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Background: Anxiety persists following coronavirus disease 2019 (COVID-19) and has caused dysfunction. Objectives: We compared the effect of the online Balint group and pharmacotherapy on COVID-19-induced anxiety in Iranian healthcare workers (HCWs). Methods: In the current clinical trial in the north of Iran in 2021, the participants were randomly assigned to two groups, including the Balint group (eight 60-minute online sessions) and the pharmacotherapy group (sertraline), following a phone screening procedure by a psychiatrist. The groups filled out two questionnaires, namely the Connor-Davidson Resilience Scale and Corona Disease Anxiety Scale, at baseline and after the intervention (fourth week). Results: Forty-five HCWs were assessed. There was a significant difference in total anxiety score and also in sub-component in each group (P ≤ 0.001). No significant differences were observed regarding the effectiveness of both interventions in anxiety (P = 0.52); however, the pharmacotherapy interventions significantly affected the resilience and related subscales (P ≤ 0.05). The domain of spiritual influences significantly increased in the pharmacotherapy group (P = 0.031). Conclusions: Balint group and pharmacotherapy can improve COVID-19-induced anxiety and boost resilience in HCWs.

Background Patients with Substance use disorder have distinct personality traits, they were high score in novelty seeking (NS) and sensation seeking and lower in Self-directedness and higher in Self-transcendence, so we aim to investigate the relationships of temperament and characteristics with related some variables such as substance of choice. Design and setting A case–control study enrolling 70 Substance use disorder patients and 70 controls was conducted at Mashhad University of medical sciences. Methods Using a case–control design, a group of 70 Substance use disorder patients and 70 controls was conducted at Mashhad university of medical sciences. All participation completed the 240 questions of Temperament and Character Inventory-Revised (TCI-R). Multivariate analysis of covariance (MANCOVA) was employed to compare the relationship between temperament and character traits and patterns of substance use. Results The scores of reward dependence, persistence, self-directedness, cooperativeness, and self-transcendence were significantly lower in the case group compared to healthy individuals (P P P = 0.637). Conclusions Higher NS in patients with substance use disorder is common and different traits, and temperaments would choose different substance combinations.

Introduction: Inflammatory processes in the brain play an important role in the etiopathogenesis of Obsessive-Compulsive Disorder (OCD). Cyclooxygenase inhibitors, such as celecoxib reduce the production of proinflammatory cytokines. This double-blind study aimed to investigate the effects of adding celecoxib to Selective Serotonin Reuptake Inhibitors (SSRIs)on treating OCD. Methods: Sixty patients who met the diagnosis criteria for OCD based on the Diagnostic and Statistical Manual of Mental Disorders -Fourth Edition- Text Revision (DSM-IV-TR) were recruited in the present study. Two psychiatrists independently confirmed the diagnosis by performing structured interviews. The study participants included 23 patients who received SSRIs and celecoxib (400 mg twice daily) and 22 patients in the control group that received SSRIs and placebo. Moreover, at baseline, in weeks 4, 8, and 12, the explored patients were assessed by a psychiatrist using the Yale-Brown Obsessive-Compulsive Scale (Y-BCOS). Results: A significant difference was observed in the change of scores on the Y-BOCS in week 12, compared with the onset of the study between the study groups (t= -8.976, df=38, P=0.001). There was a significant difference between the study groups in obsession (F= 49.19, df= 1, P≤0.001), compulsion (F= 13.78, df= 1, P= 0.001), and OCD (F= 57.25, df= 1, P≤0.001), i.e., higher in the celecoxib group. Conclusion: This study showed that adjuvant treatment with celecoxib can further improve the symptoms of OCD in individuals receiving SSRIs.

