Iranian Journal of Psychiatry and Behavioral Sciences
Volume:18 Issue: 3, Sep 2024

During the COVID-19 pandemic, there was a surge in the consumption of beverages containing methanol, as individuals have erroneously surmised that the ingestion of alcohol could potentially serve as a protective measure against the virus.

The aim of this systematic study was to investigate methanol toxicity and its clinical complications during the COVID-19 pandemic.

A comprehensive search for sources was conducted across multiple databases, including PubMed, Embase, Web of Science, and Scopus, as well as Iranian databases such as Magiran, Iran Doc, and SID. The search spanned from December 2019 to November 2022. The inclusion criteria for this review specified cross-sectional studies that examined the prevalence of methanol toxicity and its complications during the COVID-19 pandemic in Iran. Methodological quality was assessed for each study included in the review.

During the COVID-19 pandemic, the consumption of alcohol, including ethanol and methanol, increased. Men were more likely to consume alcohol compared to women, and a higher number of deaths were reported among young individuals. Visual impairment emerged as one of the most common complications of methanol poisoning, with an increase in its incidence during the disease outbreak.

Given the growing concerns about methanol poisoning, enhancing public awareness could significantly reduce both the prevalence of clinical complications and mortality rates. Therefore, it is recommended that greater emphasis be placed on improving education and raising awareness about methanol poisoning within Iran.

Context:

 Fluoxetine, a selective serotonin reuptake inhibitor (SSRI), is widely used in the treatment of various psychiatric disorders. While the standard therapeutic dose of fluoxetine is typically 20 - 60 mg per day, slow-release higher doses, such as 90 mg/weekly and more recently 180 mg/weekly, have been explored to assess their potential benefits in certain psychiatric conditions. This mini-review aims to evaluate the evidence regarding the effects, efficacy, and safety profile of fluoxetine at a dosage of 90 mg in psychiatry.

Evidence Acquisition:

 A comprehensive literature search was conducted using electronic databases (PubMed and Embase) to identify relevant studies published until July 2023. Studies investigating the use of fluoxetine at a dosage of 90 mg/week in psychiatric conditions were included. The identified studies were critically appraised for their methodology and quality.

Limited research has specifically examined the effects of fluoxetine at a dosage of 90 mg/week in psychiatry. However, some studies have investigated this dosage form and provided insights into its potential efficacy in treating certain psychiatric conditions, such as major depressive disorder (MDD), obsessive-compulsive disorder (OCD), premature ejaculation, and premenstrual dysphoric disorder. These studies have shown that compliance with weekly fluoxetine was better than with once-daily dosing.

Once-weekly dosing may be effective in psychiatry, improving compliance and enhancing psychological well-being.

The Cognitive Fusion Questionnaire (CFQ) has two versions (trait and state) that assess taking thoughts literally and thinking as likely to dominate behavior.

The current study modified original version of CFQ, which was translated previously in Iran and have usedCFQ and modified version as known as the State Cognitive Fusion Questionnaire (SCFQ) for psychometrically evaluated these measures.

A sample of individuals with mental disorders (N = 196) completed the CFQ, SCFQ, and other measures of interest.

One-factor models emerged for each measure, and each demonstrated good internal consistency. The CFQ versions were associated with psychopathology, experiential avoidance, and life satisfaction measures.

These findings provide initial support for using these measures in research and clinical contexts to further our understanding of cognitive fusion in the Iranian mental disorder population.

One of the most common psychological problems among people who use drugs (PWUD) is cognitive impairments (CIs). Several studies show that the prevalence of cognitive impairments in PWUD is higher than in the general population.

The aim of the current study was to investigate the prevalence of CI and its related factors among people who inject drugs (PWID) in Iran.

A cross-sectional study was designed among PWID in 2023. About 410 PWID were recruited using snowball and convenience sampling in four provinces in Iran. Demographic and clinical data, as well as the status of cognitive impairments, were collected using bio-behavioral and Montreal Cognitive Assessment questionnaires, respectively. We examined the relationship between all independent variables and CIs status using bivariate logistic regression.

The prevalence of CI among participants was 28% (95% confidence interval (CI): 22% - 32%). Behaviors associated with an increased risk of CIs included the length of injecting drug use [adjusted odds ratios (aOR) = 2.7, P = 0.01], methamphetamine use (aOR = 2.8, P < 0.05), and alcohol use (aOR = 2.8, P < 0.05).

Methamphetamine and alcohol use were identified as the main predictors of cognitive impairments among PWID. It also seems necessary to consider new interventions in harm reduction programs to address cognitive impairments.

