angela hamidia

Methadone-induced sexual dysfunction in men can significantly impair their quality of life and reduce methadone adherence, thereby interfering with its therapeutic benefits.

This study aimed to compare the effects of bupropion and amantadine on reducing sexual dysfunction in methadone-dependent males.

This clinical trial included 47 methadone-dependent males attending the Addiction Treatment Center in Babol, Iran. Participants were randomly assigned to either the amantadine group (n = 23) or the bupropion group (n = 24). Demographic data and addiction history were collected using a checklist, and sexual dysfunction was assessed with the International Index of Erectile Function (IIEF) Questionnaire before and after the intervention. Paired t -tests, independent t-tests, and chi-squared tests were used to compare the two groups.

Both groups had similar demographic variables and sexual function scores before the intervention (P > 0.05). However, there was a significant difference between the two groups in terms of total sexual dysfunction scores (52.13 ± 13.07 for bupropion vs. 60.79 ± 4.47 for amantadine; P = 0.006). Additionally, significant differences were observed in sexual desire (P = 0.003), satisfaction with intercourse (P = 0.001), and overall satisfaction (P = 0.034), with higher scores in the bupropion group. Adverse medication-related effects were less prevalent in the bupropion group (54.2%) compared to the amantadine group (60.9%).

Bupropion appears to be more effective in improving sexual function in methadone-dependent males undergoing methadone treatment, with patients in the bupropion group achieving better scores than those in the amantadine group. Additionally, the occurrence of adverse effects was lower in the bupropion group compared to the amantadine group.

Prenatal and postnatal depression (PND) is associated with adverse outcomes for mother, fetus, and child. The aim of study was to examine the prevalence and risk factors of prenatal and postnatal depressive symptoms.

This was a cross-sectional and hospital-based survey of 2305 pregnant women and post-partum women (18-48 years) that was registered in the Babol Pregnancy Mental Health Registry (BPMHR) database from June 2020 to March 2021. Two questionnaires, including demographics and depression, were analyzed in this study. Also, the Edinburg Postnatal Depression Scale (EPDS) was used to assess the depressive symptoms. Independent t test and the analysis of variance were used to compare the means. Multiple logistic regressions were used to determine risk factors for depressive symptoms.

According to the EPDS scale, the prevalence of depressive symptoms was 19.8% in the pregnant woman group in comparison with the postpartum period (11.6%). Risk factors for antenatal depressive symptoms were parity (women with parity ≥ 4 vs. 1 parity, ß=1.808, P=0.020), two groups of gestational age (gestational age ≤12 weeks vs. 28 weeks, ß=1.562 P=0.030) as well as (gestational age 21-27 weeks vs. 28 weeks (ß=1.586, P=0.033), and high-risk pregnancy (high-risk vs. low-risk pregnancy, ß=1.457, P=0.003). For postnatal depressive symptoms, none of the factors were a significant risk.

Prenatal and postnatal depressive symptoms should be screened, particularly for women in the first and second trimesters, with high parity, and those with a high-risk pregnancy, as recommended by the present study.

Because migraine is a common headache, finding ways to approach it better would be useful. So, studying the relation of dimensions of general health and personality types and pain severity in patients with migraine will be useful for fulfilling this aim.

In this cross-sectional study, the number of patients with migraine headache studied in this study was 170. The checklists used in this study were migraine disability assessment (MIDAS), visual analog scale (VAS), Neuroticism-Extraversion-Openness (NEO FFI), and General Health Questionnaire (GHQ-28).

The average scores of general health dimensions in migraine sufferers with aura were higher than in migraine patients without aura. But this difference was significant only in the index of physical symptoms (P=0.02). There was a negative correlation between pain intensity and general health dimensions but it was not statistically significan. A positive correlation was observed between headache intensity and extroversion, which was significant (r=0.18 and P=0.01). The score of physical symptoms increases significantly with the increase of disability severity (P=0.007).

According to the results, the severity of migraine disability, general health dimensions, and personality types in patients with and without Aura was not different. Also, general health dimensions and personality types were not associated with pain intensity and the severity of migraine disability.