BackgroundManagement of analgesia and hemodynamic status is essential for orthopedic surgery patients. This study aimed to determine the effect of intrathecal (bupivacaine + magnesium sulfate) versus (pethidine + magnesium sulfate) and sole pethidine on the hemodynamic status and onset and duration of sensory/motor block in patients with lower limb fractures.MethodsThis double-blind randomized clinical trial was done between October 2020 and August 2021 in the Gorgan 5thAzar, Hospital, northeastern Iran and included 120 patients undergoing orthopedic surgery with spinal anesthesia and divided them in four groups of A: bupivacaine (10 mg), B: (pethidine 1 mg / kg), C: (bupivacaine 10 mg + magnesium sulfate 100 mg), and D: (pethidine 1 ‌mg / kg + magnesium sulfate 100 mg). The recorded parameters were hemodynamic parameters, time of onset, and duration of sensory/motor block.ResultsThere were no clinically significant differences in hemodynamic parameters between the groups. The onset of sensory block (P = 0.235), the onset of motor block (P = 0.097), and the duration of motor block (P = 0.135) were not statistically different between the groups; however, there was a significant difference in the duration of sensory block between the groups (P = 0.035). Magnesium sulfate increased the duration of motor block in the pethidine group C (80.93 ± 30.28) and decreased it in the bupivacaine group D (75.23 ± 38.56).ConclusionsThe intrathecal drugs used in the study did not cause any specific side effects. Therefore, these drugs can be used interchangeably. Magnesium sulfate, in combination with bupivacaine reduced the duration of sensory/motor block. While in the pethidine group, it acted as suitable analgesia by increasing the duration of sensory block. Therefore, magnesium can be considered a suitable additive for intrathecal pethidine.Trial registration: Iran clinical trial register: (IRCT20170413033408N3) Registration date: 2020-06-11

Background: Schizophrenia is a devastating condition characterized by recurrent recurrences, cognitive decline, emotional and functional disabilities. This condition includes positive and negative symptoms and cognitive impairment that are very resistant to drug treatment. According to studies, many biomarkers can affect this disorder. However, there is little information about vitamin D and homocysteine levels in patients with disease complications. In the current study, we aimed to investigate this relationship in schizophreniaMethod: This is a case-control study. Thirty-three patients with schizophrenia and 33 healthy individuals from north of Iran-Golestan in 2021 were analyzed. Blood samples were taken from all participants to assess serum levels of vitamin D and homocysteine. In addition, schizophrenic patients completed the Positive and Negative Syndrome Scale (PANSS) and Simpson-Angus Extrapyramidal Side Effects Scale (SAS) questionnaires. Data analysis was performed at a significance level of 0.05 using SPSS 16 software.Results: Of the 66 participants, 66.7% had vitamin D deficiency, and 71.2% had normal homocysteine levels. However, the serum level of vitamin D in schizophrenic patients was lower than in controls (p= 0.035) and serum homocysteine ​​levels were higher in the schizophrenic group than in the control group (pp=0.04). The data obtained did not show a significant relationship between vitamin D and homocysteine ​​levels and PANSS test results (p= 0.3 and 0.8).Conclusion: Serum levels of vitamin D and homocysteine in schizophrenic patients were significantly lower and higher than in the control group, respectively. Improvement of extrapyramidal symptoms in schizophrenic patients has a direct and significant relationship with serum vitamin D.

Background and objectives: Mental disorders during pregnancy and postpartum period can affect the quality of life of mother, baby and the whole family. Psychoeducation can be offered to those at risk to prevent or reduce the incidence of these disorders, but the most appropriate time for such intervention is not determined yet. The aim of this study was to evaluate the effectiveness of a psychoeducation intervention 48 hours before delivery on postpartum general health and to identify the potential role of family in reducing the incidence and severity of these disorders. Methods: This randomized clinical trial was conducted on 80 pregnant mothers admitted to maternity ward of Shahid Sayyad Shirazi Hospital in Gorgan, Iran. Subjects were randomly divided into an intervention (n=40) and a control (n=40) group. Subjects in the intervention group and their spouses received education on postpartum mental health 48 hours before the estimated delivery date. The control group received no education. Data were collected using a demographic questionnaire and the general health questionnaire-28 (GHQ-28) at baseline and at 2nd and 4th week postpartum. Data were analyzed using SPSS (version 18) at significance level of 0.05. Results: The mean age was 26.3±5.6 years in the intervention group and 27.9 ± 5.1 years in the control group. There was no significant difference between the groups in terms of age, pregnancy order, number of abortions, type of delivery and history of addiction at baseline. The total GHQ-28 score significantly decreased from baseline to the fourth week postpartum in both groups (P=0.001). There was no significant difference between the groups in terms of total GHQ-28 score reduction (P>0.05). In addition, there was no significant difference between the groups in terms of change in GHQ-28 subscale scores over time. Conclusion: The findings of this study indicate that short-term educational intervention, 24-48 hours before delivery, is not effective in improving mental health in the postpartum period. Therefore, educational interventions should be conducted either weeks before or after delivery.

