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Gestational hypertension (GH) is an important pregnancy complication. Sparse studies have shown a correlation between this complication and psychological disorders in patients. In this study, we ai...

Objectives Evaluate the effect of functional endoscopic sinus surgery (FESS) for nasal polyposis on sleep efficiency and polysomnographic parameters. Subjects and methods This clinical trial was conducted on 15 patients with bilateral massive sinonasal polyposis who underwent FESS between August 2012 and September 2013. All participants were evaluated subjectively by employing the Pittsburgh Sleep Quality Index (PSQI) questionnaire and objectively (provided by polysomnographic parameters) before and 2 months after surgery. Results The evaluation of subjective criteria of sleep quality assessed by PSQI showed significant improvement, particularly in nocturnal awakening (P = 0.002). However, Apnea Hypopnea Index (AHI) was not reduced significantly after surgery (P = 0.233). Among patients who had suffered from obstructive sleep apnea, AHI was improved in 7 patients, deteriorated in 3 patients, and did not change in 1 patient. Although the mean duration of REM sleep stage increased from 15.2 ± 10.7 to 18.9 ± 7.9, this change was not statistically significant. Furthermore, arousal index decreased dramatically from 31.6 to 17.1 (P = 0.02) and sleep efficiency index was improved after the surgery (P = 0.008). Conclusions This study documented the effect of resuming nasal cavity patency on improvement of sleep efficiency after FESS. In spite of insignificant effect of FESS on apnea index, alteration of other sleep parameters like arousal index following surgery may have a positive effect on sleep quality.

Objective: The immediate impacts of coronavirus disease 2019 (COVID-19) on mental health of affected patients and psychiatric morbidities of these patients has been neglected by researchers. We assessed mental health outcomes and sleep status among inpatients and outpatients with COVID-19 who were initially referred to our COVID-19 clinic in Mashhad, Iran during April-October 2020. Method: In this ethically approved cross-sectional study, 130 patients with confirmed COVID-19 who were referred to outpatient clinics and wards of a referral hospital in Mashhad, Iran were surveyed during April-October 2020. Demographic data were collected after obtaining informed written consent. Validated Persian versions of insomnia severity index (ISI), 9-item patient health questionnaire (PHQ-9), and 7-item generalized anxiety disorder (GAD-7) and revised impact of event scale (IES-R) were used as main outcome measures (i.e. status of anxiety, depression, insomnia, and event-related distress). Analysis was performed with SPSS using binary logistic regression. P-values < 0.05 were considered significant. Results: Overall, 65 inpatients and 65 outpatients were surveyed. The two groups did not significantly defer in terms of insomnia and depression severity, but the outpatients showed higher levels of anxiety (52.3% vs. 24.6%, P = 0.005) and distress compared to inpatients (80.0% vs. 64.6%, P < 0.001). Male sex (OR = 0.017, 95%CI = 0.000-0.708, P = 0.032) exhibited independent and inverse association with depression in COVID-19 patients. Being married (OR = 0.102, 95% CI = 0.018-0.567, P = 0.009) was independently and inversely associated with anxiety. Insomnia was independently associated with event-related distress (OR = 7.286, 95%CI = 2.017-26.321, P = 0.002). Only depression was independently associated with insomnia (OR = 49.655, 95%CI = 2.870-859.127, P = 0.007). Conclusion: We found symptoms of psychological distress and anxiety to be more prevalent among outpatients with COVD-19 than inpatients. Insomnia can be a potential risk factor for adverse mental health outcomes in these patients.

