determine statistical significance.

Four subscales were obtained from the exploratory factor analysis (SCA, PCA, IA, and SEA), which were confirmed by the confirmatory factor analysis. Cronbach's alpha for internal consistency was found to be 0.931 for the total scale and 0.920, 0.846, 0.901, 0.828 for SCA, PCA, IA, and SEA, respectively. In addition, the test-retest scores of 30 participants (interval: between 2 to 3 weeks) for all four subscales (SCA = 0.641, PCA = 0.773, IA = 0.688, SEA = 0.727) indicated acceptable stability of the questionnaire over time.

This study validates the Persian version of the SAS-SMU for use in studies in the field of psychological problems related to social media and online communications.

This study aimed to investigate neurocognitive functioning, quality of life, and global functional performance in Ultra-High Risk (UHR) individuals compared to Familial High-Risk (FHR) individuals for developing schizophrenia.

An observational cross-sectional study was conducted using a convenient sampling method at Roozbeh Hospital in Tehran, Iran, from June 2017 to January 2020. The study included 40 UHR individuals based on the Structured Interview for Psychosis Syndrome (SIPS) interview, as well as 34 FHR individuals due to genetic risk. Neurocognitive functioning, quality of life, and global functional performance were assessed by using the Cambridge Automated Neuropsychological Test Battery (CANTAB) and Controlled Oral Word Association Test (COWAT), Quality of Life Scale (QLS), and Global Assessment of Functioning (GAF).

UHR individuals for schizophrenia demonstrated significant lower scores in phonemic and semantic verbal fluency (t = 6.218, P < 0.001; t = 4.184, P < 0.001, respectively), more total errors for spatial working memory (t = -5.874, P < 0.001), and fewer problems solved in minimum moves in Stocking of Cambridge (SOC) (t = -2.706, P < 0.01) compared to FHR individuals. Intra-Extra Dimension (IED) did not differ significantly between the two groups. Moreover, the study indicated significant GAF decline (F = 79.257, P < 0.001) and lower total score on the QLS (t = -10.655, P < 0.001) in UHR compared to FHR individuals.

It is possible to differentiate UHR individuals from FHR individuals through neurocognitive, quality of life, and global functioning assessment.

This study aimed to compare health beliefs and obsessive-compulsive symptoms (OCS) in families with (FIM+) or without an infected member (FIM–) two years after the beginning of COVID-19. Additionally, this research intended to predict a decrease in OCS from baseline (T1) to 40 days later (T2) based on health beliefs.

In a longitudinal survey, 227 participants in two groups, including FIM+ (n = 98; M = 30.44; SD = 5.39) and FIM– (n = 129; M = 29.24; SD = 4.93), were selected through purposive sampling. They responded to measurements consisting of demographic characteristics, the Obsessive-Compulsive Inventory-Revised (OCI-R), Patient Health Questionnaire (PHQ-9), Impact of Event Scale-Revised (IES-R), and COVID-19 Health Belief Questionnaire (COVID-19-HBQ) at the final assessment phase (T2). To investigate differences between the two groups and predict OCS changes from T1 to T2, data were analyzed using Chi-squared, t-tests, U-Mann-Whitney, Kruskal-Wallis, Pearson correlations, and linear regression analyses.

At T1, FIM+ demonstrated significantly greater OCS, health beliefs, posttraumatic stress symptoms (PTS), and depressive symptoms than FIM–. Furthermore, FIM+ showed a decrease in OCS from T1 to T2 after its infected member recovered from COVID-19 (P < 0.001). A decrease in OCS was correlated with a decrease in perceived susceptibility, severity, and barriers. Lack of a vulnerable family member, lower educational attainment, and being a primary caregiver were associated with a greater decrease in OCS. Changes in perceived severity and self-efficacy accounted for 17% of variation in OCS.

Even two years after the onset of the pandemic, COVID-19 not only impacts the life of patients with COVID-19 but family members who care for such patients respond to the disease by engaging in excessive health behaviors in the form of OCS.