Background: Alopecia areata is a dermatological disorder that is more prevalent among the pediatric population. This disease has been linked to behavioral problems in both pediatrics and adults. However, the behavioral problems of the pediatric population have not been widely studied. The present study aimed to evaluate the behavioral problems among the pediatric population in the north of Iran. methods: This case-control study was carried out on the 90 children aged 4-13 who have been chosen by simple sampling and equally enrolled in three study groups; Alopecia areata, another skin disease, and healthy children. The parent’s version of the strengths and difficulties questionnaire (SDQ) was used, and P Results: The mean age of the patients with Alopecia, other diseases, and healthy population were 9.27, 8.43, and 9.93 years, respectively. The total difficulty score was not significantly different between the alopecia patients and patients with other diseases (p=0.137). The total difficulty score was significantly different among those with alopecia areata and those with other diseases and the healthy population (p=0.003 and p=0.045). Emotional symptoms of conduct problems and peer relationship problems were common in children with alopecia areata compared to the healthy population (p=0.004, p=0.019, and p< 0.001, respectively). Conclusions: The pediatric patients with alopecia areata have an increased level of behavioral problems compared to the healthy population. Therefore, pediatric patients with alopecia areata need psychiatric assessments alongside treating their dermatologic concerns.

The grief caused by loved ones’ death causes grief is a global phenomenon. The Covid-19 pandemic caused significant changes in human lifestyles and the experience of grief. The purpose of the present study was to compare grief experiences in the deceased's relatives caused by Covid-19 and non-Covid-19. Seventy-five first- and second-degree relatives of the deceased infected with Covid-19 (n = 33) and non-Covid-19 (n = 42) in a Gorgan hospital in northern Iran were included cross-sectional study using convenience sampling. Data were collected using the GEQ-34 grief experience questionnaire and demographic variables and questions related to funeral and burial. The results revealed that the deceased's burial quality caused by the Covid-19 group was significantly lower (p = 0.035). However, the feeling of the Covid-19 label is significantly higher (p 0.05). Nevertheless, the experience of grief was significantly different in the group of relatives of the deceased infected by Covid-19 in terms of notoriety (P = 0.040) and physical reactions (p = 0.002). Educational interventions to reduce stigma and discrimination due to death caused by Covid-19 and clinical and psychological support of relatives of the deceased due to Covid-19 are recommended by compiling appropriate messages from different channels.

Background: An increase in symptoms of anxiety is already being reported in relation to the COVID-19 pandemic.Objectives: We aimed to compare the effectiveness of Balint group work with pharmacotherapy in coronavirus related anxiety among healthcare workers (HCWs) in Iran.Methods: In This pilot clinical trial, after passing a phone screening procedure by a psychiatrist, subjects were quasi-randomly assigned to Balint (8 sixty-minute online sessions) or pharmacotherapy (Sertraline) groups. Both groups were asked to fill two questionnaires, including the Corona Disease Anxiety Scale (CDAS) and Connor-Davidson resilience scale (CD-RISC), at the beginning and the end of the 4-week intervention period.Results: A total of 45 HCWs enrolled in this study. The results showed a significant difference between the post-test and pre-test scores of both groups in the total scores of anxiety and its subcomponents (p≤0.001). There was no significant difference between the effectiveness of the two interventions on anxiety (p=0.52). Both interventions had a significant effect on the subjects' resilience and its subscales (p≤0.05) except for positive acceptance change. The spiritual influences domain had a significantly higher increase in the pharmacotherapy group (P=0.031).Conclusions: We showed Balint group work maybe can better to pharmacotherapy with Sertraline in management of COVID-19 related anxiety and boosting resilience in healthcare workers.

