Publications by authors named "Ali Ghaleiha"

52 Publications

Pharmacokinetics and brain distribution studies of perphenazine-loaded solid lipid nanoparticles.

Drug Dev Ind Pharm 2021 Jan 18;47(1):146-152. Epub 2020 Dec 18.

Department of Pharmaceutics, School of Pharmacy, Hamadan University of Medical Sciences, Hamadan, Iran.

Background: Perphenazine (PPZ) is a typical antipsychotic that is mainly administrated for the treatment of schizophrenia. Due to its highly lipophilic nature and extensive hepatic first-pass metabolism, its oral bioavailability is low (40%).

Objective: The novel nanocarriers like solid lipid nanoparticles (SLN) have been reported to be highly effective for improving the therapeutic effect of drugs. Therefore the main scope of the present investigation was the evaluation of characteristics of PPZ-SLN in terms of pharmacokinetic parameters and brain distribution.

Methods: The PPZ-SLN was prepared by the solvent-emulsification and evaporation method. The storage stability of PPZ-SLN and empty SLN powders was studied for 3 months. pharmacokinetic studies and brain distribution evaluations were performed following a single oral dose administration of PPZ and PPZ-SLN suspensions on male Wistar rats. An HPLC method was established and validated for the quantitative determination of PPZ in plasma and brain samples.

Results: The storage stability studies revealed the good storage stability of the both PPZ-SLN and empty SLN at 4 °C. Compared to PPZ suspension, the relative bioavailability and the brain distribution of PPZ-SLN were increased up to 2-fold and 16-fold, respectively. Mean residence time (MRT) and half-life (t) of PPZ-SLN were significantly ( value < 0.01) increased in both plasma and brain homogenate compared to PPZ suspension.

Conclusion: The significant improvement in the pharmacokinetic properties of PPZ following one oral dose indicates that SLN is a promising drug delivery system for PPZ and shows a high potential for successful brain delivery of this antipsychotic.
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http://dx.doi.org/10.1080/03639045.2020.1862172DOI Listing
January 2021

A qualitative inquiry of sexuality in Iranian couples using the Information-Motivation-Behavioral skills paradigm.

J Egypt Public Health Assoc 2019 Dec 17;94(1):27. Epub 2019 Dec 17.

Health Education and Health Promotion, School of Public Health, Hamadan University of Medical Science, Hamadan, Iran.

Background: Sexuality is interwoven with individuals' information, motivation, and behaviors.

Objective: To explore sexually related information, motivation, and behaviors that Iranian newly married couples utilized through their marital lives.

Methods: We employed in-depth face-to-face interviews with 22 couples between the ages of 21 and 35 years to collect rich qualitative data. Content analysis was used to analyze the data. Our data analysis process was guided by the Information-Motivation-Behavioral skills (IMB) model as a potential framework for understanding of the participants' sexual and marital lives.

Results: IMB's conceptual bases were adequately reflected in the participants' sexual narratives. The participants highlighted information needs related to their sexual relationships and services that should be provided by the relevant programs in the educational and national health system. Fulfillment of each other's sexual needs was identified as the most important motivation of the participants. Sexual needs of husband, love, and liking were the main motivations for women's sexual submission. The main behaviors found included couples' communication skills and performing using feminine traits by women in order to fit the role of a sexually skillful wife.

Conclusion: Our data analysis revealed that couples shared a proper comprehension of each other's means of sexual behaviors. A dominance of religious discourse, non-verbal, mostly physical means of communication was employed by the couples to express or initiate sexual interactions. Furthermore, our findings support the utility of IMB as a potential basis for understanding married couples' sexual lives. Our data highlight an implication to expand the motivation structure of the IMB model to incorporate an individual's sexual understandings and the sexual needs to promote mutual and pleasurable sexual life within the Iranian culture.
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http://dx.doi.org/10.1186/s42506-019-0024-7DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7364699PMC
December 2019

Determining correlates of the average number of cigarette smoking among college students using count regression models.

Sci Rep 2020 06 1;10(1):8874. Epub 2020 Jun 1.

Department of Psychiatry, School of Medicine, Hamadan University of Medical Sciences, Hamadan, Iran.

College students, as a large part of young adults, are a vulnerable group to several risky behaviors including smoking and drug abuse. This study aimed to utilize and to compare count regression models to identify correlates of cigarette smoking among college students. This was a cross-sectional study conducted on students of Hamadan University of Medical Sciences. The Poisson, negative binomial, generalized Poisson, exponentiated-exponential geometric regression models and their zero-inflated counterparts were fitted and compared using the Vuong test (α = 0.05). A number of 1258 students participated in this study. The majority of students were female (60.8%) and their average age was 23 years. Most of the students were non-smokers (84.6%). Negative binomial regression was selected as the most appropriate model for analyzing the data (comparable fit and simpler interpretation). The significant correlates of the number of cigarettes smoked per day included gender (male: incident-rate-ratio (IRR = 9.21), birth order (Forth: IRR = 1.99), experiencing a break-up (IRR = 2.11), extramarital sex (heterosexual (IRR = 2.59), homosexual (IRR = 3.13) vs. none), and drug abuse (IRR = 5.99). Our findings revealed that several high-risk behaviors were associated with the intensity of smoking, suggesting that these behaviors should be considered in smoking cessation intervention programs for college students.
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http://dx.doi.org/10.1038/s41598-020-65813-4DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7264191PMC
June 2020

Application of group smoothly clipped absolute deviation method in identifying correlates of psychiatric distress among college students.

BMC Psychiatry 2020 05 4;20(1):198. Epub 2020 May 4.

Department of Psychiatry, School of Medicine, Hamadan University of Medical Sciences, Hamadan, Iran.

Background: College students are at an increased risk of psychiatric distress. So, identifying its important correlates using more reliable statistical models, instead of inefficient traditional variable selection methods like stepwise regression, is of great importance. The objective of this study was to investigate correlates of psychiatric distress among college students in Iran; using group smoothly clipped absolute deviation method (SCAD).

Methods: A number of 1259 voluntary college students participated in this cross-sectional study (Jan-May 2016) at Hamadan University of Medical Sciences, Iran. The data were collected using a self-administered questionnaire consisting of demographic information, a behavioral risk factors checklist and the GHQ-28 questionnaire (with a cut-off of 23 to measure psychiatric distress, recommended by the Iranian version of the questionnaire). Penalized logistic regression with a group-SCAD regularization method was used to analyze the data (α = 0.05).

