Iranian Journal of Psychiatry and Behavioral Sciences
Volume:18 Issue: 1, Mar 2024

The COVID-19 pandemic presents an extreme threat to global health and stands as one of the leading causes of death worldwide. Loss, as a broader theme, intertwines with various aspects of people’s lives during these challenging times. Failing to address the urgent needs of individuals experiencing loss and grief can result in poor mental and physical health.

Our study aimed to evaluate the impact of interpersonal psychotherapy (IPT) and compassion-focused therapy (CFT) on the grief and quality of life (QoL) of first-degree relatives who lost loved ones due to the COVID-19 pandemic.

This study was a randomized clinical trial. Participants who had lost a family member to COVID-19 between March 2019 and September 2020 and who visited the hospitals affiliated with Isfahan University of Medical Sciences were selected based on specific inclusion and exclusion criteria. Forty participants were randomly assigned to either IPT or CFT, and each group underwent 6 weekly sessions. The Grief Experience Questionnaires and the World Health Organization’s Quality of Life Questionnaires were administered to all individuals via phone interviews before commencing treatment and 1 month after completing the sessions.

The results indicated a significant improvement in both treatment groups individually (P < 0.001). However, when comparing the 2 groups while adjusting for the pre-test effects, there were no significant differences between them in any of the following areas: Physical response (P2 = 0.45), notoriety (P2 = 0.53), justification and coping (P2 = 0.59), guilt (P2 = 0.31), feelings of abandonment (P2 = 0.52), judgment by others (P2 = 0.78), and embarrassment and shame (P2 = 0.79).

The findings from our study demonstrate that both IPT and CFT resulted in improved QoL and reduced grief experiences. Therefore, these therapeutic approaches can be employed to alleviate grief symptoms and enhance overall QoL.

Numerous research studies have unveiled the significant impacts of neurofeedback (NFB) on individuals suffering from depression, anxiety, and stress.

In light of these findings, the current trial aimed to assess the efficacy of neurofeedback in alleviating stress symptoms among students experiencing high levels of stress, utilizing the neurofeedback method.

The trial comprised 30 students aged between 15 and 25 years old who were identified as experiencing psychological distress. To ensure an in-depth investigation and account for potential confounding variables, we employed a randomized controlled trial design, randomly allocating participants to either the experimental or control group. The first group received an 8-week course of neurofeedback treatment, while the control group did not receive any specific treatment but underwent psychological assessments at predetermined intervals. Baseline measurements were taken at the commencement of the study, utilizing the Depression Anxiety Stress Scales (DASS-21) and salivary tests. Subsequent measurements were conducted after 4 weeks and at the conclusion of the research. The collected data underwent repeated measures of variance analysis for statistical evaluation.

At the conclusion, the mean of the experimental group (36.8) and control group (76.67) were found to be significantly different (P < 0.001). Furthermore, after 4 weeks into the study, the repeated measures variance analysis revealed that the mean of the experimental group was lower than that of the other group (P < 0.05, ES: 0.651).

The results of this trial suggest that neurofeedback (NFB) can be considered an effective, low-risk, non-invasive treatment option for individuals experiencing high levels of stress, as indicated by the significant reduction in salivary biomarkers.

Cognitive-behavioral therapy (CBT) is acknowledged as an efficient therapeutic modality in fibromyalgia. However, its effect on the oxidative balance of fibromyalgia patients has not been investigated.

We investigated whether CBT intervention could influence serum markers of oxidative balance.

Forty fibromyalgia patients were randomly assigned to either the intervention (CBT) or control (waiting list) group. For the intervention group, traditional face-to-face CBT was performed for 20 sessions over two months. Sixteen patients in the CBT group and 17 patients in the control group completed the study. Outcomes were the serum total oxidant status (TOS) and total antioxidant capacity (TAC) that were assessed before the intervention and at the end of the intervention by an oxidation-reduction colorimetric assay. Within-group and between-group analyses were performed using theWilcoxon signed-rank test and Mann–Whitney U test, respectively.

Baseline characteristics showed no significant difference between the participants of the two groups. At the end of the study, mean TOS significantly reduced in the case group (P < 0.001) but not in the control group (P = 0.61), and mean TAC showed no significant change in the case and control groups (P = 0.1 and P = 0.09, respectively). The mean change in TOS was 0.43 ± 0.3 mM in the CBT group and 0.03 ± 0.2 mM in the control group (P < 0.001). The mean change in TAC was 0.015 ± 0.03 mM in the CBT group and 0.01 ± 0.02 mM in the control group (P = 0.57).