Nurses' resilience in the care of patients with Coronavirus Disease 2019 (COVID-19) is essential. This study aimed to develop and validate an instrument for assessing nurses' resilience control resources in the COVID-19 pandemic.   

In this qualitative study, with a conventional content analysis based on a literature review and semi-structured interviews conducted with 20 nurses, the initial draft of the instrument was prepared in different aspects based on a 5-point scale. The instrument's face validity and content validity were examined in 15 nurses and 15 experts, and construct validity was obtained in 482 nurses using the available sampling method. Data were analyzed in SPSS software Version 24 using indexes and analytic tests.   

Out of 54 items, 18 items were confirmed by the expert panel and the items had content validity ratio and content validity index scores higher than 0.79. According to the results of an exploratory factor analysis, this tool has 4 dimensions: God, chance, internal locus of control, and powerful others. They accounted for 48.06% of the total variance. CFA showed the indices confirmed the model fit (χ2/df = 1.846, comparative fit index = 0.921, incremental fit index = 0.923, root mean square approximationerror= 059, goodness of fit index = 0.905). The reliability of the instrument was acceptable (Ω > 0.70, α > 0.7, CR >0.60, and intra-class correlation coefficients > 0.70).   

The developed tool is used to measure the control resources of nurses' resilience in caring for COVID-19 patients. It can help recognize the focus areas for developing appropriate interventions.

Various physical and mental problems and diseases may develop with aging. Poor sleep quality is the third most common major problem in older adults, affecting all aspects of life. Emotional Freedom Techniques (EFT) can be used to treat the disease in older adults.

This interventional study attempted to investigate the effect of EFT on sleep quality, sleepiness, and quality of life of older adults.

This was a quasi-experimental study. The selection of the participants was based on the convenience sampling method. Twenty-one people participated in the study and were divided into two groups of interventions. The study was conducted in the adult day-care center. In one group, 11 peopleandin the other group, 10 people were included. First, an educational session regarding sleep hygiene was held. Then, the EFT was administered for 4 weeks, 2 sessions per week, and each session lasted for 30 - 45 minutes in the intervention group by the student (first author); sleep hygiene training was also provided for the second group. Study measures included the PSQI (Pittsburgh sleep quality index), the Epworth Sleepiness Scale (ESS), and the Quality-of-Life Scale. Follow-ups were performed after the intervention and one month later. The statistical tests used were repeated measures and chi-Square tests. A P-value < 0.05 was considered as statistically significant.

The trend of changes in sleep quality (P = 0.001, P = 0.001, respectively) and sleepiness (P = 0.023, P = 0.001, respectively) was incremental and significant before and after the intervention and one month later in each of the groups, but results show that there was no significant interaction effect for any subscale, including subjective sleep quality (P = 0.786), sleepiness (P = 0.568), and quality of life (P = 0.289).

According to the results, the EFT was effective on sleep quality, sleepiness, and quality of life of older adults in the adult day-care center, and sleep hygiene was influential.

 Sertraline is one of the most commonly used selective serotonin-reuptake inhibitors for patients with major depressive disorder. The prevalence of sexual dysfunction among patients who use selective serotonin-reuptake inhibitors is 40%–45% for women and 20%–30% for men. A strategy to prevent this side effect is combination therapy with medications such as buspiron and Ritalin. The aim of this study was to compare the effects of bupropion and Ritalin on sexual dysfunction among patients who use sertraline.

 This single-blind randomized controlled trial was conducted in 2018. Fifty eligible women aged 20–45 years old were purposefully selected from the psychiatric clinics of Yahyanejad and Ruhani hospitals, Babol, Iran. Structured interview was used to screen participants for major depressive disorder, sertraline use, and sexual dysfunction. All participants completed the Arizona Sexual Experience Scale and were randomly allocated to the bupropion and the Ritalin group through block randomization. All participants re-completed the Scale one month after the intervention. Data were analyzed through SPSS software by repeated measure analysis of variance.