Results: The majority of students were aged 18-25 (87.61%), and 60.76% of them were female. About 41% of students had psychiatric distress. Significant correlates of psychiatric distress among college students selected by group-SCAD included the average grade, educational level, being optimistic about future, having a boy/girlfriend, having an emotional breakup, the average daily number of cigarettes, substance abusing during previous month and having suicidal thoughts ever (P < 0.05).

Conclusions: Penalized logistic regression methods such as group-SCAD and group-Adaptive-LASSO should be considered as plausible alternatives to stepwise regression for identifying correlates of a binary response. Several behavioral variables were associated with psychological distress which highlights the necessity of designing multiple factors and behavioral changes in interventional programs.
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http://dx.doi.org/10.1186/s12888-020-02591-3DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7199302PMC
May 2020

Randomized controlled trial protocol to evaluate the effect of an educational intervention using information, motivation and behavioral skills model on sexual satisfaction of new couples in Iran.

Reprod Health 2019 Nov 15;16(1):168. Epub 2019 Nov 15.

School of Public Health, Hamadan University of Medical Science, Hamadan, Iran.

Background: Sexual satisfaction is considered as one of the key factors in assessing a person's quality of life and the quality and continuity of marital relationships. According to the results of reports in Iran, many couples are dissatisfied with their sexual lives. Sexuality education is one of the important strategies to prevent early sexual problems and improve sexual satisfaction. The aim of this randomized controlled trial is to compare the efficacy of sexual and marital enrichment package using information, motivation and behavioral skills model on sexual satisfaction of new couples in Iran to routine sexual care program that provided at governmental health centers.

Methods: This is a randomized, controlled, superiority trial with two parallel groups. One hundred new couples (n = 200) will be recruited and randomized with simple randomization method and a 1:1 allocation. Recruitment will be from governmental health centers and calling on social networks. Couples will be randomized to intervention which will receive Sexual and Marital Enrichment package and control group (routine care at health centers). Couples will be followed up for 4 months. Then primary outcomes (mean score of couples' sexual information, motivation and behavior skills) and secondary outcome (mean score of couples' sexual satisfaction) of study will be measured through the online questionnaire.

Discussion: This trial will be examined the impact of the sexual and marital skills training package tailored to the values and norms governing the sexual life of Iranian couples on their sexual satisfaction. If the trial is effective, its results will be presented to policy makers for implementation at national level.

Trial Registration: (Iranian Registry of Clinical Trials (IRCT) number): IRCT20181211041926N1. Date of registration: March 2, 2019.
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http://dx.doi.org/10.1186/s12978-019-0821-7DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6858637PMC
November 2019

Crocus Sativus L. (saffron) versus sertraline on symptoms of depression among older people with major depressive disorders-a double-blind, randomized intervention study.

Psychiatry Res 2019 12 12;282:112613. Epub 2019 Oct 12.

Department of Psychiatry, School of Medicine, Psychiatry and Psychology Research Center, Roozbeh Hospital, Tehran University of Medical Sciences, Tehran, Iran; University of Basel, Psychiatric Clinics (UPK) Center for Affective, Stress und Sleep Disorders, University of Basel, Basel, Switzerland; Kermanshah University of Medical Sciences, Sleep Disorders Research Center, Kermanshah, Iran; Kermanshah University of Medical Sciences, Substance Abuse Prevention Research Center, Health Institute, Kermanshah, Iran; Department of Sport, Exercise and Health, Division of Sport and Psychosocial Health, University of Basel, Basel, Switzerland. Electronic address:

Background: While there is sufficient evidence that Crocus Sativus L. (saffron) improves symptoms of depression in young and middle-aged adults, research on older people are missing. The purpose of the double-blind, randomized intervention study was to compare the effect of saffron and sertraline on MDD among a sample of older people.

Methods: A total of 50 older out-patients with MDD (mean age = =65 years; 70% males) were randomly assigned either to the saffron condition (60 mg/d) or to the sertraline condition (100 mg/day) for six consecutive weeks. Experts employed the Hamilton Depression Rating Scale (HDRS) to rate participants' degree of depression. Timepoints were baseline, week 2, week 4 and week 6, the end of the study.

Results: Symptoms of depression decreased over time, with no advantages or disadvantages for the saffron or sertraline condition.

Conclusion: The pattern of results suggests that both saffron and sertraline have the potential to significantly decrease symptoms of depression. The results are clinically relevant, because major depressive disorders in older people is a health concern. The results are further relevant, because saffron appears to be a powerful antidepressant for older people, who might be more reluctant to the use of synthetic drugs.
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http://dx.doi.org/10.1016/j.psychres.2019.112613DOI Listing
December 2019

Effects of crocin in reducing DNA damage, inflammation, and oxidative stress in multiple sclerosis patients: A double-blind, randomized, and placebo-controlled trial.

J Biochem Mol Toxicol 2019 Dec 16;33(12):e22410. Epub 2019 Oct 16.

Neurophysiology Research Center, Hamadan University of Medical Sciences, Hamadan, Iran.

Multiple sclerosis (MS) is an autoimmune disease in which the immune system attacks the nerve cells, resulting in neurological disorders. Oxidative stress, free radicals, and neuritis have important roles in MS pathogenesis. Here, we aim to evaluate the effect of crocin on inflammatory markers, oxidative damage, and deoxyribonucleic acid (DNA) damage in the blood of patients with MS. A total of 40 patients were divided into two groups, drug and placebo-treated groups, using random assignment. Participants of the intervention and control groups received two crocin capsules or placebo per day for 28 days, respectively. Findings revealed a significant decrease in the level of important pathogenic factors in MS, including lipid peroxidation, DNA damage, tumor necrosis factor-alpha, and interleukin 17 as well as a significant increase in the total antioxidant capacity in the serum of patients treated with crocin compared with the placebo group. Our results suggest the beneficial and therapeutic effects of crocin in MS.
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http://dx.doi.org/10.1002/jbt.22410DOI Listing
December 2019

Examining the Effectiveness of a Web-Based Intervention for Depressive Symptoms in Female Adolescents: Applying Social Cognitive Theory.

J Res Health Sci 2019 Aug 19;19(3):e00454. Epub 2019 Aug 19.

Department of Public Health, School of Public Health, Hamadan University of Medical Sciences, Hamadan, Iran.

Background: Depression is a serious mental health illness among adolescents especially girls. Web-based treatment can possibly become a solution for reducing mental health problems in adolescents. This study is one of the first trials aimed to evaluate the efficiency of web-based depression improvement program among female adolescents based on the Social Cognitive Theory (SCT).

Study Design: Randomized Controlled Trial.