Gestational diabetes mellitus (GDM) is the most common medical complication of pregnancy. The current study aimed to investigate the possibility of a relationship between affective temperaments and GDM.This ethically approved cross-sectional study was conducted on 120 pregnant women with impaired glucose tolerance and 120 healthy pregnant women, all of whom were admitted to hospitals affiliated with Mashhad University of Medical Sciences for delivery during 2019. Depression Anxiety Stress Scale (DASS)-21 and Temperament Evaluation of Memphis, Pisa, Paris and San Diego-auto-questionnaire (TEMPS-A) were used to gather data. Mann-Whitney test was used to compare data between the two groups. A multivariate binary logistic regression model with maternal age, body mass index, and multiparity as the covariates was used to assess factors associated with GDM.Outcomes of TEMPS-A showed significantly higher scores of anxious and irritable temperaments in the GDM group compared to the control group (It is ostensible that affective temperaments, especially anxious temperament, are potentially associated with the development of GDM and impaired glucose metabolism during pregnancy.Key pointsThe association of affective temperaments with pregnancy complications has drawn compelling interest.The findings of this study showed significantly higher scores of anxious and irritable temperaments in GDM patients.GDM patients also showed significantly higher levels of anxiety compared to controls.Predominance of anxious temperament can be a potential risk factor that contributes to the development of GDM.Monitoring for GDM is especially recommended in pregnant women with predominant anxious and irritable temperaments.

Abstinence-based treatment of opioid use disorder has always been faced with the probability of an increase in craving, which potentially results in relapse. Moreover, sleep problems are predominant among patients with abstinence treatment. A sample of twenty-six male subjects with opioid use disorder were selected from a residential treatment center for substance use disorders in 2017 in Mashhad, Iran. Opioid craving was evaluated using obsessive-compulsive drug use scale (OCDUS) at four-time points (days 1, 10, 20, and 30) during abstinence. Also, they were asked to report their total sleep time. The participants with an average age of 32.5 ± 8.0 years reported the use of opium and heroin to be as high as 2.0 ± 1.2 g per day and 1.5 ± 0.9 g per day, respectively. Abstinence induced a non-significant gradual decrease in self-reported craving during one month (p > 0.05). Also, they experienced significant declines in total sleep time over the first ten days (p = 0.008). The univariate analysis of variance showed no significant changes in craving after adjustment for total sleep time (p > 0.05). Insignificant reductions in opioid craving after detoxification persisted throughout the 30 days of abstinence.

Background and Objective: Chronotypes vary in different people, and the daily function outside of the framework of this rhythm can affect the quality of work. This study aimed to investigate the association between sleep disorders and chronotypes among the shift and day work nurses. Materials and Methods: This cross-sectional study was performed among nurses in two teaching hospitals in Mash-had, Iran, during 2016-2017. A total of 180 randomly-selected nurses were divided into shift work and day work groups. Participants completed demographic information form, Circadian Type Inventory (CTI), Insomnia Severity Index (ISI), Epworth Sleepiness Scale (ESS), Beck Anxiety Inventory (BAI), and Beck Depression Inventory (BDI). Results: A total of 180 female nurses (90 participants in each group) with a mean age of 35.62 ± 4.07 years were stud-ied. The prevalence of rigid circadian rhythm in the day work group (93.3%) was significantly (P = 0.004) higher than shift work group (78.9%). However, the groups did not show any significant difference regarding the languid/vigorous (LV) index of the CTI (P = 0.080). There was a significant difference in the mean score of CTI between individuals with rigid and flexible circadian rhythms in the shift work group (P = 0.021). Conclusion: In the present study, although there was no association between circadian type and sleep problems includ-ing insomnia and daytime sleepiness in shift work nurses, we observed the capability of coping with working in the rotating shifts in nurses with flexible circadian rhythms.

Introduction Current evidence on the association between COVID-19 and dementia is sparse. This study aims to investigate the associations between COVID-19 caseload and the burden of dementia. Methods We gathered data regarding burden of dementia (disability-adjusted life years [DALYs] per 100,000), life expectancy, and healthy life expectancy (HALE) from the Global Burden of Disease (GBD) 2017 study. We obtained COVID-19 data from Our World in Data database. We analyzed the association of COVID-19 cases and deaths with the burden and mortality of dementia using Spearman's rank correlation coefficient. Results Globally, we found significant positive (p, Highlights • We assessed the burden of dementia on COVID-19 caseload and mortality worldwide. • Global burden of dementia correlates with COVID-19 caseloads. • Global burden of dementia correlates with COVID-19 mortality. • Healthy life expectancy correlates with COVID-19 cases and mortality. • We recommend a targeted approach to reduce the burden of COVID-19 in dementia.