 All fifty participants (25 in each group) completed the study. The mean of participants’ age was 36.38±5.64 years and the mean score of their sexual dysfunction was 23.44±3.14 at pretest and 19.52±4.92 at posttest. Between-group differences respecting the mean scores of sexual dysfunction and all its items were insignificant both at pretest (P= 0.886) and posttest (P= 0.872). However, within-group comparisons revealed that the mean score of sexual dysfunction significantly decreased in both groups (P<0.001).

 This study concludes the same efficacy of sustained release bupropion and Ritalin in significantly reducing sexual dysfunction among patients who used sertraline.

Practical Implications: 

 According to the results of the present study and the similar efficacy of slow-release bupropion and Ritalin in improving sexual dysfunction caused by sertraline, it seems that Ritalin, due to its effectiveness in treatment, is an easier drug to use. It is more cost-effective and a better alternative to bupropion in improving sexual dysfunction in patients who are candidates for treatment with serotonin- reuptake inhibitors.

Electroconvulsive therapy (ECT) is commonly used in the treatment of psychiatric patients. However, it may cause cognitive disorders in patients undergoing the procedure. The aim of this study was to investigate the effect of memantine on the alleviation of cognitive impairments in patients undergoing ECT.

In this triple-blind clinical trial, 60 patients with depression phase of unipolar or bipolar non polycystic disorder were randomly divided into two groups of 30. In the treatment group, the patients received memantine for the whole period of treatment starting 24 hours before ECT (starting dose 10 mg/day, increased to 20 mg/day within one week) and continuing until the sixth session of ECT. In the control group, the patients received the placebo. The cognitive performance of patients was assessed using the Mini Mental Status Examination (MMSE) and the Addenbrooke's Cognitive Examination (ACE) 24 hours before the first ECT session, 24 hours after the sixth ECT session, and one month after the end of the ECT sessions. The study lasted 1.5 years.

The MMSE score at the end of the study period (one month after the completion of ECT) in the memantine group was significantly higher than the control group (P=0.008). However, there was no significant difference between the scores of ACE-R between the two groups after ECT. No significant relationship was found between the two groups in any of ACE-R items.

According to the MMSE test, it seems that memantine reduces cognitive disorders in patients receiving ECT, but this finding was not observed in ACE-R.

 Attention-deficit/hyperactivity disorder (ADHD) is one of the most common neurodevelopmental disorders in childhood. The aim of this study was to compare the efficacy of methylphenidate (Ritalin) and atomoxetine in improving ADHD symptoms and also their side effects.

 The randomized clinical trial included 60 children aged 6-14 years with ADHD who were referred to the psychiatric clinic of Yahyanejad Hospital. They were randomly divided into two groups, one of which received methylphenidate and the other atomoxetine. The patients were followed up by a psychiatrist after treatment. Improvement in symptoms was measured by examining the ADHD Rating Scale (RS) scores. The results were analyzed using an independent t-test and a value of p≤0.05 was considered significant.

 The mean ADHD RS score decreased in both groups in the fourth- and eighth-week intervals after the intervention, with a statistically significant difference in the eighth week compared to pre-treatment and the fourth week for both groups (P-value=0.001). However, no statistically significant difference was observed in the mean scale score between the two groups (P-value=0.48). In the fourth week, the mean complication rate was significantly lower with atomoxetine than with methylphenidate (P-value=0.001). Even in the eighth week, no significant difference was found in the side effects of methylphenidate and atomoxetine (P-value=0.553).

 The efficacy and tolerability of atomoxetine and methylphenidate were described as similar. However, there was no significant treatment difference between the two drugs. The frequency of side effects was similar for both drugs after eight weeks of treatment.

The benefits of addressing behavioral health issues in inpatients have been well documented. However, these problems are not frequently recognized by physicians during the hospitalization of patients in general hospitals.

This study described the current status and medical diagnoses made in psychiatric consultations to inpatients admitted to general hospitals affiliated to Babol University of Medical Sciences, North of Iran.