Methods: A six-month randomized controlled trial based on the SCT was implemented in female schools in Hamadan City, west of Iran in 2018 on 128 female students with mild to moderate depressive symptoms (CES-D =10-45). They were randomly assigned to either intervention or control group (n= 64 in each group). Depression improvement program was implemented through the website via short videos, animations and Power-Point slides. Depression was evaluated using Center for Epidemiologic Depression Scale. A researcher-made questionnaire based on the sheerer and Perceived-Social-Support-Scale-Revised (PSSS-R) questionnaires were used to evaluate the SCT constructs. The data were analyzed using SPSS software.

Results: The intervention program resulted in the improvement of depression in 12 wk based on Intent-to-treat analyses. Nevertheless, these achievements seem to have decreased by 24 wk in intervention group. The intervention increased the mean scores of the constructs of social support and self-regulation from baseline to 12 wk in the intervention group (P<0.05). The intervention had no effect on outcome expectations and self-efficacy. There were no statistically significant associated between theory constructs changes and changes in depression (P>0.05).

Conclusion: The web-based intervention improved depression in female students. Future training using strategies for the sustainable improvement of depression in female students are needed.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7183555PMC
August 2019

Effectiveness of a Peer-Led Behavioral Intervention Program on Tobacco Use-Related Knowledge, Attitude, Normative Beliefs, and Intention to Smoke among Adolescents at Iranian Public High Schools.

Int J Prev Med 2019 12;10:111. Epub 2019 Jun 12.

Department of Community Health, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Selangor 43400, Malaysia.

Background: Theory-based tobacco use prevention programs in schools were implemented to evaluate the effectiveness of this peer-led intervention on tobacco use-related knowledge, attitude, normative beliefs, and intention to tobacco use of school children aged 14-17 years old.

Methods: A school-based cluster randomized controlled intervention study was conducted among 1, 2, and 3 grade high school children in Sanandaj City, Iran. 4-h integrated tobacco use prevention program comprising of four structured modules was developed and delivered to the intervention group by trained peer educator. Outcome measures comprised changes in students' smoking-related knowledge, attitude, normative beliefs, and intention to tobacco use from baseline to 6-month follow-up through validated anonymous questionnaire.

Results: The present study showed an intervention effect on tobacco use-related knowledge, normative beliefs, and intention to tobacco use but not attitude. The results indicated that there was significant decrease in intention to tobacco use ( ≤ 0.013) observed after 6-month postintervention. The intervention module was also effective in improving smoking knowledge ( ≤ 0.001), normative beliefs with regard to perceived prevalence of cigarette smoking and water-pipe use among adults and adolescents ( ≤ 0.001) in intervention group 6-month postintervention.

Conclusions: Participation in the peer-led education program to tobacco use prevention may have improvement in knowledge, normative beliefs, and intention to tobacco use. An implementation of the peer-led behavioral intervention components in the school setting may have a beneficial effect on public health by decreasing intention to tobacco use among nonsmoker adolescents.
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http://dx.doi.org/10.4103/ijpvm.IJPVM_493_17DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6592138PMC
June 2019

Relationship between dental plaque formation and salivary cortisol level in pregnant women.

Eur Oral Res 2019 May 1;53(2):62-66. Epub 2019 May 1.

Department of Restorative Dentistry, Faculty of Dentistry, Hamadan University of Medical Sciences, Hamadan.Iran.

Purpose: Understanding how increased level of salivary cortisol contributes to the development of dental biofilm during pregnancy can help inthe prevention of dental caries and periodontal diseases. This study aims to evaluate the relationship between salivary cortisol level and dental biofilm formation in pregnant women.

Patients And Methods: This descriptive-analytic study was conducted in Hamadan, Iran in 2011. Forty consecutive pregnant women with no history of abortion, stillbirth, or any known physical or psychological disorders at weeks 25 and 33 of gestation were included. Salivary samples were collected for measurement of cortisol levels by Enzyme Linked Immunoabsorbent Assay (ELISA) method. The amount and extension of dental biofilms were determined by using a disclosing agent. Data were analyzed using descriptive and analytical statistics in SPSS version 16.

Results: The mean levels of salivary cortisol at weeks 25 and 33 of gestation were respectively, 2.45 ± 1.56 μg/dl and 5.24 ± 4.07 μg/dl which demonstrates a significant difference (P<0.001). Evaluation of dental biofilm at two time intervals revealed a significant increase in amount of dental biofilm at week 33 of gestational period (34.65 ± 10.9% vs. 42.45 ± 12.35%, P<0.001). Elevated levels of dental biofilm were significantly correlated with salivary cortisol levels at week 33 (r=0.494, P=0.001),however, it was not significant at week 25 of gestation (r=0.148, P=0.361).

Conclusion: The findings suggested that increased levels of salivary cortisol can predict dental biofilm formation and accumulation in pregnant women in the last weeks of gestation.
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http://dx.doi.org/10.26650/eor.20192484DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6614692PMC
May 2019

An Exploratory Mixed Method Study for Developing and Psychometric Properties of the Sexual Information, Motivation and Behavioral Skills Scale (SIMBS) in Iranian Couples.

J Res Health Sci 2019 Jun 18;19(2):e00447. Epub 2019 Jun 18.

Social Determinants of Health Research Center & Department of Public Health, School of Public Health, Hamadan University of Medical Sciences, Hamadan, Iran.

Background: This study was designed to construct and assay the psychometric properties of a scale in order to recognize sexual information, motivation and behavioral skills of Iranian couples.

Study Design: a mixed method study.

Methods: This was an exploratory mixed method investigation conducted in two stages from Sep 2017 to Jun 2018 in Isfahan, Iran. First, qualitative methods (individual interviews with 22 couples) were applied to generate items and develop the questionnaire. Second, psychometric properties of the questionnaire were assessed. Reliability was evaluated by composite reliability, Interclass Correlation Coefficient (ICC) and internal consistency. Moreover, Exploratory Factor Analyses (EFA) and Confirmatory Factor Analyses (CFA) were carried out to examine construct validity. To evaluate content validity were performed CVI and CVR.

Results: An item pool comprising 107 statements related to couple 'sexual information, motivation and behavioral skills were generated in the first stage. In the second stage, item reduction was exerted and the final issue of the questionnaire including 51 items was expanded. The evaluation of the psychometric properties of the final version displayed that the scale had good reliability and structure. The results from exploratory factory analysis demonstrated a 9-factor solution for the scale that jointly reported for the 39.5% of the observed variance. The mean scores of the CVI and CVR were 0.92 and 0.90, respectively. Additional analyses indicated acceptable results for composite reliability for the subscale of instrument ranging from 0.78 to 0.95.

