The Duration of Breastfeeding and Attention-Deficit Hyperactivity Disorder in School-Aged Children

Attention-deficit hyperactivity disorder (ADHD) is one of the most common childhood-onset neurodevelopmental disorders. In some recent studies breastfeeding had positive effects on physical health and mental development of children and these studies have recommended further studies in this issue.

This study evaluated the relationship between duration of breastfeeding and ADHD.

This case-control study was carried out in 2017 on 404 children aged 7-12 (196 children with ADHD and 208 children without ADHD). The questionnaire included items on the risk factors such as the child's sex, age, delivery method, birth weight, birth rank, gestational age, age of mother, duration of breastfeeding, history of neonatal hospitalization, history of drug use in neonatal period, history of drug use in pregnancy, history of hypothyroidism and hyperthyroidism in pregnancy, history of neonatal icter, history of neonatal blood exchange. Data were analyzed using t-test, chi-square and logistic regression.

The mean of breastfeeding duration in children with ADHD was 17.05 ± 7.52 months compared with 18.59 ± 6.74 months in control group (p = .03). A stepwise logistic regression that included the variables was found to be significant in univariate analysis, demonstrating a significant association between ADHD and breastfeeding duration (p = .01), male gender (OR = 2.8), mother hypothyroidism(OR = 4.5) and history of drug use in neonatal period (OR = 1.9).

Long-term duration of breastfeeding (more than 12 months) could be a protective factor in ADHD. However, further studies are required.

Effect of melatonin in reducing second-generation antipsychotic metabolic effects: A double blind controlled clinical trial

INTRODUCTION

The use of second-generation atypical antipsychotics has an increasing role in the development of metabolic syndrome. However, these medications due to metabolic disorders can lead to an increased risk of cardiovascular disease and subsequently mortality as well as reduced adherence to treatment. The main objective of current study was to determine the ability of melatonin to reduce the metabolic effects of second-generation antipsychotics.

METHODS

This double blind controlled clinical trial was conducted on 100 patients aged 18-64 years old were treated with the second-generation antipsychotics for the first time. The patients were divided randomly into two groups of 50. The case group received slow-release melatonin at a dose of 3mg and the control group was given oral placebo at 8 p.m.

RESULTS

The findings in melatonin group indicated significantly increase of HDL and decreased fasting blood sugar and systolic blood pressure, as well as had statistically significant increase in waist circumference, weight and BMI compared with placebo group.

CONCLUSION

According to the findings, it can be claimed that the addition of melatonin to atypical antipsychotics has led to a reduction in some of the metabolic effects of these drugs. In this study, HDL level was increased, and the mean systolic blood pressure and FBS were decreased in the melatonin group. Considering that these factors are contributing to cardiovascular disease as a leading cause of mortality in psychiatric patients, so the use of melatonin can reduce some of the medical effects of long-term treatment of atypical antipsychotics.

Morphology of the corpus callosum and schizophrenia: A case-control study in Kashan, Iran

Background

Corpus Callosum (CC) plays a significant role in hemispheric communication and in lateralized brain function and behaviors. Structural abnormalities in the corpus callosum of schizophrenic patients were reported. However, previous studies regarding the relationship between morphology of CC in patients with schizophrenia and healthy people are controversial.

Objective

To evaluate the morphological differences of the CC between patients with chronic schizophrenia and healthy people and to examine the relationship between the characteristics of the CC and schizophrenia severity.

Methods

This cross-sectional study was conducted on 63 patients with chronic schizophrenia (the case group) referred to Kargarnezhad Psychiatric Hospital in Kashan, Iran, and 63 healthy people (the control group) between January 2013 and December 2014. All participants underwent brain magnetic resonance imaging. Shape, anteroposterior length, and area of the CC were measured and compared in both groups. The severity of the symptoms occurring in patients with schizophrenia was evaluated using the positive and negative syndrome scale. In this study, we employed Chi-square test, t-test, Pearson product-moment correlation coefficient test, bivariate analysis of variance and logistic regression were used to test the association between different variables using SPSS software version 20.

