mohammadreza khodaei ardakani

This study aimed to assess the clinical features, Electroencephalography (EEG) findings, and brain imaging results in psychiatric patients diagnosed with epilepsy at Razi Psychiatric Hospital.

This retrospective descriptive-analytical study was carried out on patients with epilepsy and psychiatric disorders admitted to Razi Psychiatric Hospital over two years. A total of 94 patient files seizure and epilepsy comorbidity, recorded in the hospital’s health information system (HIS), were reviewed. Data collection involved a demographic checklist and an epilepsy scale; the latter, developed by DiIorio, Colleen, et al., encompassed personal characteristics, mental disorders, epilepsy, and seizures. The Kruskal-Wallis and Mann-Whitney non-parametric tests were utilized to compare the mean scores of variables, with SPSS software, version 21 facilitating the analysis.

Out of 94 patients with seizure and epilepsy, 9.6% had focal seizure, 26.6% had generalized epilepsy, 36.1% had focal-generalized seizure, and 26.8% had unknown seizure. About 12% had a structural etiology, while the remaining 88% had an etiology that remained unidentified.

The findings indicate that epilepsy, affecting individuals from adolescence through to old age, can lead to psychiatric disorders. For many patients, the etiology of their condition remains elusive, and EEG findings and brain imaging appear normal in the majority of cases.

Schizophrenia is among the most prevalent psychiatric disorders globally, with a lifetime prevalence rate of 0.3% to 0.7%, characterized by the heterogeneous presence of positive, negative, and cognitive symptoms that affect all aspects of mental activity. We aimed to describe the genetics of schizophrenia to widening our understanding of the inheritance of this illness.  

This quasi-experimental study was conducted in Razi psychiatric hospital in Tehran province, Iran. Recruitment of the study samples was conducted in Tehran, Iran, among patients with schizophrenia and their families. For this purpose, individuals with schizophrenia in 40 families with at least 1 to 2 affected members were identified and selected based on a clinical interview conducted by a psychiatrist and according to the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition. The clinical and paraclinical data, drug and substance usage, and medical treatments were collected through a standardized clinical questionnaire. Besides, the Global Assessment Scale and the Positive and Negative Syndrome Scale were completed for all study participants.  

A total of 22 families had a negative family history, and 1 affected member and the rest of the studied families had a positive family history and at least 2 affected members. In addition, genealogical data (family tree) and lymphoblastic cell categories were developed to examine genes, and subsequent research results will be reported in the future.  

As the research continues, the approach to sampling must be modified to ensure that the deoxyribonucleic acid bank is as extensively representative as possible of all schizophrenia cases.

Patients with schizophrenia receive psychiatric medications for many years, and their comorbid profile in old age remains unclear. Moreover, their pattern of non-psychiatric medicine use is of importance. Rehabilitation is crucial in patients with schizophrenia because it improves their strengths and life skills to live independently. These issues are essential in terms of polypharmacy among them, and its associated adverse effects. 

The present cross-sectional study investigated 131 patients with schizophrenia referring to Razi Hospital who were selected by a convenience sampling method. The subjects’ medical records were evaluated in terms of comorbid disorders and non-psychiatric medicine use patterns. Their demographic data were also collected by a separate questionnaire.

The frequency of schizophrenia disorder was higher in males aged ≥65 years. The comorbidity frequency of non-psychiatric disorders was significantly higher in the elderly, compared to non-elderly patients. The most prevalent comorbid disorders in the elderly were musculoskeletal, cardiovascular, and metabolic disorders; and in the non-elderly neurological, hematological, and digestive diseases. The prevalence of non-psychiatric medicine intake was significantly higher in the elderly. The prevalence of non-psychiatric medicine use in the elderly (e.g. aspirin, heart disease medications, hypertension medications, etc.) and non-elderly patients (e.g. anemia medications, antibiotics, anticonvulsants, etc.) was not similar. 

