Integration of suicide prevention program into primary health care network: A field clinical trial in Iran

Background: Suicide prevention is one of the priorities in policies of Iranian Ministry of Health and Medical Education (MHME). The suicide prevention program had two main parts of identifying and treatment of the depressed and suicide high risk individuals by Primary Health Care (PHC) network. The main aim of this study was to evaluate the results of integration of the program into PHC network in two cities with moderate to high rate of suicide with diverse socio-cultural backgrounds. Methods: This work as a field trial study was conducted in Nahavand and Savojbolagh from April 2010 to March 2011 (12 months). A screening tool was designed. Required capacities such as treatment, referral and registration system were provided six months before the main study. The intervention phase (for one year) including the treatment process and five consultation sessions was conducted to identify depressed people and individuals with high risk of suicide. The data were analyzed by Chi square test. Results: After one year of intervention, the rate of committing suicide became 4.98 and 3.36 per one hundred thousand population in Nahavand and Savojbolagh, respectively (16 and 1.6 per 100,000 in the year of before intervention respectively, 2009-2010). The female: male ratio of committing suicide was 2:1 in Nahavand and 1:1 in Savojbolagh. The most common method of committing suicide was drug intoxication in both cities. The identified cases by health workers at rural setting were 33 to 44 per 1000, in which 1.3 cases per 1000 population had been approved by general physicians. Conclusion: This study approved the feasibility and efficacy of integration of suicide prevention program into PHC. The increased rate of suicide in Savojbolagh could be related to low rate of screening and lack of treatment facilities (hospitalization and electroconvulsive therapy (ECT), and part-time psychiatrist. Increasing the PHC capacities could improve the health network efficiency to identify and manage depressed and at risk of suicide individuals. Screening tool/s and method have to be improved to provide better results

Mental health assessment in patients admitted to iran psychiatric hospital with a diagnosis of psychosis due to 2 - 5 years of methamphetamine use

Background: Psychotic disorder due to methamphetamine has a high prevalence with an unknown nature and history. Patients with such disorders are faced with the risk of recurrence of abuse and other psychiatric disorders. Methamphetamine-induced psychotic disorders may continue by independent of methamphetamine abuse, such as primary psychotic disorders (such as schizophrenia). Objectives: This study was performed to evaluate the mental health and frequency of methamphetamine-induced psychosis in patients referred to Iran psychiatric hospital (a university hospital in Tehran, Iran). Patients and Methods: The research was done on patients with methamphetamine-induced psychosis after 2 to 5 years using of methamphetamine (150 person in the Iran Psychiatric Hospital) .The diagnostic interview was done based on a semi-structured interview (SCID). The data was analyzed by Binary Logistic Regression Model. Results: From 150 patients that were followed, 6 of them (4.0) died during the phone interview-follow up. The mean age of alive patients was 34.9 ± 8.7 years and 12 of them were women (8.0). At the follow-up interview, 38 patients reclassified as the cases of schizophrenia (25.3), 17 as the cases of major depressive disorder (11.3), 7 as the cases of bipolar disorder type I (4.7), two as the cases of schizoaffective disorder (1.3), and two of them as the cases of delusional disorder (1.3). A total of 84 cases (56.0) were diagnosed as recovered cases or as methamphetamine-induced psychotic disorders. Prediction of diagnosis change showed the diagnosis of methamphetamine use disorder (adjustedOR= 3.978, 95 CI: 1.265 - 12.512), previous psychiatric admission (adjustedOR= 6.749; 95 CI: 1.639 - 27.779), and short duration of psychotic episode (adjusted OR = 0.171; 95 CI: 0.056 - 0.520. Conclusions: The results of our study show that methamphetamine-induced psychotic disorders are associated, in many cases, with the mood disorders. It seems that comorbid mood disorders, age of first use, history of previous psychiatric hospitalization, the risk of methamphetamine use disorders, and psychotic episodes are associated longer with the diagnosis towards primary psychotic disorders. © 2018, International Journal of High Risk Behaviors and Addiction

