Publications by authors named "Firoozeh Raisi"

26 Publications

  • Page 1 of 1

Evaluation of the effect of carrot seed (Daucus Carota) in women of fertile age with hypoactive sexual desire disorder: A randomized double-blind clinical trial.

Complement Ther Med 2020 Nov 29;54:102543. Epub 2020 Aug 29.

Research Institute for Islamic and Complementary Medicine, School of Persian Medicine, Iran University of Medical Sciences, Tehran, Iran. Electronic address:

Background: Hypoactive Sexual Desire Disorder (HSDD) is a common sexual problem of women which has negative impacts on their health and quality of life. Given the side effects of pharmacologic interventions, it would be beneficial to patients trying to find new options based on herbal medicine.

Objectives: To evaluate efficacy of carrot seed on sexual dysfunction of women with HSDD compared with placebo.

Methods: In this randomized double-blind clinical trial, 68 participants randomly assigned to the intervention group which took 500 mg carrot seed three times a day for 12 weeks versus placebo. Participants in two groups filled Female Sexual Function Index (FSFI) questionnaire at baseline, week six and 12. Repeated measure analysis of variance (ANOVA) test was used for statistical analysis.

Results: Thirty women in carrot seed group and thirty women in placebo group completed 12 weeks of the study. In general, carrot seed compared to placebo improved the total score of FSFI 7.329 ± 0.830 (p < 0.001), desire 4.1±0.7 (p < 0.001), lubrication 4.7±0.4 (p = 0.019), arousal 4.1±0.08 (p < 0.001), satisfaction 4.8±1.1 (p < 0.001), orgasm 3.9±0.9 (p < 0.001) and pain 5.4±1(p < 0.001). No adverse event was reported in this study.

Conclusions: Women with HSDD may benefit from six weeks' treatment with carrot seed for improvement of sexual dysfunction. Further large clinical studies are warranted to confirm efficacy of this herbal drug.
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http://dx.doi.org/10.1016/j.ctim.2020.102543DOI Listing
November 2020

Vitamin D deficiency mediates the relationship between dietary patterns and depression: a case-control study.

Ann Gen Psychiatry 2020 3;19:37. Epub 2020 Jun 3.

Department of Nutrition, School of Medicine, Mashhad University of Medical Sciences, Vakilabad Blv. Azadi Squre, Mashhad, Iran.

Background: Depression is a major contributor to disability-adjusted life years (DALY) lost in the world. Dietary patterns are widely used to investigate diet-disease relations. In the current study, the relationship between dietary patterns and depression was investigated. Besides, the role of serum vitamin D, zinc, magnesium, and total antioxidant capacity as potential mediatory variables was studied.

Methods: It was an individually matched case-control study in which 330 depressed and healthy subjects were recruited for the extraction of dietary patterns; psychiatrists diagnosed major depressive disorder, using the criteria of the Diagnostic and Statistical Manual of Mental Disorders. Serum vitamin D and aforementioned biomarkers were measured for a number of randomly selected depressed and healthy individuals. We conducted mediatory analysis by regression models.

Results: Healthy and unhealthy dietary patterns were associated with the lower and higher odds of depression (OR 0.39, CI 0.17-0.92 and OR 2.6, CI 1.04-6.08), respectively. A significant relationship between serum vitamin D with depression after adjusting for potential confounders was observed as well (OR 0.93, CI 0.87-0.99). According to the mediatory analysis the unhealthy dietary patterns were related to depression via altering the serum vitamin D concentration.

Conclusion: This study showed that vitamin D deficiency mediates the relationship between unhealthy dietary patterns and depression. However, to get a clearer result further prospective studies are required.
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http://dx.doi.org/10.1186/s12991-020-00288-1DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7271480PMC
June 2020

The relationship between dietary patterns and depression mediated by serum levels of Folate and vitamin B12.

BMC Psychiatry 2020 02 13;20(1):63. Epub 2020 Feb 13.

Department of Nutrition, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.

Background: Major depressive disorder is among main worldwide causes of disability. The low medication compliance rates in depressed patients as well as the high recurrence rate of the disease can bring up the nutrition-related factors as a potential preventive or treatment agent for depression. The aim of this study was to investigate the association between dietary patterns and depression via the intermediary role of the serum folate and vitamin B12, total homocysteine, tryptophan, and tryptophan/competing amino acids ratio.

Methods: This was an individually matched case-control study in which 110 patients with depression and 220 healthy individuals, who completed a semi-quantitative food frequency questionnaire were recruited. We selected the depressed patients from three districts in Tehran through non-probable convenience sampling from which healthy individuals were selected, as well. The samples selection and data collection were performed during October 2012 to June 2013. In addition, to measure the serum biomarkers 43 patients with depression and 43 healthy people were randomly selected from the study population. To diagnose depression the criteria of Diagnostic and Statistical Manual of Mental Disorders, fourth edition, were utilized.

Results: The findings suggest that the healthy dietary pattern was significantly associated with a reduced odds of depression (OR: 0.75; 95% CI: 0.61-0.93) whereas the unhealthy dietary pattern increased it (OR: 1.382, CI: 1.116-1.71). The mediation analysis showed that the healthy dietary pattern was associated with a reduced risk of depression via increased serum levels of the folate and vitamin B12; however, the unhealthy dietary pattern was associated with increased risk of depression via decreased serum levels of folate and vitamin B12, based on tree adjusted logistic regression models.

Conclusion: Dietary patterns may be associated with depression by changing the serum levels of folate and vitamin B12. Further studies are required to confirm the mechanism.
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http://dx.doi.org/10.1186/s12888-020-2455-2DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7020545PMC
February 2020

A study on sexual functioning in adults with attention-deficit/hyperactivity disorder.