Reviewing the literature, a vast number of studies are available about the pulmonary effects of coronavirus disease 2019 (COVID-19). However, the effects of COVID-19 infection on sexual function, especially the long-term effects, have been rarely reported. Here, we report the short and long-term effects of COVID-19 infection on male sexual function.

Using the International Index of Erectile Function (IIEF) questionnaire, the sexual function of 96 COVID-19 patients was evaluated at months 0, 1, 3, and 6 following hospitalization.

The findings showed that the sexual function indicators decline during the first month of infection, then start to improve and reach the baseline by the 6th month of infection. Additionally, the analysis of the demographic data revealed that higher age and lower education levels are associated with lower levels of sexual function indicators.

Infection with COVID-19 may result in sexual dysfunction, which gradually improves over six months.

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.

Depression is one of the most common mood disorders and a major public health concern. Ellagic acid (EA), a type of polyphenol, acts as a strong hydrogen bond network as an electron receptor, enabling it to participate in various reactions.

Major depression is a critical medical condition that has emerged as a public health issue due to its high incidence, mortality, and suicide rates. One significant factor in the pathogenesis of depression is oxidative stress. This study aimed to evaluate the effects of ellagic acid supplementation on antioxidant status and symptom improvement in patients with major depressive disorder, considering the antioxidant capabilities of ellagic acid.

A total of 40 patients diagnosed with major depressive disorder based on DSM-V criteria were assessed using the Beck Depression and Hamilton Depression Questionnaires. The dietary and caloric intake of the patients were monitored. Additionally, height and weight were measured, and patients with similar age, gender, and weight were matched. The individuals were randomly assigned to either the intervention group or the placebo group using a randomization table. The intervention group received a daily dose of 200 mg of ellagic acid in capsule form. The placebo group received a daily dose of one capsule containing 200 mg of wheat flour, identical in appearance to the intervention substance. The study period lasted for 8 weeks. Venous blood samples were collected before and after the study from all 40 individuals, and after serum separation, oxidative stress markers (malondialdehyde and total antioxidant capacity). were measured using a specific kit and ELISA method.

The study results showed a significant reduction in depression scores in the ellagic acid group during the study (P: 0.001)., with these alterations being significant when compared to the placebo group. In the ellagic acid group, a significant increase in total antioxidant capacity (P: 0.027). and a significant decrease in malondialdehyde levels (P: 0.014). were observed at the end of the study, and these changes were significant compared to the placebo group. In contrast, significant changes in total antioxidant capacity and malondialdehyde levels were not observed in the placebo group.

The current study indicates that ellagic acid intervention may have a favorable effect on depression in patients with major depressive disorder. This is achieved by reducing BDI scores and serum levels of MDA, as well as increasing serum levels of TAC in these patients compared to the placebo group. However, further investigation is necessary to explore the mechanisms underlying the different alterations of ellagic acid in depression.

The growing population of older adults and the prevalence of multiple chronic conditions (MCCs) among them present significant challenges in care and treatment. Self-management is an effective approach to managing the consequences of MCCs.

This study aimed to explore the factors related to self-management among older adults with MCCs.

This qualitative study employed a content analysis approach from June to April 2023 in hospitals and universities in Tehran. The sample consisted of 26 participants, including older adults with MCCs, family caregivers, and specialists. Data were collected through semi-structured interviews. Purposeful sampling was used, and continued until data saturation was achieved. The rigor of the study was evaluated using the Lincoln and Guba criteria, and analysis was conducted simultaneously with data collection using the Elo and Kyngäs methods.

The final analysis identified several factors affecting self-management. A total of 697 semantic units and 336 codes were categorized into 13 subcategories and 4 main categories. These categories included: Individual factors (biological factors, cognitive factors, coexisting diseases, mental health, economic status, health-oriented behaviors), interpersonal factors (interaction with the medical care team, family relationships), factors related to the health system (facilities of medical centers, staff empowerment, health policymaking), and extra-organizational factors (cultural factors, social factors).

The findings of this study highlight the factors related to self-management in older adults with MCCs, which can be utilized in the design of self-management programs.

This study was conducted due to the importance of job satisfaction in chronic psychiatric patients and the lack of sufficient information about the associated variables.

The study aimed to assess the role of personality traits, cognitive performances, and perceived social support on job satisfaction among individuals with chronic psychiatric disorders employed in supportive-productive workshops in Semnan.

This cross-sectional study was conducted using a quantitative and descriptive-correlational regression method. It included 152 individuals (both male and female) with chronic psychiatric disorders employed in supportive-productive workshops in Semnan city in 2022. Participants were randomly selected through a lottery method. Data were gathered using the NEO Five-Factor Inventory by Costa and McCrae (1985), the Field and Roth Job Satisfaction questionnaire (1951), Zimet's (1988) scale for perceived social support, and the Montreal Cognitive Assessment (1996). Data analysis was performed using regression analysis with SPSS version 24.