Cognitive-behavioral therapy improves the oxidative balance of fibromyalgia patients. Our results further support the benefits of CBT implication in the treatment of fibromyalgia.

Patients with chronic illnesses like type 2 diabetes mellitus (T2DM) are at a higher risk of depression and psychiatric disorders, potentially leading to adverse outcomes. Eating disorders appear to be one of the factors contributing to T2DM and resulting in poor glycemic control and complications.

This study aimed to compare the prevalence of eating disorders and suicidal ideation between morbid and nonmorbid T2DM patients.

A cross-sectional questionnaire was conducted at the Yazd Diabetes Research Center from August 2021 to March 2022. A total of 232 T2DM patients aged between 30 and 65 were included in the study. Through convenience sampling, data were collected using structured questionnaires to assess eating disorders, suicidal ideation, and demographic information. Statistical analyses were performed to evaluate the associations between variables.

The study revealed that there was no statistically significant difference in the prevalence of eating disorders between the two groups of T2DM patients (P = 0.083). However, upon considering age as a contributing factor, it was observed that younger patients afflicted with morbid T2DM exhibited a markedly higher incidence of eating disorders when compared to their non-morbid counterparts (P = 0.019). In contrast, a significant distinction emerged in terms of suicidal ideation between the two groups (P = 0.015), with patients suffering from morbid T2DM reporting elevated rates of contemplating suicide. Subgroup analyses further underscored a heightened prevalence of suicidal ideation among female patients and those aged 30 - 59 who were afflicted with morbid T2DM.

This study highlights the importance of mental health assessment in T2DM patients, particularly those with morbid disease, younger age, higher Body Mass Index (BMI), and poor glycemic control. Early detection and intervention for eating disorders and suicidal ideation could significantly improve the overall well-being and outcomes of T2DM patients.

Maternal reflective functioning refers to a mother’s ability to understand the mental states of herself and her child. This capacity is related to the attachment styles of the mother and child, as well as the mentalizing capacity of the child and his/her behavioral problems. The Parental Reflective Functioning Questionnaire (PRFQ) was developed to evaluate the capacity of mothers.

This study aimed to determine the factor structure, structural validity, and psychometric properties of PRFQ in mothers working at Qazvin University of Medical Sciences.

The study was a methodological one conducted by structural equation modeling to investigate the factor structure of PRFQ designed by Luyten et al. in 2017. Two samples, including 183 and 120 mothers working at Qazvin University of Medical Sciences in 2021, were selected using convenience sampling for exploratory factor analysis (EFA) and confirmatory factor analysis (CFA), respectively. For data collection, the participants completed PRFQ, Adult Attachment Inventory (AAI), Symptom Checklist-25 (SCL-25), RFQ, and Emotional Availability Self-Report (EA-SR). For data analysis, statistical methods, including EFA, CFA, and correlation analysis, were used in SPSS and AMOS software packages.

The Cronbach’s alpha for the total questionnaire was equal to 0.6. The exploratory factor analysis showed that PRFQ had a 3-factor structure with a shared variance of 38.03%. Item 11 loaded on all factors, and items 6 and 18 loaded on the pre-mentalization factor. The developed model was approved by removing item 11 and loading items 6 and 18 on the pre-mentalization factor in CFA (comparative fit index [CFI] = 0.93, normed fit index [NFI] = 0.82, Tucker-Lewis index [TLI] = 0.92, and root mean square error of approximation [RMSEA] = 0.05). The results also revealed that the developed questionnaire had adequate concurrent and predictive validity.

Overall, the 3-factor structure of PRFQ for mothers showed adequate validity and reliability

Breast cancer ranks as the most common cancer among women globally, with over 6% of deaths annually attributed to this disease. Compassion-focused therapy (CFT) alters existing emotional patterns, empowering individuals to enhance their self-care and support. It diminishes self-criticism and emotional issues while fostering self-acceptance, thereby improving individuals’ ability to handle their own well-being and interpersonal relationships more effectively in difficult circumstances like breast cancer.