Perspect Psychiatr Care 2020 Jul 11;56(3):642-648. Epub 2020 Feb 11.

Department of Psychology, Center for Interdisciplinary Brain Research (CIBR), University of Jyväskylä, JYU, Jyväskylä, Finland.

Purpose: Sexual dysfunction has been ignored in adults with attention-deficit hyperactivity disorder (A-ADHD). This study examined sexual function in adults with ADHD compared to a healthy control group.

Design And Methods: The experimental group (N = 63, mean age = 31.11 ± 4.29, females = 31) were recruited among referrals with ADHD to an outpatient A-ADHD clinic. The DIVA-2 (Diagnostic Interview for ADHD in adults) and the schedule for affective disorders and schizophrenia (SADS) were used to assess for A-ADHD and comorbid psychiatric disorders, respectively. The healthy groups (N = 66, mean age = 31.37 ± 4.30, females = 31) were demographically matched and had no psychiatric disorders based on the Conners' Adult ADHD Rating Scales-Self Report, Short Version and SADS. Sexual functions were evaluated using the Female Sexual Function Index (FSFI) for females and International Index of Erectile Function (IIEF) for males.

Findings: Females with ADHD compared to the control group showed significantly (P < .001) poorer scores in all FSFI domains (desire, arousal, orgasm, satisfaction, pain, and lubrication). The IIEF mean scores in the males with A-ADHD were lower (P = .00) than their counterparts for all the subscales including orgasm, erectile function, intercourse satisfaction, and overall satisfaction, except for the desire (P = .75). The orgasmic function had a significant negative correlation with Conners Adult ADHD Rating Scale-Self Report: Short total scores in males (r = -.48) and females (r = -.40).

Practice Implications: This study provides preliminary information on greater difficulties with sexual function in adults with ADHD. Assessment of sexual function in referrals with A-ADHD is suggested.
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http://dx.doi.org/10.1111/ppc.12480DOI Listing
July 2020

Prevalence of and Risk Factors for Genito-Pelvic Pain/Penetration Disorder: A Population-Based Study of Iranian Women.

J Sex Med 2019 07 31;16(7):1068-1077. Epub 2019 May 31.

Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.

Introduction: To date, few studies have investigated the prevalence of sexual pain in the context of the new diagnostic concept of genito-pelvic pain/penetration disorder (GPPPD).

Aim: To evaluate the prevalence of GPPPD and its associated factors.

Methods: This was a population-based, cross-sectional study of 590 healthy married women age 18-70 years conducted between May and October 2017 in Tehran, Iran.

Main Outcome Measures: Research tools included demographic characteristics checklist, factors affecting GPPPD, sexual distress and self-reporting of pain during intercourse, 2 standard questionnaires on depression (Patient Health Questionnaire 9) and Binik's guideline for the diagnosis of GPPPD.

Results: 196 women (33%) reported pain or fear in answer to self-report questions. Administration of Binik's guideline yielded a GPPPD prevalence of 16% (n = 94 women); however, this number decreased to 62 women (10.5%) when sexual distress was taken into account; thus, the final prevalence of GPPPD was considered to be 10.5%. However, if the threshold in Binik's guideline was lowered to also include those reporting "somewhat" pain in addition to the group reporting "moderate" and "quite a bit or always," then the prevalence of GPPPD increased to 25.8%. The results of backward logistic regression identified a strong aversion to looking at or touching the genitalia (odd ratio [OR] = 4.3), low sexual satisfaction (OR = 3.1), and severe depression (OR = 6.6) as independent risk factors for a diagnosis of GPPPD and secure financial status (OR = 0.3) and a high level of marital satisfaction (OR = 0.2) as protective factors against a diagnosis of GPPPD.

Clinical Implications: Reliable diagnosis of GPPPD is crucial. Application of validated tools may mitigate the overestimation of GPPPD prevalence. Simultaneously, clinicians' judgment is essential in assessing a reasonable threshold and preventing underestimation that leads to the exclusion of women suffering from pain.

Strengths & Limitations: The present study is one of the few evaluating the prevalence of GPPPD according to the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5) definition and Binik's guideline. The study also aims to point out some new perspectives on merging the 2 concepts of vaginismus and dyspareunia. Study limitations include the evaluation of factors affecting GPPPD based on self-reporting and possible recall bias.

Conclusion: Further research is needed to determine the appropriate threshold for a diagnosis of GPPPD. We suggest that a woman with mild to moderate pain or fear of vaginal penetration is under sexual distress and cannot be neglected. In addition, problems may arise following the DSM-5 merging of the 2 disorders of vaginismus and dyspareunia, owing to the significant prevalence and distress of lifelong vaginismus in some cultures. Alizadeh A, Farnam F, Raisi F, et al. Prevalence of and Risk Factors for Genito-Pelvic Pain/Penetration Disorder: A Population-Based Study of Iranian Women.J Sex Med 2019;16:1068-1077.
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http://dx.doi.org/10.1016/j.jsxm.2019.04.019DOI Listing
July 2019

Erythrocytes polyunsaturated fatty acids mediate relationship between dietary patterns and depression.

Int J Vitam Nutr Res 2020 Oct 17;90(5-6):417-424. Epub 2019 Apr 17.

Tehran University of Medical Sciences, Tehran, Iran.

