Abstract
Background
The high impact of vitamin D on brain development and its relationship with inflammatory markers in the clinical course of psychiatric disorders have compelled researchers to ...investigate the potential association between vitamin D levels, C-reactive protein (CRP) levels, and the incidence of mental disorders. In the present study, we aimed to compare the serum levels of vitamin D and its related markers, including calcium, phosphorus, and parathyroid hormone (PTH), along with CRP, in 3 groups of patients with acute psychotic episodes, including schizophrenia, bipolar disorder, and methamphetamine-induced psychosis, with a standard control group of the Iranian population.
Methods
This descriptive cross-sectional study was conducted at a psychiatric hospital in Tehran, Iran, and involved a total of 185 subjects. The subjects included four groups: acute phase of schizophrenia (n = 49), acute manic episodes of bipolar disorder (n = 43), methamphetamine-induced psychotic disorder (n = 46), and control group (n = 47). Among 138 patients in acute psychotic episodes, 33 patients were in their first episode of psychosis, while 105 patients were in acute exacerbation of their chronic psychotic disorders. The Brief Psychiatric Rating Scale (BPRS) was measured by an expert attending psychiatrist for all patients. Then, serum levels of calcium, phosphorus, parathormone, vitamin D, and CRP were assessed in all study groups.
Results
Among our 185 study subjects, it was observed that individuals with higher education levels and those who were married had a lower prevalence of mental disorders. In all patient groups, the serum levels of CRP were significantly higher, and PTH levels were significantly lower than in the control group (p < 0.001). The serum levels of calcium, phosphorus, and vitamin D were not statistically significantly different between the patient and control groups of the study. In chronic psychotic patients, CRP levels were significantly higher (p < 0.031), and vitamin D levels were significantly lower (p < 0.044) compared to first-episode psychotic patients.
Conclusion
This study suggests that CRP levels are significantly higher and PHT level is significantly lower in acute psychotic patients. Moreover, vitamin D levels were significantly lower in chronic psychotic patients compared to first-episode psychotic patients.
Introduction: This study aims to compare the positive and negative symptoms of schizophrenia in patients who had psychotic symptoms more than one month after discontinuation of methamphetamine abuse. ...These factors were analyzed by the positive and negative syndrome scale (PANSS) questionnaire. Methods: Sixty participants were selected from patients referred to Iran Psychiatric Hospital with psychotic symptoms (delusions or hallucinations, disorganized behavior, and speech). The control group was 30 patients with schizophrenia based on a semi-structured interview according to DSM-IV-TR (SCID). Thirty patients with a prolonged methamphetamine-induced psychotic disorder were also placed in the case group. For both groups of patients, questionnaires of PANSS, Brief Psychiatric Rating Scale (BPRS), and Global Assessment Of Functioning (GAF) were filled out after obtaining the companions’ consent. The scale scores were compared between groups. We used the Mann-Whitney and the Chi-square test to evaluate the mean values of PANSS, BPRS, and GAF scores between the two groups. Results: here was an insignificant difference in positive and general pathology scores between the two groups, but the total score of negative symptoms in the schizophrenia group was significantly higher than in the group of prolonged methamphetamine psychotic disorders (P=0.034). Average scores of uncooperativeness (0.008), difficulty in abstract thinking (0.004), motor retardation (0.002), unusual thought content (0.001), and hostility (0.011) in the schizophrenia group were significantly higher than those in the prolonged methamphetamine psychosis. Conclusion: The results showed that most of the disturbances in patients with schizophrenia might be more influenced by the expression of cognitive disabilities than those with methamphetamine psychosis. The difference in negative symptom scores suggests that schizophrenia and prolonged methamphetamine psychotic disorder can be two different disorders.
Increasing reports of manic episodes in patients during acute infection with COVID-19 have been documented since the pandemic began, including individuals without a previous personal or family ...history of bipolar disorder. As infections and autoimmunity have putative roles in bipolar disorder, we aimed to document the clinical presentations, associated stressors, family aggregation patterns, and brain imaging and electroencephalographic correlates with a series of patients with episodes of mania that emerged shortly after COVID-19 infections.
