seyed ali mostafavi

Eating disorders are important psychiatric conditions with serious implications for physical and mental health. These disorders may be seen in all age groups ages but are more common in adolescents and young adults. Anorexia nervosa, bulimia nervosa, and binge-eating disorder are the main eating disorders. These disorders are triggered by acute stress regarding distorted body image and identified by persistent changes in eating behaviors. Each eating disorder involves different clinical features, but they all share some common risk factors, including genetic predisposition, environmental factors, and psychological triggers. Inflammation is a core mechanism that underlies the pathophysiology of eating disorders. This editorial essay will discuss the evidence linking inflammatory markers to eating disorders' etiology, diagnosis, and treatment.

The most important hypothesis of this research was based on the fact that the mechanism of the effect of omega-3 on depression and obesity is formed through its accumulation in the dorsolateral prefrontal cortex (DLPFC), especially in women. Accordingly, we investigated the omega-3 intake and the concurrent stimulation of the DLPFC by tDCS and hypothesized that the synergy of these two treatments can increase the obtained effect size in patients with depression and overweight.

This research was a double-blind randomized controlled trial (RCT) with a factorial design consisting of four treatment and control groups. The participants were females with depression and overweight on an outpatient basis. They received 5 ml/day omega-3 syrup (545 mg DHA, 620 mg EPA) or placebo adjunct with 12 sessions sham/tDCS stimulation administered for 3 weeks with anode-left/cathode-right protocol in the prefrontal cortex (1.5 mA, 15 minutes’ stimulation / 15-20 minutes’ rest intervals/one visit per week, 4 stimulations per visit).

tDCS or omega-3 alone did not significantly improve the executive functions, depression, food cravings, and weight in the experimental groups compared to the control group (P > 0.05). However, tDCS adjunct with the omega-3 had a significant and positive effect on improving weight change (P = 0.011; df = 1; F = 1.27; Eta = 0.108) with a power of 0.73 compared to the control group. Furthermore, their interaction led to an improving trend in executive functions and a decreasing trend in food cravings which are clinically important.

tDCS could strengthen the omega-3 mechanisms of effect through stimulating its accumulation site in the brain (i.e., the DLPFC) and the synergistic effects of these two treatments result in weight control as well as an improvement trend in the executive functions and food craving in women.

Micronutrient interventions for Adult Attention-Deficit/Hyperactivity (ADHD) could be helpful. We used a naturally processed whole wheat grains supplement containing higher doses of micronutrients named Nutrition Bio Shield (NBS). We aimed to determine its effects on ADHD symptoms in adults. 

Fifty-two medication-free adults with ADHD were randomly assigned to receive 5 g of NBS supplement or placebo daily for eight weeks. 

Twenty-three participants in the NBS group and 24 participants in the placebo group completed the study. After 8 weeks, compared with the placebo, the ADHD scores significantly decreased (mean difference 95%CI): -4.9 (-8.6 to -1.1); p=0.01; Cohen’s d=0.74), and quality of life significantly improved (mean difference 95%CI): 5.6 (0.12 to 11.3); p=0.04; Cohen’s d=0.59) in the NBS group. The observed side effects were minimal and did not differ statistically between groups. 

Quality of life increased during consumption of the NBS supplement, compared to the placebo. However, despite the statistically significant findings, these changes in ADHD symptoms were small and the clinical significance may be low (about 5%).

 Social capital, by encouraging people to collaborate and engage in social interactions, has been considered as an effective factor for development of mental disorders. In the preset study, we aimed to investigate the relationship between different aspects of social capital and psychiatric disorders in children and adolescents.

 This study was conducted between 2016 and 2017 in Kohgiloyeh and Boyer-Ahmad province, Iran. A total of 1001 children and adolescents aged 6-18 years and their parents were randomly selected using multistage cluster sampling to participate in the study. The data in the present study were compiled using a Persian translated version of the Kiddie-SADS-Present and Lifetime Version (K-SADS-PL) semi-structured questionnaire as well as the Social Capital Questionnaire of Nahapiet and Ghoshal. The raw data were analyzed statistically using Fisher and chi-square tests. The statistical analysis was performed using SPSS 16.0 version.