This study aimed to examine the association between depression and dietary patterns via the intermediary role of erythrocytes polyunsaturated fatty acids (PUFA). In this individually matched case-control study, the dietary patterns were extracted for 330 individuals using factor analysis. Furthermore, erythrocyte PUFAs including n-3 and n-6 were assessed using a GC-Mass spectrometry analytical method for 84 people. Depression was diagnosed using the criteria mentioned in the Diagnostic and Statistical Manual of Mental Disorders. The dietary patterns were also extracted using a valid and reliable semi-quantitative food frequency questionnaire. The findings showed that healthy dietary patterns were related to the risk of depression (P = 0.01, odds ratio (OR) = 0.31, 95% confidence interval (CI): 0.14-0.68) by the increase of ratio n-3 /n-6 PUFA (p ≤ 0.03) and decrease of ratio n-6 /n-3 PUFA (p ≤ 0.005). Moreover, the unhealthy dietary patterns were associated with the risk of depression (P = 0.02, OR = 2.7, 95%CI: 1.25-5.9) by the decrease of ratio n-3/n-6 PUFA (p ≤ 0.03) and increase of ratio n-6/n-3 PUFA (p ≤ 0.001). Based on the results, the type of dietary pattern is related to the risk of depression considering the changes in n-3 and n-6 PUFA as well as the ratio of n-3 to n-6 as the mediator variables. Of course, further studies are required in this area.
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http://dx.doi.org/10.1024/0300-9831/a000586DOI Listing
October 2020

Effect of (Lemon balm) on Sexual Dysfunction in Women: A Double- blind, Randomized, Placebo-controlled Study.

Iran J Pharm Res 2018 ;17(Suppl):89-100

Department of Obstetrics and Gynecology Medical Science, Shahed University, Tehran, Iran.

Hypoactive sexual desire disorder (HSDD) is the most prevalent female sexual dysfunction (FSD) and its bio-psychosocial multifactorial etiology justifies its multifaceted treatment. In Persian Medicine (PM), the weakness of the main organs (heart, brain and liver) is one of the important causes of lack of sexual desire; hence, their strengthening is a priority during treatment. is one of the medicinal plants with tonic characteristics for the main organs in PM and was used for treatment in this study. The aim of the present study was to evaluate the efficacy and safety of in the improvement of HSDD in women. Eighty nine (89) eligible women suffering from decreased sexual desire were randomly assigned to groups. The participants received medication (500 mg of aqueous extract of ) or placebo 2 times a day for 4 weeks. Changes in scores of desire, arousal, lubrication, orgasm, satisfaction and pain were evaluated at the end of 4 weeks of treatment using the Female Sexual Function Index (FSFI) questionnaire in the two groups. Forty three participants completed the study. The increase in desire ( < 0.001), arousal ( < 0.001), lubrication ( < 0.005), orgasm ( < 0.001), satisfaction ( < 0.001), pain ( < 0.002) and FSFI total score ( < 0.001) in the M. officinalis group was significantly more than that of the placebo group. The willingness to continue treatment was significantly higher in the M. officinalis as compared to the placebo group ( < 0.001). M. officinalis may be a safe and effective herbal medicine for the improvement of HSDD in women.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5958328PMC
January 2018

Neglected sexual needs: A qualitative study in Iranian patients with severe mental illness.

Perspect Psychiatr Care 2018 Oct 10;54(4):488-494. Epub 2018 Feb 10.

Tehran University Medical Sciences (TUMS),Professionalism Office, Tehran, Iran.

Background: This paper has attempted to explore views of patients with severe mental illness and their care providers about sharing sexual problems with care providers in these patients within the context of Iran.

Method: A total of 17 in-depth semi-structured interviews were conducted in one of the psychiatric hospital in Tehran: 4 with patients, 2 with patient's family, and 11 with health providers who had been employed for 5 years in psychiatric wards at least. All participants were selected by purposive sampling. Using conventional qualitative content analysis data reduction was done.

Findings: A total of 89 codes about the reasons for lack of communication between clinician and patients, about sexuality were extracted. These are classified in two categories. The first is "Clinicians avoidance from addressing sexual issues" and second is "Patients avoidance from expressing their sexual problems."

Conclusion: Despite having sexual needs, severe mental illnesses patients do not disclose it due to poor communication between clinician and patients, about sexuality. So, physician had to be pioneer in communicating with them. Therefore, to enhance clinicians' sexual knowledge and effective communication skills with patients, especially those with severe mental illnesses, training is completely necessary.
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http://dx.doi.org/10.1111/ppc.12253DOI Listing
October 2018

Why don't you share your satisfaction with me?

Perspect Psychiatr Care 2018 Apr 23;54(2):162-167. Epub 2017 Feb 23.

Psychosexual Department, Roozbeh Hospital, Tehran, Iran.

Background: Healthy spousal communication of marital and sexual expectations is one of the most important factors to improve the quality of sexual relations in marriage.

Objectives: This paper has attempted to explore women's expectations of men for having pleasurable sex in a monogamous and steady sexual relationship within the context of Iran.

Methods: In this qualitative study, 20 interviews were conducted in Tehran from December 2013 to May 2014. Participants were recruited using purposive sampling, face-to-face, in-depth, and semistructured interviews. The collected data were analyzed using qualitative conventional content analysis. The research was designed with regard to Lincoln and Guba's four major rigor criteria in qualitative investigation.

Results: Women's expectations for having enjoyable sex were classified in two areas: (1) marital components and (2) sexual components. Marital components included romantic relationships, attention, respect and admiration, appreciation, man's loyalty, and having compatibility. Sexual components included enough sexual skills, good sexual function, and commitment to equity in sex.