We obtained all relevant clinical information from 12 patients whose first manic episode started within a month of COVID-19 infection and were treated at Rasool-e-Akram hospital and Iran psychiatric hospital, two tertiary medical centers in Tehran, Iran, in 2021.
Patients had a mean age of 44. The interval between the onset of symptoms of COVID and mania ranged between 0 and 28 days (mean: 16.25, median: 14 days); it was observed to be shorter in patients with a family history of mood disorders but not in those receiving corticosteroids. Alongside a descriptive overview of our sample, we provide detailed narrative descriptions of two of the cases for illustrative purposes and discuss our observations in the context of other cases reported elsewhere and the state-of-the-art regarding infectious diseases, COVID-19, and bipolar disorder as reported in previous literature.
Our case series documents observational and naturalistic evidence from a dozen of cases of mania in the context of acute COVID-19, which, while limited, calls for analytical research of the phenomenon, and points at a family history of bipolar disorder and the use of corticosteroids as factors for particular focus.
Introduction: Verbal fluency is a cognitive function that can be easily assessed at the bedside and provide valuable data for clinical assessment of various cognitive functions. We decided to provide ...a standardized test to assess verbal fluency in the Persian language, including both phonemic and semantic fluency subtests. Methods: First, three phonemes (/p/, /d/, and /ʃ/) and three categories (animals, fruits, and kitchen appliances) were selected based on a pilot study and a panel of specialists. Then, we selected 500 Persian-speaking participants (47.8% male) aged 18 to 65 years via a convenient sampling method from the general population. Participants were grouped according to age, gender, and education. They performed the verbal fluency test. Results: The Mean±SD number of generated words in letter fluency and semantic fluency was 8.3±4.1 and 18.0±5.5, respectively. Age, educational level, and mother tongue were associated with letter fluency. Semantic fluency was associated with age, gender, education level, and mother tongue. Conclusion: For a more reliable clinical assessment, we suggest using all three letters (phonemes) and three semantic categories for each subject, calculating the mean of the produced words, and comparing them with the suggested cut-off points provided for each subcategory. Age was negatively correlated with the number of generated words in letter fluency (r=-0.33; P<0.001) and semantic fluency tasks (r=-0.26; P<0.001). In the letter fluency task, there was no statistically significant difference between males and females according to the number of generated words (P=0.057). However, in semantic fluency, female participants generated more words (P=0.005). Mother tongue (Farsi) showed a significant effect both on letter fluency (t=5.55, P<0.001) and semantic fluency (t=9.41, P<0.001). Level of education had a significant association with both letter fluency (F=117.23, P<0.001) and semantic fluency (F=64.48, P<0.001).
Moral judgment is a complex cognitive process that partly depends upon social and individual cultural values. There have been various efforts to categorize different aspects of moral judgment, but ...most studies depend upon rare dilemmas. We recruited 25 subjects from Tehran, Iran, to rate 150 everyday moral scenarios developed by Knutson et al. Using exploratory factor analysis (EFA), we observed that the same moral dimensions (except socialness dimension) were driven by the same moral cognitive factors (norm violation, intention, and social affect) in Iranian vs. American studies. However, there were minor differences in the factor loadings between the two cultures. Furthermore, based on the EFA results, we developed a short form of the questionnaire by removing eleven of the fifteen scenarios from each of the ten categories. These results could be used in further studies to better understand the similarities and differences in moral judgment in everyday interactions across different cultures.
Background: This study aimed to compare the efficacy of gabapentin and oxazepam on sleep quality, the severity of anxiety, and pain level in patients admitted to the coronary care unit (CCU). ...Materials and Methods: This double-blind randomized clinical trial was done on the patients with unstable angina (UA) admitted to the CCU of Hazrat Rasool Akram Hospital in Tehran. A total of 56 patients were entered the study and randomly divided into two groups of 26. The first group was given a gabapentin capsule at a dose of 300–1200 mg/day, and the second group was given 10–20 mg of oxazepam tablets per day until hospitalization in the CCU. On the first and 4 th days of hospitalization, Groningen sleep quality score (GSQS), Beck Anxiety Inventory, and severity of pain experienced by Visual Analogue Scale were recorded, and the mean frequency of chest pains was calculated in 24 h during the first 4 days. The amount of drug (morphine) prescription in CCU also compared between the two groups. Results: There was no significant difference in GSQS scores between both groups. The mean score of Beck's anxiety scale did not differ significantly between the two groups. However, the incidence of chest pain was significantly lower in the gabapentin-receiving group than in the oxazepam-receiving group (<0.001). The days that the patients experienced chest pain were significantly less in the gabapentin-receiving group than in the oxazepam-receiving group (<0.001). Conclusion: The results of our study showed that gabapentin compared to oxazepam could significantly reduce chest pain in patients with UA.
