Iranian Journal of Psychiatry and Behavioral Sciences
Volume:14 Issue: 1, Mar 2020

The prevalence of infertility, as one of the most unpleasant experiences, is approximately 13.2% in Iran. It can affect the quality of life in infertile people through mental disorders, such as depression and anxiety.

This systematic review was carried out to assess the effect of cognitive-behavioral therapy (CBT) on anxiety and depression of infertile women in Iran.
Data Sources: All articles published in English and Persian until 20 February 2019 in databases, including Magiran, Iranmedex, SID, Medline (via PubMed), Scopus, Google Scholar, Embase, Cochrane Library, and Web of Sciences were searched.
Study Selection: All randomized controlled clinical trials conducted in Iran on the effect of CBT on anxiety and depression were studied. In the selected studies, participants were Iranian infertile women. The used intervention was the application of CBT, the control group had received only routine care, and the outcomes were anxiety and depression.
Data Extraction: Two authors separately investigated the acceptability and quality of articles, and any disagreement was solved through consensus and a third opinion.

Six clinical trials with 321 infertile women entered the systematic review. The meta-analysis of six studies showed that the mean depression and anxiety score in the CBT group was lower than the routine care group, which was significant only for anxiety.

The results indicated the effectiveness of CBT intervention in reducing anxiety and depression in infertile women. However, the between-group difference was not significant in terms of depression. Convenience sampling and small sample size in the selected studies reduced the generalizability of research findings. Therefore, it is recommended to conduct clinical trials with larger sample size and accurate methodology to obtain more generalizable results.

Although there are a number of acceptable means of measuring mindfulness for adults, this is not the case with the child and adolescent population. A requirement, therefore, is to establish and evaluate the child and adolescent mindfulness tools, such as the child and adolescent mindfulness measure (CAMM).

The purpose of this study was to examine the validity and reliability of a Persian version of the CAMM.

This descriptive research involved a sample of 620 students aged 12 to 18 years in Kashan who were selected via cluster sampling in 2017. The participants completed the Persian CAMM, the eight-item Avoidance and Fusion Questionnaire for Youth (AFQ-Y8), the Mindfulness Attention Awareness Scale for Adolescents (MAAS-A), the Revised Children’s Manifest Anxiety Scale, and the Children’s Depression Inventory (CDI). The factor structure of the Persian CAMM was evaluated using exploratory and confirmatory factor analyses by separate samples. Test-retest reliability (with four-week interval and 50 participants), internal consistency, and convergent and divergent validities were also determined.

The results of Confirmatory Factor Analysis (CFA) showed that the one-factor (original) model of the CAMM did not meet the goodness of fit indexes. The Exploratory Factor Analysis (EFA, n = 300) indicated that the Persian CAMM had a two-factor structure and the CFA verified the acceptable fit of the two-factor scale. The instrument also exhibited good reliability (α =0.73). The correlation between CAMM and anxiety, depression, and psychological inflexibility was negative, whereas its correlation with the MAAS-A was positive (P < 0.001).

Based on the results of this study, the Persian CAMM is an appropriate tool with acceptable psychometric properties for measuring adolescent mindfulness. Mindfulness can be considered an important protective construct in the mental health of children and adolescents.

One of the consequences of violence during pregnancy is impaired mother-fetus attachment.

The present study aimed at determining the effect of supportive-educational intervention on maternal-fetal attachment in pregnant women facing domestic violence.

The current study was conducted on 100 pregnant women subjected to domestic violence by their husbands. The subjects were selected using convenience sampling method and were randomized to the intervention and control groups. The intervention group received four sessions of individual supportive-educational intervention, while the control group were provided with routine care during the same period. Data were collected using the Cranley maternal- fetal attachment scale in the two groups and analyzed by statistical tests eight weeks after the intervention.

After the intervention, the mean maternal-fetal attachment score was significantly higher in the intervention group than the control group (80.36 ± 6.75 vs. 65.50 ± 6.78; P = 0.0001).

The study results showed that supportive-educational intervention was effective in promoting maternal-fetal attachment. Therefore, it was recommended that such interventions be integrated in the prenatal care programs of pregnant women facing domestic violence.