Conclusions: This research helps to identify women's expectations for having a gratifying sexual relationship and thus contributes to enhanced sexual satisfaction, as well as marital stability and continuity.
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http://dx.doi.org/10.1111/ppc.12216DOI Listing
April 2018

Effects of Passion Flower Extract, as an Add-On Treatment to Sertraline, on Reaction Time in Patients ‎with Generalized Anxiety Disorder: A Double-Blind Placebo-Controlled Study.

Iran J Psychiatry 2016 Jul;11(3):191-197

Psychiatric and Psychology Research Centre, Roozbeh Psychiatric Hospital, Tehran University of ‎Medical Sciences, Tehran, Iran.

Because of functional impairment caused by generalized anxiety disorder and due to cognitive side ‎effects of many anti-anxiety agents, in this study we aimed to evaluate the influence of Passion ‎flower standardized extract on reaction time in patients with generalized anxiety disorder.‎ Thirty patients aged 18 to 50 years of age, who were diagnosed with generalized anxiety disorder and ‎fulfilled the study criteria, entered this double-blind placebo-controlled study. Reaction time was ‎measured at baseline and after one month of treatment using computerized software. Correct ‎responses, omission and substitution errors and the mean time of correct responses (reaction time) in ‎both visual and auditory tests were collected. The analysis was performed between the two groups ‎and within each group utilizing SPSS PASW- statics, Version 18. P-value less than 0.05 was ‎considered statistically significant.‎ All the participants were initiated on Sertraline 50 mg/day, and the dosage was increased to 100 ‎mg / day after two weeks. Fourteen patients received Pasipy (Passion Flower) 15 drops three times ‎daily and 16 received placebo concurrently. Inter-group comparison proved no significant difference ‎in any of the test items between assortments while a significant decline was observed in auditory ‎omission errors in passion flower group after on month of treatment using intra-group analysis.‎‎ This study noted that passion flower might be suitable as an add-on in the treatment of generalized ‎anxiety disorder with low side effects. Further studies with longer duration are recommended to ‎confirm the results of this study.‎.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5139955PMC
July 2016

Effects of Passion Flower Extract, as an Add-On Treatment to Sertraline, on Reaction Time in Patients ‎with Generalized Anxiety Disorder: A Double-Blind Placebo-Controlled Study.

Iran J Psychiatry 2016 Jul;11(3):191-197

Psychiatric and Psychology Research Centre, Roozbeh Psychiatric Hospital, Tehran University of ‎Medical Sciences, Tehran, Iran.

Because of functional impairment caused by generalized anxiety disorder and due to cognitive side ‎effects of many anti-anxiety agents, in this study we aimed to evaluate the influence of Passion ‎flower standardized extract on reaction time in patients with generalized anxiety disorder.‎ Thirty patients aged 18 to 50 years of age, who were diagnosed with generalized anxiety disorder and ‎fulfilled the study criteria, entered this double-blind placebo-controlled study. Reaction time was ‎measured at baseline and after one month of treatment using computerized software. Correct ‎responses, omission and substitution errors and the mean time of correct responses (reaction time) in ‎both visual and auditory tests were collected. The analysis was performed between the two groups ‎and within each group utilizing SPSS PASW- statics, Version 18. P-value less than 0.05 was ‎considered statistically significant.‎ All the participants were initiated on Sertraline 50 mg/day, and the dosage was increased to 100 ‎mg / day after two weeks. Fourteen patients received Pasipy (Passion Flower) 15 drops three times ‎daily and 16 received placebo concurrently. Inter-group comparison proved no significant difference ‎in any of the test items between assortments while a significant decline was observed in auditory ‎omission errors in passion flower group after on month of treatment using intra-group analysis.‎‎ This study noted that passion flower might be suitable as an add-on in the treatment of generalized ‎anxiety disorder with low side effects. Further studies with longer duration are recommended to ‎confirm the results of this study.‎.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5139955PMC
July 2016

A Study on Sexual Function in Obsessive-Compulsive Disorder (OCD) Patients With and Without Depressive Symptoms.

Perspect Psychiatr Care 2017 Jul 8;53(3):208-213. Epub 2016 Apr 8.

Narges Ebrahimkhani, BA, is Master Student of Health Psychology, Department of Clinical Psychology, Bahonar Hospital, Alborz University of Medical Sciences, Alborz, Iran.

Purpose: The aim of study was to evaluate sexual function in obsessive-compulsive disorder (OCD) patients with and without depressive symptoms.

Design And Method: Fifty-six married OCD patients referred to the outpatient clinic of Roozbeh Hospital from 2011 to 2013 filled out the demographic questionnaire, obsessive compulsive inventory-revised OCI-R, Maudsley obsessional-compulsive inventory (MOCI), Beck depression inventory-II (BDI-II), international index of erectile function (IIEF), and female sexual function index (FSFI).

Findings: In total, 80.6% of women and 25% of men had sexual dysfunction and 82% of them had depressive symptoms. Comparing sexual dysfunction in OCD patients with and without depressive symptoms demonstrated that the mean index of IIEF in subscales of erection and satisfaction without depressive symptoms (BDI-II index ≤ 15) is higher than in those with depressive symptoms and the mean index of FSFI showed a marginal significance in the pain subscale of the FSFI.

Practice Implications: Regarding the possible role of the symptoms of depression on sexual function, sexual assessment in OCD patients should be considered.
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http://dx.doi.org/10.1111/ppc.12160DOI Listing
July 2017

Healthy and Unhealthy Dietary Patterns Are Related to Depression: A Case-Control Study.

Psychiatry Investig 2015 Oct 30;12(4):434-42. Epub 2015 Sep 30.