The frequency of sexual abuse and depression in a sample of street children of one of deprived districts of Tehran

The purpose of this study was to determine the frequency of sexual abuse and depression among street children who live in a deprived district of Tehran. The researchers used the K-SADS questionnaire and a clinical interview were used to evaluate depression and sexual abuse in 87 street children in Tehran. Eighteen (20.9) of the children had been sexually abused. Depressed children were 3.2 times more likely to be sexually abused than non-depressed children. Furthermore, 26 girls (86.7) and 27 boys (48.2) suffered from depression. The frequency of depression demonstrated a significant association with the father's or breadwinner's history of imprisonment or unemployment. Interventional programs providing education and support should be implemented for street children. Copyright © by The Haworth Press, Inc. All rights reserved

Dopamine receptor gene (DRD1-DRD5) expression changes as stress factors associated with breast cancer

Breast cancer is the most common cancer among females worldwide and a most prevalent malignancy in Iranian women. Chronic stress may make an important contribution to cancer, especially in the breast. Numerous studies showed roles of neurotransmitters in the occurrence and progression of cancers which are mediated by their various types of receptors. This study was conducted to evaluate alterations in the expression profile of dopamine receptor genes in peripheral blood mononuclear cells (PBMC) as stress factors in breast cancer patients and the human breast cancer cell line (MCF-7). Peripheral blood samples were obtained from 30 patients and 30 healthy individuals. Total mRNA was extracted from PBMC and MCF-7 cells and RT-PCR was performed to confirm the presence of five dopamine receptors (DRD1-DRD5). Expression changes of dopamine receptor genes were evaluated by real time PCR. We observed that DRD2-DRD4 in PBMCs of breast cancer patients were increased compared to healthy individuals. In addition, all dopamine receptor subtypes but DRD1 were expressed in MCF-7 cells. Therefore, alterations of these receptors as stress factorsshould be assessed for selecting appropriate drugs such as D2-like agonists for treatment of breast cancer after performing complimentary tests. Determining the expression profile of dopamine receptor genes thus seems promising

Evaluation of gene expression changes of serotonin receptors, 5-HT3AR and 5-HT2AR as main stress factors in breast cancer patients

Breast cancer is a serious and potentially lethal multi-factor disease among 40-50 aged women in both developed and developing countries. Also, various studies have pointed to roles of neurotransmitters like serotonin in development of cancers, through action on various types of receptors. This study was conducted to evaluate serotonin receptor (5HT2AR and 5HT3AR) genes expression in peripheral blood mononuclear cells (PBMCs) of breast cancer patients in comparison with the healthy people and in the MCF7 cell line. Peripheral blood samples were obtained from 30 patients and 30 healthy individuals. Total RNA was extracted from PBMCs and MCF-7 cells. and 5HT2AR and 5HT3AR were detected by RT-PCR techniques. Finally, serotonin receptor gene expression variation in breast cancer patients and MCF-7 cells were determined by real time-PCR. This latter indicated significant promotion in expression of 5HT3AR and 5HT2AR in PBMCs in breast cancer patients but expression of 5HT2AR in the MCF-7 cell line was significantly decreased. In conclusion, after performing complimentary tests, determine of gene expression changes in serotonin receptors (5HT2AR and 5HT3AR) may be useful as a new approach in treatment of breast cancer based on use of antagonists

Epigenetic and genetic aberrations of the brain dopaminergic system in schizophrenia and bipolar disorder: Achievements and prospective

The molecular mechanisms of the fact that more than 50 of the individuals with the same genetic make up (e.g. identical twins in schizophrenia) do not show the same psychiatric phenotype remained undefined in psychiatry. This along with the failure to find responsible genes with major effects in psychiatric disorders and lack of consistency of genetic association studies led to the current unanimous conclusion that, in addition to the genetic factors, environmental and epigenetic factors influence the functions of brain and the presentation of the symptoms in mental diseases. Here we reviewed the potential epigenetic dysregulations of genes related to dopaminergic (DAergic) system. A comprehensive genetic and epigenetic analysis of the DAergic and the interacting pathways such as serotoninergic and glutaminergic systems could help to understand the molecular bases of the differences in disease severity in individuals with similar or identical genetic make-up that can assist for the identification of novel targets with therapeutic and preventive applications