 Our results show that better relationship, cooperation, mutual understanding, and commitment are significantly and inversely correlated to psychiatric disorders among children and adolescents. In this regard we found that the mutual understanding (P=0.008) and relationships (P=0.001) are strongly related to social capital, while other components may have more or less effects.

 Our findings show that various aspects of social capital are associated with development of psychiatric disorders in children and adolescents. Some of the social capital components including better relationship, cooperation, mutual understanding, and obligation have significant effects; however, others including networks, values and trust could not exert significant effects on mental health.

The present study aimed to investigate the prevalence of substance use disorder in Iranian children and adolescents and its relationship with demographic characteristics and psychiatric comorbidities.

The data were taken from a national survey on the prevalence of psychiatric disorders in Iranian children and adolescents. The national survey was conducted on 30,532 children and adolescents aged 6-18 years which were selected using multistage cluster sampling. The psychiatric disorders were assessed by employing k-SADS-PL questionnaire and interviews carried out by 240 clinical psychologists with the participants and their parents. Data were analyzed by Chi-square test and logistic regression.

A total of 277 (0.97%) were diagnosed as people with substance use disorder that were further studied for comorbid disorders. Among the various types of drugs, hypnotic/sedative/anti-anxiety drugs were abused by 84 people (46.15%), cannabis by 68 (37.36%) and stimulants by 43 (23.63%). The variables of gender, place of residence, and father’s occupation and parents’ education level were identified as predictors of substance use disorder in children and adolescents. At the same time, 42.50% substances and alcohol abusing people had at least one comorbid psychiatric disorder and the highest comorbidity was observed in oppositional defiant disorder, attention deficit and hyperactivity disorder and separation anxiety disorder (p≤0.05).

The findings can be used in the prevention and treatment of substance use disorder and promotion of mental health in children and adolescents by focusing on the psychiatric comorbidities of people with substance use disorder.

 Given the growing rate of psychiatric disorders, especially in young populations, detailed data on frequency of these disorders for further national public health strategiesis of great importance.We aimed to survey the frequency of different psychiatric disorders among children and adolescents in Kohgiloyeh and Boyer-Ahmad province.

 1001 cases were selected using the random cluster sampling method and all cases were interviewed by expert psychologists using a Persian version of semi- structured K-SADS-PL questionnaire. Data were then statistically analyzed by SPSS software.

 20.5% (205 out of 1001) of studied cases showed at least one psychiatric disorder and 79.5 % showed no sign of any disorders. Anxiety disorders were the most frequent disorders  (15.5%) followed by the behavioral disorders (7%), smoking and drug abuse (6%), behavioral disorders (2.4%) and neurodevelopmental disorders (2%), but no case was observed with psychosis.

 in comparison with other studies from Iran or other countries the prevalence of psychiatric disorders in Kohgiloyeh and Boyer-Ahmad is relatively high and special policies and efforts are suggested for enhancement of mental health values in this region.

Children with Attention Deficit Hyperactivity Disorder (ADHD) treated with methylphenidate may lose their appetite and body weight. In this study, an attempt was to compare the effects of folic acid with cyproheptadine on appetite, weight, and symptoms of attention deficit and hyperactivity in children with ADHD who are taking methylphenidate. 

This was a randomized clinical trial performed on 7-12 year old children who were diagnosed with ADHD, treated with methylphenidate, and complained of appetite loss. In the first visit, anthropometric measurements were performed and then mothers completed the ADHD rating scale, Sleep Disturbance Scale for Children, and visual analogue scale for appetite. Then, the participants were randomly assigned to receive either cyproheptadine (4 mg/day), or folic acid (1 mg/day). All assessments were repeated after 8 weeks. 

