Iranian Journal of Psychiatry
Volume:19 Issue: 1, Winter 2024

Methamphetamine use has been recognized as a prominent public health issue, which is associated with psychotic and depressive symptoms. This study aimed to assess factors that show a significant relation with psychotic and depressive symptoms in adults who use methamphetamine.

We assessed 95 patients who had used methamphetamine within the last month and were admitted to the outpatient treatment clinic. Evaluation of all patients was carried out through face-to-face interviews, and their symptoms were evaluated using different scales. The Scale for the Assessment of Positive Symptoms and the Scale for the Assessment of Negative Symptoms were employed to assess positive and negative symptoms of psychosis, respectively. Depressive symptoms were measured using the Montgomery-Asberg Depression Rating Scale, while illness severity was evaluated using the Clinical Global Impression- Severity Scale. Additionally, functioning status was assessed using the Functioning Assessment Short Test, and withdrawal severity was measured by employing the Amphetamine Cessation Symptom Assessment Scale. Craving severity was evaluated using the Stimulant Craving Questionnaire, anxiety severity using the Hamilton Anxiety Rating Scale, and insight status using the Schedule for Assessment of Insight Expanded.

Among the demographic variables, working with family was associated with lower positive symptoms scores (OR = 6.31, P < 0.05). Parole/probation related admissions were associated with lower positive and depressive symptoms scores (OR = 15.06, P = 0.03; OR = 9.87, P = 0.02). Having suicide attempts, number of suicide attempts, and amount of methamphetamine used were found to show association with higher positive (OR = 13.59, P < 0.01; OR = 2.52, P < 0.05; OR = 3.48, P < 0.05, respectively) and depressive symptoms scores (OR = 10.35, P < 0.001; OR = 2.23, P < 0.01; OR = 2.3, P < 0.05). After adjusting for all variables, clinical impression and insight scores remained significantly associated with positive symptoms scores (AOR = 6.74, P < 0.05; AOR = 2.63, P < 0.001, respectively), while anxiety, amphetamine cessation, and positive symptoms scores remained associated with depressive symptoms scores (AOR = 0.48, P < 0.001; AOR = 0.11, P = 0.003; AOR = 0.36, P = 0.02, respectively).

This study appears to be the first to examine the associations between clinical variables and both positive symptoms and depressive symptoms in methamphetamine users. Increased attention should be paid to suicide history, anxiety level, amount of methamphetamine use and loss of insight to provide effective treatment in patients with methamphetamine use.

The present study is devoted to the study of brain activation using fMRI in patients with depression (after acute coronary syndrome and somatically healthy) and in healthy volunteers.

The study enrolled a total of 51 patients: 11 with depression after acute coronary syndrome, 16 with primary depressive episode and recurrent depression without prior coronary event, and 24 with ACS without depression. The groups were matched by sex and age. The emotional information processing was evaluated with the Pennsylvania Test of Emotion Recognition. All patients underwent fMRI at the time of this test. The data processing was performed with SPM12 and xjView applications.

During the processing of emotional information in the depressed patients after ACS, specific activation zones in the frontal cortex (P < 0.001), right fusiform gyrus (P < 0.001), and right insular lobe were identified (P = 0.017). In the patients with primary depressive episode and recurrent depression without ACS, certain zones of activation were identified in frontal cortex (P < 0.001; 0.001), left fusiform gyrus (P < 0.001), occipital cortex (P < 0.001). In the patients who had ACS, without depression, some zones of activation were specified in the right middle occipital gyrus (P < 0.001), the right superior frontal gyrus (P = 0.088), and the putamen projection on the right (P < 0.001) and on the left (P = 0.009), as well as the left insular lobe (P = 0.015).

The pathogenesis of depression is significantly associated with the peculiarities of processing emotionally significant information, regardless of the conditions under which it develops.

Theory of mind (ToM) denotes the ability to understand the mental state of others and perceive their unique beliefs and emotions. In this study, we compared ToM between individuals with major depressive disorder (MDD) and stimulant-induced depressive disorder (SIDD).

