Significant improvement of risperidone-induced retrograde ejaculation on drug holidays: a case report

Risperidone, which is one of the most commonly prescribed second-generation antipsychotics can cause several sexual adverse effects. To date, research on the sexual side effects of risperidone has been mostly restricted to symptoms of decreased libido, erectile dysfunction and delayed ejaculation and far too little attention has been paid to risperidone associated retrograde ejaculation. What is not clear is that whether this side effect appears in a dose-dependent manner and whether structured treatment interruptions/drug holidays can diminish sexual adverse effects without a reduction in treatment efficacy. Another question is whether concurrent use of opiates and risperidone can increase the risk of retrograde ejaculation due to their anticholinergic and adrenergic blocking properties. Here we describe a case of a 30-year-old male with schizophrenia and opium dependence who developed risperidone-induced retrograde ejaculation; however, the ejaculatory dysfunction improved significantly on drug holidays. This is the first report on the use of structured treatment interruptions in the management of risperidone-induced retrograde ejaculation. © 2019, © 2019 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group

Determining test-retest reliability and internal consistency of the persian version of personality inventory for diagnostic and statistical manual of mental disorders-5th edition (PID-5) among medical students and patients with psychiatric disorders

Background: Given the need for access to reliable diagnostic instruments of mental disorders in Persian language, the present study was designed to translate and determine the reliability and internal consistency of the Personality Inventory for Diagnostic and Statistical Manual of Mental Disorders-5th Edition (PID-5) instrument. Methods: Research sample was selected based on non-random (convenience) method for medical students (healthy population) and patients with personality disorder. After translating PID-5 via forward and backward translation method, test-retest reliability (10-20 days period) and internal consistency of the instrument were determined. This study was conducted in Hazrat-Rasoul Hospital, Iran Psychiatry Hospital and Tehran Psychiatric Institute, Tehran, Iran, during the year 2015. Questionnaires were self-reported and interviews were done by well-trained psychiatry residents. Findings: Totally, 217 individuals were assessed (114 healthy volunteers and 103 patients with personality disorders). Of 25 surveyed facets, eccentricity had the highest Cronbach�s alpha coefficient. The lowest alpha was seen for suspiciousness. Overall, in 22 facets from all 25 facets, alpha coefficients were higher than 0.700. To assess test-retest reliability, 28 persons of the medical students group completed the questionnaire for the second time. The correlation coefficient between the two measures in three facets (irresponsibility, perceptual dysregulation and rigid perfectionism) was between 0.800 and 0.900. In other aspects, the correlation coefficient between the two measures was higher than 0.900. Conclusion: The Persian version of PID-5 instrument had good test-retest reliability (r = 0.829 to 0.944) in a short time (about two weeks) and its internal consistency was desirable (Cronbach�s alpha = 0.697 to 0.944). � 2016, Isfahan University of Medical Sciences(IUMS). All rights reserved

Management of attention deficit hyperactivity disorder in children and adolescents: A national clinical guideline

One of the best approaches for evidence-based care is providing and using the guidelines. Observing these guidelines results in a better quality of health care, decreased unnecessary or harmful interventions, lower health costs, and an increase in patients� satisfaction. Management of Attention Deficit Hyperactivity Disorder (ADHD)-1 in children and adolescents is a guideline published after 6 years of research and review of resources in the domain of treatment of ADHD. A research team formed in Iran University of Medical Sciences provided this guideline by addressing reliable references and observing a scientific approach. This guideline is provided with respect to the present resources for the standard treatment of ADHD in our country. To prepare this guideline, this research team considered the most recent and strict version of the writing method in the treatment section of Health, Treatment, and Education Ministry. Although the present guideline has some shortcomings, it is a turning point in the history of the development of health care. It presents a systematic approach in the treatment of such disorder, one of the most prevalent disorders in child psychiatry. The colleagues and treatment centers can help such an issue by applying this guideline. © 2020, Iran University of Medical Sciences. All rights reserved

Prevalence of Dementia Among Older Patients: A Hospital-Based Study in Iran

Background: Dementia constitutes a public health hazard in developing countries. The aim of this study was to evaluate the prevalence of dementia and its associated factors in older hospitalized patients. Methods: The participants of this cross-sectional study consisted of older patients admitted to medical wards in Rasoul-e Akram hospital in Tehran, Iran. Mini-Mental State Examination, Mini-Cog test, Geriatric Depression Scale, Activities of Daily Living-Instrumental Activities of Daily Living (ADL-IADL) scale, and socioeconomic questionnaires were used. Results: A total of 205 elderly inpatients were included. The mean age was 71.33 ± 7.35 years; 63.4 of the participants had normal cognitive function, while 36.6 had some degree of cognitive impairment. There was a statistically significant relationship between gender, age, number of children, and occupation and the prevalence of dementia. Conclusion: Appropriate cognitive screening of older patients upon admission to hospitals could help identify potential adverse events and enhance the quality of care for patients with comorbid dementia. © The Author(s) 2019

