Catatonia: extinct, lost, or forgotten?

Catatonia is a neuropsychiatric syndrome that occurs in some primary psychiatric disorders (e.g., schizophrenia, mood disorders), or due to general medical conditions (e.g., neurological disorders, drug poisoning, metabolic disorders) (1). Although it is uncommon, but if it goes unrecognized in medical and surgical units (2), it can increase morbidity and mortality. Moreover, making a connection between signs observed across different systems (the motor, somatic, and psychiatric symptoms) could lead to misdiagnosis and a delay in treatment (3)

Venlafaxine-induced Thyroiditis: A Case Report

Thyroiditis is the most common inflammatory disorder that affects thyroid gland.The diagnosis is mainly based on clinical findings, in particular the degree of pain and tenderness of thyroid. Confirmatory laboratory test includes presence of thyroid specific autoantibodies. Treatment is based on the severity of symptoms (pain and redness) and aims to restore the normal function of thyroid. Drug-induced thyroiditis has been described previously in the literature. Venlafaxine is an antidepressant agent with an efficacy similar to that of selective serotonin reuptake inhibitors. The dose of this medicine can be adjusted up to 150 mg/day one year after initiation. However, usage of venlafaxine may be limited due to the dose-dependent side effects. Here we describe a patient diagnosed with generalized anxiety disorder and migraine headache who developed venlafaxine-induced thyroiditis following dose adjustment to the maximum of 150 mg/day. The diagnosis was made based on the clinical symptoms and confirmatory laboratory tests according to the Naranjo Adverse Drug Reaction Probability Scale. Thyroiditis symptoms subsided after reducing venlafaxine dose and initiating prednisolone therapy. It should be noted that thyroid function was fully restored to normal only after cessation of venlafaxine administration

Oxymetholone-Induced Acute Renal Failure: A Case Report

Background: The prevalence of using anabolic steroids such as oxymetholone is increasing. This highlights the need for closely monitoring side effects of this drug. Acute renal failure (ARF) has been reported as a complication of rhabdomyolysis in anabolic steroids users. Case presentation: We present one 33-year-old man complaining of decreased urine volume, urine color change, and lower abdominal pain. He is engaged with a rare side effect of oxymetholone abuse. During assessments of potential medical issues associated with the intake of anabolic steroids, known side effects are known to be transient, but the need for appropriate interventions remains essential. Conclusions: Rhabdomyolysis due to drug use and the consequent acute kidney injury are among the lethal risks associated with anabolic steroid abuse. In most cases, the symptoms are extensive and often misleading. Therefore, detailed history taking, physical scrutiny, paraclinical testing, and early diagnosis are crucial for rhabdomyolysis patients

Fear of childbirth in Iran: A systematic review of psychological intervention research

Background: Due to the fear of childbirth (FOC) and failure to provide painless delivery in Iran, the prevalence rate of elective cesarean section (C-section) performed on request by pregnant women is on the rise. However, no systematic review assessing the results of studies in this respect has been thus far developed. Objective: To systematically review published psychological intervention research reflecting on FOC in Iran. Materials and Methods: In this systematic review, the databases of PubMed, MEDLINE, PsycINFO, Wiley, ISI Web of Science, Scopus, Science Direct, Cochrane Library, Google Scholar, and Scientific Information Database were searched to retrieve the relevant studies. Manual searches were performed to find the relevant articles and finally 21 intervention studies were reviewed. Results: Based on the modified Jadad Scale, a methodological quality (risk of bias) assessment tool, 14 and 7 studies had acceptable or good and low quality, respectively. The included articles covered fear, fear of childbirth, pregnancy, and psychological intervention in Iran. Cognitive behavioral therapy, relaxation techniques, psychological counseling, childbirth preparation classes (CPCs), mindfulness programs, and psychoeducation had been also practiced as the main types of psychological interventions for reducing FOC in pregnant women. Conclusion: There was no clear evidence to establish the most effective method for minimizing levels of FOC in pregnant women. Based on the assessment tool and since most of the studies had moderate or low quality, conducting standard and high-quality randomized controlled trials focusing on FOC in pregnant women is of most importance in Iranian population. Key words: Fear, Childbirth, Pregnancy, Psychological intervention, Iran

Improvement in patient–reported outcomes after group poetry therapy of women with breast cancer