Somatic symptoms are one of the most common complaints among patients with psychiatric disorders and are considered as one of the most common psychiatric disorders in the new coronavirus pandemic. This study aimed to evaluate the effect of the COVID-19 pandemic on the physical symptoms in patients with mood disorders and compare it with healthy individuals. In this case-control study, 67 patients with mood disorders were referred to the psychiatric clinic of 5 Azar Hospital in Gorgan, who met the inclusion criteria, and 68 healthy individuals as control group were entered into the study. For all participants after informed consent, a demographic information questionnaire was completed along with Screening for Somatic Symptoms-7 (SOMS7) and Patient Health Questionnaire-15 (PHQ-15), and the data were analysed by SPSS software version 25. The mean score obtained for the SOMS-7 questionnaire for the group of patients with mood disorders and the control group was 32.37 ± 8.19 and 35.42 ± 11.3, respectively. The mean obtained for the PHQ-15 questionnaire for the mood disorders group and the control group was 8.56 ± 5.93 and 5.86 ± 4.63, respectively. In the mood disorder group, 26.9% of patients had no risk for physical symptoms, 31.3% of patients had a low risk, 25.4% of patients had a moderate risk, and 16.4% of patients had a high risk for physical symptoms. The statistical test showed that although the risk of physical symptoms was high in both groups, this rate was higher in the group with mood disorders, and there is a significant difference between the two groups (P < 0.05). The results also showed a significant and direct relationship between the two questionnaires (P < 0.05). According to the results, although the prevalence of somatic symptoms increased in both groups, the prevalence of somatic symptoms is significantly higher in the mood disorder group.

Background: The outbreak of coronavirus disease 2019 (COVID-19) pandemic has led to public panic and psychological problems. In this regard, few studies have reported the post-discharge mental health status of COVID-19 survivors. Objectives: This study aimed to evaluate the mental health status of COVID-19 survivors and determine the risk factors of adverse psychological outcomes. Methods: This cross-sectional study consisted of 188 COVID-19 survivors discharged from hospital. Data were recorded using social media applications. To evaluate the mental health status, Hospital Anxiety and Depression Scale (HADS) and Depressive Anxiety and Stress Scale 42 (DASS-42) were used. Ordinal regression with a logit link was used to assess the simultaneous effect of variables. Results: The mean age of participants was 56.4 ± 9.6 years, and the majority of patients were male (62.2%). According to HADS, 81 (43.1%) and 24 (12.8%) patients suffered from anxiety and depression, respectively. Using DASS-42, we reported at least a mild degree of depression [23 (12.2%)], anxiety [20 (10.6%)], and stress [74 (39.4%)] among the discharged patients. Depression, anxiety, and stress were significantly associated with length of hospital stay (P < 0.05). In addition, there was a direct association between stress and patients’ number of children (β = 0.38, P = 0.02). Conclusions: Depression, anxiety, and stress are relatively high among COVID-19 survivors. Length of hospital stay and number of children were identified as the predisposing factors for adverse psychological outcomes.

