Psychotic experiences in patients with obsessive compulsive disorder. A cross sectional clinical study

Background: Obsessive-compulsive disorder (OCD) is associated with heterogeneous and diverse symptoms. A diagnosis is challenging when patients experience psychotic symptoms. This study aimed to evaluate the pattern of psychotic symptoms in patients with OCD. Methods: Using semi-structured clinical interviews, 185 patients meeting the DSM-IV diagnostic criteria for OCD were selected. The Yale-Brown Obsessive Compulsive Scale (Y-BOCS) and the Scale for the Assessment of Positive/Negative Symptoms (SAPS/SANS) were used to measure the OCD severity and insight levels and the pattern of psychotic symptoms, respectively. Characteristics of patients with and without psychotic experiences were compared. Results: A total of 38 patients (20.5%) displayed psychotic symptoms. Delusions were observed in 63.2% of these patients, while in 13.2% of them, delusions were accompanied with negative symptoms. Men, those aged between 18 and 34 years, less educated, and singles displayed significantly higher rates of psychotic symptoms. The mean Y-BOCS score (26.42 +/- 5.07) was significantly higher in patients with psychotic symptoms than in those without (24.97 +/- 6.38). Conclusion: The results showed that in OCD patients, psychotic symptoms are more common in young

Comparison of citalopram and fluoxetine sexual side-effects in male patients referred to psychiatric clinic

Introduction: Selective serotonin reuptake inhibitors (SSRIs) are among the selected medication to treat depression, panic disorder and many other psychiatric disorders. The most common undesirable effects of SSRIs are sexual dysfunctions that may lead to discontinuation of treatment in some patients. This study was conducted to compare sexual side-effects of two common drugs, citalopram and fluoxetine in male patients. Methods: This cross-sectional study was carried out on 60 male patients referred to the psychiatric clinics of Tabriz University of Medical Sciences, Iran, in 2013. They were candidates for SSRIs treatment and the clinic physicians prescribed citalopram or fluoxetine for them. The patients were examined in two groups after taking written informed consent and initial completion of the International Index of Erectile Function (IIEF) questionnaire and no history of sexual dysfunction, considering the inclusion and exclusion criteria. Both citalopram and fluoxetine groups completed IIEF questionnaire again at the end of the first and second months after treatment and statistical analysis was done using SPSS. Results: Sexual dysfunction was observed in both groups in the all sexual function indices and its components. Although there was no significant difference in terms of sexual function components between the two groups, general sexual dysfunction was significantly higher in the fluoxetine group. In both groups, age was inversely related to the general sexual function index. Conclusion: Unlike many other studies suggesting no difference on SSRI sexual side-effects, the present study showed a reduction in sexual function of men taking citalopram and fluoxetine and the reduction was more prominent with fluoxetine

Effects of a "Brief Stress Management Training Program" from Medical Students’ Viewpoints: A Qualitative Study

Introduction: Medical students undergo many stressors during various stages of medical education and must learn to cope with their new situation. Some studies have reported that stress management training methods have significant effects on decreasing stress in medical students. The aim of this study was to evaluate the efficacy of a "Stress Management Training Session" from medical students’ viewpoints. Methods: This study design employed a qualitative phenomenological research method. Using a goal-directed sampling method, medical students in the psychiatry ward during 3 months, participated in a "Stress Management Training Session". In this section, the nature of stress and some simple techniques for stress management were taught practically. After 1 month, participants cooperated in 3 focus group discussions. In the FGDs students explained their experiences in the stress management session and its effectiveness. After recording and writing discussions, subjects’ content was analyzed. Results: In total, 6 themes and 2:10 subthemes materialized from data analysis. In the students’ opinions, learning and using stress management techniques had good effects on their stress, sleep and headaches. Although some students didn’t notice to the efficacy on concentration, others believed stress management techniques were useful for learning and concentration. Conclusion: Based on the medical students’ opinions, learning and using stress management techniques had good effects on their stress, sleep and headaches and may improve concentration and learning quality

ARAS recent onset acute phase psychosis survey, a prospective observational cohort of first episode psychosis in Iran—the cohort profile

The Middle East is underrepresented in psychosis research. The ARAS recent onset acute phase psychosis survey (ARAS) is a longitudinal cohort across multiple centers in Iran, established to investigate characteristics, determinants and early course of psychosis in a non-Western, Middle East context. Here, baseline characteristics of the ARAS cohort are reported. The ARAS cohort enrolled patients with recent onset psychosis from September 2018 to September 2021 in East Azerbaijan, Kermanshah and Tehran, including Iranian patients from different sociocultural contexts. The baseline assessment included demographics, socioeconomic status, clinical (positive, negative, depressive symptoms) and psychosocial (religiosity, social support, self-stigma) characteristics, cognitive functioning, metabolic profile, substance use and medication use measured by validated questionnaires. These assessments will be followed up after one and five years. A total of 500 patients with a first episode of psychosis were enrolled from three provinces in Iran. With 74.1% being male, the mean age (SD) of patients was 32.3 (9.7) years. Nearly a quarter of patients was diagnosed with schizophrenia and 36.8% with substance induced psychotic disorder. Amphetamine (24%) and opium (12%) use were common, cannabis use was not (5%). Only 6.1% of patients lived alone while 29% of patients was married and had children. The majority of them had achieved secondary educational level and 34% had a paid job. The most common antipsychotic treatment was risperidone. There was a wide range for scores of PANSS, with 9.4% having dominant negative symptoms. The most common prescribed medication was risperidone. Near to 40% of patients had noticeable signs of depression and prevalence of metabolic syndrome was 13.4%. The majority of patients (57.2%) had moderate and 5.4% reported to have severe disability. More than 30% reported to be highly religious. Patients had the highest satisfaction with people living with, and the lowest for finance and job