Background: One of the best ways of achieving the patients’ views and expectations about the effects of a therapeutic or palliative intervention on their quality of life is using PatientReported Outcome Measures (PROMs). Poetry therapy as a psychotherapy intervention has been used for palliation of stressful conditions of several chronic diseases and disabilities. In the present study, we aimed to evaluate the effectiveness of group poetry therapy on the quality of life measures in women with breast cancer.Methods: A total of 30 women with breast cancer, undergoing chemotherapy at a referral center in the north of Iran, participated in the current quasi-experimental before-after study conducted in 2016. The study protocol included eight weekly sessions of group poetry therapy using poems from the great Persian poets. The European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC-QLQ-C30) was completed by the patients before beginning group poetry therapy and, twice more, one week and two months after the last session. Items of the questionnaire were manually scored and then analyzed using appropriate statistical tests in IBM SPSS Statistics for Windows, Version 21.0. Armonk, NY: IBM Corp.Results: A total of 28 patients participated in all the group poetry therapy sessions and completed the questionnaire. The mean and standard deviation of age were 45±66. The changes in the score of quality of life from 51.8 to 65.5 and 69 were observed to be significant in the one-week and two-month follow ups (both with P=0.002). Also, changes in symptom score from 34.5 to 23.7 (P=0.01) and functional score from 65.6 to 77.2 (P=0.01) in the two-month follow up were found to be statistically significant.Conclusion: Based on the findings of the study, it can be concluded that group poetry therapy, as a psychotherapy approach, can be used to improve quality of life in breast cancer patients

Bradycardia Caused by interaction of Venlafaxine and Cyclosporine: A case report

Background: Selective serotonin reuptake inhibitors (SSRIs) and serotonin-norepinephrine reuptake inhibitors (SNRIs) are prescribed widely for the treatment of depression, anxiety disorders and other psychiatric disorders. Although antidepressants are considered as a safety drug category but unexpected cardiovascular events have been reported as the most serious complications. The aim of this study was to introduce a case presentation on bradycardia due to the drug interference of venlafaxine and cyclosporine. Case presentation: The patient was a 38-year old woman diagnosed with systemic lupus erythematosus 5 years ago, who was admitted to a general educational hospital in northern Iran due to intensified rheumatologic symptoms and complaining about abdominal pain. Cyclosporine tab were administered to the patient, 50 mg twice daily. Two weeks after the administration of cyclosporine, the level of blood cyclosporine was checked. The patient became bradycardic after starting a single dose of venlafaxine (heart rate 52 ppm). Cardiac assessment showed no reason for bradycardia and it subsided after a drop of venlafaxine. Conclusion: As a result of the potential adverse drug interactions between cyclosporine and antidepressants such as venlafaxine, physicians should be aware of the possibility of bradycardia in the simultaneous prescription of these drugs in cases

The Validity and Reliability of the Persian Version of Nomophobia Questionnaire

Background: Nomophobia is the fear of being disconnected from one’s mobile phone, prevailing in modern area. To the best of our knowledge, no Persian psychometric scales are available for investigating nomophobia among Iranians. Therefore, we here aimed to translate and validate the Nomophobia Questionnaire (NMP-Q) for being used in Iran. Methods:The NMP-Q was translated from English to Persian using a classical “backward and forward” procedure. Exploratory factor analysis (EFA) was carried out to explore the underlying factor structure of the translated questionnaire. A principal component analysis (PCA) approach with varimax rotation was further performed. Findings: 425 volunteer students were included. Among them, 80.2% were 20-30 years old. Men and women constituted 187 (44.0%) and 238 (56.0%) of the participants, respectively. 100 (23.5%) of the subjects were medicine graduates. Using mobile phones for more than 5 years was noted in 215 (50.6%) subjects. Also, 422 (99.3%) subjects connected to the Internet via their cellphones. Regarding cellphone usage, 301 (70.8%) subjects used them less than 5 hours a day, 158 (37.2%) subjects checked their cellphones less than 10 times a day, and 92 (21.6%) subjects checked their cellphones every 20 minutes. Eigenvalues and the scree-plot supported a 3-factorial nature of the translated questionnaire. NMP-Q showed an overall Cronbach's alpha coefficient of 0.93 (the coefficients of 0.90, 0.77, and 0.71 for the three factors, respectively). The first, second, and third factors explained 26.30%, 20.84%, and 17.60% of the variance, respectively. The total score of NMP-Q correlated with the hours spent with mobile phones, the years of using them, and the age. Conclusion: Our findings showed that the Persian version of the NMP-Q was a valid and reliable tool for evaluating nomophobia among Iranians

A Systematic Review of the Effects of Aromatherapy with Lavender Essential Oil on Depression