Department of Psychiatry, School of Medicine, Psychiatry Resident in Tehran University of Medical Sciences, Tehran, Iran.

Objective: Major depressive disorder is the leading cause of disability around the world. The relationship between depression and dietary patterns has been reported in a few studies but with controversial results. This study aimed to investigate this relationship in an Iranian population.

Methods: In our study, 330 depressed patients (cases) and healthy people (controls) (1:2) were individually matched according to age, sex and area of residence. New cases of depression were recruited from two psychiatric clinics in Tehran. Interviewers went to each patient's residential area, and invited qualified individuals to participate in the study as controls. Food intake over the past year was collected using a validated semi quantitative food frequency questionnaire. Dietary patterns were determined by the principal components method. Binary logistic regression was used to test the effect of dietary patterns on depression.

Results: We identified two major dietary patterns by using factor analysis: the healthy and unhealthy dietary patterns. We categorized the scores of these patterns to quartiles. After adjusting for non-depression drug use, job, marital status, children number, and body mass index, the relations of depression and quartiles of two dietary patterns are significant (p=0.04 & p=0.01, respectively). Compared with participants in the lowest quartile, those in the highest quartile had significantly lower odds ratio (OR) for depression in healthy dietary pattern, and higher OR for depression in unhealthy dietary pattern.

Conclusion: This study indicates that healthy and unhealthy dietary patterns may be associated with the risk of depression. The results can be used for developing interventions that aim to promote healthy eating for the prevention of depression.
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http://dx.doi.org/10.4306/pi.2015.12.4.434DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4620299PMC
October 2015

Psychiatrists and Their Role in an Integrative Approach to Sexual Problems.

Iran J Psychiatry Behav Sci 2015 Mar 21;9(1):e911. Epub 2015 Mar 21.

Department of Psychiatry, School of Medicine, Roozbeh Hospital, Tehran University of Medical Sciences, Tehran, IR Iran ; Psychiatry and Behavioral Sciences Research Center, Addiction Institute, Mazandaran University of Medical Sciences, Sari, IR Iran.

Sexuality is a unit part of humans that has been evaluated as several fragmented particles for years. Although many biomedical and psychosocial approaches have been developed in the field of sex, these approaches usually have not been led to the complete satisfaction of the patients. It seems that for a comprehensive evaluation and management of the sexual problems, the unity of sex should be respected and the biopsychosocial multilayer aspects of the sex should be apprehended. Psychiatry is a unique point that both biomedical and psychosocial sciences reach each other. Therefore, psychiatrists should play a critical role as a modulator in the multidisciplinary team for management of the sexual problems. In this regard, comprehensive training of psychiatrists is highly recommended. One of the primary steps could be developing the psychosexual fellowship.
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http://dx.doi.org/10.17795/ijpbs911DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4525453PMC
March 2015

Sexual Satisfaction Concept Analysis in Iranian Married Women: A Hybrid Model Study.

Glob J Health Sci 2015 May 20;7(6):345-53. Epub 2015 May 20.

Tehran University of Medical Sciences.

Background: Sexual satisfaction is considered to be a sexual right and an important component of sexual health. The purpose of this qualitative study was to clarify the meaning and the nature of sexual satisfaction in Iranian married women, and to provide a cultural-based definition of it.

Method: Sexual satisfaction was examined in three phases by the Hybrid Model of concept analysis: (1) the theoretical phase; (2) the fieldwork phase and (3) the analytical phase. Hybrid concept analysis method was chosen because its inclusion of married women's perspectives enriches the limits of sexual health search literature.

Result: The critical attributes of sexual satisfaction were investigated. They included 'two-dimensional structure', 'an affective response', 'a means to achieve marital satisfaction', 'unique', 'a concept based on expectations' and 'a concept on shadow of values'.

Conclusion: The concept analysis of sexual satisfaction showed some of the attributes and antecedents for this concept that, have not been mentioned in the literature.
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http://dx.doi.org/10.5539/gjhs.v7n6p345DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4803876PMC
May 2015

Married Women's Sexual Satisfaction Questionnaire; A Developmental and Psychometric Evaluation.

Iran Red Crescent Med J 2015 Apr 25;17(4):e26488. Epub 2015 Apr 25.

Department of Biostatistics, Faculty of Medical Sciences, Tarbiyat Modares University, Tehran, IR Iran.

Background: Despite the significant contribution of cultural factors to sexual satisfaction, most of the current sexual satisfaction scales pay little attention, if any, to cultural factors and marital status.

Objectives: The current study aimed to develop and validate the Married Women's Sexual Satisfaction Scale.

Patients And Methods: The current methodological study went through three consecutive phases. In the first phase, the concept of sexual satisfaction was defined and analyzed by the hybrid model approach. In the second phase, an item pool was generated by the findings of the first phase. Finally, the psychometric properties of the scale were evaluated in the third phase. All data analyses were performed by the SPSS version 19.0.

Results: A 78-item pool was generated based on the findings of the concept analysis phase. After assessing and confirming its face and content validity, 27 items remained in the final version of the scale. The exploratory factor analysis revealed a four-factor structure for the scale. The results of the known-groups comparison showed that females with lower educational status had significantly lower sexual satisfaction. Moreover, there was a significant correlation between the scores of the finalized scale and those of the ENRICH Marital Satisfaction Scale (r = 0.706, P = 0.01). The interclass correlation between the test and the retest measurements was also statistically significant (ICC = 0.939, P value = 0.001).