The regression analysis illustrated that although neuroticism, agreeableness, extraversion, conscientiousness, perceived social support, and cognitive performances had a significant predictive role on job satisfaction among patients with chronic psychiatric disorders, perceived social support and conscientiousness had the most significant effect, while cognitive performances had the least significant effect on predicting job satisfaction (P < 0.05).

It is recommended that authorities pay special attention to the perceived social support from society and family, as well as cognitive rehabilitation focusing on attention and concentration for individuals with chronic psychiatric disorders.

The Perfectionistic Self-Presentation Scale (PSPS) is a self-reported 27-item measure that assesses the interpersonal aspect of perfectionism. It indicates how individuals tend to present themselves as perfect to others.

The aim of this study was to translate and evaluate the psychometric properties of the Perfectionistic PSPS in an adult sample.

The research sample included 332 adults aged 18 to 53 years old residing in Tehran who completed the PSPS scale. After the translation and back-translation process, the construct validity of the PSPS was assessed using confirmatory factor analysis as well as divergent and convergent validity. Internal consistency reliability was conducted to evaluate the reliability. Data analysis was performed using SPSS (version 22) software and LISREL (version 8.8).

The three-dimensional factor structure with all 27 items was confirmed based on the fit index results and their appropriate values. Internal consistency for the total score, perfectionistic self-promotion, non-display of imperfection, and non-disclosure of imperfection scales were 0.94, 0.90, 0.89, and 0.74, respectively.

The present study showed that the Persian version of the PSPS had appropriate validity and reliability among the Iranian adult population.

The beneficial effect of transcranial direct current stimulation (tDCS) on substance use disorders, achieved by reducing craving, impulsivity, and risk-taking behavior, can be considered an effective therapeutic approach.Transcranial direct current stimulation can be considered an effective therapeutic approach for reducing cannabis craving, improving levels of depression, and enhancing working memory in cannabis users.

This study investigated the effectiveness of tDCS applied to the Dorsolateral prefrontal cortex (DLPFC) on craving, depression, and working memory in cannabis users.

This was a randomized, sham-controlled, double-blind, parallel-group study. Fifty male participants who met the criteria for cannabis use disorder according to DSM-5 were randomly assigned to either the real tDCS group (25 participants) or the sham tDCS group (25 participants). Pretests, including marijuana urine tests, the Marijuana Craving Questionnaire-Short Form (MCQ-SF), the Hamilton Depression Rating Scale (HDRS), and the Wechsler Memory Scale, were conducted before the intervention. The real tDCS group underwent 20 sessions of tDCS stimulation, each lasting 20 minutes, with a current intensity of 2 milliamperes applied at the F3 and F4 positions for DLPFC stimulation. The sham tDCS group received only 30 seconds of initial electrical stimulation, with no further current delivered. Both groups also received standard psychological treatments alongside the tDCS interventions. After completing the interventions, the same tests were administered again to assess the outcomes.

Participants who received real tDCS showed significant improvement in levels of craving, depression, and working memory. This reduction in scores and levels was statistically significant compared to the sham group.

Transcranial direct current stimulation can be considered an effective therapeutic approach for reducing cannabis craving, improving levels of depression, and enhancing working memory in cannabis users.

Suppression of negative, uncomfortable emotions can lead to moral injury, resulting in emotional, behavioral, and social issues, as well as mental health conditions such as depression and post-traumatic stress disorder. During the COVID-19 pandemic, the concept of moral injury-typically associated with conflict situations—has gained increased attention.

This study aimed to assess the prevalence of moral injury during the pandemic and its correlation with psychological distress.

Between December 2020 and January 2021, we evaluated the frequency of depression, anxiety, and stress, and their correlation with moral injury in 333 medical interns, residents, and nurses. We used validated versions of the Moral Injury Symptom Scale-Healthcare Professionals (MISS-HP) and the Depression Anxiety Stress Scale (DASS-21).

The study included 333 medical professionals, most of whom were aged 26 - 30. Clinically significant moral injuries were observed in nearly half of the participants. Women had higher average scores for stress and anxiety compared to men. A lack of personal protective equipment (PPE) at the workplace was associated with increased depression, anxiety, and stress. Nurses reported higher levels of depression, anxiety, and stress than other healthcare professionals. Additionally, there was a significant positive correlation between moral injury and symptoms of depression, anxiety, and stress. Female participants experienced higher rates of moral injury than male participants, and single individuals reported more suffering than married ones. Moral injury was notably higher among nurses compared to other healthcare professionals.