Results

Results showed that the most common shape of the CC in each group was splenial bulbosity. The length and area of the CC in patients with schizophrenia were less than those of the control group and were greater in men compared with women in both groups. Although there was a significant difference in the surface area of the CC between the schizophrenic and control groups (p<0.001), no significant difference was seen regarding the anteroposterior length of CC (p=0.75). Moreover, a significant correlation was found between the surface area and anteroposterior length of the CC (p<0.001 and p<0.014, respectively).

Conclusions

Morphologic characteristics of the CC can be helpful to anticipate schizophrenia especially in patients’ family, and it can be used for suitable and faster treatment to prevent progressive cognitive dysfunction.

Comparing the effects of treatment with sildenafil and cognitive-behavioral therapy on treatment of sexual dysfunction in women: a randomized controlled clinical trial

Background

Sexual dysfunction in women is prevalent and common in women after menopause. Many attempts to treat patients with sexual dysfunction by cognitive-behavioral therapy (CBT) methods. But to the best of our knowledge, there has been no study that compared these two methods.

Objective

The aim of this study was to assess and compare the effects of sildenafil and cognitive-behavioral therapy on treatment of sexual dysfunction in women.

Methods

In this randomized, controlled, clinical trial, 86 women with arousal and orgasm dysfunction were surveyed. The patients were divided into two groups, i.e., sildenafil and CBT groups. The patients in the sildenafil group were treated by 50 mg of oral sildenafil one hour before intercourse, and the other group had weekly sessions of CBT for eight weeks. Sexual dysfunctions were evaluated by the Female Sexual Function Index (FSFI), a sexual satisfaction questionnaire, and the Enrich marital satisfaction scale.

Results

The mean age of the participants was 33.14 ± 7.34 years. The mean scores for female sexual function index, sexual satisfaction, and the Enrich marital satisfaction scale were increased in both groups during treatment (p < 0.001). It was found that cognitive-behavioral therapy compared to treatment with sildenafil increased all subscales, except arousal, orgasm, and lubrication.

Conclusion

Cognitive-behavioral therapy is more effective than treatment with sildenafil for improving female sexual function.

Clinical trial registration

The trial was registered at the Iranian Registry of Clinical Trials (http://www.irct.ir) with the IRCT ID: IRCT2014070318338N1.

Funding

The authors received no financial support for the research, authorship, and/or publication of this article.

Interleukin-6 and tumor necrosis factor-alpha gene polymorphisms in chronic idiopathic urticaria

BACKGROUND

This study was performed to evaluate association of gene polymorphisms among proinflammatory cytokines and susceptibility to chronic idiopathic urticaria (CIU).

METHODS

Ninety patients with prolonged urticaria more than 6 weeks were included as case group. Single nucleotide polymorphisms (SNPs) of IL-6 (G/C -174, G/A nt565) and TNF-α (G/A -308, G/A -238) were evaluated, using polymerase chain reaction (PCR); and the results were compared to the control group.

RESULTS

G allele was significantly higher in the patients at locus of -238 of promoter of TNF-α gene (p<0.001). Frequency of following genotypes were significantly lower in patients with CIU, compared to controls: AG at -308 and GA at -238 of TNF-α gene (p<0.05 and p<0.001, respectively), CG at -174 and GG at +565 of IL-6 gene (p<0.05). Additionally, following genotypes were more common among patients with CIU: GG at -308 and -238 of TNF-α gene (p<0.05 and p<0.001, respectively), GG at -174 and GA at +565 of IL-6 gene (p<0.05).

CONCLUSIONS

Pro-inflammatory cytokine gene polymorphisms can affect susceptibility to CIU. TNF-α promoter polymorphisms as well as IL-6 gene polymorphisms are associated with CIU.