This study aimed to examine the impact of group CFT on body image and interpersonal stress among women with breast cancer. It sought to assess the average scores for body image and interpersonal stress, along with their respective subscales, within the CFT and control groups before, after the intervention, and during the follow-up phase.

The study included 44 women diagnosed with breast cancer, referred to hospitals in Kashan, Iran, in 2022. With informed consent obtained, participants were randomly allocated to the CFT group (n = 22) or the control group (n = 22). They completed the Body Image Scale (BIS) and the Interpersonal Stress Scale (ISS) before treatment, after treatment, and at a 2-month follow-up.

The findings indicated no significant differences in demographic variables (such as age, marital status, employment status, number of children, and education level) between the two groups. Repeated measures of analysis of variance (ANOVA) analysis demonstrated that CFT significantly improved body image and reduced interpersonal stress among women with breast cancer.

Compassion-focused therapy proves to be a potentially effective therapeutic strategy for women with breast cancer. Further studies are necessary to comprehensively explore the benefits of CFT for breast cancer patients and its integration into conventional care practices.

Freshmen have to face different requirements, such as deciding on a future job, establishing a relationship with the other gender, adapting to a new environment, building new relationships, being away from family, and experiencing different courses and teachers. These different demands might make this period one of the most stressful times and turn the adaptation process into a difficult stage. Therefore, it is necessary to provide appropriate tools to determine the levels and difficulties of adaptation in various fields.

This study aimed to investigate the psychometric properties of Baker and Siryk 67-Question Student Adaptation to College Questionnaire (SACQ) to provide an appropriate tool for diagnosing freshmen’s problems.

The current study is a methodological study with a descriptive cross-sectional design. Given the construct structure of the questionnaire, it was tried to select 445 freshmen across different undergraduate fields using a multi-stage sampling method. Then, SACQ, Brief Psychological Adjustment-6, the Social and Emotional Loneliness Scale for Adults - Short Version, and the Beck Depression Inventory were administered. Then, confirmatory factor analysis, convergent and divergent validity, and Cronbach’s alpha were calculated for data analysis.

The results showed that the internal consistency coefficient of this questionnaire for all components was higher than 0.70, and it indicated that the tool was a suitable one. The confirmatory factor analysis showed that the 4-factor model of original developers had a better fit than the one-factor and six-factor models in this sample.

Since the factor structure of this scale was approved, it could be used to measure adaptation to college to determine and identify troubled or at-risk freshmen.

Alzheimer’s disease (AD), the most prevalent form of dementia worldwide, is characterized by memory impairment and the accumulation of tau and beta-amyloid (Aβ) plaques. Naringin, a flavonoid, has exhibited strong anti-inflammatory, anti-oxidant, and anti-apoptotic properties.

In this study, we aimed to demonstrate the neuroprotective effects of naringin on memory function, the total number and density of Aβ plaques, and the volume of the hippocampal CA1 region in a scopolamine (SCO)-induced AD model in rats.

Forty male Wistar rats were randomly divided into the following groups: A control group, a saline + SCO (3 mg/kg) group (pretreated with 200 µL saline), and 3 treatment groups receiving naringin at doses of 50 mg/kg/day + SCO, 100 mg/kg/day + SCO, and 200 mg/kg/day + SCO (pretreated with 50, 100, or 200 mg/kg of naringin) for 14 consecutive days via intraperitoneal (IP) injection. After the 14-day pretreatment period, the saline + SCO and 3 naringin treatment groups received SCO (3 mg/kg) to induce an AD-like condition. Memory function was assessed using the inhibitory passive avoidance test. Following brain harvesting, paraffin-embedded coronal brain slices were stained with Congo red, and the density and the total number of Aβ plaques and the volume of the hippocampal CA1 area were estimated using unbiased stereological techniques.

The results indicated that naringin significantly improved memory function, with the most pronounced effect observed in the naringin 200 mg/kg + SCO group. Stereological analysis revealed that SCO reduced the volume of the hippocampal CA1 area and increased the total number and density of Aβ plaques. Pretreatment with naringin significantly restored the hippocampal CA1 volume in the 200 mg/kg + SCO group compared to the saline + SCO group. Additionally, naringin reduced the total number and density of Aβ plaques, with the most significant decrease observed in the 200 mg/kg + SCO group.