This study aimed to explore the aspects of emotional dysregulation (ED) and childhood trauma (CT) which are associated with suicide ideation (SI) and suicidal behaviour (SB) severity in depressive female adolescents who previously attempted suicide.

In this cross-sectional study, we evaluated SI and SB severity. The Columbia-Suicide Severity Rating Scale (C-SSRS) was administered to 80 depressive female patients who had suicide attempts within the last month. Current suicide ideation (C-SI) and total score (C-TS), lifetime- suicide ideation (L-SI), and total score (L-TS) were obtained with the C-SSRS. Patients were recruited from five different provinces in Turkey. Additionally, the patients completed the Difficulties in Emotion Regulation Scale (DERS), Childhood Trauma Questionnaire (CTQ), and Beck Depression Inventory (BDI). The Pearson correlation test and a multiple linear regression analysis were used to determine variables predictive of suicide scores.

The results of multiple linear regression analysis indicated that the BDI and DERS - total scores explained 35% (adjusted R) of the variance in C-SI ((F (2;67) = 19.61, P < 0.001). C-TS was explained by ‘BDI,’ ‘emotional neglect’ and ‘DERS impulse’ (38% (adjusted R) (F (3;66) = 15.15, P < 0.001). L-SI was only associated with DERS strategies (explains 13% (adjusted R) of the variance in L-SI (F (1;68) = 10.411, P = 0.02). Concerning the C-SSRS L-TS, the DERS impulse and CTQ total accounted for 24% (adjusted R) of the variance (F (2;67) = 10.620, P < 0.001).

The results of our study suggest that adolescents who have experienced emotional neglect and depressive symptoms are more at risk for suicidal ideation and behaviour. In addition, depressed adolescents who show impulsive behaviours and restricted emotional strategies are also at risk. Identifying neglected depressed adolescents and teaching impulse control and effective emotional strategies is important for the prevention of suicidal behaviours and thoughts.

The current study aimed to compare the impact of acupressure and clonazepam tablets on the quality of sleep in hemodialysis patients in light of the rising prevalence of chronic kidney disease (CKD), the high prevalence of sleep disturbance in these patients, and the side effects of hypnotic drugs.

A total of 60 patients were selected for this randomized, controlled clinical trial and randomly assigned to two groups. For two weeks during the researcher's evening shift, one group received acupressure (six spots bilaterally for three minutes each day). The opposing group was administered clonazepam tablets (0.5 mg) for two weeks. The Pittsburgh Sleep Quality Index (PSQI), which measures sleep quality, was used to compare sleep in the two groups before and after the intervention.

There was no statistically significant difference between the two groups prior to the intervention (P = 0.75) in terms of the mean pre-intervention PSQI scores for the acupressure and clonazepam groups, which were 15.83 ± 1.51 and 16.17 ± 0.91, respectively. However, the average PSQI scores after the intervention in the clonazepam and acupressure groups were 13.25 ± 2.88 and 8.97 ± 4.29, respectively, indicating a statistically significant difference (P < 0.0001). Both the acupressure and the clonazepam groups showed improvements in their post-intervention sleep quality among the patients. However, when the percentage changed in the mean scores of the total score and all of the PSQI components were calculated for each group, it became clear that acupressure was more effective at enhancing sleep than clonazepam tablets.

The findings of the present investigation demonstrate that acupressure has a greater impact on patients’ sleep quality compared to clonazepam tablets. Depending on the circumstances, acupressure can be used as a simple, safe, and non-drug way to enhance hemodialysis patients' quality of sleep.

This study was designed to explore the psychometric properties of the Persian version of the Interpersonal Mindfulness in Parenting Scale (IMP-S).