Recent studies have revealed a growing number of patients affected by opioid use disorders (OUDs). Comorbid disorders are suspected to increase the risk of opioid-related adverse effects or treatment failure. The correlation of opioid use with sleep disturbances has been reported in many different studies and suggested to be linked to the brain regions involved in reward processing. This narrative review was intended to discuss the most recent developments in our understanding of the intricate interaction between sleep disturbance and OUD. In addition, in this study, the effects of sleep problems on the occurrence of unpleasant consequences in addiction management, such as craving and relapse in OCD patients, were highlighted. It has been shown that drug use may trigger the induction of sleep disturbances, and those suffering from difficulties in sleeping are prone to relapse to drug use, including opioids. Moreover, pharmaceutical sleep aids are likely to interfere with opiate use.

Introduction: Little is known regarding long-term stroke outcomes in patients with substance use disorder (SUD). Based on anecdotal data, some individuals use illicit drugs, particularly opioids, in an attempt to reduce stroke mortality, disability, or recurrence. This study is aimed to assess the effect of SUD on stroke outcomes. Methods: Patients were recruited from the Mashhad Stroke Incidence Study, a population-based study of stroke in Iran. For a period of 1 year, all patients with first-ever stroke (FES) were recruited and then followed up for the next 5 years. Disability and functional dependency were defined using modified Rankin Scale (>2) and Barthel Index (Results: 595 FES patients (mean age of 64.6 ± 14.8 years) were recruited in this study. Eighty-one (13.6%) were current substance users, including opium (n = 68), naswar (n = 5, 6.1%), hashish (n = 1), heroin (n = 1), and (n = 7) others. The frequency of vascular risk factors was similar between the SUD and non-SUD groups, except for a higher rate of cigarette smoking in the SUD group (p < 0.001). After adjusting for various sociodemographic variables, vascular risk factors, and the severity of stroke at admission, SUD increased the 3-month (aHR: 1.60, CI: 1.01–2.49), 1-year (aHR: 1.73, CI: 1.20–2.65), and 5-year (aHR: 1.72, CI: 1.23–2.35) poststroke mortality risk. We did not observe a significant change in the risk of stroke recurrence, disability, and functional dependency in those with a history of SUD. Conclusion: SUD increased the hazard ratio of stroke mortality with no effect on the disability rate. The public should be advised about the potential harm of substance abuse.

Background: Patients under Methadone Maintenance Therapy (MMT) are susceptible to several problems, including sleep disturbances and risk of relapse. The present study aimed to assess the effect of transcranial direct current stimulation (tDCS) on sleep quality of addicts under MMT.Methods: This clinical trial was conducted on 27 male patients who underwent maintenance methadone therapy in MMT clinics of Mashhad City, Iran. They were divided into the experimental and sham groups. The experimental group received seven 20-min sessions of tDCS every other day. In the sham group, the electrical current was delivered for a few seconds, but the electrodes were remained to the end of the session. Sleep quality was measured at baseline, during, and after the intervention by Pittsburg Sleep Quality Index (PSQI). The obtained data were analyzed by descriptive statistics such as mean and standard deviation and inferential statistics, such as t test, Chi-square, Mann Whitney, and Fischer exact test in SPSS v. 25.Results: The difference between the two groups after tDCS in sleep duration was significant (P=0.04). In the experimental group, the total score of sleep had a reducing trend (P

Background: Regarding the high prevalence of methamphetamine (MA) abuse among the youth population and its consequences, especially psychiatric problems. Objectives: This research aimed to investigate the relationship between the rate and severity of methamphetamine associated psychotic symptoms with duration and dose of methamphetamine in Iranian abusers. Patients and Methods: The statistical population of this descriptive-correlational study consisted of all methamphetamine abusers who referred to Ibn-e-Sina Psychiatric Hospital in Mashhad city. The cases were selected through convenience sampling method. The research instrument included the demographic questionnaire and positive and negative symptoms scale. Data were analyzed by descriptive statistics and Pearson correlation coefficient through SPSS software. Results: The participants included 100 amphetamine abusers (80 men and 20 women) with the mean age of 30.84 ± 6.62 years. There were significant relationships between dose of amphetamine abuse and positive (P = 0.004) and negative psychotic symptoms (P = 0.04), while the duration of amphetamine abuse did not have any significant relationships with positive and negative psychotic symptoms and general psychopathology (P > 0.05). Conclusions: The findings indicated dose-related psychosis in amphetamine abusers while the duration of abuse did not have any significant relationships with psychotic symptoms and general psychopathology.