This cross-sectional observational research was carried out at Babol University of Medical Sciences from 2019 to 2020. All psychiatric consultations for patients hospitalized in different departments of two general hospitals affiliated to this university for 6 months were included. The mental disorders diagnosed for patients were recorded by a psychiatrist according to the diagnostic and statistical manual of mental disorders (DSM-5) criteria.

A total of 266 patients with a mean age of 51.21 ± 16.95 years were examined. Most of the consults were requested by the departments of cardiology (39.5%) and neurology (16.2%). According to the psychiatric visits, 32.3%, 51.1%, and 15.4% of the patients had no, one, and two concomitant psychiatric disorders, respectively. Mental disorders were found to have a significant association with gender (P < 0.001), admission department (P < 0.001), comorbid malignancies (P = 0.011), cardiovascular disorders (P < 0.001), need for surgical intervention (P = 0.018), a history of substance use (P = 0.001), and reasons for consult request (P < 0.001).

Mental disorders, especially mood and anxiety disorders, were identified in approximately 70% of consultations. Therefore, requesting a timely psychiatric consultation can lead to better managing hospitalized patients.

Teaching, learning and evaluation in the field of psychiatry has always been considered. During the psychiatric assistantship course, learning the skill of interviewing the patient and prescribing appropriate therapies is one of the highest educational priorities. In this study, an attempt has been made to investigate the effect of the Objective Structured Clinical Exam (OSCE) on improving the skills of residents.

In this cross-sectional study from the academic year 2015-2016 to 2009-2010, all psychiatry residents were tested weekly by the OSCE method according to the curriculum topics. After the test, the satisfaction of professors and residents was assessed using a questionnaire. Also, the scores of these tests were compared with the scores at the end of the year.

The mean scores of residents for OSCE and end-of-year exams were 21 ± 3.04 and 125.54 ± 18.48, respectively. Pearson correlation coefficient for the relationship between OSCE score and end-of-year score during these 4 consecutive academic years was r = 0.830 and P <0.001. The results of the survey of professors and assistants showed a high level of satisfaction with the tests.

The relationship between end-of-year scores and OSCE test scores and the results shown in the success of residents in the specialized board exam is evidence of the success of the design and implementation of the OSCE method to improve the skills of residents in OSCE evaluation.

Context:

 Depression is one of the most common psychiatric disorders, and poor sleep quality is a risk factor for it.

This study aimed at determining the effect of aromatherapy with lavender essential oil on sleep quality of patients with major depression. Settings and Design: This single-blinded randomized clinical trial in Psychiatric Clinic in Yahya Nejad Hospital, Babol, Iran, during 2019.

Eighty major depressive patients with sleep disorder were recruited from those referred to Psychiatric Clinic in Babol City, Iran. They were assigned into intervention and control groups(forty participants in each group). The intervention group inhaled lavender essential oil and the control group received almond oil as placebo. Sleep quality of the participants was measured before and after the intervention. Statistical Analysis Used: Data analysis was performed employing statistical tests including Chi-square, Kolmogorov–Smirnov, ANCOVA, independent t-test, and paired t-test.

The intervention and control groups were homogeneous in terms of demographic characteristics and the mean score of sleep quality before the intervention (P > 0.05). The patients in the intervention group had a better quality of sleep comparing to that in the control group, and the difference was statistically meaningful (P = 0.001).

Aromatherapy with lavender essential oil has positive effects on sleep quality in depressed patients. It can be used as a noninvasive complementary method to improve sleep quality in patients with major depression.

Psychiatric disorders are associated with poor pregnancy outcomes both for mother and child. This study aimed to determine the prevalence and related demographic risk factors of psychiatric symptoms among the pregnant women in Babol City.

This cross-sectional study was conducted in five private and public obstetrics clinics of Babol city. During routine appointments of prenatal care, 176 pregnant women filled in three questionnaires including; sociodemographic questionnaire, Edinburg Prenatal Depression Scale (EPDS), and Symptom Checklist-25 (SCL-25). Wilcoxon test, Spearman correlation, and multivariate logistic regression tests were used to interpret the data.