Comorbidity and pattern of substance use in hospitalized psychiatric patients

BACKGROUND

Substance use in patients with psychiatric disorder is an every-day seen. Detection of this comorbidity can significantly affect the treatment of these disorders, as well as substance use.

OBJECTIVES

This study has been conducted to determine the prevalence and pattern of substance use in hospitalized psychiatric patients.

PATIENTS AND METHODS

In this cross-sectional study, 210 hospitalized psychiatric patients were selected by simple randomization from all records of hospitalized patients. The instrument of gathering data was a demographic checklist including age, gender, marital status, education, type of disorder and substance abuse and duration of psychiatric disorder. Data were analyzed by SPSS version 16 using Fisher exact and Chi square tests.

RESULTS

The mean age of patients was 37.9 years. Most of the patients were male, married and unemployed. The Prevalence of substance use was 36.7%. The most prevalent pattern of substance use was opium, opioid, methamphetamines and other substances (poly substance). The prevalence of substance use in patients with mood disorders was more than the other disorders and the most prevalent substance use in these patients was opium and opioid. Poly substance use was the most prevalent pattern of use (80 %) in psychotic and mood disorders due to substance. Significant difference was seen between genders, marital status, occupation, duration of illness and frequency of substance use (P < 0.05 ), however no significant difference was seen between educational levels, age and substance use.

CONCLUSIONS

The patients with mood disorders had the highest comorbidity with substance use and concurrent use of poly substance was the most prevalent pattern of use in these patients. Therefore, successful treatment of psychiatric disorders and substance use needs multimodal and more serious interventions. Regarding to the pattern of poly substance use in these patients, careful screening should be performed at admission.

Prevalence of psychiatric disorders and related factors in male prisoners

Background:

Prisoners are at risk of mental disorders. Therefore attention to mental health of prisoners is important.

Objectives:

This study aimed determine to the prevalence of mental disorders among Kashan prisoners.

Patients and Methods:

This cross sectional study was carried out in Kashan prison (Iran). 180 Subjects were selected by using stratified random sampling and evaluated with Symptoms Check List-90-Revised (SCL-90-R) questionnaire and clinical interview based on Diagnostic Statistical Manual of Disease-IV (DSM-IV) check list by two psychiatrists. Data were analyzed by SPSS-16 software and Chi square, Kolmogrov Smirnov, Mann-whiteny and Leven tests.

Results:

The mean age of prisoners was 31.9 ± 8.96. The prevalence of psychiatric disorders in prisoners was 43.4 %. The most frequent disorders were major depressive disorders (27.9 %), Post traumatic Stress Disorder (17.4%) and substance use disorder (17.4 %). 28.3% of prisoners had personality disorders, that the most prevalent were antisocial personality and borderline personality. The comorbidity of psychiatric disorders was (36 %) in axis I. Suicidal thoughts there were in 44.6 % of prisoners. History of head trauma in Prisoners with psychiatric disorders was (52.2 %). There was significant difference between head trauma and psychiatric disorders (P = 0.05). Significant difference was between marital status and duration of imprisonment with psychiatric disorders P < 0.05. There was not significant difference between type of crime and educational level with psychiatric disorders.

Conclusions:

About half of all prisoners suffered from psychiatric disorders; therefore treatment psychiatric disorder in this group is essential for prevention of crime. Prisoners are at risk of mental disorders. Therefore attention to mental health of prisoners is important.