The present study is designed to evaluate the efficacy of acceptance–commitment therapy (ACT) on craving beliefs in opioid dependent patients on methadone maintenance treatment (MMT). Twenty-eight opioid dependent participants, aged 18–50 years, who were on MMT based on Iran’s Ministry of Health and Medical Education published protocol, were evaluated in Mashhad during 2011–2012. The treatment group comprised fourteen participants, who received eight sessions of individual ACT alongside MMT while fourteen participants of the control group received just MMT. The effectiveness of the intervention was assessed by the craving beliefs questionnaire (CBQ), the action and acceptance questionnaire (AAQ-I) and the mean dosage of methadone the participants consumed in the last 3 days. Assessment was performed three times; the first was before the initiation of ACT (as pretest), the second was 2 weeks after ACT was terminated (as posttest), and the third one was 12 weeks after the termination of ACT (as follow-up). The extracted data were analyzed by two way ANOVA and ANCOVA using SPSS-20. While there was no significant difference in the mean methadone dosage between the treatment and the control group at pretest (p = 0.067), patients in the treatment group had a significantly lower methadone dosage at posttest (p

Background In this trial, additive effects of acupuncture to selective serotonin reuptake inhibitors (SSRIs) treatment for reducing anxiety, were investigated. Methods 112 patients with anxiety disorder were randomly divided into three groups including SSRIs alone (drug group), SSRIs with sham acupuncture (control group) and SSRI with acupuncture (acupuncture group), and treated for 4 weeks. At the beginning of the study and on day 28, Spielberger State-Trait Anxiety Inventory (STAI) questionnaire was completed and serum levels of cortisol were measured. Results 105 patients completed the treatment period. STAI score showed significant differences among the three groups at the end of the study; importantly, changes in STAI score in the acupuncture group were significantly larger than the other groups. A decrease in cortisol levels was observed in all groups; though statistically non-significant, this decrease in the acupuncture group was larger. Conclusion Acupuncture combined with SSRIs can significantly improve anxiety state compared to anti-anxiety therapy using SSRIs alone.

Background Posttraumatic stress disorder (PTSD) is one of the chronic and disabling psychiatric disorders, particularly in combat veterans. In a case series, rivastigmine was suggested to be an effective augmentation in treatment of PTSD. The aim of the present study was to evaluate this finding in a randomized controlled trial. Method A 12-week, double-blind, placebo-controlled clinical trial was performed on 36 male patients (aged 42-60 years) diagnosed with chronic, combat-related PTSD. Subjects were screened for apparent cognitive deficits by means of Mini-Mental State Examination. All patients received selective serotonin reuptake inhibitors plus sodium valproate for 4 weeks and then reevaluated. Subjects who did not show adequate response were randomly assigned into 3 groups receiving rivastigmine (up to 6 mg/d), placebo, or the prior treatment regimen. Efficacy of medication was measured by administering PTSD Check List-Military Version at baseline and weeks 2, 4, 8, and 12. Collected data were analyzed by analysis of variance and repeated measurement. Reported differences were considered significant at the level of 0.05 or less. Results The 3 groups showed statistically significant reductions in the total PTSD Check List-Military Version, avoidance subscale, and the reexperience subscale but not in the hyperarousal subscale. No significant differences were found between the 3 groups. Conclusions In contrast to the previous case series, findings of the current study did not support the efficacy of adjunctive rivastigmine in treatment of PTSD. This hypothetically could be due to the fact that all the study's subjects scored higher than 25 on Mini-Mental State Examination.