Conclusion: The sexual information, motivation and behavioral skills scale is a reliable and valid instrument that can be used in future studies on Iranian couples.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7183540PMC
June 2019

Prevalence of depression and its associated sociodemographic factors among Iranian female adolescents in secondary schools.

BMC Psychol 2019 Apr 24;7(1):25. Epub 2019 Apr 24.

Department of Public Health, School of Public Health, Hamadan University of Medical Sciences, Hamadan, Iran.

Background: Across the globe, depression is a common psychiatric disorder and is the main cause of disability among adolescents. To this end, this study was conducted to screen for the prevalence of depression among secondary school female students in the city of Hamadan, in western Iran.

Methods: In this cross-sectional study, a total of 670 secondary school female students, within the age range of 15-18 years were investigated using multistage random sampling method. Moreover, the Persian version of Center for Epidemiologic Studies Depression Scale (CES-D) and a researcher-designed questionnaire containing demographic variables were employed as research instruments. Analyses of the findings were made using SPSS version 16 software followed by stratified logistic regression model, which was performed for correlation analysis.

Results: The mean (standard deviation) age of students was 16.2 (0.68) years. The prevalence of severe depression in female students estimated by the Center for Epidemiologic Studies Depression Scale (CES-D) was equal to 52.6%. A statistically significant relationship was also observed to exist between prevalence of depression and type of school (P < 0.001), family income (P < 0.001), living in the suburbs (P < 0.001), and field of study at school (P < 0.001). However, no statistically significant correlation was found between depression among students and school grade, type of living with parents, father's education and occupation, mother's education and occupation, and family size.

Conclusion: Depression was prevalent among the secondary school female students examined and it significantly correlated with socioeconomic status. Therefore, periodic screening, psychological training programs, proper diagnosis of high-risk individuals in secondary schools, and early intervention among secondary school female students are urgently needed.
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http://dx.doi.org/10.1186/s40359-019-0298-8DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6480819PMC
April 2019

The Prevalence of Psychiatric Disorders in Children and Adolescents in Hamadan Province, West of Iran.

J Res Health Sci 2018 Dec 10;18(4):e00432. Epub 2018 Dec 10.

Department of Psychology, Islamic Azad University, Hamadan, Iran.

Background: There are numerous reports regarding increasing childhood and adolescent mental health problems. The aim of this study was to determine the prevalence of psychiatric disorders in Hamadan Province, west of Iran from July 2016 to May 2017.

Study Design: A cross-sectional study.

Methods: The sample included 1025 Hamadan residents selected using multistage cluster sampling. Psychiatric disorders were assessed by semi-structured psychiatric interview Kiddie-Sads-Present and Lifetime Version (K-SADS-PL). The data were analyzed using the SPSS software. We used the multivariable logistic regression to predict the Odds Ratios (ORs).

Results: The prevalence of total psychiatric disorder was 8.6%. Psychiatric disorders in boys were higher than girls (12.6% and 4.9%, respectively). The psychiatric disorders were most prevalent in 6-9 yr old age group (11%). The prevalence of behavioral disorder was 3.8% with attention deficit hyperactivity disorder (ADHD) as the most prevalent case (2.0%). The prevalence of anxiety disorder was 2.8% in which the highest prevalence belonged to separation anxiety disorder (SAD) (1.1%). The prevalence of neurodevelopment disorder was 1.5% with the highest prevalence of 1% observed in epilepsy. The prevalence of mood disorder was 1.1% with the depressive disorder as the most prevalent one (1.0%). The prevalence of enuresis was 2.7%. The most common comorbidities were anxiety and mood disorders 5(50.0%).

Conclusion: The prevalence of these disorders in Hamadan was less than the prevalence in other cities of Iran. These findings can be helpful for large-scale planning for children and adolescents.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6941632PMC
December 2018

Cognitive Process in Patients With Obsessive-Compulsive Disorder: A Cross-Sectional Analytic Study.

Basic Clin Neurosci 2018 Nov-Dec;9(6):448-457. Epub 2018 Nov 1.

Behavioral Disorders and Substance Abuse Research Center, Hamadan University of Medical Sciences, Hamadan, Iran.

Introduction: In recent studies, deficit in cognitive process has been investigated as one of the etiological hypotheses in a wide range of Obsessive-Compulsive Disorder (OCD). This research aimed to compare cognitive process in patients with OCD and healthy groups.

Methods: In the current cross-sectional analytic study, 43 patients with OCD and 43 healthy individuals matched with gender, age, educational and marital status were selected by convenience sampling method and assessed by Wisconsin Cart Sorting Test (WCST), Paced Auditory Serial Addition Test (PASAT) and Yale-Brown Obsessive Compulsive Scale (Y-BOCS). The obtained data were analyzed with Chi-square, Independent t test, Mann-Whitney U test and Pearson correlation in SPSS version16.

Results: There was no difference between the patients with OCD and the healthy group in demographic characteristics (P>0.05). There was a significant differences between two group on the all subscale of WCST test and PASAT3, PASAT2 tests (P<0.01). These findings indicate that the OCD patient's performance in cognitive process was significantly worse than the healthy controls.

Conclusion: The findings indicate that individuals with OCD suffer from a deficiency in various aspects of cognitive processes. Therefore, paying attention to these deficiencies can make an important contribution to the treatment of these patients.
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http://dx.doi.org/10.32598/bcn.9.6.448DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6359683PMC
November 2018

Differential pattern of brain functional connectome in obsessive-compulsive disorder versus healthy controls.

EXCLI J 2018 8;17:1090-1100. Epub 2018 Nov 8.

Institute for Cognitive and Brain Sciences, Shahid Beheshti University GC, Tehran, Iran.

Researchers believe that recognition of functional impairment in some of brain networks such as frontal-parietal, default mode network (DMN), anterior medial prefrontal cortex (MPFC) and striatal structures could be a beneficial biomarker for diagnosis of obsessive-compulsive disorder (OCD). Although it is well recognized brain functional connectome in OCD patients shows changes, debate still remains on characteristics of the changes. In this regard, little has been done so far to statistically assess the altered pattern using whole brain electroencephalography. In this study, resting state EEG data of 39 outpatients with OCD and 19 healthy controls (HC) were recorded. After, brain functional network was estimated from the cleaned EEG data using the weighted phase lag index algorithm. Output matrices of OCD group and HCs were then statistically compared to represent meaningful differences. Significant differences in functional connectivity pattern were demonstrated in several regions. As expected the most significant changes were observed in frontal cortex, more significant in frontal-temporal connections (between F3 and F7, and T5 regions). These results in OCD patients are consistent with previous studies and confirm the role of frontal and temporal brain regions in OCD.
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http://dx.doi.org/10.17179/excli2018-1757DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6295628PMC
November 2018

Differential pattern of brain functional connectome in obsessive-compulsive disorder versus healthy controls.