Background: Inflammatory processes in the brain contribute to the aetiopathogenesis of acute mania. Cyclooxygenase-2 (COX-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 in the treatment of acute mania.Methods: We conducted a double-blind, placebo-controlled trial at the Specialty in-patient Clinic of Ibn-e-Sina Hospital [Mashhad University of Medical Sciences, Iran] from March 2017 to August 2017. The study involved 58 patients who met the Diagnostic and Statistical Manual of Mental Disorders (DSM-V) criteria for acute mania screening to participate in the trial were used for the study. Twenty-three patients were assigned to a study group and were given Valproate Sodium 200 mg /BD plus Celecoxib 400 mg/day (200 mg BID). The control group included 22 patients who were given Valproate Sodium 200 mg /BD plus placebo. Patients were assessed by Young Mania Rating Scale (YMRS) at baseline 0, after 9, 18, and 28 days after the medication started. Data were analyzed by using Statistical Package for Social Sciences (SPSS) 11.5., two-way repeated measures analysis of variance, Fisher’s exact test, and T-Test. P≤0.05 was considered to be statistically significant.Results: A total of 58 patients were screened and 45 were randomized. Most of participations in celecoxib group were male (55%) and in placebo group were female (75%). There were no statistically significant differences between the groups regarding number of episode. sex, marital status, past medical history, past psychiatry history and family history P value ≥0.05. A significant difference was observed in the change of scores on Young Mania Rating Scale (YMRS) at week 4 as compared to the baseline in patient groups P: 0.04.Conclusion: This study suggested that Celecoxib can be an effective adjuvant agent in managing patients with acute mania and anti-inflammatory therapies should further be investigated in these patients.Trial registration: Iran clinical trial register: IRCT20200306046708N1

Background: Inflammatory processes in the brain contribute to the aetiopathogenesis of acute mania. Cyclooxygenase-2 (COX-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 in the treatment of ACUTE MANIA.Methods: We conducted double-blind, placebo-controlled trial at the Specialty in-patient Clinic of Ibne Sina Hospital [Mashhad University of Medical Sciences, Iran] during March 2014 to August 2014. The study involved 58 patients who met the Diagnostic and Statistical Manual of Mental Disorders (DSM-V) criteria for ACUTE MANIA screening to participate in the trial were used for the study. 23 patients were assigned to a study group and were given valprovate sodium 200 mg /BD plus celecoxib 400 mg/day (200 mg BID). The control group included 22 patients who were given valprovate sodium 200 mg /BD plus placebo. Patients were assessed by yung mania rating scale (YMRS) at baseline 0, after 9, 18, and 28 days after the medication started. Data were analyzed by using Statistical Package for Social Sciences (SPSS) 11.5., two-way repeated measures analysis of variance, Fisher’s exact test, and T-Test. P≤0.05 was considered to be statistically significant. Conclusion: This study suggested that celecoxib can be an effective adjuvant agent in management of patients with ACUTE MANIA and anti-inflammatory therapies should further be investigated in this patients.Trial registration: Iran clinical trial register: IRCT20200306046708N1 Registered on 2 October 2019.

Background Empathy is one of the essential components of physician-patient relationship that has a significant effect on treatment outcomes. Objective The aim of this study was to assess the empathy score among medical students in Mashhad, Iran. Methods In this cross-sectional study in 2015, 624 medical students at Mashhad University of Medical Science (Iran) completed the Jefferson Scale of Physician Empathy (JSPE). Data were analyzed by SPSS ver. 16, using independent-samples t-test, Chi-square, MANOVA, Spearman correlation, and Confirmatory factor analysis. Results Of the 38.4% males and 65% females who participated in this study, the mean score of JSPE in the sample was 103.67 (±15.34) which was higher in women than in men. Also, the mean scores for each of the three factors of the scale were calculated. The total empathy score, compassionate care, and taking perspectives among different age groups were significant (p=0.000). Furthermore, students having high interest in their field were more empathic (p=0.008). Empathy of interns in relation to three areas of basic sciences (the first year, the second year and the first half of the third year), physiopathology (the second half of the third year, and the fourth year), and clinical trainings (the fifth year, and the first half of the sixth year), experienced significant reduction (p≤0.001). Conclusions This study showed that empathy was higher in women in their first medical year and who were of younger age. The overall rate of empathy in the basic sciences period was more than that in the clinical period. Therefore, the initial exposure to clinical education, especially patient education and empathy, has a very prominent effect on the ability of medical students.