Conclusions: The 27-item Iranian Married Women's Sexual Satisfaction Scale is a simple, valid, and reliable tool to assess married women's sexual satisfaction.
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http://dx.doi.org/10.5812/ircmj.17(4)2015.26488DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4443391PMC
April 2015

Married Women's Sexual Satisfaction Questionnaire; A Developmental and Psychometric Evaluation.

Iran Red Crescent Med J 2015 Apr 25;17(4):e26488. Epub 2015 Apr 25.

Department of Biostatistics, Faculty of Medical Sciences, Tarbiyat Modares University, Tehran, IR Iran.

Background: Despite the significant contribution of cultural factors to sexual satisfaction, most of the current sexual satisfaction scales pay little attention, if any, to cultural factors and marital status.

Objectives: The current study aimed to develop and validate the Married Women's Sexual Satisfaction Scale.

Patients And Methods: The current methodological study went through three consecutive phases. In the first phase, the concept of sexual satisfaction was defined and analyzed by the hybrid model approach. In the second phase, an item pool was generated by the findings of the first phase. Finally, the psychometric properties of the scale were evaluated in the third phase. All data analyses were performed by the SPSS version 19.0.

Results: A 78-item pool was generated based on the findings of the concept analysis phase. After assessing and confirming its face and content validity, 27 items remained in the final version of the scale. The exploratory factor analysis revealed a four-factor structure for the scale. The results of the known-groups comparison showed that females with lower educational status had significantly lower sexual satisfaction. Moreover, there was a significant correlation between the scores of the finalized scale and those of the ENRICH Marital Satisfaction Scale (r = 0.706, P = 0.01). The interclass correlation between the test and the retest measurements was also statistically significant (ICC = 0.939, P value = 0.001).

Conclusions: The 27-item Iranian Married Women's Sexual Satisfaction Scale is a simple, valid, and reliable tool to assess married women's sexual satisfaction.
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http://dx.doi.org/10.5812/ircmj.17(4)2015.26488DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4443391PMC
April 2015

Compare the effectiveness of PLISSIT and sexual health models on women's sexual problems in Tehran, Iran: a randomized controlled trial.

J Sex Med 2014 Nov 5;11(11):2679-89. Epub 2014 Aug 5.

Department of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran.

Introduction: Sexuality is an important aspect of human life and sexual problems are common, but there is limited evidence for cost-effective treatments of women's sexual dysfunctions.

Aims: The aim of this study was to assess whether group therapy such as Sexual Health Model (SHM) can be as effective as individual therapy like Permission, Limited Information, Specific Suggestions, and Intensive Therapy (PLISSIT) model in women with sexual problems.

Methods: A randomized controlled trial was conducted between May 2012 and September 2013 in five Tehran, Iran health clinics. Eighty-four consecutive married women aged 20-52 years, with sexual problems who were admitted for the first time, were recruited and randomized into two groups. The intervention included two therapeutic models: the SHM, which consisted of two sessions of 3 hours of group education, and the PLISSIT model, which required a total of 6 hours of one-on-one consultation at an interval of 1-2 weeks.

Main Outcome Measures: Sexual function and sexual distress were assessed, respectively, with the Brief Index of Sexual Function for Women and Female Sexual Distress Scale Revised questionnaires.

Results: Seven months after intervention, the mean (SD) of the sexual distress score decreased and sexual composite score increased significantly in both groups (P < 0.001). The overall analysis of repeated measure manova revealed borderline significance differences for combined outcomes between two groups (P = 0.051).

Conclusions: Due to the considerable human resource, time, and cost spent conducting the PLISSIT, it seems that group education based on SHM could be more cost-efficient and nearly as effective. This conclusion may be more applicable in communities where the treatment of sexual problems is in the beginning stages and where people have not received any sexual education or knowledge during their lifetime.
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http://dx.doi.org/10.1111/jsm.12659DOI Listing
November 2014

Tribulus terrestris for treatment of sexual dysfunction in women: randomized double-blind placebo - controlled study.

Daru 2014 Apr 28;22:40. Epub 2014 Apr 28.

Psychiatry, Fellow of the European Committee of Sexual Medicine (FECSM), Roozbeh Psychiatric Hospital, Psychiatric and Clinical Psychology, Research Center, Tehran University of Medical Sciences, South Kargar Street, Tehran 13337, Iran.

Background: Tribulus terrestris as a herbal remedy has shown beneficial aphrodisiac effects in a number of animal and human experiments. This study was designed as a randomized double-blind placebo-controlled trial to assess the safety and efficacy of Tribulus terrestris in women with hypoactive sexual desire disorder during their fertile years. Sixty seven women with hypoactive sexual desire disorder were randomly assigned to Tribulus terrestris extract (7.5 mg/day) or placebo for 4 weeks. Desire, arousal, lubrication, orgasm, satisfaction, and pain were measured at baseline and after 4 weeks after the end of the treatment by using the Female Sexual Function Index (FSFI). Two groups were compared by repeated measurement ANOVA test.

Results: Thirty women in placebo group and thirty women in drug group completed the study. At the end of the fourth week, patients in the Tribulus terrestris group had experienced significant improvement in their total FSFI (p < 0.001), desire (p < 0.001), arousal (p = 0.037), lubrication (p < 0.001), satisfaction (p < 0.001) and pain (p = 0.041) domains of FSFI. Frequency of side effects was similar between the two groups.

Conclusions: Tribulus terrestris may safely and effectively improve desire in women with hypoactive sexual desire disorder. Further investigation of Tribulus terrestris in women is warranted.
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http://dx.doi.org/10.1186/2008-2231-22-40DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4045980PMC
April 2014

Comparing dietary patterns of depressed patients versus healthy people in a case control protocol.