Lower folate levels in methamphetamine-induced psychosis: A cross-sectional study

Background: Folate deficiency is shown to be associated with schizophrenia. Folate profile in patients with psychosis due to stimulant use has not been investigated. We aim to determine whether there is an association between serum folate level and the presence of psychosis in patients with methamphetamine (METH) use disorder. Methods: Forty patients diagnosed with METH-use disorder were included in this cross-sectional study. Serum folate levels were measured using enzyme immunoassay technique and compared between psychotic and non-psychotic subgroups (N = 25 and 15, respectively). We designed a logistic regression model to measure the extent of any association and also to adjust for potential confounders. Results: We detected lower serum folate level in the psychotics 3.4 (IQR = 5.3) compared to non-psychotic METH users 8.9 (IQR = 2.5), p = 0.01. The model demonstrated that every 1-unit increase in serum folate decreases the odds of presence of psychosis by 27% (R2 = 53.5%, CI 12�64%, p = 0.006). The observed difference was not associated with the duration of METH use, patient's age at first METH use, or concurrent use of other substances. Conclusions: Our findings suggest that low folate level in psychotic METH users does not correlate with previously established risk factors for meth-induced psychosis such as duration of use, age of onset of using, and poly-drug use. We assume that low folate levels may play a crucial role in the pathophysiology of psychosis. © 2019 Elsevier B.V

A study on microstructure development and mechanical properties of pure copper subjected to severe plastic deformation by the ECAP-Conform process

Commercially pure copper rod was successfully subjected to severe plastic deformation by applying the continuous equal channel angular pressing (ECAP-Conform) method at room temperature. Microstructural characterizations of copper rod samples at various stages of plastic deformation were carried out by optical microscopy and electron backscatter diffraction methods. X-ray diffractometry and Kernal average misorientation were used for dislocation density estimations. Microstructural evaluations revealed grain size change of 30 μm for the initial annealed copper rod to less than 5 μm and even 100 nm for severely deformed samples. Mechanical behaviors of samples after different deformation stages were characterized using tensile and hardness tests. The ultimate tensile strength of the severely deformed copper rod was increased threefold by ECAP-Conform while elongation halved in comparison to the initial annealed copper. Low-temperature annealing of severely plastic deformed samples led to bi-modal grain size distribution and lowering of strength accompanied by the increase of elongation. Tensile properties of severely deformed and then annealed copper samples showed around a 40% increase in both ultimate tensile strength and elongation in comparison to the initial annealed copper rod

Dopamine Receptor Gene Expression Changes in Peripheral Blood Mononuclear Cells from Schizophrenic Patients Treated with Haloperidol and Olanzapine

We investigated dopamine receptor gene expression in peripheral blood mononuclear cells of schizophrenic patients before and after treatment. Also dopamine receptor genes expression profile was compared in two treatment groups including haloperidol and olanzapine. The peripheral blood mononuclear cells were separated from whole blood by Ficoll-hypaque; the total cellular RNA was extracted and the cDNA was synthesized. This process was followed by real-time polymerase chain reaction using primer pairs specific for five dopamine receptor mRNAs and β-actin as internal control. The results show the presence of all types of dopamine receptor in lymphocytes. Dopamine receptor gene expression profile in dopamine receptor D2 gene and dopamine receptor D4 gene showed significant changes that were correlated with the type of treatment and Clinical Global Impressions score improvement. In conclusion, the present study shows that human lymphocytes express dopamine receptor D1–D5 genes. Moreover, investigated dopamine receptors gene expression in peripheral blood mononuclear cells of schizophrenic patients correlated with clinical symptom improvement