Introduction Empathy, an essential component of the physician-patient relationship, may be linked to positive patient outcomes. This study aimed to determine the empathy score among student residence assistants (RAs). Methods In this descriptive design (cross-sectional study), 102 Iranian RAs participated in the study during 2015, completing the Jefferson Scale of Empathy (JSPE). Data collection was analyzed using SPSS version 17. MANOVA, independent-samples t-test, Spearman correlation and confirmatory factor analysis (CFA) were used for data analysis. Results Mean score of JSE in the sample was 87.06 (±15.14). The mean scores for perspective taking, compassionate care, and standing in the patients shoes were 38.90 (±13.11), 39.27 (±7.94), and 8.89 (±2.80) respectively. Among the three specialties, (psychiatric, internal medicine, surgery) results showed significant differences in total empathy score (p=0.001) and perspective taking score (p= 0.008). Conclusions this study showed significant differences in total empathy score and perspective taking in three specialties. We suggest that the curriculum in Iranian RAs include more teaching on empathy and communicational skills.

Methadone is a drug associated with the development of prolonged Correcred QT (QTc) interval, as QT interval prolongation can occur in up to 15% of methadone-maintenance patients. In recent years, methadone found to be associated with an increased risk of sudden death in a community-based study (1, 2). ‘‘Torsades de Pointes’’ is a quick and dangerous rhythm that quickly becomes ventricular fibrillation. If this rhythm is rapid or prolonged, it can lead to ventricular fibrillation or sudden cardiac death. The usual clinical manifestations of TdP are palpitations, dizziness, and syncope. It is certain that no cardiac drugs are recognized to increase the propensity for TdP. The most common risk factors of methadone-associated QT prolongation and TdP include a high dose of methadone or chronic use, old age, accompaniment with enhancing drugs methadone levels, infections such as AIDS, old age, low potassium, kidney failure, heart disease, female gender, and cirrhosis of the liver (3). Despite the availability of methadone for over 60 years, only in the past 10 years has this medication received attention for its potential to cause QTc prolongation leading to Torsades de Pointes (4-6). We report 4 cases of methadone-induced Torsades de pointes. Through rapid taper of methadone, the patient’s ECG normalized.

Background: Schizophrenia is associated with increased cardiovascular morbidity. Asymmetric dimethylarginine (ADMA) has been suggested as a cardiovascular biomarker. Treatment with atypical antipsychotics can increase some traditional risk factors of coronary artery disease. In addition to traditional risk factors, this study is carried out as a comparison of serum levels of ADMA and non-traditional factors among patients who take two types of atypical antipsychotics. Methods: In this clinical study, 57 schizophrenic patients with multiple episodes and 20 healthy voluntaries that fulfilled inclusion and exclusion criteria were entered into the study. The patients were divided into 3 groups (18 patients received risperidone alone, 20 patients received clozapine alone and 19 patients did not receive any drug). Plasma concentrations of ADMA, high-sensitivity Creactive protein (hs-CRP) and homocysteine were measured through enzyme-linked immunosorbent assay (ELISA), and traditional risk factors of metabolic syndrome were measured. Results: Mean age of participants was 46.08±12.54 years. Moreover, the traditional (High-density lipoprotein (HDL), total cholesterol, waistline, and Body Mass Index (BMI)) and non-traditional factors (Homocysteine, hs-CRP) and ADMA were higher in patients with schizophrenia compared to healthy group (p≤ 0.05). Also, in the clozapine group, all mentioned non-traditional factors and ADMA were significantly higher than other groups (p≤ 0.05). Conclusion: In the clozapine group, levels of non-traditional factors and ADMA were significantly higher which indicates these patients are at risk of cardiovascular disease.

Due to industrialization and sedentary life, incidence of type 2 diabetes (DM2) is increasing seriously. Repaglinide is a glucose reducing agent that predominantly reduces post-prandial glucose. Continuous glucose monitoring system (CGMS) monitors blood glucose excursions over a 3-day period. CGMS can be used as a therapeutic and diagnostic instrument in diabetics. There are not enough studies about using CGMS in DM2. The aim of this study was to determine the blood glucose excursions in patients with new onset of DM2. 10 patients with new onset of DM2 were entered to this study. As the first therapeutic management, patients received diabetic diet and moderate exercise for 3-weeks, if they did not achieve blood glucose goal (Fasting blood glucoser (FBG)