EXCLI J 2018 8;17:1090-1100. Epub 2018 Nov 8.

Institute for Cognitive and Brain Sciences, Shahid Beheshti University GC, Tehran, Iran.

Researchers believe that recognition of functional impairment in some of brain networks such as frontal-parietal, default mode network (DMN), anterior medial prefrontal cortex (MPFC) and striatal structures could be a beneficial biomarker for diagnosis of obsessive-compulsive disorder (OCD). Although it is well recognized brain functional connectome in OCD patients shows changes, debate still remains on characteristics of the changes. In this regard, little has been done so far to statistically assess the altered pattern using whole brain electroencephalography. In this study, resting state EEG data of 39 outpatients with OCD and 19 healthy controls (HC) were recorded. After, brain functional network was estimated from the cleaned EEG data using the weighted phase lag index algorithm. Output matrices of OCD group and HCs were then statistically compared to represent meaningful differences. Significant differences in functional connectivity pattern were demonstrated in several regions. As expected the most significant changes were observed in frontal cortex, more significant in frontal-temporal connections (between F3 and F7, and T5 regions). These results in OCD patients are consistent with previous studies and confirm the role of frontal and temporal brain regions in OCD.
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http://dx.doi.org/10.17179/excli2018-1757DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6295628PMC
November 2018

Executive functions, selective attention and information processing in patients with obsessive compulsive disorder: A study from west of Iran.

Asian J Psychiatr 2018 Oct 5;37:140-145. Epub 2018 Sep 5.

Behavioral Disorders and Substance Abuse Research Center, Hamadan University of Medical Sciences, Hamadan, Iran. Electronic address:

Obsessive-compulsive disorder (OCD) is associated with cognitive dysfunction. Deeper and wider knowledge of the cognitive components of these patients can play an important role in better understanding of this disorder. This study aimed to compare executive function, selective attention and information processing in OCD patients and healthy controls. The current study was performed on 54 patients meeting DSM-5 criteria for OCD and 54 healthy subjects who matched with patients in gender, age, marital and educational status. The cognitive functions were assessed by The Stroop test, Wisconsin Cart Sorting Test (WCST), Paced Auditory Serial Addition Test (PASAT) and the Yale-Brown Obsessive-Compulsive Scale (Y-BOCS). The performance of the OCD group was significantly worse than the healthy group in comparison with the all subscales of the Stroop and WSCT tests. Also, functions in information processing among two groups were statistically significant for 3- and 2-second PASAT. The results demonstrated that OCD patients have deficits in several aspects of cognitive functions. Hence, the treatment of these patients can be contributed by paying more attention to these deficits.
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http://dx.doi.org/10.1016/j.ajp.2018.09.002DOI Listing
October 2018

Genes Encoding GABA-β and HT1D Receptors in Bipolar I (Manic Phase) Patients.

Basic Clin Neurosci 2018 Mar-Apr;9(2):129-134

Behavioral Disorders and Substance Abuse Research Center, Hamadan University of Medical Sciences, Hamadan, Iran.

Introduction: According to the cumulative evidence, genes encoding GABA receptors inhibit neurotransmitters in CNS and are intricately involved in the pathogenesis of mood disorders. Based on this hypothesis, these genes may be expressed in bipolar patients. As a result, we evaluated the gene expressions of GABA-β3 and HT1D receptors to assess their associations with bipolar mood disorder.

Methods: In this study, 22 patients with bipolar I disorder (single manic episode) and 22 healthy individuals were enrolled. All participants were older than 15 years and had referred to Farshchian Hospital, Hamadan, Iran. They were diagnosed based on DSM IV-TR criteria and young mania rating scale in order to determine the severity of mania by a psychiatrist as bipolar Type 1 disorder in manic episode. We evaluated the expression of GABA-β3 and HT1D receptor genes in peripheral blood mononuclear cells, using real-time RT-PCR analysis.

Results: In our study, a reduction in the gene expression of GABA-β3 and HT1D receptors was observed in peripheral blood mononuclear cells of the patients with bipolar disorders compared to the healthy controls.

Conclusion: The results of this study supports the hypothesis that the gene expression for serotonin and GABA receptors can be employed in elucidating the pathogenesis of bipolar disorders.
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http://dx.doi.org/10.29252/NIRP.BCN.9.2.129DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6026092PMC
July 2018

Acetaminophen as Adjuvant to Risperidone in Chronic Schizophrenia: A Randomized, Double-Blind, Placebo-Controlled Clinical Trial.

Iran J Psychiatry 2018 Jan;13(1):1-9

Psychiatric Research Center, Roozbeh Hospital, Tehran University of Medical Sciences, Tehran, Iran.

Although the pathogenesis of schizophrenia is still uncertain, a variety of predisposing mechanisms have been implicated including inflammatory cascades. The present study was conducted to investigate the effectiveness of acetaminophen as a cyclooxygenase inhibitor in treating patients with schizophrenia. A double-blind clinical trial was performed on 52 patients with chronic schizophrenia. Patients received risperidone (up to 6 mg/day) plus either acetaminophen (975mg/day) or placebo. Psychotic symptoms were assessed by the Positive and Negative Syndrome Scale (PANSS) at the onset of the trial, and at 2, 4, 6, and 8 weeks post therapy. Compared to the placebo group, the acetaminophen group showed no significant difference in any subtypes of PANSS. Moreover, the side effect profiles of the 2treatment regimens were not significantly different. Acetaminophen adjuvant to risperidone showed no significant effect in ameliorating symptoms of schizophrenia.

Trial Registration: The trial was registered at the Iranian Registry of Clinical Trials (registration number: IRCT201410251556N67).
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5994225PMC
January 2018

Palmitoylethanolamide as adjunctive therapy in major depressive disorder: A double-blind, randomized and placebo-controlled trial.

J Affect Disord 2018 05 21;232:127-133. Epub 2018 Feb 21.

Psychiatric Research Center, Roozbeh Hospital, Tehran University of Medical Sciences, Tehran, Iran. Electronic address:

Background: Experimental studies provide evidence for antidepressant effects of Palmitoylethanolamide (PEA) in animal models of depression. We aimed to evaluate the efficacy and tolerability of PEA add-on therapy in treatment of patients with major depressive disorder (MDD).