Twenty-four children in the cyproheptadine group and 23 in the folic acid group (19 boys in each group) completed the study and statistical analyses were performed. The hyperactivity score significantly decreased in the folic acid group compared with the cyproheptadine group (p=0.035). However, the change in attention deficiency scores between groups was not significant. During the study, only girls in the folic acid group had significant body weight increase in contrast to other subgroups. 

Improving hyperactivity symptoms in the folic acid group along with better growth especially in girls reveals the clinical superiority of folic acid over cyproheptadine.

Anthropometric studies in children and adolescents are important to screen changes in growth and puberty. Hence, standard percentiles and cutoffs are set by the World Health Organization (WHO), Centers for Disease Control and Prevention (CDC), and Iranian national criteria. This study aimed to examine and compare the prevalence of weight disorders in children and adolescents in Lorestan province according to different criteria.

Children and adolescents (6–18 years) were randomly selected from the urban and rural areas by the multistage stratified cluster sampling method. All Iranian citizens aged who resided in Lorestan province for at least one year were eligible to participate in this study. After obtaining consent forms, researchers gathered the accurate anthropometrics and body mass index (BMI) measurements.

A total of 866 children and adolescents took part in the study, 447(51.6%) of whom were girls and 419 (48.4%) were boys. The overall prevalence of overweight and obesity was 17% in boys and 12.5% in girls. The prevalence of underweight in girls was 5.8%; while in boys it was 4.5%. The total prevalence rate of underweight according to the national criteria was 5.2%. However, this rate increased to 12% and 12.6% by using WHO and CDC cut-off points, respectively. The highest prevalence of overweight was obtained by CDC (15.8%), followed by WHO (13%); while national cut-off points resulted in 9.7%. Furthermore, 9.2% of the studied population was found to be obese by WHO; while this rate was 4.2%, and 5% by CDC and national cut-off points.

This study indicated the coexisting prevalence of underweight and obesity and high prevalence of overweight among children and adolescents in Lorestan province. Furthermore, using the WHO and CDC criteria leads to overestimating the prevalence of weight disorder compared to the national cut-off points in Iran.

Anxiety is an unpleasant feeling characterized by symptoms of tachycardia, sweating, and stress. The exact relationship between anxiety and cardiovascular disorder is not well distinguished. The aim of the present study was to evaluate the relationship between anxiety disorders and anthropometric indices and risk factors, including fasting blood sugar (FBS), hyperlipidemia, and hypertension, according to the results, FBS low-density lipoprotein (LDL) and symptoms of cardiovascular disorder in children and adolescents aged 6 to 18 years.

In this community-based study, multistage cluster sampling method was used. We randomly selected 1174children and adolescents who referred to Afshar hospital in Yazd, then, 167 blocks were randomly collected by each cluster head. Each cluster consisted of 6 cases, including three cases of each gender in different age groups (6-9, 10-14, and 15-18 years). The clinical psychologists instructed the participants to complete the Persian version of Kiddie-Schedule for Affective Disorders and Schizophrenia -Present and Lifetime version (K-SADS-PL). In addition, cardiovascular risk factors were determined for participants and demographic data were obtained from the participants.

A total of 1035 children and adolescents participated in this study. Theresults showed that 228 of the participants (22.2%) suffered from anxiety disorder. There was an indirect significant correlation between anxiety disorder and the symptoms of heart palpitation, shortness of breath, and chest pain. There was no statistically significant relationship between the different types of anxiety disorders and FBS, hyperlipidemia, andhypertension. According to the results, FBS and LDL are a predictor for anxiety disorders.

There was a statistically significant association between anxiety in children and adolescents and some risk factors of cardiovascular disorder. Also, this study introduces some cardiovascular predictors of anxiety. However, further studies are needed in this regard.

This study investigated how the parents’ personality disorders may be related to substance use disorder in children and adolescents.

The study was a cross-sectional study in which 28,540 children and adolescents (aged 6 to 18 years) and their parents participated between 2015 and 2016. The diagnosis of substance use was made using the Kiddie Schedule for Affective Disorders and Schizophrenia--Present and Lifetime Version (K-SADS-PL) interview and the personality disorders were assessed using Millon Clinical Multiaxial Inventory - Third Edition (MCMI-III). The parents were also surveyed for their personality assessed with MCMI.