The prevalence of depressive disorders was 15.4%% for Edinburg scores ≥13.  The overall rate of maternal psychiatric symptoms (global severity index or GSI scores ≥ 1.75) was 48.5%. The prevalence of psychiatric symptoms was high; for 25% somatization, 258% anxiety, obsession-compulsion disorders or OCD 6.4%, 8.8% interpersonal sensitivity, 5.3% phobia, 7.6% paranoid ideation, and 1.2% psychoticism. Multivariate logistic regression revealed that pregnant women with history of abortion in previous pregnancy were at risk of depressive symptoms more (β=3.18, CI 1.28-7.93, p=0.01) than those without history of abortion. Also, the only demographic factor related to psychiatric symptoms was the age of pregnant women; younger age was associated with higher symptom levels for GSI ((r=-0.17).

The high prevalence of psychiatric symptoms, especially depressive symptoms, in pregnant women highlights the need for continued research on screening, identifying the risk factors, and developing effective treatments for mental disorders in pregnant women.

Parents of children with attention deficit hyperactivity disorder (ADHD) have more problems than parents of normal children due to the prevalence of behavioral abnormalities in children with ADHD. Mood disorders in parents, including mothers can lead to lower tolerance thresholds and the use of punitive methods to control the children, which can cause other complications. Therefore, evaluation of mood disorders and timely treatment could be of great help in treating these children and improving the prognosis of the disease.

This cross-sectional study was conducted in 125 mothers of children with ADHD attending two psychiatric clinics in Babol, Iran 2014-2016. Data were collected using the Conners' Parent Rating Scales - Revised (CPRS-R) and Structured Clinical Interview for DSM-IV Axis I Disorders (SCID-I). Data analysis was done in SPSS V22.

The prevalence of mood disorders in mothers of 6-14 year-old children with ADHD was 44% (n=55). Among the mood disorders, dysthymia (27%) was the most common disorder. Forty-five mothers (36%) had depression and 9 (7.2%) had bipolar disorder.

According to current study, depression was the most common mood disorder in mothers. Maternal depression influences the management of a child with ADHD, so, early diagnosis and treatment of maternal depression play major roles in the prognosis of ADHD in a child with this disorder.

Cataract induced vision impairment can lead to loss of older people’s independence and self-esteem and limit their daily activities. Moreover it has comorbid cognitive impairment and depression. Cataract surgery may be one way to attenuate these comorbidities. The aim of this study was to compare pre-operative and postoperative depressive symptoms and cognitive impairments of patients who underwent cataract surgery. This study was a before - after clinical trial. Participants completed the following validated surveys one day before and again three months after surgery. Dependent variables were preoperative to postoperative within-patient difference in Geriatric Depression Scale (GDS) and Mini-Mental State Examination (MMSE) scores. Independent variable was improvement of visual acuity. Mean age was 71.77±8.08, 54% were females. Mean postoperative visual acuity improvement was 0.7720±0.1758, mean GDS score difference was -1.49±1.72 and mean MMSE score difference was 0.28±0.88. Postoperative improvement of visual acuity, GDS and MMSE scores were statistically significant (p=0.001). The mean visual acuity improvement in the participants with age over 80 years was lower than the younger subjects; while improvement in MMSE scores in this age group was significantly higher than them. There were no significant relationship between visual acuity, GDS and MMSE scores before and after surgery based on BMI and educational level. It was concluded that cataract surgery is effective for relieving depressive symptoms in the elderly. Improved visual acuity at older ages has far more effects on reducing cognitive impairment.

