Reliability, validity, and factorial structure of the world health organization-5 well-being index (WHO-5) in iranian psychiatric outpatients Confiabilidade, validade e estrutura fatorial do world health organization-5 well-being index (WHO-5) em pacientes psiquiátricos ambulatoriais iranianos

Introduction: The association between psychological well-being and physical and mental health has been shown in the literature. Psychological well-being is a multifaceted concept. The World Health Organization-5 Well-Being Index (WHO-5) is a 5-item instrument used to screen for depression. However, the validity of the WHO-5 has not been investigated in Iranian psychiatric or psychological settings. Objective: To investigate the validation of the Farsi version of the WHO-5 in a sample of Iranian psychiatric outpatients. Methods: A cross-sectional study was conducted with a convenience sample of 116 Iranian volunteer psychiatric outpatients selected from the psychiatric and psychological clinics at the School of Behavioral Sciences and Mental Health � Tehran Institute of Psychiatry, Iran University of Medical Sciences. Patients completed the WHO-5, the Patient Health Questionnaire-9 (PHQ-9), the Patient Health Questionnaire-15 (PHQ-15), and the short form of the Beck Depression Inventory-13 (BDI-13). Results: The mean score of the WHO-5 was 8.95 (standard deviation SD = 5.49). Cronbach�s α for the WHO-5 was 0.91. The WHO-5 negatively correlated with PHQ-9 (-0.358), PHQ-15 (-0.328), and BDI-13 (-0.475), indicating good validity. Factor analysis of the WHO-5 items identified one factor labeled psychological well-being. Conclusions: The WHO-5 has a single dimensional structure and acceptable psychometric parameters. The results of this study suggest that WHO-5 can be used in a clinical context in Iran. © 2018, Sociedade de Psiquiatria do Rio Grande do Sul. All rights reserved

A noninterventional study evaluating the effectiveness of rotigotine and levodopa combination therapy in younger versus older patients with Parkinson\u27s disease

Background: PD0013 was a 6-month non-interventional study in clinical-practice comparing effectiveness and tolerability of rotigotine+levodopa in younger (<70years) vs. older (≥70years) Parkinson’s disease (PD) patients.Methods: Patients previously received levodopa for ≥6-months as monotherapy or in combination with another dopamine-agonist (DA). Primary variable: Unified PD Rating Scale (UPDRS) Part-II change from baseline to end-of-observation-period (EOP).Results: 91 younger/99 older patients started rotigotine; 68 younger/62 older patients completed the study. Most switched from levodopa+another DA. Addition of rotigotine as first DA was more common in older patients (20.2% vs.15.4%). Mean\ub1SD rotigotine-exposure: 6.1\ub13.4mg/24h younger vs. 4.9\ub12.4mg/24h older. Eleven patients changed levodopa dose during the study.At EOP, improvement in mean UPDRS-II was greater in younger patients (p=0.0289). UPDRS-II responder-rate (≥20% decrease in UPDRS-II score) was higher in younger patients (42.3% vs. 25.9%). Improvement across age-groups was similar on PD Sleep Scale-2 and Clinical Global Impressions-Improvement Scale. Adverse-drug-reactions (ADRs), and discontinuations because of ADRs, were more common among older patients. There were no new safety-signals.Conclusions: Despite low rotigotine doses, when added to levodopa or switched from levodopa+another DA, rotigotine led to greater improvement in UPDRS-II in younger patients (<70years). Assessment of individual patient data revealed clinically-meaningful improvements in UPDRS-II in both age-groups

Transcranial magnetic stimulation as a translational biomarker for AMPA receptor modulation

TAK-653 is a novel alpha -amino-3-hydroxy-5-methyl-4-isoxazolepropionic acid receptor (AMPAR)-positive allosteric modulator being developed as a potential therapeutic for major depressive disorder (MDD). Currently, there are no translational biomarkers that evaluate physiological responses to the activation of glutamatergic brain circuits available. Here, we tested whether noninvasive neurostimulation, specifically single-pulse or paired-pulse motor cortex transcranial magnetic stimulation (spTMS and ppTMS, respectively), coupled with measures of evoked motor response captures the pharmacodynamic effects of TAK-653 in rats and healthy humans. In the rat study, five escalating TAK-653 doses (0.1-50mg/kg) or vehicle were administered to 31 adult male rats, while measures of cortical excitability were obtained by spTMS coupled with mechanomyography. Twenty additional rats were used to measure brain and plasma TAK-653 concentrations. The human study was conducted in 24 healthy volunteers (23 males, 1 female) to assess the impact on cortical excitability of 0.5 and 6mg TAK-653 compared with placebo, measured by spTMS and ppTMS coupled with electromyography in a double-blind crossover design. Plasma TAK-653 levels were also measured. TAK-653 increased both the mechanomyographic response to spTMS in rats and the amplitude of motor-evoked potentials in humans at doses yielding similar plasma concentrations. TAK-653 did not affect resting motor threshold or paired-pulse responses in humans. This is the first report of a translational functional biomarker for AMPA receptor potentiation and indicates that TMS may be a useful translational platform to assess the pharmacodynamic profile of glutamate receptor modulators.Stress-related psychiatric disorders across the life spa

Suicide attempt and its relation to stressors and supportive systems: a study in Karaj city

Background: Psychosocial stressors and the quality of the support system are important factors in attempted suicide. This research has studied these stressors and the condition of the support system in suicide attempt cases in Karaj, Iran. Methods: This is a part of the Iranian section of the widest multisite study on suicide prevention (SUPRE-MISS) proposed and directed by the WHO in eight countries, including Iran. Here we present data obtained from 632 suicide attempters presenting in emergency centers over a period of ten months. Results: According to the time lapse from the stressor to the suicide attempt, proximal stressors are considered to be precipitating while distal stressors are considered to be perpetuating factors. Although, family conflicts were found to increase the risk of suicide one year after the conflict, conflicts with family (25%) and spouse (35%) were the most frequent stressors one month before the attempt, acting as proximal factors. Conflict with spouse was more prominent for people who had been married less than seven years. Conflict with family was the most important stressors for 15-25 year-old attempters. Though it is not clear which areas of conflict are more crucial in a suicide attempt, especially considering gender differences, educational and financial problems were more prominent one year before the suicide attempt. The support system was more crucial for female attempters: Although they received more practical support than males, females complained more of deficiencies in support. Conclusions: The roles of different psychological stressors in attempted suicide vary according to the time lapse from the stressor until the suicide. Family and marital conflicts can be precipitating and perpetuating factors, while educational and financial problems appear to be perpetuating factors. Family is considered to be an important support system for a great number of attempted suicide cases, especially since it offers practical support. Support systems are crucial in preventive programs for suicide, especially among women