The results showed that the paranoid personality disorder in father (odds ratio [OR] = 8.34, 95% CI, P = 0.042) and borderline personality disorder in mother (OR = 4.6, 95% CI, P = 0.049) increase the chance of substance use in children.

The findings suggest that in designing preventive programs for substance use, the personality characteristics of the parents need to be taken into account.

 Children with Attention-Deficit/Hyperactivity Disorder (ADHD) who take Ritalin may be faced with appetite reduction and weight loss. Herein, we aimed to evaluate the effects of a high-protein diet on weight and height growth in children with ADHD receiving Ritalin.

 In this randomized controlled trial, performed during 2016-2018 in Tehran, 50 children with ADHD treated with Ritalin were randomly assigned to the high-protein diet (HPD) group (35% of the total calories intake from protein) or the control group receiving a standard diet (STD) (15% of the total calories from protein). The height and weight were measured in the standard mode and three-day food record was completed at baseline. The measurements were repeated on a monthly basis for 5 months. We used independent sample t-test to analyze the data. The study protocol was registered in the Iranian Registry of Clinical Trials with the code of IRCT2014062116465N4.

 A total of 40 children and adolescents (19 in HPD and 21 in STD) completed the study. Baseline characteristics between the trial arms were equal. After 5 months, the protein intake of HPD group was significantly higher based on a seven-day food record. In girls’ subgroup, after 5 months, the mean difference concerning height, weight, and BMI change in HPD group compared to the control group were respectively +0.5 cm (P =0.41), -2.5 kg (P=0.04), and -1.6 kg/m2 (P=0.01) while in boys’ subgroup, they were +0.4 cm (P=0.59),+0.3 kg (P =0.37), and+0.02 kg/m2 (P=0.51).

 Girls responded differently to the HPD. The BMI in the girls decreased significantly after 5 months of HPD consumption as a result of weight loss. This effect was not observed in the boys. This may be due to different patterns of growth and puberty in the two genders.

Personality disorders (PDs) would be associated with an unhealthy lifestyle. To date, however, there have not been sufficient studies on the relationship between them. This study aimed to investigate the association between personality disorders and an unhealthy lifestyle by using an analytical cross-sectional study. We selected 1538 married women based on the multistage cluster sampling method. We used the Millon Clinical Multiaxial Inventory (MCMI) and Lifestyle Questionnaire (LSQ). Apart from descriptive statistics, a one-sample t-test, multivariate analysis, and structural equation modeling were used. Analysis of the data suggested that negativistic (β= -0.321), schizotypal (β= -0.285), schizoid (β= -0.159), borderline (β= -0.136), melancholic (β= -0.079) PDs had a significant association with an unhealthy lifestyle, respectively. Cluster A personality disorders were prone to an unhealthy lifestyle more than the other two clusters.

Childhood/adolescence under- and over-nutrition are among the major public concerns worldwide. This study aimed to determine the prevalence of underweight, overweight, and obesity among children living in Yazd, Iran using different criteria.

This community-based cross-sectional study was conducted among children and adolescents aged 6-18 years. Body weight, height, waist, and hip circumference were measured. Furthermore, the body mass index (BMI) and waist to hip ratio were calculated. Afterwards, BMI was classified according to four criteria including the US center for disease control and prevention (CDC), world health organization (WHO), the international obesity task force (IOTF), and Iranian national cut-points.

The mean age of the included children was 11.32 ± 3.89 years. Overall, the highest rate of underweight was estimated by IOTF %16.9 and the lowest rate was estimated by the national criteria %1.2. Furthermore, the highest and the lowest rates for overweight were obtained by CDC2000 %19.0 and WHO criteria %12.2, respectively. The highest and lowest rates for obesity were obtained by the national %22.3 and the CDC2000 criteria %11.3, respectively. The selected criteria were significantly different in estimating underweight, overweight, and obesity (P < 0.05).