This cross-sectional, causal-comparative study included patients with MDD or SIDD admitted to Ostad Moharary Neuropsychiatric Hospital between January and June 2022. Each diagnosis was confirmed through a semi-structured interview conducted by a single attending psychiatrist according to the DSM-5 criteria. After consecutive sampling of 110 individuals, 51 patients completed the study in each group. Demographic characteristics were recorded, and the Persian version of the revised Reading the Mind in the Eyes Test (RMET) was used to evaluate ToM. Statistical analysis was performed using SPSS v.25, employing the t-test, chi-squared test, linear regression, and analysis of covariance (ANCOVA).

Our analysis included 102 subjects (65.7% male) with a mean age of 35.17 ± 7.54 years. The two groups were similar in age, gender, marital status, working status, occupation, economic class, and ethnicity (P > 0.05). The RMET scores were 12.94 ± 4.03 and 11.86 ± 3.15 in the MDD and SIDD groups, respectively (P = 0.135). Almost all patients had low RMET scores (< 22); only two individuals in the MDD group achieved normal scores (22–30). ANCOVA revealed no significant confounding effects between the independent variables. Furthermore, regression analysis revealed that the level of education had a significant linear relationship (β = 0.249) with the RMET score (P = 0.021).

Hospitalized patients with MDD and SIDD have similar ToM deficits, as measured by the RMET.

Obsessive-Compulsive Disorder (OCD) has been considered a heterogeneous psychiatric disorder. Identifying this heterogeneity can lead to better diagnosis and treatment. The two most common OCD subtypes include contamination/cleaning and danger/checking. This study aimed to identify the network structure of OCD symptoms, personality, and obsessive beliefs in these OCD subtypes.

333 patients with OCD were included in the study (156 patients with the danger/check subtype and 177 patients with the contamination/cleaning subtype). In addition, 276 healthy individuals participated in this study. We used a network analysis approach to determine the OCD central symptoms [nodes]. The Personality Beliefs Questionnaire-Short Form [PBQ-SF], Obsessive-Compulsive Inventory-Revised [OCI-R], and Obsessional Beliefs Questionnaire-44 [OBQ-44] were used for network estimation.

The results indicated that the network structure in healthy individuals was different from the network structure in patients with obsessive-compulsive disorder [PwOCD]. In healthy individuals, "obsessive” personality belief and “danger” obsessive belief were the most strength nodes and formed the core of the central communication between symptoms in these subjects. Regarding the contamination/cleaning subtype, the most central symptoms include "washing" obsessive symptom, “danger” obsessive belief, and "wash" obsessive symptom. However, "perfect" obsessive beliefs, "check" obsessive symptoms, and “avoidant” personality beliefs were the most central symptoms in the danger/check subtype. These results demonstrated that each of the studied groups had a unique network structure, which is consistent with the heterogeneous nature of OCD.

Different OCD subtypes have different cognitive-behavioral network structures. According to the results of this study, these symptoms should be given priority in OCD theoretical models and treatment strategies.

The aim of this study was to investigate the factors contributing to enjoyment in old age.

To this end, this research used a qualitative exploratory research design known as grounded-theory research. Seventeen elderly participants (aged 65-85 years), comprising 11 men and 6 women, were selected using purposive sampling. A semi-structured interview was used as the data collection instrument. The method proposed by Corbin and Strauss was employed to design the interview questions. In this study, data analysis was interpretive using phenomenological analysis, which was done through open, axial, and selective coding.

The results indicated that the new emergent construct – ageing enjoyment – consisted of five categories and 19 subcategories. These categories include present moment awareness, liberating past, psychosocial safety, ultimate purpose for being, and self-peace. Subcategories include: Vitality, Family solidarity and intimacy, Occupational Adequacy, Economic wisdom, Social Acceptability, Healthy society, Talent flourish, productive experiences, Physical well-being, Willingness to develop, Mindfulness, satisfaction, Moralization, Adaptability, Benevolence, Acceptance, Desire to live, Meaningfulness, Religiosity.

These categories suggest that present moment awareness, liberating past, as well as having psychosocial safety help the elderly experience ageing enjoyment. Hence, they are likely to reach self-peace through an ultimate purpose for being as they deal with challenging life issues. Practical implications of the findings are further discussed.

The National Mental Health Services (N-MHSs) in Iran was integrated with Primary Health Care (PHC) in 1988. This study aimeds to analyze the policy of integrating N-MHSs in PHC, focusing on the analysis of the current situation, pathology, and the existing challenge.

