Iranian Journal of Psychiatry
Volume:8 Issue: 2, Spring 2013

This is a parallel, three group, randomized, controlled clinical trial, with outcomes evaluated up to three months after randomization for children and adolescents with chronic nail biting. The current study investigates the efficacy of habit reversal training (HRT) and compares its effect with object manipulation training (OMT) considering the limitations of the current literature. Ninety one children and adolescents with nail biting were randomly allocated to one of the three groups. The three groups were HRT (n=30), OMT (n=30), and wait-list or control group (n=31). The mean length of nail was considered as the main outcome. The mean length of the nails after one month in HRT and OMT groups increased compared to the waiting list group (P<0.001, P<0.001, respectively). In long term, both OMT and HRT increased the mean length of nails (P<0.01), but HRT was more effective than OMT (P<0.021). The parent-reported frequency of nail biting did show similar results as to the mean length of nails assessment in long term. The number of children who completely stopped nail biting in HRT and OMT groups during three months was 8 and 7, respectively. This number was zero during one month for the wait-list group. This trial showed that HRT is more effective than wait-list and OMT in increasing the mean length of nails of children and adolescents in long terms.

Having a good quality of life has always been desirable for humans, and the concept of a good life and the ways of achieving it have become important over the years. Personal wellbeing is the mental component of quality of life. Thus, the current study was conducted to assess the reliability and validity of the ‘‘Personal Well-Being Index- Cognitive Disability’’ on mentally retarded students. 200 mentally retarded students in north districts of Tehran (districts 1, 2 and 3) were selected by systematic random sampling. The collected data using Personal Well-Being Index- Cognitive Disability was analyzed by Cronbach’s alpha coefficient for internal consistency and linear multivariate regression for construct validity. Results confirmed the reliability and validity for the Personal Well-Being Index- Cognitive Disability in mentally retarded students of exceptional schools. Studying the internal consistency of seven items showed that all the items were correlated with the total score and their scores averages were similar to each other. This indicates that the test’s questions have reliability with regard to evaluation of a common feature and results showed Personal Well-Being Index- Cognitive Disability had the most extensive coverage of construct validity. Personal Well-Being Index- Cognitive Disability scale could be applied to measure personal wellbeing in mentally retarded students.

Major depression is a mood disorder that causes changes in physical activity, appetite, sleep and weight. Regarding the role of zinc in the pathology of depression, the present study was aimed to investigate the effects of zinc supplementation in the treatment of this disease. This study was a double-blind randomized clinical trial. Forty four patients with major depression were randomly assigned to groups receiving zinc supplementation and placebo. Patients in Zinc group received daily supplementation with 25 mg zinc adjunct to antidepressant; Selective Serotonin Reuptake Inhibitors (SSRIs), while the patients in placebo group received placebo with antidepressants (SSRIs) for twelve weeks. Severity of depression was measured using the Beck Depression Inventory at baseline and was repeated at the sixth and twelfth weeks. ANOVA with repeated measure was used to compare and track the changes during the study. The mean score of Beck test decreased significantly in the zinc supplement group at the end of week 6 (P<0.01) and 12 (P<0.001) compared to the baseline. The mean score of Beck Depression Inventory reduced significantly compared to the placebo group at the end of 12th week (P<0.05) The results of the present study indicate that zinc supplementation together with SSRIs antidepressant drug improves major depressive disorders more effectively in patients with placebo plus antidepressants (SSRIs).

Inventory Drug-Taking Situations (IDTS) is a universal instrument used to determine high-risk situations resulting in drug abuse. The aim of this study was to translate this questionnaire to Farsi, and to assess its validity and reliability by applying it to Iranian drug users. As a psychometric study, 300 drug users participated in a treatment program in National Center of Addiction Studies filled in a version of Inventory of Drug Taking Situations. We assessed face and content validity, internal consistency, and reliability based on the completed questionnaires, using test-retest method and confirmatory factor analysis. Internal consistency analysis confirmed that all subscales of IDTS were reliable (Cronbach alpha was ranging from 0.7 to 0.81). Analyses indicated that each of the subscales was unifactorial; however, unpleasant emotions had a second eigenvalue that was nearly large enough to be a second factor. Confirmatory factor analysis was used to test the fit of the data to the original version of IDTS. Based on goodness of fit indices, we found that all factors were fitted (χ2/df=1.43, GFI=0.98, RMSEA=0.038). The test-retest reliability was satisfactory(r>0.6). The Farsi version of Inventory of Drug Taking Situations was shown to be a valid and reliable instrument to apply in clinical and research settings in Iran.