Suicidal behaviors are serious public health problems. The prominent association of mood disorders with suicide, along with the renaissance of the spectrum concept of psychiatric disorders in the recent decades, prioritizes the investigation of temperament variants in suicidal individuals. This study aimed to explore the relationship between affective temperaments and nonviolent suicide attempts. We administered Temperament Evaluation of the Memphis, Pisa, Paris, and San Diego Auto questionnaire (TEMPS-A) to 141 (27 males and 114 females) consecutive self-poisoning non-lethal suicide attempters at a Medical Toxicology Center and a sex and age matched group of healthy individuals (28 males, 112 females). Female suicide attempters scored significantly higher in depressive, cyclothymic, irritable, and anxious temperaments compared with female controls, whereas male cases’ scores were significantly higher in depressive and anxious subscales compared with control males. Except for hyperthymic temperament which did not reveal any significant effects, depressive (OR: 11.5), cyclothymic (OR: 3.8), irritable (OR: 2.3), and anxious (OR: 8.8) temperaments were predictors for nonviolent suicide attempts. Therefore, this study replicated the evidence for the strong association of depressive temperament with suicide attempts. The hyperthymic temperament appeared to have neither protective nor predisposing influence. Further studies are needed to identify the role of this independent temperament.

The purpose of the present study was to identify the prevalence of sleep disturbances in ESRD, and to compare the sleep quality before and after kidney transplantation.A semi-experimental study was performed on 40 participants with ESRD from September 2017 to September 2018 in Mashhad, Iran. Participants were in the waiting list of kidney transplantation, aged 18-years-old or more, had no history of any major psychological problems. They were excluded from the study if new medical condition or psychiatric disorder was initiated throughout the study. Patients' medical information including the duration of dialysis and laboratory data was extracted from medical records. Their sleep quality was assessed with the Pittsburgh sleep quality index (PSQI) within1-month prior the kidney transplantation and at the 3rd and 6th months after it. Collected data was analyzed using SPSS-16. P.05 considered as significant.The frequency of poor sleepers was 37.5%, 37.5%, and 20.0%; before the kidney transplantation, 3 months and 6 months after the surgery; respectively. The average sleep quality score decreased significantly 6-month post-operation compared to pre-transplant phase (P0.05). We found a significant relationship between the gender and quality of sleep before transplant surgery, whereas no correlation was found between sleep quality and the age, type or duration of dialysis, serum phosphorus or hemoglobin level, and the cause of kidney failure (P.05,.05,.05,.05,.05,.05, and.05; respectively).Kidney transplantation has a positive effect on patients' sleep quality after 6 months.

INTRODUCTION: Academic burnout is one of the issues involving the educational systems at all levels, which wastes the human resources and expenditures. Academic burnout refers to the sense of exhaustion due to educational requirements, the sense of cynicism and indifference, and the sense of lack of competence. Considering the fact that burnout has already been studied in different professions and in cultures different from that of ours, there is a need to identify these factors among the Iranian medical students and accordingly propose some strategies to reduce burnout symptoms among these students. With this end, this study aimed to identify and quantify the importance of possible factors causing burnout among medical students in the 2nd and 4th years of their studies in Mashahd University of Medical Sciences and provide some suggestions. METHODS: The present research is a cross-sectional study conducted in 2017. The participants included medical students who had entered Mashhad University of Medical Sciences in Iran in 2013 and 2015 and were in their 4th and 2nd year of their studies in the university. A questionnaire prepared and validated by Maslach et al. was used to collect the data and distributed among 195 participants who were selected randomly as the sample. RESULTS: The results showed that the mean scores given by 195 selected respondents regarding emotional exhaustion, indifference, and inefficiency were respectively 3.89, 3.87 and 4.12 out of 7. CONCLUSION: Based on the results, students had the highest level of academic burnout in personal inefficiency or incompetence component and the lowest level was observed in indifference. Therefore, burnout and its components were explicitly seen among medical students; the authorities are recommended to take measures to reduce academic burnout among the students.