Global evidence indicates that transgender people are disproportionately at risk for HIV infection. However, limited data are available characterizing sexual behaviors and HIV infection among ...transgender people in Iran. This study aims to determine the prevalence of high-risk sexual behaviors and HIV infection among transgender people in Iran. In 2009, we assessed data of 58 transgender individuals (41 female-to-male (FTM) and 17 male-to-female (MTF)). Their demographic characteristics and risky sexual behaviors, and other risky behaviors such as substance use were gathered using a structured questionnaire. Rapid tests were used to confirm HIV seropositivity. Fifty-four participants who provided blood samples, none were positive (exact 95% confidence intervals: 0.0, 0.07). 75.6% of FTM and 64.7% of MTF reported having sex in the past six months, respectively. Of the sample who reported having sex in the past six months (n=42), only 19% reported using condoms. No participants reported a history of injection. In this study of HIV infection among a small sample of transgender people in Iran, no one was HIV positive. Some reasons for these findings can be outlined as a lack of history of intravenous drug use and related behaviors, limited high-risk relationships and behaviors, and the limited number of males among the samples.
Background and Objectives: The present study aimed to determine the correlation of male and female gender roles with the big five personality traits and general health in a group of people without ...personality disorders. Methods: In total, 170 participants (85 males), including the staff of Iran Psychiatric Hospital, Tehran Psychiatric Institute, and the psychiatric ward of Hazrat Rasoul Akram Hospital were enrolled in this research. These individuals did not have any personality disorder based on a semistructured clinical interview for DSM-5 (SCID-II). The required data were collected through three questionnaires, namely Gender Masculine (GM) and Gender Feminine (GF) scales of the Minnesota Multidimensional Personality Questionnaire, General Health Questionnaire, and NEO Five-Factor Inventory. Results: In both genders, GM scores were correlated with higher extraversion and lower neuroticism scores. On the other hand, GF scores were correlated with lower extraversion and higher neuroticism in males and lower extraversion in females. Higher levels of masculinity were also associated with higher levels of almost all general health scales in both genders. However, higher levels of femininity were associated with more anxiety and depression in males and higher anxiety and social isolation in females. Conclusion: There were clear correlations between both gender roles and some personality dimensions, including extroversion and neuroticism. Also, higher masculinity in both genders was associated with better general health, but the relationship between femininity and general health was less clear. Mediating and moderating factors have not been investigated in this study.
Other inclusion criteria were: providing an informed consent for participating in the study, being literate to the extent that the individual was able to answer the questionnaires by themselves, ...having the physical ability to complete the questionnaires and to participate in the diagnostic interviews, and the ages of 18-64 years. ...based on the semistructured clinical diagnostic interview based on DSM-IV criteria by a well-educated resident of psychiatry,21 major psychiatric disorders including schizophrenia, schizophreniform disorder, schizoaffective disorder, bipolar disorder type I, and acute mania or major depressive episodes, or substance intoxication were excluded and other psychiatric diagnoses were established. Reaction formation is a kind of reversal defense mechanism, and projection is within a separate category of defense mechanisms.13'19 In two other studies that examined the mechanisms used in IBS, there was no significant difference between the two groups of patients and the control group.18'19 However sample sizes were obviously limited in the mentioned studies. Since somatoform disorders have a psychological view of proximity to IBS and as the frequency of obsessive-compulsive disorder in the patients group was higher than the control group, we considered these disorders as the probable interfering factors. ...the discrepancy between the three patterns of the disease can be attributed to the limited sample size of the study. ...the incidence of IBS, such as the central amplification of pain 5 and a decrease of cognitive flexibility,7 may be a common factor in all types of IBS. ...it should also be noted that in addition to the limited number of the samples, the present study experienced other constraints.
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