Methods: In a randomized double-blind, and placebo-controlled study, 58 patients with MDD (DSM-5) and Hamilton Depression Rating Scale (HAM-D) score ≥ 19 were randomized to receive either 600 mg twice daily Palmitoylethanolamide or placebo in addition to citalopram for six weeks. Patients were assessed using the HAM-D scale at baseline and weeks 2, 4, and 6.

Results: Fifty-four individuals completed the trial. At week 2, patients in the PEA group demonstrated significantly greater reduction in HAM-D scores compared to the placebo group (8.30 ± 2.41 vs. 5.81 ± 3.57, P = .004). The PEA group also demonstrated significantly greater improvement in depressive symptoms [F (3, 156) = 3.35, P = .021] compared to the placebo group throughout the trial period. The patients in the PEA group experienced more response rate (≥ 50% reduction in the HAM-D score) than the placebo group (100% vs. 74% respectively, P = .01) at the end of the trial. Baseline parameters and frequency of side effects were not significantly different between the two groups.

Limitations: The population size in this study was small and the follow-up period was relatively short.

Conclusions: Palmitoylethanolamide adjunctive therapy to citalopram can effectively improve symptoms of patients (predominantly male gender) with major depressive disorder. PEA showed rapid-onset antidepressant effects which need further investigation.
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http://dx.doi.org/10.1016/j.jad.2018.02.057DOI Listing
May 2018

Evaluation of Bipolar Disorder in Several Relapses over Time Using Generalized Estimating Equations.

Iran J Psychiatry 2017 Jul;12(3):182-187

Department of Biostatistics & Epidemiology, School of Public Health and Research Center for Health Sciences, Hamadan University of Medical Sciences, Hamadan, Iran.

Bipolar disorder is defined as a common and severe chronic disorder that causes several problems in a person's psychosocial functioning. This study aimed at modeling the development of bipolar disorder episodes using its determinant risk factors over time. This retrospective cohort study was conducted in Hamadan province, the West of Iran, from April 2008 to September 2014. In this study, 124 patients with bipolar disorder (both Type I and Type II) participated. All patients had experienced 4 relapses. Generalized Estimating Equation (GEE) was used to model bipolar disorder episodes, and significance level was set at 0.05. The mean (±SD) age of the patients was 33.2 (±11.55). Males were more likely to experience mania than depression compared to females (odds ratio = 2.30, 95% CI (1.37-3.86)). Patients who received psychotherapy plus medicine were less likely to experience mania than depression compared to drug receivers (odds ratio = 0.39, 95% CI (0.18-0.88)). In the spring, patients were more likely to experience mania than depression compared to the winter (OR = 2.22, 95% CI (1.18-4.19)). The results of the present study revealed that among bipolar disorder patients in the West of Iran, mania was much more prevalent than depression and mixed episodes. Moreover, it was found that sex, treatment, and season can determine the episodes of bipolar disorder.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5640579PMC
July 2017

The Prevalence of Psychiatric Distress and Associated Risk Factors among College Students Using GHQ-28 Questionnaire.

Iran J Public Health 2017 Jul;46(7):957-963

Counseling Center, Hamadan University of Medical Sciences, Hamadan, Iran.

Background: Adolescent and young adults are at increased risk of psychiatric distress and serious disability. We estimated the prevalence and associated risk factors of psychiatric distress among the college students of Hamadan University of Medical Sciences, Iran.

Methods: We performed this cross-sectional study, from Jan to May 2016 at Hamadan University of Medical Sciences, Hamadan, Iran. Students filled out voluntarily an anonymous self-administered questionnaire, including demographic characteristics, personal information, behavioral risk factors, and a validated Persian version of the GHQ-28 questionnaire, including somatic symptoms (items 1-7), anxiety/insomnia (items 8-14), social dysfunctions (items 15-21), and severe depression (items 22-28).

Results: Of 1259 participants, 518 (41.1%) had psychiatric distress, 166 (13.2%) had heterosexual intercourse, 100 (8.0%) had homosexual intercourse, 204 (16.2%) were smokers (31.6% in males and 6.3% in females), 124 (9.9%) reported a history of using opium/psychedelic substances, 204 (16.2%) reported suicide thought, and 103 (8.2%) had attempted suicide at least once in the past. After adjusting odds ratio (95% CI) for age and sex, psychiatric distress were significantly associated with emotional breakdown 2.67 (2.09, 3.40), heterosexual intercourse 2.56 (1.82, 3.62), homosexual intercourse 2.42 (1.57, 3.71), smoking 3.19 (2.29, 4.45), substance abuse 5.03 (3.26, 7.76), suicide thought 7.81 (5.42, 11.27), suicide attempt 5.64 (3.49, 9.12), uninterested in the discipline 2.29 (1.70, 3.07), and non-optimistic about future 2.16 (1.63, 2.86).

Conclusion: A majority of college students had psychiatric distress and a substantial number of them reported one or more high-risk behaviors that if neglected, may severely impair the students' function and influence their subsequent development and productive lives.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5563878PMC
July 2017

Influence of adjuvant detached mindfulness and stress management training compared to pharmacologic treatment in primiparae with postpartum depression.

Arch Womens Ment Health 2018 02 18;21(1):65-73. Epub 2017 Jul 18.

University of Basel, Psychiatric Clinics (UPK), Center for Affective, Stress and Sleep Disorders (ZASS), Basel, Switzerland.

Ten to 15% of mothers experience postpartum depression (PPD). If untreated, PPD may negatively affect mothers' and infants' mental health in the long term. Accordingly, effective treatments are required. In the present study, we investigated the effect of detached mindfulness (DM) and stress management training (SMT) as adjuvants, compared to pharmacologic treatment only, on symptoms of depression in women with PPD. Forty-five primiparae (mean age: M = 24.5 years) with diagnosed PPD and treated with an SSRI (citalopram; CIT) took part in the study. At baseline, they completed questionnaires covering socio-demographic data and symptoms of depression. Experts rated also symptoms of depression. Next, participants were randomly assigned to one of the following study conditions: adjuvant detached mindfulness (CIT+DM); adjuvant stress management training (CIT+SMT); control condition (CIT). Self- and experts' ratings were completed at the end of the study 8 weeks later, and again at 8 weeks follow-up. Symptoms of depression decreased significantly over time, but more so in the CIT+DM and CIT+SMT group, compared to the control condition. The pattern of results remained stable at follow-up. In primiparae with PPD and treated with a standard SSRI, adjuvant psychotherapeutic interventions led to significant and longer-lasting improvements.
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http://dx.doi.org/10.1007/s00737-017-0753-6DOI Listing
February 2018

Buprenorphine augmentation improved symptoms of OCD, compared to placebo - Results from a randomized, double-blind and placebo-controlled clinical trial.