The study found that healthcare professionals experienced anxiety, stress, depression, and moral injury during the COVID-19 pandemic. Moral injury was strongly associated with increased stress, worry, and depression. Female healthcare professionals exhibited higher levels of anxiety and stress, while being married appeared to offer some protection against depression. Nurses were particularly vulnerable, with end-stage patients and insufficient resources contributing to elevated levels of anxiety, stress, and moral injury.

Psoriasis is a chronic disease that significantly negatively affects a patient’s quality of life. Based on etiopathological characteristics, there is strong evidence of susceptibility to psychological disorders, such as depression and bipolar disorder, in patients suffering from psoriasis.

We investigated the frequency of bipolar spectrum disorders in psoriasis patients compared to healthy controls in a selected population in Iran.

This case-control study was conducted on two sample groups, with and without psoriasis (50 people in each group). The statistical population included all individuals referred to Shohadaye Tajrish and Taleghani Hospitals of Shahid Beheshti University of Medical Sciences, selected using the available method and assigned to two groups in 2023. The participants were examined for the presence of bipolar spectrum disorders using the Mood Disorder Questionnaire (MDQ) and the Bipolar Spectrum Diagnostic Scale (BSDS).

According to the MDQ questionnaire, the frequency rates of bipolar disorder in the patients and controls were 20% and 40%, respectively, with no significant difference between the groups (P = 0.108). Based on the BSDS, the frequency of bipolar disorder in the two groups, with and without psoriasis, was estimated to be 25% and 32.1%, respectively, with no significant difference (P = 0.226). The rate of major depressive disorders was also 22% and 26%, with no significant difference (P = 0.640).

Among Iranian patients with psoriasis, the presence of the disease may not be associated with an increased risk of bipolar spectrum disorders.

Given the inherent nature of their job, law enforcement staff regularly confront major stressors.

The prevalence of post-traumatic stress disorder (PTSD) among law enforcement staff is about twice that of the general population. We conducted this study to assess PTSD risk factors among this population.

This prospective case-control study was conducted on patients with PTSD working as law enforcement staff as the case group, and their comrades with no PTSD as the control group. We used a questionnaire, including possible factors contributing to the development of PTSD, to gather the data. Binomial logistic regression was used to calculate the odds ratio (OR) and 95% confidence intervals.

A total of 84 participants were included in the study. We found that some factors could be protective against PTSD, including marriage (OR: 0.270, 95% CI: 0.087 - 0.839, P-value: 0.024), having an academic degree (OR: 0.333, 95% CI: 0.114 - 0.978, P-value: 0.045), higher income (R2: 0.081; OR: 0.849, 95% CI: 0.721 - 1.000, P-value: 0.050), and receiving satisfactory family support (OR: 0.413, 95% CI: 0.171 - 0.999, P-value: 0.050). Furthermore, logistic regression showed that a positive psychological history (OR: 2.562, 95% CI: 1.025 - 6.406, P-value: 0.044), a positive familial psychological history (OR: 2.667, 95% CI: 1.099 - 6.406, P-value: 0.030), and encountering trauma (aside from the current trauma) after 18 years of age (OR: 2.643, 95% CI: 1.038 - 6.731, P-value: 0.041) are risk factors for PTSD.

Our results showed that marriage, having an academic degree, higher income, and receiving satisfactory family support are protective factors. In addition, the risk factors for PTSD include a positive psychological history, a positive familial psychological history, and encountering trauma (aside from the current trauma) after 18 years of age. However, given our limitations, further studies should be conducted before drawing solid conclusions.

The validity of self-reported methamphetamine use among treatment-seeking patients has been reported as inconsistent and therefore inconclusive.

To evaluate the validity of self-reported methamphetamine use versus urinalysis in patients with methamphetamine use disorder at a drug treatment center.

In this cross-sectional study, we enrolled 71 individuals with methamphetamine use disorder who were referred to the Iranian National Center for Addiction Studies (INCAS) clinic. Self-reported methamphetamine use in the last 72 hours was compared to urinalysis, conducted using the immunoassay technique. Sensitivity, negative predictive value (NPV), Cohen's kappa statistics, percent agreement, and positive percent agreement were estimated.

Only 24.6% of participants reported methamphetamine use during treatment. Self-reported methamphetamine use had a sensitivity of 50.0% and a NPV of 86.0%. The percent agreement, positive percent agreement, and Cohen's kappa statistic between self-reported use and the urine test were 86.0%, 42.8%, and 52.4%, respectively. No significant factors were found to be associated with the agreement between self-reported use and the urine test.

The validity of self-reported methamphetamine use appears to be relatively acceptable and can be used with caution for monitoring treatment.