All the mentioned criteria showed high rate of overweight and obesity among children and adolescents in Yazd. Furthermore, the highest rate of obesity was detected by national criteria. The national distribution of BMI in Iranian children is skewed to overweight and obesity.

Coronavirus infection (COVID-19) is spreading rapidly in the world beyond the health care capacity. The World Health Organization (WHO) has announced an emergency state that needs quick and effective actions. In the lack of specific medicine and vaccine, integration of mental health and nutritional care in the platform of a powerful managerial technique named the “Logical Framework Approach” (LFA) could be helpful for successful control of this pandemic. The strengths of the LFA for coronavirus management program are stakeholders’ involvement, integrative teamwork in research and medical procedures, as well as Inter-sectoral cooperation. The related organizations like WHO and ministries of health of every country could easily adopt this approach and act more efficiently to manage this pandemic.

The Coronavirus disease 2019 (COVID-19) is a considerable psychological stressor that has a significant impact on every facet of people’s life. Since 2002 that the first Coronavirus epidemic has emerged, many pieces of researches have indicated several psychological problems during this period. In circumstances such as COVID-19, researchers could deploy previous resources to identify the most prevalent psychological effects of Coronavirus diseases. We aim to systematically review and quantitatively assess the psychological problems during Coronavirus epidemics to identify the most prevalent psychological problems.

A systematic review of the literature will be conducted on psychological problems during previous and the new Coronavirus epidemics. Electronic databases, including PubMed/MEDLINE, Web of Science, Cochrane Library, PsycINFO/ProQuest, Scopus, and Google Scholar will be systematically searched using predefined search terms to identify relevant articles published from January 1, 2002 to June 20, 2020. Two authors independently identify papers that reported the prevalence rates of the psychological problems during Coronavirus outbreaks. The outcomes will include the most prevalent psychological problems during Coronavirus outbreaks. To ensure we have gathered all the evidence, we will conduct another search on the specific psychological problems revealed in the previous search. Study selection will follow the Cochrane library guideline. Afterward, data synthesis will be performed via the meta-analysis of the prevalence rates using the random effect model.

The findings can allow identifying the most prevalent psychological problems since the first Coronavirus epidemic in 2002. This can help health policymakers and clinicians to be informed of the priorities of the psychological problems related to COVID-19.

Although the prevalence of abdominal obesity and metabolic syndrome has been widely studied in the adult population, little is known about it in children and adolescents especially in developing countries. This study aimed to determine the prevalence of abdominal obesity and metabolic syndrome among children and adolescents in Yazd Greater Area, Iran; over the period of 2016-2017.

This study was part of a larger national study with a cross-sectional design. Using multistage cluster random sampling method, 1035 children, and adolescents of both sexes aged 6-18 yr were randomly selected from rural and urban districts in Yazd Greater Area, Iran. Components of metabolic syndrome, and anthropometry measured in the standard situation.

The prevalence of abdominal obesity in children 6-10 yr old was 13.2% in boys versus 24.7% in girls. The overall prevalence of metabolic syndrome according to International Diabetes Federation (IDF) criteria in adolescents aged 10-18 yr old was 7.6% (9.4% in boys). The most prevalent metabolic syndrome components were low HDL-cholesterol (56.2%) and abdominal obesity (27.8%).

Comparatively, the prevalence of metabolic syndrome in Yazd is high. Low HDL-cholesterol levels and abdominal obesity were the most common component, and family history of heart disease, BMI, and male gender were the main determinants of metabolic syndrome in adolescents.

Body mass index undergoes a substantial change in some psychiatric disorders. This study aimed to explore the status of body mass index (BMI) in different psychiatric disorders in a national survey among children and adolescents and to identify the role of gender in this regard.

A total of 30 532 children and adolescents were randomly selected using cluster sampling method with equal blocks of 3 age groups and 2 genders. Psychiatric disorders were assessed using a standardized face-to-face diagnostic interview of Kiddie Schedule for Affective Disorders and Schizophrenia-Present and Lifetime Version (KSADS-PL), and Body Mass Index (BMI) was measured for each participant.