BMJ Open 2014 Feb 12;4(2):e003843. Epub 2014 Feb 12.

Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran.

Introduction: Major depressive disorder is the leading cause of disability around the world. Because of the high rate of medication discontinuation by patients and the risk of recurrence, factors such as nutrition could be useful for the prevention or treatment of depression. The relationship between depression and dietary patterns has been reported in a few studies but with controversial results. Therefore, we have decided to study the possible effects of cultural, social, racial, geographic and environmental conditions on this relationship in an Iranian population.

Methods And Analysis: In our case control protocol, 110 cases and 220 controls will be individually matched based on age, sex and area of residence. New cases of depression, based on the criteria of the Diagnostic and Statistical Manual of Mental Disorders, fourth edition (DSM-IV), will be recruited from two psychiatric clinics in Tehran. Interviewers will then go to each patient's home and invite qualified individuals to participate in the study as controls. Food intakes of all participants will be obtained by semiquantitative food frequency questionnaires covering the past year; these will be transformed into actual food intake (g/day). Dietary patterns will be determined by the principal components method. Conditional logistic regression, as a multivariate analysis, will be used for assessing the relationship between dietary patterns and depression, taking into consideration the potential role of different variables. The results may help to identify differences in dietary patterns between depressed and healthy people.

Ethics And Dissemination: The study protocol has been approved by ethics committee of Tehran University of Medical Sciences. At the beginning of the study, a written informed consent form will be signed and dated by subjects and investigators. The results will be published in due time.
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http://dx.doi.org/10.1136/bmjopen-2013-003843DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3927997PMC
February 2014

Saffron for treatment of fluoxetine-induced sexual dysfunction in women: randomized double-blind placebo-controlled study.

Hum Psychopharmacol 2013 Jan 20;28(1):54-60. Epub 2012 Dec 20.

Infertility Ward, Arash Hospital, Tehran University of Medical Sciences, Tehran, Iran.

Objective: Saffron (Crocus sativus L.) has shown beneficial aphrodisiac effects in some animal and human studies. The aim of the present study was to assess the safety and efficacy of saffron on selective serotonin reuptake inhibitor-induced sexual dysfunction in women.

Methods: This was a randomized double-blind placebo-controlled study. Thirty-eight women with major depression who were stabilized on fluoxetine 40 mg/day for a minimum of 6 weeks and had experienced subjective feeling of sexual dysfunction entered the study. The patients were randomly assigned to saffron (30 mg/daily) or placebo for 4 weeks. Measurement was performed at baseline, week 2, and week 4 using the Female Sexual Function Index (FSFI). Side effects were systematically recorded.

Results: Thirty-four women had at least one post-baseline measurement and completed the study. Two-factor repeated measure analysis of variance showed significant effect of time × treatment interaction [Greenhouse-Geisser's corrected: F(1.580, 50.567) = 5.366, p = 0.012] and treatment for FSFI total score [F(1, 32) = 4.243, p = 0.048]. At the end of the fourth week, patients in the saffron group had experienced significantly more improvement in total FSFI (p < 0.001), arousal (p = 0.028), lubrication (p = 0.035), and pain (p = 0.016) domains of FSFI but not in desire (p = 0.196), satisfaction (p = 0.206), and orgasm (p = 0.354) domains. Frequency of side effects was similar between the two groups.

Conclusions: It seems saffron may safely and effectively improve some of the fluoxetine-induced sexual problems including arousal, lubrication, and pain.
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http://dx.doi.org/10.1002/hup.2282DOI Listing
January 2013

Effect of saffron on fluoxetine-induced sexual impairment in men: randomized double-blind placebo-controlled trial.

Psychopharmacology (Berl) 2012 Oct 3;223(4):381-8. Epub 2012 May 3.

Psychiatric Research Center, Roozbeh Hospital, Tehran University of Medical Sciences, South Kargar Street, Tehran 13337, Iran.

Rationale: Saffron (Crocus sativus L.) has shown aphrodisiac effects in some animal and human studies.

Objectives: To assess the efficacy and tolerability of saffron in fluoxetine-related sexual dysfunction.

Methods: This was a 4-week randomized double-blind placebo-controlled study. Thirty-six married male patients with major depressive disorder whose depressive symptoms had been stabilized on fluoxetine and had subjective complaints of sexual impairment entered the study. The patients were randomly assigned to saffron (15 mg twice per day) or placebo for 4 weeks. International Index of Erectile Function scale was used to assess sexual function at baseline and weeks 2 and 4.

Results: Thirty patients finished the study. Baseline characteristics as well as baseline and final depressive symptoms scores were similar between the two groups. Effect of time × treatment interaction on the total score was significant [Greenhouse-Geisser-corrected, F (1.444, 40.434) = 6.154, P = 0.009]. By week 4, saffron resulted in significantly greater improvement in erectile function (P < 0.001) and intercourse satisfaction domains (P = 0.001), and total scores (P < 0.001) than the placebo group. Effect of saffron did not differ significantly from that of placebo in orgasmic function (P = 0.095), overall satisfaction (P = 0.334), and sexual desire (P = 0.517) domains scores. Nine patients (60%) in the saffron group and one patient (7%) in the placebo group achieved normal erectile function (score > 25 on erectile function domain) at the end of the study (P value of Fisher's exact test = 0.005). Frequency of side effects were similar between the two groups.

Conclusions: Saffron is a tolerable and efficacious treatment for fluoxetine-related erectile dysfunction.
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http://dx.doi.org/10.1007/s00213-012-2729-6DOI Listing
October 2012

Effects of Herbal vigRX on Premature Ejaculation: A randomized, double-blind study.