Validity and reliability of the Persian version of �drug-related knowledge and attitude questionnaire� among Iranian medical students

Background: Promoting drug-related knowledge and improving relevant attitudes among students are of crucial importance toward the prevention of drug misuse. Objective: This study aimed to assess the validity and reliability of the �drug-related knowledge and attitude questionnaire� among Iranian medical students. Methods: The participants of this cross-sectional study were students of Iran University of Medical Sciences. The �drug-related knowledge and attitude questionnaire� and a socio-demographic questionnaire were used to gather the data. Content validity was assessed by a panel of 11 experts, and face validity was evaluated by 10 participating students. Item-total correlation and Cronbach�s alpha coefficients were used as internal consistency estimates. Results: The face and content validity of the questionnaire were satisfactory. The overall content validity index was.82. Cronbach�s alpha was.679, indicating an acceptable degree of internal consistency and homogeneity between the items. Overall, most of the students had adequate knowledge about the harmful effects of addictive substances (48.11 ± 3.26). Conclusions: The �drug-related knowledge and attitude questionnaire� has favorable validity and reliability to assess the knowledge and attitude of Iranian students toward drug misuse and may be used in clinical and epidemiological studies. Besides, our findings can provide a suitable starting point for the implementation of effective psychoeducational interventions aimed at the improvement of the students� knowledge and attitudes toward drug misuse. © 2020, © 2020 Taylor & Francis Group, LLC

De lokale samenleving: een integratiekader én een interventiekader?

Caregiving for dependent older adults with dementia has become an important public health issue. However, not much is known about the caregiver experience for caregivers of patients with dementia in Iran. This study was designed to examine the relationship between variables pertaining to primary caregivers and patients and the level of perceived caregiver burden. The participants of this cross-sectional study were 60 caregiver and care-recipient pairs presented to Rasoul-e Akram hospital and Brain and Cognition Clinic, in Tehran, Iran. A sociodemographic questionnaire, the Zarit Caregiver Burden Interview (ZBI), the General health questionnaire-28 (GHQ-28), the NEO Five-Factor Inventory (NEO-FFI), the Spiritual Well-Being Scale (SWBS), the Neuropsychiatric Inventory (NPI), and the Mini-Mental State Examination (MMSE) were used. Descriptive statistics, correlation coefficients, T-test, and multiple linear regression analyses were used in this study. Years of caregiving, hours of caregiving/week, total and subscale GHQ-28 scores, existential well-being subscale score on SWBS, and total NPI score were found to be significantly associated with the level of caregiving burden (p < 0.05). In addition, among the caregivers� personality traits, neuroticism and agreeableness predicted caregiver burden. Other sociodemographic factors and MMSE scores were not found to be significantly related to caregiver burden. A better understanding of the indicators of caregiver burden can help physicians, policy makers, and mental health managers to tailor the most appropriate preventative and remedial interventions for family caregivers. © 2020 Taylor & Francis Group, LLC

Comparison of vortioxetine and sertraline for treatment of major depressive disorder in elderly patients: A double-blind randomized trial

What is known and objective: Major depressive disorder (MDD) is a complex disease and one of the leading contributors to disease burden throughout the world. In the current study, we explored the efficacy and tolerability of vortioxetine versus sertraline on symptoms of depression in elderly patients with MDD. Methods: Sixty patients diagnosed with MDD (based on DSM-5) and Hamilton Depression Rating Scale (HAM-D) score � 19 were entered into a randomized double-blind study and were randomized to receive either vortioxetine (15 mg daily) or sertraline (75 mg daily) for six weeks. Patients were assessed using the HAM-D scale at baseline and weeks 3 and 6. Changes in HAM-D score, response rates, remission rate and time to response or remission were also compared between the two study groups. Results and Discussion: Fifty patients completed the trial after six weeks. General linear model repeated measures demonstrated no difference in trend of the two treatment groups (P =.897). There was no significantly different improvement in the HDRS scores from baseline to weeks 3 and 6, as well. Differences in response rate, remission rate, time to response and time to remission periods were not statistically significant. Finally, there was not any significantly difference between the two study groups in the frequency of adverse events. What is new and conclusion: This study showed no significant differences in the efficacy and safety of vortioxetine in comparison with sertraline in order for it to be used safely for treatment of major depressive disorder in elderly patients. © 2020 John Wiley & Sons Lt