In this study, 22 730 children and adolescents (109 46 boys and 11784 girls), with valid data of BMI, completed the KSADS-PL interview. The prevalence of psychiatric disorders was 21.2% among underweight participants, 22.8% among overweight participants, and 22.2% among obese participants, which was significantly higher than normal weight participants with 19.6% (X2 = 17.55; p = 0.001). In boys’ subgroup, depression and separation anxiety were mostly seen among the underweight category, while tic disorder was mostly seen in the obese category. In girls’ subgroup, on the other hand, generalized anxiety was mostly observed in the underweight category, while oppositional defiant disorder (ODD), depression, and mental retardation were mostly observed in the obese category. In total, the highest mean BMI rates were among the children and adolescents with alcohol abuse disorder, mania, and panic disorder. However, the lowest BMI rates were among those with attention deficit hyperactivity disorder (ADHD), separation anxiety disorder (SAD), and enuresis.

This study gives an overall picture of BMI status in different psychiatric disorders according to gender. Furthermore, in a multidisciplinary approach, the results of this study drew the attention of child psychiatrists to the status of BMI in their clients.

There is no clear picture regarding the prevalence rates of autism and its comorbidities among Iranian children and adolescents. The present study aimed to estimate these rates as part of a large national population-based study on epidemiology of psychiatric disorders in Iranian children and adolescents.

The total sample consisted of 31000 children and adolescents between 6 to 18 years of age. The Kiddie Schedule for Affective Disorders and Schizophrenia for School-Age Present and Life time version (K-SADS-PL) was used as the diagnostic tool.

The prevalence of autism in the total sample is equal to 0.1% (10 per 10000), with a 2:1 male-to-female ratio. In total, 86% of people with autism had at least one comorbid condition. Intellectual disability, epilepsy, enuresis and attention deficit and hyperactivity disorder (ADHD) with prevalence rates of 70.3%, 29.7%, 27% and 21.62%, respectively, were the most prevalent comorbid conditions in people with autism. Maternal personality disorders were also shown to be associated with increasing risk of autism.

The present study shows high prevalence rates for autism and its comorbid conditions among Iranian children and adolescents. It also reveals that there is a relationship between some maternal psychiatric disorders and the risk of autism.

This study aimed to investigate the epidemiology of psychiatric disorders in children and adolescents in Chaharmahal and Bakhtiari Province of Iran. This community-based cross-sectional study included 1038 children and adolescents aged 6-18 years from Chaharmahal and Bakhtiari province selected by the multistage cluster sampling method. Samples were interviewed using the Schedule for Affective Disorders and Schizophrenia for School-Age Children. Also, demographic data (gender, age, child education, parent education, and economic situation) were obtained. Binary logistic regression was used to analyze the data. A total of 16.1% of participants were diagnosed to have psychiatric disorders. Total psychiatric disorders were significantly more prevalent in boys than in girls (P=0.025). Unemployment of fathers was significantly related to increased prevalence of psychiatric disorders in children (P=0.016). Other demographic variables had no significant correlation with prevalence of psychiatric disorders in children. Anxiety disorders were highly comorbid with behavioral problems (16.4%). Behavioral disorders also had high comorbidity with elimination disorders (16.7%) and substance use disorders (10%). Enuresis was the most frequent psychiatric disorder (5.8%), followed by epilepsy (3.5%), tobacco use (3.4%), and attention deficit hyperactivity disorder (3%). Total anxiety disorders were the most prevalent group of psychiatric disorders in the sample (21.9%), followed by behavioral disorders (16.3%), elimination disorders (8.2%), and neurodevelopmental disorders (4.5%). Our findings suggest that psychiatric disorders affect a significant number of children and adolescents. Prevalence estimates and identification of sources of heterogeneity have important implications to service providers and modifications are needed in mental health services in the community.

 Lifestyle is an important factor in determining family and community health. Therefore, the current study aimed to determine the status of mothers' lifestyle in Zanjan province, Iran.