Naringin restored memory function and the volume of the hippocampal CA1 region while reducing the total number and density of Aβ plaques in a SCO-induced AD model in rats. This stereological study complements previous molecular research on naringin’s neuroprotective effects in AD-like pathogenesis.

Elder abuse presents a significant public health concern with implications for overall well-being. As Iran undergoes demographic aging, there is a lack of data regarding the prevalence of elder abuse.

This study aimed to provide insight into the prevalence of elder abuse in Isfahan, Iran.

A cross-sectional study was conducted in Isfahan in 2021, recruiting 424 individuals aged 60 and above from the "Comprehensive Health Services Centers" through simple random sampling. Demographic information and responses to the Elderly Abuse questionnaire were collected via interviews. Descriptive statistics, including mean and confidence intervals, were utilized, while analytical methods such as independent t-tests, chi-square tests, Spearman and Pearson correlation coefficients, and logistic regression were employed for data analysis.

The study revealed a 36% prevalence of elder abuse across at least one category, with authority deprivation (19.6%) and emotional neglect (19.3%) being the most prevalent forms. This prevalence was higher among individuals aged 60 - 69 years (adjusted odds ratio (OR) = 2, CI (1.19 - 3.45), P = 0.01), females (adjusted OR = 2.61, CI (1.30 - 5.25), P = 0.007), retirees (adjusted OR = 4.15, CI (1.59 - 10.92), P = 0.004), and those with a history of chronic illness (adjusted OR = 2.11, CI (1.26 - 3.53), P = 0.004).

Elder abuse emerges as a significant public health issue in Isfahan. Given the ongoing aging process nationwide, there is a critical need for interventions aimed at preventing and mitigating this public health concern.

Obstructive sleep apnea (OSA) is a common and debilitating sleep disorder with both mental and physical complications. Although medical treatments may improve OSA symptoms, they may not affect its mental sequelae.

The aim of this study was to evaluate the effect of training the components of compassion-focused therapy (CFT) on sleep quality, anxiety, and memory in patients with OSA.

This experimental study was performed on 37 patients (18 to 65 years old) with confirmed OSA diagnosed in the past year with a minimum apnea index score of 5 and no history of medical or psychiatric diseases. The study was conducted between 2022 and 2023. Exclusion criteria were being absent from more than two training sessions, experiencing stressful events, and refusing to continue the study. The intervention group (n = 19) received the training component of CFT in 8 sessions (once a week), while the control group received no psychological intervention. The Pittsburg sleep quality index (PSQI), Rey Auditory-Verbal Learning Test (RAVLT), Rey-Osterrieth complex figure (ROCF), and Beck Anxiety Inventory (BAI), as well as a demographic information questionnaire, were filled out by the participants at the baseline and after the intervention.

There was no significant difference between the groups in terms of demographic variables. The training component of CFT was effective in reducing anxiety and improving sleep quality, as well as the auditory-verbal and visual-spatial components of short-term memory in patients with OSA (P < 0.05).

The training component of CFT was efficient and beneficial in reducing anxiety and improving immediate memory and sleep quality in patients with OSA.

Methadone maintenance treatment (MMT) has been a cornerstone in heroin addiction management. However, its efficacy varies among individuals. The complex interplay of genetic backgrounds and demographic data could influence the response to MMT in heroin addiction. No previous adoption study has aimed to merge these findings into a potential pre-treatment screening tool.

This study aimed to investigate the combined influence of dopamine and opioid receptors and receptor endocytosis machinery genes, individual genetic backgrounds, and demographic data on the response toMMT in patients with heroin addiction.

We enrolled 80 heroin addicts receiving MMT for 3 months alongside 80 healthy individuals in a comparative study. The approach utilized multinomial, linear, and binary logistic regression analyses to investigate the interplay of genetic factors (DRD1-5, opioid receptors [µ1, δ1, and κ1], DNM1L, RAB22A, and COMT), demographic independent variables, including, family history, heroin duration, age onset, heroin dose, and methadone dose, and clinical markers Subjective Opiate Withdrawal Scale (SOWS) with compliance with MMT protocols.

Results revealed that a positive family history and a higher level of heroin dose significantly predicted poor compliance to MMT. Additionally, the patients with lower expression levels of DRD2 and higher expression levels of DNM1L and COMT genes were at higher risk for poor compliance with the treatment.