Postpartum depression is a mood disorder that has harmful effects on infants and family relationships. However, its low diagnostic rate (50%) limits the proper treatment of women suffering from this disorder. The identification of women who are at risk can be useful. Oxidative stress may be a risk factor for depression. Oxidative stress occurs when the production of reactive species exceeds the capacity of cellular antioxidant defenses to remove these toxic species. However, little is known about the peripheral oxidative stress in depressive disorder.

This study aimed to determine the relationship between oxidative stress during pregnancy and postpartum depression.

This prospective cohort study was conducted in the health centers affiliated to Shahid Beheshti University of Medical Sciences from January to May 2017. Eighty pregnant women were assessed for serum total antioxidant capacity and Malondialdehyde levels at 38 - 40 weeks of pregnancy. They were also assessed for postpartum blues (using Maternity Blues Questionnaire of Stein) and postpartum depressive symptoms (using Edinburgh Postnatal Depression Rating Scale, EPDRS) on day 3 and at 4 - 6 weeks after delivery, respectively. The chi-square, Mann-Whitney, and linear regression were used to analyze the relationship between oxidative stress and depressive symptoms.

The prevalence of postpartum blues and postpartum depression was 45% and 27%, respectively. The mean serum total antioxidant capacity was significantly lower in the depression group (P < 0.05). There was a significant reverse correlation between serum total antioxidant capacity and EPDRS scores (P < 0.05).

The present study demonstrated a relationship between the serum total antioxidant capacity and postpartum depression.

Hypovitaminosis D may be related to some metabolic vulnerable, including metabolic disorders associated with inflammatory cytokines and insulin resistance in subjects undergoing methadone maintenance treatment (MMT).

This study aimed to determine the impact of vitamin D intake on withdrawal symptoms and genetic response related to inflammatory cytokines and insulin in patients treated with MMT.

This investigation was performed on 40 subjects under MMT to consume either 50,000 IU vitamin D supplements (n = 20) or placebo (n = 20) every 2 weeks for 12 weeks, between April and June 2017 in Kashan, Iran. The clinical opiate withdrawal symptoms (COWS) were evaluated to examine withdrawal scale and gene expression at baseline and after the a 3-month intervention. Statistical analysis of the data was performed using SPSS 18 with Fisher’s exact test, t-test, chi-square, and ANCOVA. Also, P values < 0.05 were considered statistically significant.

The results of our study showed that compared with the placebo, taking vitamin D downregulated interleukin-1 (IL-1) expression (P = 0.01) in peripheral blood mononuclear cells (PBMCs) of patients under MMT. In addition, consuming vitamin D increased peroxisome proliferator-activated receptor gamma (PPAR-γ) expression (P = 0.01). Administration of vitamin D did not change COWS and IL-8 and tumor necrosis factor-alpha (TNF-α) expression.

According to the results of the present study, vitamin D can be recommended as an adjunct to MMT which may elevate the quality of life and decrease methadone side effects.

Subsidization is a policy to encourage the purchase and use of goods and services and to promote their affordability for the poor. The Welfare Organization of Iran subsidizes substance use treatment in order to increase coverage and adherence to treatment.

This study aimed to answer the following questions: is the model efficient? Has the policy resulted in increased coverage and higher adherence to substance use treatment? How could the model be improved?

We compared two types of substance use treatments of abstinence-based residential program and outpatient methadone maintenance. Based on their severity of addiction and retention in treatment clients who benefited from subsidization were compared with other clients. Therefore, 109 clients, 78 from methadone maintenance and 31 from residential abstinence-based programs were interviewed.

Subsidization had an encouraging effect on clients to enter substance use treatment in both treatment programs (P = 0.001). However, we were unable to find evidence that subsidization helped retention in the treatment (P = 0.389), or that concomitant use of illegal substances in clients on methadone maintenance was lower (P = 0.500). Based on economic status of clients (P = 0.05) their criminal record (P = 0.001), length of use of substances (P = 0.05), and comorbid psychiatric conditions (P = 0.05), it was evident that assignment to subsidization in methadone maintenance services was significantly more reasonable, while it was almost random in abstinence-based residential facilities assignment.

The current model of substance use treatment subsidization is not efficient. Addiction severity subscales and socioeconomic status of clients could be considered appropriate factors for assignment to the subsidization program.