 The study is part of a national cross-sectional project implemented by the National Institute for Medical Research Development (NIMAD) in Iran. This study used multi-stage cluster sampling and included 1039 mothers from Zanjan province in 2015-2016. The data gathering tools were the lifestyle questionnaire (LSQ) and a demographic questionnaire. Data were analyzed by SPSS 20.

 The results showed that the lifestyle status of 4.6% of the mothers was lower than the normal level, 89.3% at the normal level, and 6.1% was good. Mean and standard deviation of the total lifestyle of mothers was 2.01±0.31. Evaluating the mean of lifestyle components showed that the highest mean of lifestyle status in mothers in Zanjan province was related to drugs avoidance (M=2.65) and the lowest mean was related to sport and health components (M=1.44).

 The lifestyle status of the studied samples was predominantly at normal level. However, their status in such components as exercise and health, environmental health, weight control, nutrition, and physical health was not very favorable, which makes it necessary to plan more precisely in this area. Results showed that mothers living in the city had a significantly better lifestyle than those living in rural areas. Findings also indicated that mothers with a higher level of education had a better lifestyle than those with a lower level.

Although the pathogenesis of schizophrenia is still uncertain, a variety of predisposing mechanisms have been implicated including inflammatory cascades. The present study was conducted to investigate the effectiveness of acetaminophen as a cyclooxygenase inhibitor in treating patients with schizophrenia.
A double-blind clinical trial was performed on 52 patients with chronic schizophrenia. Patients received risperidone (up to 6 mg/day) plus either acetaminophen (975mg/day) or placebo. Psychotic symptoms were assessed by the Positive and Negative Syndrome Scale (PANSS) at the onset of the trial, and at 2, 4, 6, and 8 weeks post therapy.
Compared to the placebo group, the acetaminophen group showed no significant difference in any subtypes of PANSS. Moreover, the side effect profiles of the 2treatment regimens were not significantly different.
Acetaminophen adjuvant to risperidone showed no significant effect in ameliorating symptoms of schizophrenia.
Trial Registration: The trial was registered at the Iranian Registry of Clinical Trials (registration number: IRCT201410251556N67).

Trichotillomania (TTM) is a type of impulse control disorder with chronic hair pulling. It effects on behavior, feelings, thoughts and quality of life.
The patient is a 28 year-old single woman that was referred to hair transplantation. She was worried about her appearance, cosmetic problems and marriage. The physician noticed that she is a patient with trichotilomania type of impulse control disorder. After confirming the diagnosis of trichotillomonia by a psychiatrist, pharmacotherapy begun with Rispridone 1 mg at night, Fluvoxamine 50 mg/daily and Clomipramine 5 mg at night. Over nine months of treatment there were significant reductions in hair pulling. She was followed up and finally, the response was acceptable.
TTM is a poorly understood disorder that requires more studies. Despite what we know about TTM, those with the disorder report not receiving enough information for diagnose and treatment. However, the information presented in this paper can help us to prevent this disorder, reduceing the prevalence and selecting the appropriate treatment.

There are different pathophysiological mechanisms for obsessive- compulsive disorder (OCD) as suggested by the serotonergic, dopaminergic, and glutamatergic hypotheses. The present study aimed at comparing the efficacy and safety of saffron (stigma of Crocus sativus) and fluvoxamine in the treatment of mild to moderate obsessive- compulsive disorder.
In this study, 50 males and females, aged 18 to 60 years, with mild to moderate OCD, participated. The patients were randomly assigned to receive either saffron (30 mg/day, 15 mg twice a day) or fluvoxamine (100 mg/day) for 10 weeks. Using the Yale-Brown Obsessive Compulsive Scale (Y-BOCS) and the Adverse Event Checklist, we assessed the patients at baseline, and at the second, fourth, sixth, eighth, and tenth week. Finally, the data were analyzed using general linear repeated measures.
In this study, 46 patients completed the trial. General linear repeated measures demonstrated no significant effect for time-treatment interaction on the Y-BOCS total scores [F (2.42, 106.87) = 0.70, P = 0.52], obsession Y-BOCS subscale scores [F (2.47, 108.87) = 0.77, p = 0.49], and compulsion Y-BOCS subscale scores [F (2.18, 96.06) = 0.25, P = 0.79]. Frequency of adverse events was not significantly different between the 2 groups.
Our findings suggest that saffron is as effective as fluvoxamine in the treatment of patients with mild to moderate OCD.