J Psychiatr Res 2017 11 13;94:23-28. Epub 2017 Jun 13.

University of Basel, Psychiatric Clinics (UPK), Center for Affective, Stress and Sleep Disorders (ZASS), Basel, Switzerland; University of Basel, Department of Sport, Exercise, and Health, Division of Sport and Psychosocial Health, Basel, Switzerland; Kermanshah University of Medical Sciences (KUMS), Sleep Disorders Research Center, Kermanshah, Iran. Electronic address:

Background: In the search for new psychopharmacologic options in the treatment of obsessive-compulsive disorders (OCD), some findings suggested that augmentation with buprenorphine, a partial-opioid agonist used to treat opioid addiction, moderate acute pain and moderate chronic pain, is worthy of consideration. Accordingly, to explore this possibility further, a double-blinded, placebo-controlled clinical trial was performed.

Method: A total of 43 patients (mean age: 34.41 years; SD = 6.58; 53.5% males) with refractory OCD and treated with SSRIs or clomipramine at therapeutic dosages were randomly assigned either to an adjuvant buprenorphine or to an adjuvant placebo condition. Patients completed the Yale-Brown-Obsessive-Compulsive Scale (Y-BOCS) at baseline, weeks 3, 9 and 12 (study completion). Buprenorphine (2-4 mg; sublingual) and placebo (tablets with identical shape, color, consistency, and scent) were given daily.

Results: Symptoms of obsessive-compulsive disorders decreased over time, but more so in the buprenorphine than in the placebo condition. Substantial improvements were observed up to week 3 and then 9. Response and partial response were observed in the buprenorphine at week 9 more than in the placebo condition. The advantage had disappeared by week 12.

Conclusions: The pattern of results suggests that adjuvant buprenorphine augmentation can reduce symptoms of obsessive-compulsive disorders after only three weeks, compared to a placebo. Adjuvant buprenorphine seems to accelerate symptom improvement.
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http://dx.doi.org/10.1016/j.jpsychires.2017.06.004DOI Listing
November 2017

Further evidence of psychological factors underlying choice of elective cesarean delivery (ECD) by primigravidae.

Braz J Psychiatry 2018 Jan-Mar;40(1):83-88. Epub 2017 Jun 12.

University of Basel, Psychiatric Clinics (UPK), Center for Affective, Stress and Sleep Disorders (ZASS), Basel, Switzerland.

Objective: Requests for elective cesarean delivery (ECD) have increased in Iran. While some sociodemographic and fear-related factors have been linked with this choice, psychological factors such as self-esteem, stress, and health beliefs are under-researched.

Methods: A total of 342 primigravidae (mean age = 25 years) completed questionnaires covering psychological dimensions such as self-esteem, perceived stress, marital relationship quality, perceived social support, and relevant health-related beliefs.

Results: Of the sample, 214 (62.6%) chose to undergo ECD rather than vaginal delivery (VD). This choice was associated with lower self-esteem, greater perceived stress, belief in higher susceptibility to problematic birth and barriers to an easy birth, along with lower perceived severity of ECD, fewer perceived benefits from VD, lower self-efficacy and a lower feeling of preparedness. No differences were found for marital relationship quality or perceived social support.

Conclusions: The pattern suggests that various psychological factors such as self-esteem, self-efficacy, and perceived stress underpin the decision by primigravidae to have an ECD.
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http://dx.doi.org/10.1590/1516-4446-2017-2229DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6899414PMC
April 2018

‎ Recurrence in Patients with Bipolar Disorder and Its Risk Factors.

Iran J Psychiatry 2016 Jul;11(3):173-177

Department of Biostatistics, School of Public Health, Hamadan University of Medical ‎Sciences, Hamadan, Iran. Email: Research Center for Health Sciences, Hamadan University of Medical Sciences, Hamadan, Iran.

The aim of this study was to identify prognosis factors associated with recurrence in patients ‎with bipolar disorder.‎‎ This retrospective cohort study was conducted in Hamadan Province, the west of Iran. All ‎patients (n = 400) with bipolar disorder who were hospitalized for the second time or more ‎during April 2008 to September 2014 were included in this study. Ordinal logistic regression ‎analysis was employed to determine the effective factors in each recurrence, and odds ratio (OR) and 95% confidence intervals (CI) were obtained.‎ The mean (SD) age of the participants at the entrance to the study was 34.62 (11.68) years. ‎There was an association between recurrence and type of bipolar disorder (P = 0.033). The ‎OR of recurrence was 0.28 (95% CI: 0.09, 0.90) for bipolar disorder II; 0.35 (95% CI: 0.13, ‎‎0.92) for the patients‎‏ ‏with college education; 0.39 (95% CI: 0.25, 0.60) for employed ‎patients; 0.55 (95% CI: 0.35, 0.87) for patients who received both drugs and ‎electroconvulsive therapy, and 1.89 (95% CI: 1.23, 2.92) for patients who stopped using ‎drugs. In addition, a non-significant association was found between recurrence and age, sex, ‎marital status, place of residence, season, mood classification and family history of mood ‎disorder.‎ Type of bipolar disorder and cessation of medication were the leading causes of an increase in ‎the relapse of the disease. Furthermore, patients who received both drugs and ‎electroconvulsive therapy had a fewer risk of recurrence.‎.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5139952PMC
July 2016

Synaptosome-Associated Protein 25 (SNAP25) Gene Association Analysis Revealed Risk Variants for ASD, in Iranian Population.

J Mol Neurosci 2017 Mar 26;61(3):305-311. Epub 2016 Nov 26.

Department of Medical Genetics, Faculty of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

Autism spectrum disorder (ASD) is a common, complex neurological condition, affecting approximately 1% of people worldwide. Monogenic neurodevelopmental disorders which showed autistic behavior patterns have suggested synaptic dysfunction, as a key mechanism in the pathophysiology of ASD. Subsequently, genes involved in synaptic signaling have been investigated with a priority for candidate gene studies. A synaptosomal-associated protein 25 (SNAP25) gene plays a crucial role in the central nervous system, contributing to exocytosis by targeting and fusion of vesicles to the cell membrane. Studies have shown a correlation between aberrant expression of the SNAP25 and a variety of brain diseases. Single nucleotide polymorphisms (SNPs) in this gene are associated with several psychiatric diseases, such as bipolar, schizophrenia, and attention-deficit/hyperactivity disorder. The aim of the present study was to investigate whether polymorphisms (rs3746544 and rs1051312) in the regulatory 3'-untranslated region (3'UTR) of the SNAP25 gene have an association with ASD in unrelated Iranian case (N = 524)-control (N = 472) samples. We observed robust association of the rs3746544 SNP and ASD patients, in both allele and haplotype-based analyses. Our results supported the previous observations and indicated a possible role for SNAP25 polymorphisms as susceptibility genetic factors involved in developing ASD.
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http://dx.doi.org/10.1007/s12031-016-0860-2DOI Listing
March 2017

Minocycline as Adjunctive Treatment to Risperidone in Children with Autistic Disorder: A Randomized, Double-Blind Placebo-Controlled Trial.