Evaluation of the effects of resting in appearance of post lumbar puncture headache

Lumbar puncture (LP) is a procedure for obtaining spinal fluid from spinal meningeal spaces this can be done as a diagnostic or therapeutic procedure which can result in to a typical positional headache named as post lumbar puncture headache .This can cause a lot of discomforts for patients and makes fear from the procedure. This study designed to evaluate the effect of resting position after LP on post lumbar puncture headache (PLPH). Patients who had a diagnostic lumbar puncture were divided randomly in two groups .Group A patients had one hour rest in the supine position while group B patients had one hour rest in the prone position. Both groups followed for appearance of symptoms of PLPH for 5 days. 119 patients completed the study, 57 (48%) male patients and 62 (52%) female .PLPH totally appeared in 38 (31.9%) patients .In the group A PLPH was present in 20 patients whereas in group B it was present in 18 patients. Statistical analysis showed no significant differences between two groups (P>0.07). Position of rest after LP has no significant effect on reducing post lumbar puncture headache and there is no need to emphasize on position of rest after LP.

Prevalence of psychiatric disorders in the general population of Kashan, Iran

BACKGROUND

Mental health is one of the most important public health issues because of its major contribution in decreasing the global burden of disease and its important role in assurance, dynamism, and efficacy. The present study evaluates the prevalence of mental disorders in the over 18-year-old population in Kashan, Iran during 2008-2009.

METHODS

This was a descriptive, cross-sectional study. Subjects were selected via stratified random sampling. The study was conducted in two stages. In the first stage, subjects were evaluated using the General Health Questionnaire. In stage two, two psychiatrists used a DSM-IV checklist to conduct clinical interviews. The collected data were analyzed by SPSS version 16, OR, CI, Chi-square, and Mantel-Heanszel tests.

RESULTS

The prevalence of mental disorders in Kashan was 29.2%. In women it was 35.5%, and in men, 21.2%. The most prevalent disorders were mood (9.3%) and anxiety disorders (4.7%). Among the 505 subjects with mental disorders based on clinical interviews, 162 (32.1%) suffered from mood disorders, 129 (25.6%) anxiety disorders, 21 (4.2%) psychotic disorders, 16 (3.4 %) neurologic disorders, 17 (3.4%) dissociative disorders, and 120 (23.7%) had other disorders. In this study, 7.8% of the subjects had at least one mental disorder. In the case of mood disorders, major depression (8.2%) was the most common; as for anxiety disorders, generalized anxiety disorder (7.2%) was the most prevalent. The prevalence was higher in people aged 56-65 (35.8%), widows (35.8%), the illiterate (42.8%), and the unemployed (38.8%). Mental disorder was significantly affected by gender, education, occupation, and marital status.

CONCLUSIONS

The results show that psychiatric disorders in Kashan are higher than at the time of the previous research in this region (1999). Therefore, prevention programs and treatment of psychiatric disorders in this city are of great priority.

FC26-03 - Comparison of quality of life and global function in chronic psychiatric patients before and after rehabilitation center in kashan (2009)

Introduction

The concept of quality of life has considerably important in evaluation of efficacy of therapeutic and rehabilitation programs in all medical fields, especially psychiatric disabilities therefore any intervention which cannot improve patient’s quality of life, their effectiveness is doubt. The aim of this study is evaluation of quality of life of chronic mental patients, before and after residence in rehabilitation center.

Methodes

This study is quasi experimental that carried out on all of patients in rehabilitation center in Kashan(Iran). Demographic, Quality of Life and Global Function Scale questionnaires were used at the time of admission and next 6 months. Data were analyzed by paired T-Test and correlation tests.

Results

The mean of function level was at the time of admission 31/47+/−7/5 and after of 6 months 36/52+/−7/15, that this difference was significant (p = 0/0001).

The mean of physical quality of life was 49/28+/−16/01 at the time of admission and after 6 months was 56/64+/−16/99, so the mean of mental quality of life at the time of admission was 37/20+/− 11/10 and after follow up 46/19+/−4/05.the mean of global quality of life was 42/75+/− 10/34 at the time of admission and after 6 months 54/59+/− 12/84, which this difference was significant.(p = 0/0001)

In this study relation between age and quality of life was significant. (p = 0/0001)

Conclusion

Results showed that various factors may have role in this change. Such as type of provided services, quality of treatment, emotional support of staff and family, homogenous group therapy, organized life.