In schizophrenic patients, the old age period is associated with more comorbid disorders, compared to their healthy counterparts. Such comorbid profile is similar to other patients; e.g. the most prevalent comorbidities were musculoskeletal, cardiovascular, and metabolic disorders. Polypharmacy is a medical problem in the elderly, with numerous adverse effects. The adjunct consumption of psychiatric medications with the non-psychiatric ones highlights the vital phenomena of drug interactions and associated adverse effects of polypharmacy.

The effect of metformin on weight changes and some metabolic parameters in patients with schizophrenia and schizoaffective disorder was investigated in this study.

As a randomized double-blind controlled clinical trial, this study was performed from 2018 to 2019. A total of 66 obese patients (BMI≥27) with schizophrenia and schizoaffective disorder, hospitalized in the departments of Razi Psychiatric Hospital, entered the study; then, they were randomly divided into intervention and control groups after completing the informed consent form. The patients received metformin or placebo for 12 weeks. The dose of metformin was gradually increased and in case of a patient’s tolerance, was prescribed up to 500 mg twice daily. During the study, all patients received their previous therapies. The variables included BMI, weight, waist circumference, lipid profile, and fasting blood glucose, which were studied at the beginning of the study and at weeks 4, 8, and, 12. The data were analyzed, using a post hoc test by SPSS software.

The results showed a significant decrease in weight (3.5 kg) and BMI (1.30) at the end of the week 12, and there was a significant reduction in waist circumference (5.9 cm) at the end of the week 8 compared to the placebo group (P<0.05). Moreover, metformin had no significant effect on fasting blood glucose and lipid profile in comparison with the placebo group.

Based on the findings of this study, by reducing the weight, waist circumference, and BMI, metformin can have a significant role in decreasing the complications of obesity and metabolic disorders in patients with schizophrenia and schizoaffective disorder. Therefore, given that the complications of metformin are low and transient, it can be recommended as a safe and tolerable drug in obese patients with schizophrenia and schizoaffective disorder.

Traffc injuries are considered as the most important health issues for different countries in the world, especially developing countries that are experiencing rapid social changes. The purpose of this study was to investigate the prevalence of road traffc injuries (RTIs) and its socioeconomic differences among road users in Iran as it is one of the countries with high rates of accidents in the world. The study population included all people in Iran. The target sample was 3,096 clusters consisting of 2,187 urban and 909 rural households. Source of the raw data was the Iran’s Multiple Indicator Demographic and Health Survey (IrMIDHS) 2010, which is a multi‑stage stratifed cluster‑random cross‑sectional study. The logistic regression has been performed for investigating the socioeconomic determinants which influence the RTIs among pedestrian,
vehicle, and motorcycle users. The prevalence of RTIs is 13.8 (95% CI: 13.1, 14.5) per 1,000 people in the year leading up to the study. The injured groups included pedestrians (14.37%),
vehicles (38.36%), motorcyclists (43.37%), and 3.9% of users injured with other vehicles. A total of 78.3% of the injured people underwent outpatient treatment or were hospitalized. The mean age in these three groups was signifcantly increased (27.9, 32.5, 33.4, respectively), and the proportion of men decreased (89.2, 75.2, and 60.6). RTIs in Iran are higher than previous estimates due to consideration of non‑hospitalized cases. Considering the high contribution of human factors in
developing countries, these measures should prioritize vulnerable groups.