This qualitative research was conducted in 2020 using a case study approach. This study used the policy triangle model to analyze the policy. The required data were collected via interviews, literature review, and document analysis. The interviews were conducted with 23 experts, stakeholders across the country who were selected through purposive sampling, and the data were analyzed using the content-analysis method.

The main goals of this policy were to raise mental health literacy among the people and eliminate its stigma in the society, while implementing the referral system for N-MHSs. Twenty weaknesses were extracted in eight areas, including negative views of mental health, weaknesses in human resource training, compensation for the service of psychologists, unfavorable working conditions of the workforce, inappropriate service delivery facilities, lack of meaningful communication between different levels of service delivery, poor inter-sectorial communication, and the challenging nature of mental health care. De-stigmatizing psychological disorders in the society and identifying hidden patients are some of the most significant achievements of this policy.

Despite the successful implementation and significant achievements in integrating N-MHSs in PHC, the results of the present study indicate that there are many challenges in this field that require serious planning and attention from relevant authorities.

Breast cancer is the most commonly diagnosed cancer in women worldwide, and its incidence has increased recently. Diagnosing cancer can create many challenges, especially for married women. The aim of the present study was thus to evaluate the effect of the relationships among marital empathy, body image, and perceived social support on quality of life (QoL) and the mediating role of perceived marital quality.

Married women with breast cancer (N = 160) were selected through purposive accessible sampling. Measures included body image scale, Batson empathy adjectives, multidimensional scale of perceived social support, perceived marital quality, and QoL. The research method was descriptive-correlational and using structural equation modeling.

The best model obtained showed that all predictors directly predicted QoL: marital empathy, body image, and perceived social support (P < 0.001). Predictors (except for perceived social support by family, friends, and others) also worked indirectly through perceived marital quality to predict QoL (P < 0.001).

Several variables predicted QoL for women with breast cancer, including body image and marital empathy. Most of such variables had both a direct effect and an indirect effect, working through perceived marital quality to affect QoL. Social support, however, had only a direct effect on QoL.

Stuttering is a type of communication and fluency disorder that hurts mental and emotional health. It is also associated with a significant increase in both trait and social anxiety. Studies on stuttering in adults have indicated the nature and impact of this phenomenon. In addition, some psychological aspects of this phenomenon remain vague and need further investigation. Therefore, the present study aimed to compare emotion regulation difficulties, repetitive negative thinking, and experiential avoidance between people who stutter and healthy individuals.

In this study, 101 people who stutter (43 females and 58 males, with a mean age of 29.55 ± 187 years), as well as 110 healthy individuals (74 females and 36 males, with a mean age of 25.57 ± 489 years) as participants were chosen using the convenience sampling method among those who referred to the speech therapy clinics of Tehran, Iran. Research instruments including the repetitive negative thinking inventory, Difficulties in Emotion Regulation Scale, and Acceptance and Action Questionnaire (AAQ-I) were used for data collection. Data were analyzed using multivariate ANOVA test and Multiple Regression Analysis.

The mean age of the participants was 29.55 years in the people who stutter and 25.57 years in the healthy individuals (P < 0.01). The present results indicated that the mean score of experiential avoidance was higher in the people who stutter (M ± SD: 35.74 ± 9.24) compared to the healthy individuals (M ± SD: 8.89 ± 31.11). Additionally, the mean score of emotion regulation difficulties was higher in the people who stutter (M ± SD: 88.75 ± 20.59) compared to the healthy individuals (M ± SD: 64.14 ± 94.94) (P < 0.001). However, there was no significant difference in the mean score of repetitive negative thinking between the people who stutter (M ± SD: 98.45 ± 25.85) and healthy individuals (M ± SD: 93.71 ± 25.24) groups (P > 0.05). There was a significant correlation between experiential avoidance and emotion regulation difficulties in people who stutter (P < 0.01). Experiential avoidance and repetitive negative thinking can significantly predict emotion regulation difficulties in people who stutter (R = 0.65, P < 0.01).

People who stutter obtained higher emotion regulation difficulties and experiential avoidance scores than those without stuttering and A significant correlation between experiential avoidance and emotion regulation difficulties was found. Future studies should consider the role of emotion regulation difficulties and experiential avoidance in people who stutter.

This research is primarily conducted to determine the psychometric properties of the Beliefs about Emotions Scale (BES) in community and clinical samples. The BES is a scale measure used for evaluating individuals’ beliefs in terms of how acceptable it is for them to experience and express their emotions.