Introduction: While Restless leg syndrome (RLS) is a common sleep related movement disorder with a negative impact on sleep, quality of life and health, it may remain underdiagnosed for years. This study aims to evaluate RLS in military veterans with post-traumatic stress disorder (PTSD) suffering from sleep disturbances. Material and methods: Thirty-One Iranian male military veterans diagnosed with PTSD entered this study. None of them had diabetes, Parkinson’s disease and renal failure or were taking medications affecting RLS. Daytime sleepiness, anxiety and depression, RLS severity and the risk of obstructive sleep apnea (OSA) were assessed by standard questionnaires. Results: The mean age was 51.6 ± 6.1 years. The most common complaint was difficulty falling asleep. Eight individuals (25.5% of participants) had RLS. All of them had evidence of OSA based on the STOP-BANG questionnaire. The severity of RLS was not associate with sleepiness, depressive symptoms and body mass index (BMI), but with anxiety symptoms. Conclusion: RLS should be taken into consideration in veterans with PTSD, particularly in those with sleep disturbances including insomnia, sleep related movements and sleep apnea.

Involvement of personality traits in susceptibility to suicidal behaviour has attracted considerable research interest over the past decades. This study was motivated by reports that emotionality may play a potentially confounding role in the association between the personality profile and suicidal behaviour. We assessed the association between personality traits, as measured using the Temperament and Character Inventory (TCI), and suicidal behaviour, while controlling for the effects of Affective Temperaments, measured using the Temperament Evaluation of the Memphis, Pisa, Paris and San Diego auto-questionnaire (TEMPS-A) in a sample of 140 consecutive self-poisoning nonlethal suicide (SNS) attempters admitted to the Emergency Toxicology Clinic, comparing them with a sample of 140 age and sex matched healthy controls. After controlling for Affective Temperaments, the temperament dimension of Novelty Seeking (NS) and the character dimensions of Self-directedness and Self-transcendence remained significantly associated with SNS attempts. NS, in particular, was most consistently and uniquely associated with suicidal behaviour. The present study conveys the difficulty in disentangling the personality profile of SNS attempters from their emotionality. We conclude that the risk associated with certain personality traits is often entirely mediated by Affective Temperaments and few dimensions independently contribute to the risk of self-poisoning nonlethal suicidal behaviour.

Background: Neurodegenerative effects of illicit drugs have been proposed in many investigations. Amyotrophic lateral sclerosis is a fatal motor neuron disease characterized by degeneration of motor neurons, but the risk of amyotrophic lateral sclerosis among drug abusers is unknown. Methods: A nested case–control study was conducted in a teaching hospital to examine the association between drug abuse and amyotrophic lateral sclerosis. The study population included persons 18 to 40 years of age who were admitted in an electrodiagnostic medicine clinic for more than two year during the study period (January 2013 through April 2015) For each subject with ALS, 2 smoking-matched controls without ALS were randomly selected from the same population. Self-reported history of drug abuse was acceptable in both groups. Results: A total of 17 persons with ALS and 34 controls were identified, of whom 10 (58.8 percent) and 8 (23.5), respectively, had history of drug abuse. Persons with history of drug abuse had an increased risk of ALS (adjusted odds ratio, 2.6; 95 percent confidence interval, 1.2 to 5.7) as compared with controls. Conclusion: Drug abuse is an important risk factor for ALS, at least among young adults. The risk among drug abusers was at least or about double that among control group. The burden of mortality due to background ALS in drug abusers needs to be determined in future investigations.

BACKGROUND: Parental substance abuse confronts children with a variety of psychological, social, and behavioral problems. Children of substance abusing parents show higher levels of psychiatric disorders including anxiety and depression and exert lower levels of communication skills. Weak social skills in this group of adolescents put them at a higher risk for substance abuse. Many studies showed school based interventions such as life skill training can effective on future substance abusing in these high risk adolescences. MATERIALS & METHODS: The participants consisted of 57 middles schools girls, all living in rural areas and having both parents with substance dependency. The participants were randomly assigned to intervention (n=28) and control (n=29) groups. The data were collected before and six weeks after training in both group. The intervention group received eight sessions of group assertiveness training. Participants were compared in terms of changes in scores on the Oxford Happiness Questionnaire and the Gambrills-Richey Assertion Inventory. RESULTS: The total score for happiness change from 43.68 ±17.62 to 51.57 ±16.35 and assertiveness score changed from 110.33±16.05 to 90.40±12.84. There was a significant difference in pretest-posttest change in scores for intervention (7.89±4.13) and control (-2.51±2.64) groups; t (55) =2.15, p = 0.049. These results suggest that intervention really does have an effect on happiness and assertiveness . CONCLUSION: Determining the effectiveness of these school based interventions on other life aspects such as substance abuse calls for further study on these rural adolescent girls.