Iran J Psychiatry 2010 ;5(1):4-6

Psychiatry and Psychology Research Center, Tehran University of Medical Sciences, Tehran, Iran.

Objective: We conducted a double-blind, placebo-controlled study to determine the efficacy of an herbal sexual supplement (vigRX) on premature ejaculation (PE).

Method: A randomized double blind study was conducted on a fixed dose of herbal vigRX at Roozbeh Psychiatry Hospital, Tehran University of Medical Sciences. The sample consisted of 85 married patients diagnosed with primary PE according to Diagnostic and Statistical Manual of Mental Disorders. Each patient underwent diagnostic evaluation by one trained psychiatrist, using Structured Clinical Interview for DSM-IV-TR. Each patient was evaluated by researchers to exclude the organic sexual dysfunctions. The patients were randomly assigned in to two groups: group 1 consisting of 42 patients receiving placebo, and group 2 consisting of 43 patients receiving 540 mg herbal vigRX for a 4-week treatment course. The effects of the drug on the ejaculatory function in each group were assessed by the intravaginal ejaculation latency time (IELT), and the Chinese Index of Premature Ejaculation (CIPE) before and at the end of the treatment course. Statistical analysis was performed using SPSS software (15th version).

Results: The mean IELT increased 22.4 and 32.0 seconds in the placebo and the vigRX group respectively after the treatment course. The mean IELT differences between the two groups was not significant. The mean CIPE score increased 2.40 and 4.37 in the placebo and the vigRX group respectively. The mean CIPE score differences between the two groups was not significant.No side effect was reported by the subjects in neither groups during the treatment course.

Conclusion: Although the improvement in IELT and CIPE scores in the herbal vigRX group was more than the placebo group, this difference was not statistically significant. The increasing of IELT and CIPE score in the placebo group may be due to the placebo effects. Further studies with higher vigRX doses, greater sample size and longer treatment courses are warranted.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3430409PMC
September 2012

Clinical trial of adjunctive celecoxib treatment in patients with major depression: a double blind and placebo controlled trial.

Depress Anxiety 2009 ;26(7):607-11

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

Background: The pathophysiology of depression is associated with the hyperactivity of immune inflammatory responses. Cyclooxygenase-2 inhibitors such as celecoxib reduce the production of pro-inflammatory cytokines. The purpose of the present investigation was to assess the efficacy of celecoxib as an adjuvant agent in the treatment of major depression in a six-week double blind and placebo controlled trial.

Methods: Forty adult outpatients who met the DSM-IV-TR criteria for major depression participated in the trial. Patients have a baseline Hamilton Rating Scale for Depression score of at least 18. Patients were allocated in a random fashion: 20 to fluoxetine 40 mg/day plus celecoxib 400 mg/day (200 mg bid) (morning and evening) and 20 to fluoxetine 40 mg/day plus placebo. Patients were assessed by a psychiatrist at baseline and after 1, 2, 4, and 6 weeks after the medication started.

Results: Although both protocols significantly decreased the score of Hamilton Rating Scale for Depression over the trial period, the combination of fluoxetine and celecoxib showed a significant superiority over fluoxetine alone in the treatment of symptoms of major depression. There were no significant differences in the two groups in terms of observed side effects.

Conclusion: The results of this study suggest that celecoxib may be an effective adjuvant agent in the management of patients with major depression and anti-inflammatory therapies should be further investigated.
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http://dx.doi.org/10.1002/da.20589DOI Listing
November 2009

Adjunctive estrogen treatment in women with chronic schizophrenia: a double-blind, randomized, and placebo-controlled trial.

Prog Neuropsychopharmacol Biol Psychiatry 2003 Sep;27(6):1007-12

Psychiatric Research Center, Roozbeh Psychiatric Hospital, Tehran University of Medical Sciences, and Institue of Medicinal Plants, Tehran, Iran.

The estrogen hypothesis of schizophrenia postulates that estrogen exerts a protective effect against schizophrenia and that this partly explains the observed sex differences in premorbid adjustment, onset age, treatment response, and illness course. It has been suggested that estrogen supplementation can augment the treatment effects of antipsychotics. The purpose of the present investigation was to access the efficacy of ethinyl estradiol as an adjuvant agent in the treatment of premenopausal women with chronic schizophrenia in an 8-week, double-blind, and placebo-controlled trial. Eligible participants in the study were 32 women of childbearing age with schizophrenia. All patients were inpatients, in the active phase of illness, and met DSM-IV criteria for chronic schizophrenia. Patients were allocated in a random fashion, 16 to haloperidol 15 mg/day plus ethinyl estradiol 0.05 mg/day and 16 to haloperidol 15 mg/day plus placebo for an 8-week, double-blind, placebo-controlled study. Although both protocols significantly decreased the score of the positive, negative, and general psychopathological symptoms over the trial period, the combination of haloperidol and ethinyl estradiol showed a significant superiority over haloperidol alone in the treatment of positive and general psychopathology symptoms as well as Positive and Negative Syndrome Scale (PANSS) total scores. Although the means Extrapyramidal Symptoms Rating Scale (ESRS) for the placebo group were higher than ethinyl estradiol group, the differences were not significant over the trial. A significant difference was observed between the overall mean biperiden dosages in the two groups. The results of this study suggest that estrogen may be an effective adjuvant agent in the management of women of childbearing age with chronic schizophrenia. Nevertheless, results of larger controlled trials are needed before recommendation for a broad clinical application can be made.
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http://dx.doi.org/10.1016/S0278-5846(03)00161-1DOI Listing
September 2003