By utilizing a comprehensive dataset of gene expression profiles and demographic and clinical parameters, this study developed a regression model predicting resistance or response to methadone. This innovative approach seeks to bridge the gap between pharmacogenomics and clinical practice and offer a potential pre-treatment screening tool for personalized MMT strategies in opioid addiction management. The obtained findings hold intriguing promise for future research, potentially unlocking deeper insights into the underlying risk factors of addiction.

Previous studies have indicated abnormalities in the immune system, such as central nervous system inflammation and high levels of activating cytokines in the cerebrospinal fluid of schizophrenic patients. Celecoxib, a modulator of proinflammatory cytokines, as an adjunctive therapy add-on risperidone (a well-established atypical antipsychotic) and amisulpiride (a benzamide antipsychotic), had improved these patients significantly.

A trial was conducted to evaluate the therapeutic effects of celecoxib add-on haloperidol, a classic antipsychotic that has been reported to have an immunomodulatory effect and mainly affects positive psychotic symptoms in schizophrenia.

In a prospective, double-blind study, after a washout period, 49 patients with schizophrenia were randomly assigned to either 15 - 30 mg/day haloperidol plus 400 mg/day of celecoxib or the same dose of haloperidol plus placebo for 5 weeks. Psychopathology was evaluated via the Positive and Negative Symptoms Scale (PANSS). The data were reported as mean ± standard deviation and frequency. An Independent t-test was carried out when comparing the data of these two groups for each week. The proportion comparison was carried out using the chi-square test. In terms of age, gender, marital and educational state, and duration or severity of disease or psychopathology and subtypes of schizophrenia, there were no significant differences.

Over 5 weeks, there was significantly greater improvement in the celecoxib group in scores on the total PANSS and on positive symptoms and general psychopathology subscales ([t = 2.89, P = 0.006], [t = 2.37, P = 0.022], and [t = 3.34, P = 0.002] respectively).

Celecoxib is an efficient adjuvant agent in the treatment of patients with schizophrenia. Significant superiority of management with a modulator of proinflammatory cytokine, which balances immune responses over haloperidol alone, reconfirms the immune dysfunction and inflammation hypothesis of schizophrenia.

Suicide represents a significant global health issue, shaped by a complex interplay of psychological, cultural, and economic factors. Key objectives in suicide prevention programs include reducing the stigma associated with suicide and enhancing suicide literacy.

The purpose of this study is to evaluate the psychometric properties of the Persian short forms of the Literacy of Suicide Scale and the Stigma of Suicide Scale (LOSS-SF and SOSS-SF).

This cross-sectional study utilized an online survey to gather data from 240 individuals in the general population. The scales were translated from English to Persian and then back-translated into English by professional translators, with the translation quality confirmed by an independent review team. The scales’ validity, reliability, and factor structure were thoroughly analyzed.

The scales’ internal consistency was determined using Cronbach’s alpha, with LOSS-SF scoring 0.76 and SOSS-SF scoring 0.79. The intraclass correlation coefficients for LOSS-SF and SOSS-SF were 0.81 and 0.75, respectively. Confirmatory factor analysis affirmed the structure of both scales.

The findings suggest that LOSS-SF and SOSS-SF possess appropriate psychometric properties for the Iranian context, enabling Persian-speaking professionals to use these tools for assessing key aspects of suicide.

Treatment adherence, the key to therapy success and patients’ quality of life, can be influenced by many factors in psychiatric patients, including self-stigma, alongside insight, illness duration, social support, health beliefs, personality, substance abuse, side effects, and life circumstances.

This study aims to identify factors, particularly self-stigma, affecting treatment adherence in stable psychiatric outpatients.

A sample of 200 adult mental health patients in Arak, Iran, diagnosed with schizophrenia, bipolar disorder, major depressive disorder, or anxiety disorders, participated in this study. Self-stigma was assessed using the Internalized Stigma of Mental Illness (ISMI) scale, and treatment adherence was measured using the Drug Attitude Inventory (DAI-10). Data were analyzed using descriptive statistics, correlation, regression, and chi-square tests.