Background and objective: Among substances that have a significant effect on sleep are stimulants, including amphetamines. As there are few studies assessing sleep quality in methamphetamine withdrawal this study aims to evaluate changes in sleep quality of methamphetamine dependent patients during early remission period by controlling depression and anxiety as confounding variables. Methods: This study was conducted in Mashhad, Iran. Ninety amphetamine dependent patients, who were admitted in residential centers during 2012–2014 and met our inclusion criteria, were chosen by purposive nonprobability sampling method. Sleep quality was assessed by Pittsburg sleep questionnaire, in the first, second, and after the fourth week of abstinence. Additionally all participants were assessed by Beck Depression Inventory-2 and Beck Anxiety Inventory for controlling depressive and anxiety symptoms. Results: The prevalence of improper quality of sleep was very high (97.8%) within the first week of withdrawal, but it reduced considerably four weeks after abstinence (52.2%), which was statistically significant (P=0.00). The variations of depression and anxiety levels within four weeks after quitting methamphetamine, have low impact on variation of patients' sleep quality (adjusted R2

Background: Some studies have demonstrated high cognitive deficits in patients with post-traumatic stress disorder (PTSD). Considering the limited available information about this issue, we decided to assess the cognitive deficits and memory disturbances in these patients.Materials and Methods: The present study is a case control research conducted on 50 patients with post-traumatic stress disorder who were admitted to Ibn-e-Sina psychiatric hospital in Mashhad, in north-eastern part of Iran in 2008. The control group included 50 people of first degree relatives of these patients who met the inclusion criteria of the study. Case and control groups were selected by simple sampling method; and for all of them, a questionnaire of demographic information, Wechsler memory scale, and mini mental status examination (MMSE) were completed. The gathered data were analyzed using SPSS 14th edition by chi square, t-test, and analyze of variance.Results: The mean score of Wechsler memory scale in patients with PTSD (80.78±18.39) was significantly higher than control group (67.92±7.38) (p=0.001). The mean score of MMSE was significantly lower in patients with PTSD compared to control group (p=0.001). The determined disability level assessed by Iranian veterans’ organization and also comorbidity of other psychiatric disorders with PTSD did not have a significant relationship with cognitive deficits, but the duration of PTSD and age of patients were significantly related to the level of cognitive deficits.Conclusion: Cognitive deficits and memory disturbances are higher in patients with PTSD than general population.

Background: Substance dependence disorder is a psychiatric disorders with different factors that influence its nature, severity, outcome, and treatment options. Objectives: This study evaluates the effectiveness of Acceptance-Commitment Therapy (ACT) to decrease anxiety and depression in patients with opioid dependencies who are undergoing methadone maintenance treatment (MMT). Materials and Methods: The present study was done in Mashhad from 2011-2012. Twenty-eight patients (18-50 yr) with opioid dependency who were on MMT were selected using purposive sampling and were divided equally between case and control groups. The case group received 8 sessions of individual psychotherapy with ACT. The level of depression and anxiety of these patients were measured using the Beck Depression Inventory-II and Beck Anxiety Inventory before the initiation of ACT as a pretest, 2 weeks after the termination of ACT as the posttest, and 3-months after the termination as a follow-up. The collected data was analyzed with SPSS (ver. 20) using χ2, paired t-test, ANOVA, and MANOVA. Results: The pretest-posttest-follow up of anxiety showed no significant differences between the two groups (P = 0.05); however, the case group had lower depression scores in the posttest and follow-up than the control group (P = 0.04). Evaluating the results of the case group revealed that depression significantly decreased in the posttest group when compared to the pretest (P = 0.01) and there were no significant decreases in the follow up compared to the pretest (P = 0.34). Conclusion: Short-term ACT for opioid dependent patients on MMT are not associated with a significant decrease in the level of anxiety; however, it is associated with a significant decrease in the level of depression. Nonetheless, this reduction was not maintained long term.