This cross–sectional and psychometric study was performed on a sample of 491 parents in Iran who had at least one child in their home and were selected using the convenient sampling method. The Interpersonal Mindfulness in Parenting Scale (IMP-S), Mindful Attention Awareness Scale, Parental Authority Questionnaire, and the Forms of Self-Criticizing/Attacking & Self-Reassuring Scale were conducted on the sample. The validity of the IMP-S was assessed by factor analysis and Pearson correlation coefficients, while reliability was calculated by Cronbach’s alpha.

At first, the whole data was analyzed using confirmatory factor analysis based on the original English version of the IMP-S. The proposed hypothesized factor solution was not good enough (CMIN / DF = 7.06. RSMEA = 0.081, CFI = 0.732, SRMR = 0.0860). Exploratory factor analysis and parallel analysis led to a three-factor structure for the 28 items, which included mindfulness toward the child, mindfulness about oneself and emotional awareness of parenting. The results of confirmatory factor analysis showed that the data was more fitted with this new three-factor solution (CMIN / DF = 2.06, CFI = 0.82, NFI = 0.715, RMSEA = 0.065, SRMR = 0.0795). The IMP-S was found to have a positive correlation with trait mindfulness, reassured self, and authoritative parenting style, whereas this association for the IMP-S and hatred self, inadequate self, and authoritarian parenting style was negative. The reliability of the whole scale was 0.84 and it was 0.77, 0.83, and 0.68 for the first, second, and third subscales, respectively.

It seems that the Persian version of the IMP-S with three factors can better evaluate mindful parenting among the Iranian population. In contrast to people from other countries, Iranian people perceive mindfulness toward themselves and their children during parenting practice as two distinct issues.

Psychoses of epilepsy usually have an acute onset, accompanied by brief symptom duration and a risk of recurrence. Managing these conditions can be challenging due to the potential for seizures associated with certain antipsychotic medications, as well as exacerbating psychosis resulting from some antiepileptic medications. Our objective in this study was to assess the occurrence of psychosis among patients with epilepsy, as well as identify the factors linked to the presence and severity of psychosis in this population.

In this study, we included a total of 514 subjects diagnosed with epilepsy referring to our neuropsychiatry clinic affiliated with Tehran University of Medical Sciences from April 2011 to December 2021, among whom 57 patients showed psychotic presentations. We compared baseline and clinical characteristics between patients with psychosis of epilepsy and non-psychosis patients who also had epilepsy.

Marital status was the sole demographic factor that displayed a statistically significant difference between the psychosis and non-psychosis groups (P = 0.019). There was no significant difference observed between the two groups regarding family history of epilepsy and age at the onset of the epilepsy. Patients with psychosis experienced significantly more frequent seizures and generalized type (P < 0.001). Participants were matched for demographics and other clinical factors between the refractory and controlled psychosis groups, except for the psychosis frequency (P = 0.007). The type of epilepsy was significantly associated with psychosis when adjusted for the covariates (P < 0.001).

Patients with psychosis of epilepsy experienced more episodes of epilepsy than non-psychotics. We identified generalized epilepsy as an independent risk factor for the development of psychosis. Additional cohorts are warranted to explore the factors associated with epilepsy-related psychosis across diverse populations.

Research findings on the relationship between vitamin D and suicide are not consistent; therefore, the objective of the present paper is to assess the relationship between vitamin D and suicide behaviors using a systematic review and meta-analysis.

A search strategy was developed using keywords including “Vitamin D”, “Vitamin D deficiency”, “suicide” "attempted suicide", "completed suicide”, “Suicide, Attempted”, “Suicidal Ideation.” We searched databases including Scopus, Medline, Web of Science, and Google Scholar by July 7, 2022. We examined the titles, abstracts, and full texts of the articles to select eligible ones. To pool the results of the selected studies, we used the random-effect method and mean difference as the effect size. The quality of the articles was evaluated by the Newcastle-Ottawa Scale (NOS). Moreover, heterogeneity and bias of reporting were evaluated by the I2 statistic and Egger's and Begg's tests, respectively.