Premenstrual syndrome (PMS) is a common health problem in women in reproductive age which can impact their performance and quality of life. Considering drug- related side effects and limited evidences supporting the efficacy of hypnosis in PMS, the present study aimed to compare the effectiveness of hypnosis and the muscle relaxation in the symptom-relief of premenstrual syndrome.
This randomized controlled clinical trial (RCT) was conducted on all 38 women with diagnostic criteria of premenstrual dysphoric disorder (based on DSM IV) who were referred to the clinics of Yahyanejad and Rohani Hospital in Babol (Iran) in 2016. They were allocated into two groups randomly. The first group received muscle relaxation and the second group received hypnotherapy. The patients filled out PMS symptom severity questionnaires at baseline, the 1st and 3rd months after intervention. Eight patients lost the follow up; therefore, data related to 30 patients was analyzed
Data analysis showed that the two groups were similar in demographic characteristics (P > 0.05). Mean of symptom severity score decreased significantly in the hypnotherapy group in comparison with the muscle relaxation group (p It seems that hypnosis can be significantly effective in the treatment of PMS and can reduce its symptoms.

Stimulant pharmaceuticals are abused among academic students to elevate mood, improve studying, intellectual capacity, memory and concentration, and increase wakefulness. This study was designed to evaluate the current situation of stimulant use among medical students and residents of Babol University of Medical Sciences.
This cross-sectional study was conducted among 560 medical students and clinical residents of Babol University of Medical Sciences during the academic year 2014-2015. A self-administered questionnaire was used for data collection.
Four hundred and forty-four (79.3%) students filled out the questionnaires. 49 (11%) individuals reported amphetamine and methylphenidate (ritalin) use. The mean age of the stimulant drug users was 24.6±4.8 years. The main initiator factor was to improve concentration (29 persons; 59.2%). There were significant statistical correlations between stimulant drugs abuse and male gender, living in dormitor in residence and internship and past medical history of psychiatric disorders (depression, attention deficit hyperactivity disorder and substance abuse) (p Because of significant prevalence of stimulant use, regulatory governmental policies and also planning to improve essential life skills, awareness about the side effects and complications of these drugs, screening of at-risk college students and early identification of the abusers are suggested

The association between serum zinc levels and cognitive impairment is a controversial issue.
The association between serum zinc levels and cognitive impairment was investigated in the elderly population of Amirkola city, northern Iran.
The data of this cross-sectional study came from a large cohort study, known as the Amirkola health and ageing project (AHAP). The sample included 1004 eligible participants aged 60 years or older (486 females and 518 males). The staff of healthcare centers interviewed the participants and completed the Persian version of the Mini Mental State Examination (MMSE). Their serum zinc levels were measured using the ZishChem diagnostic kit.
Of all of the participants, 347 (33.3%) had cognitive impairment. Furthermore, 254 participants (25.2%) were classified as having mild cognitive impairment, 82 (8.2%) moderate, and 11 (1.1%) severe. A total of 160 females (32.9%) and 180 males (34.7%) were within the normal range of serum zinc (80 to 120 μg/dL), 133 females (27.4%) and 121 males (23,4%) were within the high range of serum zinc (> 120 μg/dL), and 193 males (39.7%) and 217 males (41.9%) were at low range of serum zinc ( The results do not support the belief that serum zinc levels may be associated with cognitive function in the elderly population.

Hepatitis B is the most prevalent type of viral hepatitis. Psychological reactions among patients with hepatitis B infection is considerably different and affects their decision about treating and following up the disease. The present study aims at explaining the psychological demonstrations experienced by these patients.
In this qualitative study, a total of 18 patients with hepatitis B (8 women and 10 men) were selected by purposive sampling method. Data were collected by unstructured in-depth interviews during 2014-2015 in the medical centers of three cities in Iran. All interviews were recorded, typed and analyzed by the conventional content analysis approach.
By analyzing the data, the main theme including psychological instability, with three sub-themes were emerged: grief reaction (stupor, denial, anger and aggression), emotional challenges (worry and apprehension, contradiction with beliefs, fear of deprivation, fear of stigma, waiting for death and prognosis ambiguity) and inferiority complex (social withdrawal, sense of humiliation and embarrassment and sense of guilt and blame) were acquired.
The findings indicate that patients with hepatitis B experience various psychological reactions that need to be controlled and managed by themselves or healthcare providers. Thus, implementation of health interventions with emphasis on psychological care to prevent problems and execution of educational and consultation programs about hepatitis especially by medical centers and mass media is seems necessary.