Among the 200 participants (73 men and 127 women, with an average age of 35.1 years), the average stigma score was 62.8. The mean DAI-10 score was 4.8, with 172 showing positive medication attitudes. Younger, smoking, and alcohol-consuming patients showed lower treatment adherence. Higher self-stigma correlated with lower adherence, but there were no significant associations with gender, marital status, diagnosis, or diagnosis duration.

This study highlights the importance of addressing self-stigma as a barrier to treatment adherence in individuals with mental illnesses. Strategies to reduce self-stigma may improve treatment outcomes, especially among younger patients and those with substance use disorders. Further research is warranted to develop effective interventions for enhancing medication adherence in stable psychiatric outpatients.

Irritable bowel syndrome (IBS) is a functional gastrointestinal disorder that greatly affects the quality of life. While prior research suggested a linear connection between conscientiousness and health outcomes like quality of life, recent studies propose a more intricate, curved relationship.

The present study aimed to determine the inverted U-shaped curvilinear relationship between conscientiousness and quality of life in patients with irritable bowel syndrome.

This descriptive-correlational study in Tehran’s private gastroenterology clinic in 2020 included 232 IBS patients. Data collected via the NEO Five-Factor Inventory (NEO-FFI) and Irritable Bowel Syndrome Quality of Life (IBS-QOL) questionnaire were analyzed using SPSS version 26 and Excel 2023 for statistical assessment at a 95% confidence interval.

Scatter plots and regression equations demonstrated a strong curvilinear relationship (R2 = 0.14) between conscientiousness and IBS patients’ quality of life, surpassing the linear relationship (R2 = 0.08). Curvilinear regression analysis revealed significant correlations (95% CI) for both the first-degree coefficient (β1 = 2.304, P < 0.001) and the second-degree coefficient (β2 = -2.043, P < 0.001).

The findings indicate an inverted U-shaped relationship between conscientiousness and quality of life in IBS individuals. This underscores the importance of addressing exceptionally high conscientiousness levels in healthcare.

Despite the challenging nature of cancer, research has indicated that the battle against this illness can lead to positive transformations following diagnosis and treatment, a phenomenon known as post-traumatic growth.

This study aimed to explore the association between body image and mental well-being and post-traumatic growth among women who have undergone breast cancer treatment and mastectomy surgery.

Employing a correlational research design, this study sampled 276 participants, focusing on married women in Tehran who have experienced mastectomy. The instruments used included McKinley and Hyde’s Body Image Scale (1996), the Ryff Scale of Psychological Well-Being 1989 (RSPWB-18), and the Post-traumatic Growth Inventory (PTGI) by Tedeschi.

Data analysis was conducted using Pearson’s correlation test and multivariate regression analysis. The findings revealed a significant association between psychological well-being and post-traumatic growth in women (P < 0.01).

The results underscore the importance of incorporating an understanding of the relationship between these variables into the development of educational and psychological interventions, integrating them with treatment plans for patients post-breast cancer surgery

Mental health disorders influence emotions and behavior and frequently result in stigma, particularly personal stigma, where affected individuals internalize societal biases. This study explores the relationship between internalized stigma and hope, self-esteem, and self-efficacy in individuals with mental illness.

The aim was to investigate the relationship between internalized stigma and hope, self-esteem, and self-efficacy in patients with mental illness and to contribute to the discourse on mental health care.

A cross-sectional study involving 126 mental illness outpatients from Amirkabir Hospital in Arak, Iran, was conducted. Instruments such as the Internalized Stigma Of Mental Illness (ISMI) Scale, Schneider's Dispositional Hope Scale, Rosenberg's Self-esteem Scale, and the General Self-efficacy Scale were utilized. Data were analyzed using statistical methods.

In this study of 126 participants (54% women, 46% men; ages ranging from 18 to 89), the average score for internalized stigma was 61.04 ± 18.37. There were significant negative correlations observed between self-stigma and hope (r = -0.658, P < 0.001), self-esteem (r = -0.666, P < 0.001), and self-efficacy (r = -0.641, P < 0.001). No significant relationships were identified with socio-demographic factors such as age, gender, and marital status. However, a significant relationship was observed between education level, self-stigma, and self-efficacy.

The study confirms that internalized stigma significantly affects hope, self-esteem, and self-efficacy in patients with mental disorders. The findings emphasize the necessity for improved psychological services and educational programs to strengthen these factors, thus diminishing the impact of stigma and enhancing patients' lives.