Background: Substance dependency is a major problem for the general health of a society. Different approaches have investigated the substance dependency in order to explain it. Gray’s reinforcement sensitivity theory (RST) is an advanced and important neuropsychological theory in this area. Objectives: The aim of this study was to compare three systems of the revised reinforcement sensitivity theory the behavioral activation system (r-BAS), the revised behavioral inhibition system (r-BIS), and the revised fight/flight/freezing system (r-FFFS) between patients dependent on methamphetamine and opiates, and a group of controls. Patients and Methods: This research was a causal-comparative study that was conducted in the first six months of 2012. The population of the study was males of Mashhad city, who were dependent on methamphetamine or opiates, and ruling out psychotic disorders and prominent Axis II. Twenty-five people were selected by the convenient sampling method. Also, 25 non-dependent people from the patients’ relatives were selected and matched for the variables of age, gender, and education to participate in this study. Participants were evaluated using a structured clinical interview (SCID) for DSM-IV, demographic questionnaire information, and a Jackson-5 questionnaire (2009). Data were analyzed by Chi-square, K-S, and independent t-test. Results: The methamphetamine dependent group had a higher sensitivity in the r-BAS, r-BIS, and the r-Fight and r-Freezing systems compared to the control group (P < 0.05). However, there was no significant difference in r-Flight between the two groups (P > 0.05). “The scores of r-BIS were also significantly higher in the methamphetamine-dependent group than the opioid-dependent and control groups. For the r-Fight variable, the methamphetamine-dependent group was higher than the opioid-dependent group”. Conclusions: The personality patterns of patients dependent on methamphetamines were different from the controls. These people have a high sensitivity to punishment cues, such as being compared in social conditions and a tendency for reinforcement and reward, because of their higher sensitivity in the behavioral inhibition and activation systems.

Background: Antidepressant-induced sexual dysfunction (SD) is a common problem, associated with a significant risk of non-adherence. Selective Serotonin Reuptake Inhibitors (SSRIs) are associated with a substantial risk of SD. Only 10 % of patients show spontaneous improvement during follow up period. Objectives: This study aimed to compare two proposed medication (bupropion vs. amantadine) in alleviating SD in patients treated with SSRIs. Patients and Methods: In a randomized, single-blinded, clinical trial in Iran, 46 patients were recruited based on DSM-IV-TR criteria and semi-structured interview. Then, they were randomized into two treatment groups using table of random numbers. Eight patients were excluded and finally 38 patients completed the study which lasted for 4 weeks. Twenty patients were given bupropion, 18 patients were randomly assigned to another group, and given amantadine. Patients were assessed with the Arizona sexual experience scale (ASEX) at baseline and 4 weeks after the treatment. Results: A total of 38 patients completed the study (18 patients in amantadine vs. 20 patients in bupropion).The mean ASEX scores gradually declined in both study groups during the trial. The reduction of ASEX score in bupropion group was more than that of amantadine group that was statistically significant. So, the addition of bupropion at higher doses appears to be more effective approach in comparison with amantadine. Conclusions: These results provide empirical support for conducting a further study on comparing different add-on strategies for treating drug-induced SD.

Background: Anxiety is one of important disorders of mental health in children and adolescents which is influenced by various endogenous and environmental factors. The aim of this study was a comparative survey of anxiety level in primary school children with working and unemployed mothers in Gorgan in 2013. Materials and Methods: In this descriptive-analytical and cross-sectional study, 745 male and female primary school students in public and private schools in Gorgan were selected using a combination sampling (stratification and clustering). For data collection were used Spence Children's Anxiety Scale (SCAS) included 38 questions. The collecting data were analyzed using SPSS-21 statistical software and chi-square and t tests. P values of less than 0.05 were considered as the significance level. Results: The results showed that the average age of students were 9.4 ± 1.65 and in the 38.4% of them were males and 61/6% were female 61/9% of the students had working mothers and 38.1% of their mothers were unemployed. Spence Children's Anxiety Scale total score for the studied sample was 22.74 ± 12.72. A significant difference was observed between two groups of the students with working and unemployed mothers and between two sexes (P