This study was conducted on two separate samples. In the first part, 300 individuals were selected from a general sample in Tehran using the quota sampling method. For the second part of the study, we used purposive sampling to gather data from 119 patients suffering from Major Depressive Disorder (MDD) and 121 patients from Somatic Symptoms Disorder (SSD), whose disorders were diagnosed based on the DSM-5 diagnostic criteria. The BES structural validity was examined through Confirmatory Factor Analysis (CFA). Additionally, test-retest composite and internal consistency indices were explored to investigate the reliability of the BES score. Finally, the associations of the BES score with the Hospital Anxiety and Depression Scale (HADS), Young Schema Questionnaire (YSQ), Multidimensional Perfectionism Scale (MPS), Difficulties in Emotion Regulation Scale (DERS), and Emotion Regulation Questionnaire (ERQ) scores were highlighted to investigate the discriminant and convergent validity of the BES score.

According to CFAs, the one-factor model for the BES demonstrated a good fit with the data collected from both the clinical and community samples. The internal consistency (Cronbach's alpha) was satisfactory in the community sample (α = 0.84) and the clinical samples of SSD (α = 0.86) and MDD (α = 0.83). The community sample demonstrated high overall test-retest reliability (ICC = 0.93, P < 0.001; 95% CI: 0.89 - 0.95). In terms of convergent validity, the findings confirmed that in the MMD sample, there was a significant relationship between the BES and almost all measures (including Depression (r = 0.39, P < 0.01), Anxiety (r = 0.21, P < 0.05), Self-Sacrifice (r = 0.27, P < 0.01), MPS-total score (r = 0.22, P < 0.05), DERS total score (r = 0.50, P < 0.01), and Suppression (r = 0.38, P < 0.01). However, in the SSD group, this finding was not found.

The results demonstrated that the Persian BES is a reliable and valid scale of maladaptive beliefs about emotions which could be implemented for both clinical and research aims.

This research investigates the alleles of Variable Number of Tandem Repeats (VNTR) intron 8 of the gene SLC6A3 with attention-deficit / hyperactivity disorder (ADHD) in children and adolescents.

The study’s target population consisted of children and adolescents referred to the specialized clinic, as well as students attending school in Rasht city during 2021-2022. A sample of 95 children between the ages of 6 and 10 with ADHD was selected as the ADHD group, and 95 healthy children were selected as the control group using purposive sampling. The subjects completed the Child Symptom Inventory-4 (CSI-4) checklist after a clinical interview, and demographic information was collected. Genetic sampling was carried out through hair follicles. The sequence of interest was proliferated using the Polymerase Chain Reaction technique )PCR(; afterward, the samples were used for genotype identification on polyacrylamide gel electrophoresis.

The chi-square test results indicated that the 5R / 5R genotype (P = 0.026, χ2 = 7.26) and the 5R allele (P = 0.002, χ2 = 9.35) had a higher frequency compared to the control group. Additionally, the odds ratio test indicated that, compared to other genotypes and alleles, the 5R / 5R genotype (OR = 2.75, 95% CI = 1.29-5.82, P = 0.01) and the 5R allele (OR = 2.02, 95% CI = 1.28-3.19, P = 0.002) increase the odds of developing ADHD by 2.7 and 2 times higher, respectively.

The present study successfully showed the association between intron 8 gene polymorphism, which is responsible for encoding the dopamine transporter as well as ADHD in children and adolescents in Iran.

Patients with leukemia suffer from significant psychological, spiritual, and social symptoms. Therefore, the current research aimed to study the impact of spiritual end-of-life support on the quality of life for leukemia patients.

To this end, the present quasi-experimental research with a pre-test and post-test design was performed. The sample included 60 cancer patients randomly assigned to intervention and control groups through the method of permutation block. The experimental group received spiritual support intervention for eight sessions of 60 minutes, while the control group received no intervention. Patients filled out the questionnaire of World Health Organization Quality of Life. The World Health Organization conducts a three-phase assessment to measure the quality of life. These phases include a pre-test, which is conducted before any intervention takes place. Then comes the post-test, which occurs after the intervention. Finally, there is a follow-up assessment conducted two months after the post-test. The obtained results were analyzed by repeated-measures analysis and independent samples t-test using SPSS software.