Out of 149 studies retrieved in the databases, 11 studies were included in the final phase. Among these, the pooled findings of seven studies included in the meta-analysis phase showed that low levels of vitamin D are related to increased probability for suicide behaviors (P < 0.05). Moreover, subgroup analysis showed a significant relationship between vitamin D and suicide ideation and suicide attempt (P < 0.05). In addition, the I2 statistic indicated moderate heterogeneity (58%) and Egger's and Begg's tests did not show any evidence of publication bias (P > 0.05).

This study provides evidence in favor of the relationship between vitamin D and suicide behaviors. It suggests that insufficient levels of vitamin D play a role in suicidal behaviors. However, it should be noted that further and stronger evidence is needed to establish this role. Finally, incorporating vitamin D-rich foods into the diet or taking vitamin D supplements is recommended to reduce the risk of suicide.

In recent years, researchers and neuroscientists have begun to use a variety of nonlinear techniques for analyzing neurophysiologic signals derived from fMRI, MEG, and EEG in order to describe the complex dynamical aspects of neural mechanisms. In this work, we first attempted to describe different algorithms to estimate neural complexity in a simple manner understandable for psychiatrists, psychologists, and neuroscientists. Then, we reviewed the findings of the brain complexity analysis in psychiatric disorders and their clinical implications.

A non-systematic comprehensive literature search was conducted for original studies on the complexity analysis of neurophysiological signals such as electroencephalogram, magnetoencephalogram, and blood-oxygen-level-dependent obtained from functional magnetic resonance imaging or functional near infrared spectroscopy. The search encompassed online scientific databases such as PubMed and Google Scholar.

Complexity measures mainly include entropy-based methods, the correlation dimension, fractal dimension, Lempel-Ziv complexity, and the Lyapunov exponent. There are important differences in the physical notions between these measures. Our literature review shows that dementia, autism, and adult ADHD exhibit less complexity in their neurophysiologic signals than healthy controls. However, children with ADHD, drug-naïve young schizophrenic patients with positive symptoms, and patients with mood disorders (i.e., depression and bipolar disorder) exhibit higher complexity in their neurophysiologic signals compared to healthy controls. In addition, contradictory findings still exist in some psychiatric disorders such as schizophrenia regarding brain complexity, which can be due to technical issues, large heterogeneity in psychiatric disorders, and interference of typical factors.

In summary, complexity analysis may present a new dimension to understanding psychiatric disorders. While complexity analysis is still far from having practical applications in routine clinical settings, complexity science can play an important role in comprehending the system dynamics of psychiatric disorders.

Dyslexia is a prevalent neurodevelopmental condition that is characterized by inaccurate and slow word recognition. This article reviews neural correlates of dyslexia from both electrophysiological and neuroimaging studies.

In this brief review, we provide electrophysiological and neuroimaging evidence from electroencephalogram (EEG) and magnetic resonance imaging (MRI) studies in dyslexia to understand functional and structural brain changes in this condition.

In both electrophysiological and neuroimaging studies, the most frequently reported functional impairments in dyslexia include aberrant activation of the left hemisphere occipito-temporal cortex (OTC), temporo-parietal cortex (TPC), inferior frontal gyrus (IFG), and cerebellar areas. EEG studies have mostly highlighted the important role of lower frequency bands in dyslexia, especially theta waves. Furthermore, neuroimaging studies have suggested that dyslexia is related to functional and structural impairments in the left hemisphere regions associated with reading and language, including reduced grey matter volume in the left TPC, decreased white matter connectivity between reading networks, and hypo-activation of the left OTC and TPC. In addition, neural evidence from pre-reading children and infants at risk for dyslexia show that there are abnormalities in the dyslexic brain before learning to read begins.

Advances in comprehending the neural correlates of dyslexia could bring closer translation from basic to clinical neuroscience and effective rehabilitation for individuals who struggle to read. However, neuroscience still has great potential for clinical translation that requires further research.