J Child Adolesc Psychopharmacol 2016 11 29;26(9):784-791. Epub 2016 Apr 29.

1 Behavioral Disorders and Substance Abuse Research Center, Hamadan University of Medical Sciences , Hamadan, Iran .

Objective: This is an investigation of minocycline efficacy and safety as an adjuvant to risperidone in management of children with autism.

Methods: Forty-six children with diagnosis of autistic disorder, according to the Diagnostic and Statistical Manual of Mental Disorders, 4th ed., Text Revision (DSM-IV-TR) criteria and a score of ≥12 on the Aberrant Behavior Checklist-Community (ABC-C) irritability subscale, who were already drug-free for at least 6 months participated in a randomized controlled trial and underwent 10 weeks of treatment with either minocycline (50 mg twice per day) or placebo in addition to risperidone titrated up to 2 mg/day (based on bodyweight). Patients were evaluated using ABC-C at baseline and at weeks 5 and 10.

Results: General linear model repeated measures showed significant effect for time × treatment interaction on the irritability [F(2, 88) = 3.94, p = 0.02] and hyperactivity/noncompliance [F(1.50, 66.05) = 7.92, p = 0.002], but not for lethargy/social withdrawal [F(1.61, 71.02) = 0.98, p = 0.36], stereotypic behavior [F(1.34, 58.80) = 1.55, p = 0.22], and inappropriate speech subscale scores [F(1.52, 66.88) = 1.15, p = 0.31]. By week 10, 21 (91.3%) patients in the minocycline group and 15 (65.5%) patients in the placebo group achieved at least partial response (p = 0.03). Frequencies of adverse events were not significantly different between groups.

Conclusions: Minocycline seems to be a safe and effective adjuvant in management of patients with autistic disorder. Future studies with larger sample sizes, longer follow-ups, and inflammatory cytokine measurements are warranted to confirm these findings and provide insight into minocycline mechanism of action in autistic disorder.
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http://dx.doi.org/10.1089/cap.2015.0175DOI Listing
November 2016

Riluzole in augmentation of fluvoxamine for moderate to severe obsessive-compulsive disorder: Randomized, double-blind, placebo-controlled study.

Psychiatry Clin Neurosci 2016 Aug 26;70(8):332-41. Epub 2016 May 26.

Psychiatric Research Center, Roozbeh Psychiatric Hospital, Tehran University of Medical Sciences, Tehran, Iran.

Aim: The aim of the present randomized, double-blind, placebo-controlled, 8-week trial was to assess the efficacy and tolerability of riluzole augmentation of fluvoxamine in treatment of patients with moderate to severe obsessive-compulsive disorder.

Methods: Patients were randomized into two parallel groups to receive fluvoxamine plus placebo or fluvoxamine plus riluzole (50 mg twice daily). All patients, regardless of their treatment group, received fluvoxamine at 100 mg/day for the initial 4 weeks of the study followed by 200 mg/day of fluvoxamine for the rest of the trial course. A total of 50 patients (25 in each group) were evaluated for response to treatment using the Yale-Brown Obsessive Compulsive Scale (Y-BOCS) at baseline and at weeks 4, 8 and 10. Side-effects were recorded using predesigned checklists in each visit. Repeated-measure analysis of variance showed a significant effect for time × treatment interaction in the Y-BOCS total score and a significant effect for time × treatment interaction in the Y-BOCS Compulsive subscale score between the two groups.

Results: Repeated-measure analysis of variance showed a significant effect for time × treatment interaction (Greenhouse-Geisser corrected: F = 4.07, d.f. = 1.22, P = 0.04) in the Y-BOCS total score and a significant effect for time × treatment interaction (Greenhouse-Geisser corrected: F = 4.45, d.f. = 1.33, P = 0.028) in the Y-BOCS Compulsive subscale score between the two groups. Riluzole augmentation therapy demonstrated higher, partial or complete treatment response according to the Y-BOCS total scores.

Conclusion: Riluzole may be of clinical use as an adjuvant agent to fluvoxamine in treatment of moderate to severe obsessive-compulsive disorder.
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http://dx.doi.org/10.1111/pcn.12394DOI Listing
August 2016

Adjuvant thiamine improved standard treatment in patients with major depressive disorder: results from a randomized, double-blind, and placebo-controlled clinical trial.

Eur Arch Psychiatry Clin Neurosci 2016 Dec 16;266(8):695-702. Epub 2016 Mar 16.

Psychiatric Clinics of the University of Basel, Center for Affective, Stress and Sleep Disorders, University of Basel, 4012, Basel, Switzerland.

Given that antidepressants (ADs) work slowly, there is interest in means to accelerate their therapeutic effect and to reduce side effects. In this regard, thiamine (vitamin B) is attracting growing interest. Thiamine is an essential nutrient, while thiamine deficiency leads to a broad variety of disorders including irritability and symptoms of depression. Here, we tested the hypothesis that adjuvant thiamine would reduce depression, compared to placebo. A total of 51 inpatients (mean age: 35.2 years; 53 % females) with MDD (Hamilton Depression Rating Scale score (HDRS) at baseline: >24) took part in the study. A standardized treatment with SSRI was introduced and kept at therapeutic levels throughout the study. Patients were randomly assigned either to the thiamine or the placebo condition. Experts rated (HDRS) symptoms of depression at baseline, and after 3, 6, and 12 weeks (end of the study). Between baseline and the end of the study, depression had reduced in both groups. Compared to placebo, adjuvant thiamine improved symptoms of depression after 6 week of treatment, and improvements remained fairly stable until the end of the study, though mean differences at week 12 were not statistically significant anymore. No adverse side effects were reported in either group. Results suggest that among younger patients with MDD adjuvant thiamine alleviated symptoms of depression faster compared to placebo. Importantly, improvements were observed within 6 weeks of initiation of treatment. Thus, thiamine might have the potential to counteract the time lag in the antidepressant effects of ADs.
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http://dx.doi.org/10.1007/s00406-016-0685-6DOI Listing
December 2016