Several studies have implicated the 5-HTTLPR polymorphism in treatment outcomes of selective serotonin re-uptake inhibitors in patients with major depression. The aim of this study was to examine the association between polymorphism in the serotonin transporter gene and citalopram effectiveness in Iranian patients suffering from major depressive disorder (MDD). The sample consisted of 104 patients, with Fars ethnic background, who were diagnosed according to DSM-IV-TR criteria. Beck Depression inventory was used to evaluate the severity of the symptoms during the follow-up, and to determine clinical response of the patients at 4th and 8th week, respectively. Our results showed a correlation between the genotype and response to antidepressant drug citalopram, (odds ratios for L/S and L/L were 3.90 (95 percent CI: 1.29- 11.80) and 1.90 (95 percent CI: 0.72-5.08), respectively). In conclusion, our results reveal that genetic variation of serotonin transporter is involved in clinical remission of major depressive episodes in Iranian patients after citalopram treatment.

Malnutrition and depression are highly prevalent in the elderly and can lead to unfavorable outcomes. The aims of the current study were to determine the association between malnutrition and depression and also to find any correlation of depression with some anthropometric indices in free living elderly. In this cross-sectional study, 337 elderly subjects (193 females) were selected using cluster sampling. Depressive symptoms and nutritional status were determined by the Geriatric Depression Scale (GDS) and the Mini-Nutritional Assessment (MNA) scores questionnaires, respectively. Anthropometric indices were measured all in standard situations. Chi squared test and t-test were used when necessary. Pearson correlation coefficients were calculated for linear relations between variables. Of all the total subjects, 43.62 %were depressed; and of whom, 48.01% were malnourished or at risk of malnutrition. GDS had a significant negative dependence with the MNA for the entire sample (r=-0.58, p <0.0001). However, there was no significant correlation between age and GDS or MNA scores. Moreover, the mean GDS scores differed significantly between men and women (p <0.05), and women were more depressed than men (27.9% vs. 15%, respectively). The elderly subjects living in urban areas were more depressed than those living in rural areas (39.46% vs. 3.85% respectively). The results of the present study revealed a high prevalence of depression and malnutrition among old subjects. Moreover, depression was associated with worsening of nutritional status. The mechanism of this association needs further study.

Drug craving is defined as an urge to continue substance abuse. Drug dependents use different terms to express their subjective feeling of craving. This study was an attempt to generate an understanding of craving terminology among different groups of Persian speaking Iranian opiate dependents. Terms used for the meaning of drug craving were listed by 36 ex-opiate dependents in focus group discussion meetings in the first phase of the study. These terms were composed from Craving Terms Questionnaire. In the second phase, 120 subjects in 3 groups of opiate dependents and a group of Current Opiate Abusers rated usage frequency of each term in the questionnaire under a Twelve-Step Program, Methadone Maintenance, and Other Abstinence-based Programs. Eighty nine terms were categorized in stimulation and triggering, attention bias and obsession, decision making difficulty, information processing impairment, withdrawal induction, drug euphoric experience, mental urge, motor control problem, negative valancing and stigmatizing. Terms for the three categories of mental urge, attention bias and obsession and motor control problem were used more than others. Patients in Methadone Maintenance Treatment (MMT) group used different categories of craving terms in comparison to other groups. Abstinent cases reported higher total score for craving terms in comparison to other groups in Twelve-Step Program and other abstinence-based programs. Each craving-related term is associated with some aspects of the multidimensional concept of craving. A drug-craving thesaurus could provide a better understanding of craving nature from a drug dependent point of view. There are differences among abstinence vs. maintenance based treated opiate dependents in using craving terms. Addiction therapists will benefit from accessing drug dependents’ lexicon to assess and create therapeutic alliance with their clients.

The aim of this study was to evaluate changes of anger scores in female karate athletes during 18 months, and to compare anger scores in adolescents who continue or stop training karate. The sample consisted of 18 female elite karate athletes, practicing modern style of karate. To measure anger and its subscales, participants were asked to complete “Adolescent Anger Rating Scale” (AARS) questionnaire in both stages of the study. Athletes were divided in to two groups of “stayer” (n=12) and “quitter” (n=6) if they continued practicing karate or stopped it, respectively. In order to study the changes of anger score with time, paired T test was used. In analysis of changes in anger scores with time, there was a statistically significant increase in instrumental anger (p=0.001) and non-significant increase in other anger scores among 14-year-old girls who continued practicing karate. Increased instrumental anger in female karate athletes could be due to the impact of participation in a combative sport. However, the results should be interpreted cautiously due to limitations of the study.