The findings from the repeated measures analysis revealed that there was a statistically significant interaction between time and group (P = 0.01). In other words, being compared to the control group, the spiritual support significantly increased the life quality of the patients in the experimental group. The experimental group witnessed a sustained enhancement in the quality of life for a period of two months following the intervention (follow-up, P = 0.01).

Ultimately, the provision of spiritual support has the potential to enhance the overall well-being of individuals approaching the end of their lives, offering solace and aiding them in comprehending the true essence and purpose of their existence.

Borderline personality disorder (BPD) is a serious public health problem. Dialectical Behavior Therapy (DBT) is a program that has provided encouraging results for its treatment. However, scientific evidence about its efficacy is scarce. Therefore, we aimed to describe the scientific production on the components of the DBT program and its therapeutic efficacy in the treatment of people with BPD.

A systematic review with relevant keywords was conducted based on studies available in Scopus, Web of Science, and PubMed until June 2023, including studies in English, research on therapeutic intervention, studies with a randomized controlled trial (RCT) design that included people with the diagnosis of BPD.

We found 18 RCTs, most of which supported the effectiveness of DBT for BPD. There were a total of 1,755 participants in these studies, most of whom were women. These studies looked for treating self-injurious behaviors, suicidal thoughts or ideations, number of visits to emergency services, and frequency of hospital admissions. Most studies revealed that both short-term DBT and standard DBT improved suicidality in BPD patients with small or moderate effect sizes, lasting up to 24 months after the treatment period. Furthermore, these studies showed that DBT can significantly improve general psychopathology and depressive symptoms in patients with BPD. Improvement of compliance, impulsivity, mood instability, as well as reduction in hospitalization rate are other findings observed in the trials following DBT.

Although DBT shows efficacy in the treatment of BPD, heterogeneity in the methodologies employed is highlighted. Therefore, it is necessary to design studies from a homogeneous theoretical and methodological framework.

The aim of this study was to clarify various aspects and dimensions of the prosociality concept in later life as an important concept that gains significance in people as they age. This concept has been expressed through a variety of dimensions in different studies.

This is a scoping review of the relevant literature on the concept of prosociality and its dimensions in later life, including quantitative and qualitative studies. The required data were collected from Web of Science, Scopus, PubMed, ProQuest, and Google Scholar databases between the years 1987 and 2022.

First, 877 articles were identified, and after the screening phase, 57 eligible studies were reviewed. Two main categories, prosocial dispositions and prosocial behaviors, and seven subcategories were extracted. The subcategories of prosocial dispositions include empathy, prosocial norms, innate tendencies, and generative desires. Prosocial behaviors subcategories include informal spontaneous helping, formal planned helping, and pro-environmental behaviors.

The various aspects and dimensions of the prosociality concept in later life identified in this study can be used as a basis for assessing and planning the promotion of prosociality among older adults.

Recent studies have utilized innovative techniques to investigate the neural mechanisms underlying social and individual decision-making, aiming to understand how individuals respond to the world.

In this review, we summarized current scientific evidence concerning the neural underpinnings of social decision-making and their impact on social behavior.

Critical brain regions involved in social cognition and decision-making are integral to the process of social decision-making. Notably, the medial prefrontal cortex (mPFC) and temporoparietal junction (TPJ) contribute to the comprehension of others' mental states. Similarly, the posterior superior temporal sulcus (pSTS) shows heightened activity when individuals observe faces and movements. On the lateral surface of the brain, the inferior frontal gyrus (IFG) and inferior parietal sulcus (IPS) play a role in social cognition. Furthermore, the medial surface of the brain, including the amygdala, anterior cingulate cortex (ACC), and anterior insula (AI), also participates in social cognition processes. Regarding decision-making, functional magnetic resonance imaging (fMRI) studies have illuminated the involvement of a network of brain regions, encompassing the ventromedial prefrontal cortex (vmPFC), ventral striatum (VS), and nucleus accumbens (NAcc).

Dysfunction in specific subregions of the prefrontal cortex (PFC) has been linked to various psychiatric conditions. These subregions play pivotal roles in cognitive, emotional, and social processing, and their impairment can contribute to the development and manifestation of psychiatric symptoms. A comprehensive understanding of the unique contributions of these PFC subregions to psychiatric disorders has the potential to inform the development of targeted interventions and treatments for affected individuals.