The Three-Factor Eating Questionnaire Reduced (TFEQ-R18) is one of the most widely used instruments for assessing eating behavior worldwide. The present study aimed at confirming the reliability and validity of the Persian version of TFEQ-R18 among overweight and obese females in Iran.
Material and In the present study, 168 overweight and obese females consented to participate. We estimated the anthropometric indices and asked the participants to complete the TFEQ-R18. Beck Depression Inventory (BDI), Spielberger Anxiety Scale, Appetite Visual Analogue Rating Scale, Food Craving Questionnaire (FCQ), Compulsive Eating Scale (CES), and Restraint Eating Visual Analogue Rating Scale were performed simultaneously to assess concurrent validity. Two weeks later, TFEQ-R18 was repeated for 126 participants to assess test-retest reliability. Moreover, we reported the internal consistency and factor analysis of this questionnaire.
Using the results of the reliability analysis and exploratory factor analysis of the principal component by varimax rotation, we extracted 3 factors: hunger, cognitive restraint, and emotional eating. After removing the Items 16 and 18, the Cronbach’s alpha was increased to 0.73 (The Cronbach’s alpha of the factors was 0.84, 0.64, and 0.7, respectively). The results of the Pearson correlation revealed a consistency of 0.87 between the test and retest administrations (p = 0.001). Significant positive correlations were observed between TFEQ-R18 and BDI, Spielberger Anxiety Scale, FCQ, CES, appetite, body weight, fat percentage, and calorie intake. Moreover, a negative correlation was observed in Restraint Eating Visual Analogue Rating Scale and muscle percentage.
This study aimed at presenting preliminary support for the reliability and validity of the Persian version of TFEQ-R18 and its psychometric characteristics. This instrument may be helpful in clinical practice and research studies of obesity, appetite, and eating behavior.

The present study aimed to review the literature on non-pharmacological interventions used to treat stereotyped and repetitive behaviors by a systematic method.
Two authors independently performed a search strategy on Medline/PubMed, Scopus and PsycINFO on English articles published up to April 23, 2014 with relevant search keywords. We also reviewed the bibliographies of retrieved articles and conference proceedings to obtain additional citations and references. We used those articles that address any non-pharmacological interventions on reducing stereotyped and repetitive behaviors in preschool children with autism. Four independent reviewers screened relevant articles for inclusion criteria and assessed the quality of eligible articles with CONSORT checklist.
In our search, 664 relevant articles were found. After removing duplicates and screening based on title, abstract, and full text, 15 high quality studies were finally included in data analyses. The included articles were published from 1987 to 2013. Three studies were designed as A-B, two as A-B-A and reminders as A-B-A-B. The data and results of 3 clinical trials were synthesized; two of them were parallel randomized clinical trial and another one was designed as cross-over. Interventions were completely heterogeneous in case studies, including non-contingent auditory stimulation, response interruption and redirection, teaching the children to request assistance on the difficult tasks, family-implemented treatment for behavioral inflexibility with treatment approach, vocal or motor response interruption and redirection, brushing, water mist treatment, exposure response prevention, tangible reinforcement or social reinforcement, and music. Interventions in clinical trials included touch therapy, kata techniques training program, and aerobic exercise.
The results of our review indicate that different kinds of non-pharmacological interventions can be used to treat repetitive behaviors in children with autism, however, sufficient evidence for their effectiveness does not exist. Future research using more precise methods (RCTs) can clarify that which methods and techniques are effective in reducing repetitive behavior of children with autism.