Introduction: Depression is considered as one of the most serious health issues worldwide, and the search for the most effective and safe treatments for depression is essential. Aromatherapy with lavender have attracted the attention of many researchers due to their low cost and ease of use, so this study was conducted to review of the effects of aromatherapy with lavender essential oil on depression.Methods: This systematic review study was conducted by searching the databases (SID, Magiran, Google-Scholar, Medline via PubMed, Scopus, and Web of Science) by using the keywords such as depression, Lavandula, Lavender, and Aromatherapy, as well as applying OR and AND operators to the end of January 1, 2020 A.D. The inclusion criteria were: 1) Interventional studies that determined keywords were in the title or keywords of the article, 2) aromatherapy was conducted through inhalation or massage, 3) the full text of paper was accessible, and 4) published in English or Persian. Finally, the information obtained from articles was extracted using a checklist.Results: Out of 278 studies, 9 studies were included to the systematic review process after screening and eliminating duplicate papers according to the purpose of the study. Aromatherapy with lavender essential oil was conducted on the patients suffering from migraine, patients with the acute coronary syndrome, patients undergoing hemodialysis, community-dwelling older adult, and postpartum depression. The results obtained from some studies showed the positive effect of aromatherapy with lavender essential oil on depression whereas some studies did not report the effect of aromatherapy with lavender on depression significantly.Conclusion: It seems that aromatherapy with lavender probably can be used as a complementary, simple, and inexpensive method to improve mild and moderate depression. It is recommended to earmark using a collaborative approach and make use of interdisciplinary and psychology specialists as well as complementary medicine in applying aromatherapy with lavender essential oil

Investigating the mental health status of infertile women

Letter to Editor The stressful experience of infertility is associated with a wide range of psychological damage (1), so infertility affects people’s mental health and all aspects of an individual’s life (2). Since women in the family are considered to be the main pillars of the community and they are also more vulnerable to illnesses, therefore consideration of their health is also very important (3). The objective of the current letter is investigating the mental health status of infertile women and its related factors as predictors of mental health ininfertile women. This is a descriptive study conducted on 100 infertile women referred to the infertility treatment centers in Mazandaran province, North of Iran. The General Health Questionnaire was provided to the infertile women. The questionnaire is a self-reporting questionnaire that is used clinically to track those who are prepared for mental illness(4).Based on the findings, Total Scale of General Health Questionnaire was 33.18 ± 10.27 that was according to the cut-off point of 22, 85% of the infertile women in this study are in the disorder condition. Also, in terms of subscales: physical complaints was 8.65 ± 3.97, anxiety and insomnia was 8.69 ± 5.58, disruption of social function was 12.73 ± 3.34, and depression was 3.10 ± 3.79. The most common disorder was related tosocial disorder subscale and the least common subscale was related to the depressiondisorder. The subscales of physical symptoms and sleep disturbance and anxiety areranked almost at one level, and they are classified between the two subscales that werealready mentioned. Therefore, based on our findings and the level of women’s mental health, there isa need for a psychologist or midwifery counselor in the infertility treatment centers to improve the mental health of women. In addition, since the mental disease may also affect the outcome of the treatment, attention to the mental health of infertile women is really importance

The efficacy of group counselling on perceived stress among infertile women undergoing in vitro fertilization treatment: An RCT

Background: One of the stressful and critical experiences that threat the individual, family, marital, and social stability is infertility. Objective: To identify the effects of midwifery-led counselling programs on the perceived stress of the women undergoing assisted reproductive treatment. Materials and Methods: In this randomized clinical trial, 50 infertile women who underwent in vitro fertilization treatment for the first time were enrolled in two groups. The intervention group received six sessions of group counselling by M.Sc. midwifery of counseling student and the control group received only the routine care. All participants filled Newton’s standard questionnaire before and at the time of puncture, embryo transfer and the pregnancy test. Results: The mean ± SD scores for the perceived infertility stress before the intervention in the control and the intervention groups were 167.92 ± 12.14 and 166.75 ± 13.27, respectively. The mean of perceived stress after intervention at the time of oocyte puncture in the control and case group were 177.12 ± 19.37 and 115.75 ± 13.88, at the time of embryo transfer were 179.40 ± 18.34 and 118.08 ± 15.37, and at the time of pregnancy test was 183.76 ± 14.97 and 120.50 ± 16.24, respectively. The perceived stress of infertility after intervention were statistically significant in the two groups (p ≤ 0.001). Conclusion: Group counselling is one of the effective methods for reducing the perceived stress in women undergoing assisted reproductive treatment. Key words: Infertility, Group counselling, Perceived infertility stress