Introduction: It has been estimated that the metabolic syndrome may predict cardiovascular disease and the occurrence of sudden death, independent of the presence of other cardiovascular risk factors. The aim of the present study was to assess the metabolic syndrome among Turkmen women in this area. Material and Methods: The present study consisted of 160 Turkmen women. Baseline data and prevalence of metabolic syndrome and the components of metabolic syndrome in Turkmen women were determined. Observations and Results: The prevalence of high levels of fasting glucose, low levels of high density lipoprotein-cholesterol, high triglyceride levels, high waist circumference and high blood pressure were shown to be 29.37%, 70.62%, 35.62%, 75% and 26.25%, respectively. It was shown that high waist circumference (75%) and Low HDL-cholesterol levels (70.62%) were the most frequent characteristics in comparison to other metabolic components. The prevalence of high waist circumference, high triglyceride levels, high levels of fasting glucose, high blood pressure and BMIs which were ≥25 were higher in subjects with metabolic syndrome (92.85%, 73.21%, 73.21%, 57.14% and 83.92%, respectively). Conclusion: Metabolic syndrome is more prevalent among Turkmen women. Our data has shown that the prevalence of abnormal waist circumference in this ethnic group was highest. The waist circumference can be used as a predictor for cardiovascular disease and coronary heart disease.

Smoking habits are common in schizophrenic patients. Nicotine can suppress negative symptoms and cognitive impairments. The aim of this study was to determine the efficacy of bupropion on cognitive function in schizophrenic patients. This study is a double blind randomized controlled trial in a large referral psychiatric university hospital in Iran. Ninety smoker schizophrenic patients were randomly allocated (based on DSM -IV TR criteria) in two groups (46 patients for case group and 44 patients in control group). They get risperidone up to 6 mg/d and bupropion up to 400 mg/d .clinical assessment (Positive and Negative Syndrome Scale (PANSS), Brief psychiatric rating scale (BPRS) were taken in beginning of study, 14th and 28th days of study. Cognitive assessment (Stroop, Digit Span, and Wechsler, Wisconsin) were taken in begging of study, the days 2nd, 7th, 14th, 28th. All data were analyzed by SPSS Ver. 17 with analytic and descriptive tests. Mean age of patients was 37.66±1.01. Mean duration of disorder was 11.63±.98 years. The scores were significantly lower at the day 28th compared to the beginning of the study in both groups in Wechsler, Stroop color word , Stroop word , Stroop color , BPRS, PANSS p value ≤0.05 .The difference between the two treatments was not significant as indicated by the effect of group, the between-subjects factor p value ≥0.05. In this study, the side effects were examined and there was no significant difference between the two groups p value ≥0.05. Augmentation of bupropion to routine treatment improves cognitive symptoms of schizophrenia in abstinence of tobacco.

Introduction and aims Diabetes causes life expectancy reduction in to one third of optimal degree.several chronic complications are known for diabetes but psychiatric complications are rarely researched wherea diabetic patients have two times grater risk for mood disorders establishment than general population. So we aim to evaluate the anxiety disorders in diabetic type two patient's reffering to Gorgan's 5th Azar hospital clinic of diabetes in 1391 and then estimate their counter relations with their quality of life Methods and materials A cross sectional study consists of 330 prooved DMT2 patients were referring to Gorgan's 5th azrar hospital clinic of diabetes in 1391. Datas were collected by demographic, Beck Anxiety Inventory & WHOQOL-BREF questionnaires . Tables, Diagrams, Central & dispersion indices were used to describe the Datas. Chi square used for estimating the comparison of QOL between 2 groups . Pearson correlation coefficient also used to demonstrate the relation between QOL and BAI .results and the applied hardware for this purpose was SPSS.(p value = 0/005) Results In this study 35/45% were male and 64/54% were female, There was no significant correlation between anxiety with independent factors. There was just a significan correlation between ' other diseases” and quality of life. Positive significant correlation between anxiety and quality of life were observed. Conclusion Anxiety disorders in patients with diabetes can reduce the overall quality of life, Not only as a factor adversely affecting the mental realm It applies to all areas of quality of life effects, so identification and treatment of these disorders can improve patients quality of life is.