Mental health status in healthcare workers during COVID-19 pandemic: An online questionnaire study in the southwest Iran

OBJECTIVES

This study aimed to evaluate Mental Health Status, such as stress, anxiety, or depression symptoms, during the Covid-19 pandemic in healthcare workers at Ahvaz Jundishapur University of Medical Sciences.

METHODS

This study is an online cross-sectional study conducted on healthcare professionals at Ahvaz Jundishapur University of Medical Science from November 25, 2020, to March 30 2021. PHQ9 and Kessler collected outcome variables of depression, anxiety, and psychological distress questionnaires.

RESULTS

In total, 2552 healthcare workers in 24 hospitals and 212 Comprehensive health centers were enrolled in this study. The mean age of participants was 37.94 ± 8.07 years, and 25.3% were male. There was a significant difference between the mean Kessler and PHQ9 Scale scores on males and females (P< 0.001). Also, the results showed a significant difference between depression, anxiety, and stress and working in the intensive care unit. According to the result of the Kessler scale, 27% of participants had moderate to severe. Most respondents (65.5%) in all professions had moderate to severe mental distress scores according to the Kessler scale. The logistic regression model results illustrated the relationship between depression and anxiety with gender, workplace, support from families, and collogue job satisfaction, and feeling the stress of media coverage of COVID-19 were statistically significant (P< 0.05).

CONCLUSIONS

The present study revealed that medical and health workers suffer from mental health problems. In this study, up to one-fifth of medical staff had stress, anxiety, or depression symptoms, and more than half had psychological distress. Low educational level, lack of family support, lack of colleague's support, and being a female were the significant risk factors for stress, anxiety, and psychological distress in medical staff.

Effects of brief cognitive behavioral therapy on mental health in substance-related disorder: a randomized controlled trial

BACKGROUND & OBJECTIVES

Population and aging are major contributing factors influencing the increase in substance use disorder (SUD), which in itself affects mental health, particularly anxiety and depression. Cognitive behavioral therapy (CBT) and pharmacotherapy co-treatment are considered the gold standard for the treatment of SUD. Thus, the present study has been carried out to investigate the efficacy of brief CBT on the general health of opioid users.

METHODS

A randomized controlled trial (RCT) was conducted with forty opioid users whose addiction was dully confirmed by a psychiatrist at the drop-in center of the Ahvaz Jundishapur University of Medical Sciences. The patients were then randomly divided into two equal groups (n = 20). The control group was treated solely using methadone maintenance therapy (MMT); however, the intervention group underwent four sessions of CBT in addition to MMT. The general health questionnaire (GHQ) consisting of 28 items (Goldberg, 1979) was applied to both groups at the beginning and end of the study. The collected data was analyzed using IBM SPSS ver. 26, and data analysis was carried out using chi-square, t-test, Mann-Whitney, and Poisson regression model. P < 0.05 was statistically significant for all the aforementioned tests.

RESULTS

The mean age for the control and intervention groups were 37.95 ± 7.64 and 43.85 ± 9.92, respectively (p = 0.042). There was no statistically significant difference in terms of gender and levels of education (p = 0.311 and p = 0.540). Both groups differed statistically regarding marital status and occupation (p = 0.025 and 0.002). There was no significant statistical difference in all subclasses and the total scores of GHQ-28 for both groups, except for anxiety and insomnia in the intervention group (p = 0.038). After applying a Likert scale with a 23-point cut-off score, there was no statistically significant difference in terms of psychosis after intervention in the intervention group (p = 0.077).

CONCLUSION

The results of the current study show that brief CBT is effective on psychiatric health, especially anxiety and sleep disorders, whereas brief CBT fails to affect the patient's depression, somatic symptoms, and social dysfunction.

TRIAL REGISTRATION

The Iranian Registry of Clinical Trials (IRCT) approved the study design (IRCT registration number: IRCT20190929044917N1, registration date: 13/01/2020).

Evaluation of Pharmaceutical Products of St. John's Wort Efficacy Added on Tricyclic Antidepressants in treating Major Depressive Disorder: A Double Blind Randomized Control Trial

BACKGROUND

Major depressive disorder (MDD) is the most common disorder in our community. Hypericum perforatumm, is a herb with a long application history in treating depression. A controlled study to evaluate the effects of this herbal medicine in Iran did not exist.

OBJECTIVES

This study aimed to assess the effect of Hypericum perforatom (perforan), in combination with tricyclic antidepressants in MDD treatment.

MATERIALS AND METHODS

The present study was a placebo-controlled double blind randomized clinical trial including 40 patients with major depressive disorder who referred to Psychiatric Clinic and Golestan Hospital in 2011. Patients were randomly distributed in 4 blocks with 10 patients in each. 5 out of 10 patients took medicine (group I) and the others received placebo (group II).

RESULTS

After six weeks, both groups indicated some improvement, there was also a significant degree of recovery in the perforan group (P = 0.04).

CONCLUSIONS

The results of the current study suggested that combinations of St. John's Wort and tricyclic antidepressants compared to tricyclic antidepressants alone had significant effect on mild to moderate depression improvement. According to the numerous side effects of antidepressants, their continuous use was not well tolerated. There is a strong global tendency to use herbal medicines. Hypericum perforatom (St. John's Wort) is one of the best types of unapproved MDD treatments. Also, the most common reason to discontinue antidepressant treatments is their sexual side effects. None of the patients in the two groups had complained about sexual side effects which was consistent with other studies and it was an advantage of using this herbal medicine. Perforan group had improved in quality of sleep and the increase of energy. This improvement had not been reported in previous studies. Sleep problems are common complications of specific serotonin reuptake inhibitors (SSRIs).

Expenditure audit of women with breast cancer in a tertiary care hospital of Delhi

BACKGROUND

Breast cancer is associated with substantial medical and economic burden. This study assisted the expenditure incurred by the subjects on diagnosis and treatment till the period of follow-up.

MATERIALS AND METHODS

This is a prospective study; a case series of patients studied at the time of diagnosis and followed after 6 months. The study was conducted at one of Hospitals in India, from January 2006 to December 2007. One hundred and seventy-two women with new primary breast cancer were included in the study. During the study period 69 subjects were lost to follow-up. The comparative analysis was done for 103 subjects. Cost implications of breast cancer include direct medical costs and indirect costs. Questionnaire for the data collection was used. Descriptive statistics and correlation analysis were used.

RESULTS

The median total direct and indirect expenditure was Rs. 12,100 (US$ 1 = Rs 50) with the range of Rs. 0-54000. The largest component of total direct medical costs was in stage I (median Rs. 6530), total indirect costs (median Rs. 7500), and median total cost was Rs. 17,600. The total expenditures (median Rs. 13,100) were the highest in younger age group (<40). The median direct expenditure was higher in the subjects who visited private setup before coming to Hospital (Rs. 8250) than those who came directly (Rs. 4500).

CONCLUSIONS

Cost of treatment for breast cancer depends on many factors, including the stages of the cancer, the woman's age, perhaps the costs of treatment, private hospital and insurance.