Attention-deficit/hyperactivity disorder is the most common behavioral disorder in children that results in social, educational, and familial ability problems. Psychodrama is one of the effective psychotherapy methods in curing some of psychological disorders. Therefore, the aim of this research is to study the effect of psychodrama on social skills of school children suffering from attention-deficit/hyperactivity disorder. This research is a semi-experimental research including a pretest-posttest instrument with a control group. The statistical population includes all school children suffering from attention-deficit/hyperactivity disorder were referred to Tehran NezamMafi Rehabilitation Clinic in 2016; in 90 children who had the quality of participating in the research 40 children were selected to be available and were placed accidentally and simply into two equal 20-population experiment and control groups. The Social Skill Rating System (SSRS) by Gresham & Elliot (1990) was used to investigate the children’s social skills. After the pretest, the experiment group participated in 12 sessions of psychodrama lasting 40-60 minutes and the control group received routine interventions. After conducting the experiment, the social skills of the two experiment and control group were investigated and the data was analyzed through descriptive statistical calculations and differential T-test by SPSS v.22 software. The comparison of the scores between two experimental and control groups of the children with attention-deficit/hyperactivity disorder showed that the average of the scores in experimental group was 35.72 with standard deviation 19.4 )P = 0.001) that was more than the average of the control group 29.63 with standard deviation of 30.2 (P = 0.069), and it showed that the experiment group in comparison with the control group had a meaningful increase in social skills and their subdivisions (P < 01.0, t = 71.5). The findings demonstrates that psychodrama increases social skills of children with attention-deficit/hyperactivity disorder, so it can be used as a therapeutically method in teaching social skills to these children.

Identifying risk factors of recurrent relapses interval durations in patients with schizoaffective disorder in order to increase the intervals of relapses is important. Controlling the disorder procedure in this recursive disorder is one of the treatment stages. This study aimed to identify some risk factors of recurrent relapses intervals in patients with schizoaffective disorder.
Medical records of 212 treated patients with schizoaffective disorder in Tehran Razi Mental Center were investigated. In addition to the recurrent relapses and hospital discharge times, factors including gender, marital status, education, and history of substance abuse, alcohol and psychedelic pills usage were also investigated as possible influential factors in the process. Gap time recurrent frailty model of survival analysis was fitted to the data and model parameters were estimated using EM algorithm with R3.2.1 software.
Of the patients, 74.5%, 33% and 67% were male, single and with history of smoking, respectively. Frailty parameter was significant (θ = 0.232, P = 0.021). Gender (P Significance of the frailty parameter indicated that the impact of entered individual factors on relapse intervals in patient with schizoaffective disorder was unmeasurable. Male patients indicated 0.78 times more than females, illiterates 0.9 times less than those with diplomas, singles 0.83 times more than married people, psychotropic pills consumers 0.91 times and alcohol consumers 0.83 times more than others, and self-employed people, housewives and unemployed ones experienced subsequent relapses 0.85, 0.81 and 0.83 times faster.

Psychotropic drugs use in the elderly with chronic schizophrenia is considered as an important issue in the field of psychiatry. The main goal of this study was to clarify the pattern of such drug use in these patients, in order to deem such therapy plan and focus on its cost attributing measures, for a more reasonable quality of care program. Methods &Materials: The study sample included 52 elderly resided at the Tehran`s Razi Mental Hospital who had chronic (more than six months) schizophrenia in the residual phase. Selected patients were taking at least two psychotropic drugs equivalent to 500 mg Chlorpromazine. We prepared the list of their drug use by obtaining their responses to our pre designed questionnaire charts. Data were collected and analyzed by SPSS version 17. In one case (1.92%), there was used for entries (Risperidone+Chlorpromazine+Fluphenazine Decanoate+Thiothixene). In 11 cases (21.2%) three entries and in 40 cases (76.8%), two entries of the psychotropic drugs were used. Chlorpromazine equivalent dose in each group ranged from the lowest dose (750 /mg) to the highest of (5600 /mg). The highest Chlorpromazine dose (5600) equivalent per milligram belonged to the four entries of(Risperidone+Chlorpromazine+Fluphenazine Decanoate and Thiothixene). The lowest Chlorpromazine dose (750/mg), was resulted in 3 entries of (Risperidone+Chlorpromazine and Fluphenazine Decanoate). At the end of the study, we found a high prevalence of using more than two psychotropic medications from the first atypical antipsychotic category. We also found, less frequent usage of the second and the third typical antipsychotic. We recommend more research to be applied for more feasible patterns of psychotropic prescriptions, with considerations of lowering the amount of medication use and deem their cost-benefits issues in elderly with chronic schizophrenia. Keywords: psychotropic drugs, chronic schizophrenia, elderly, monotherapy, polypharmacy