Is psychosexual therapy a reliable alternative to bupropion extended-release to promote the sexual function in infertile women? An RCT

Background: Various treatment methods are used to deal with sexual problems. Objective: This study was applied to answer the question of whether psychosexual therapy (PST) can be a reliable alternative to bupropion extended-release (BUP ER) to promote sexual function in infertile women. Materials and Methods: In this randomized clinical trial, 105 infertile women with sexual dysfunction were randomly allocated to three groups: PST, BUP ER, and a control group. The PST group participated in a total of eight 2-hr group sessions. In BUP ER group, 150 mg/day Bupropion ER was administered for eight weeks. The control group did not receive any interventions. The female sexual function index (FSFI) and a clinical interview were used to assess their sexual dysfunction. Results: The mean pre-to-post treatment scores of FSFI and its subscales increased significantly in PST and BUP ER groups (except in the subscale of sexual pain) (p = 0.0001, p = 0.0001). The changes in the subjects were not significant in the control group. After adjusting for the baseline values, the results remained significant for the mean FSFI (p = 0.0001), and its subscales between the groups. Compared to the control group, a significant increase was observed in the mean FSFI (p = 0.0001, p = 0.002) and its subscales in the PST group and in the BUP ER group (except in the subscale of sexual pain). Comparison of two intervention methods showed that PST had the better effect on the sexual function improving (p = 0.0001) and its subscales (exempting the subscale of orgasm) than BUP ER. Conclusion: PST can be considered not only a reliable alternative to pharmacotherapy; it also produces better results in terms of improving sexual function in infertile women. Key words: Infertility, Sexual activities, Drug therapy, Psychotherapy, Bupropion

Stress Factors in Dental Students of Babol University

Objective: Dental profession is associated with a high level of stress experienced by clinicians in private practice as well as students and instructors in dental school environment. The purpose of this study was to detect the main stressors in dental students of School of dentistry, Babol University of Medical Sciences in 2011-2012.Methods: In this descriptive, analytical study, data were collected via Dental Environment Stress (DES) questionnaire. Understudy subjects were all dental students in Babol University (n=199) selected by census sampling. Data were analyzed using chi-square and t-tests.Results: Six factors were found to be the main stressors in dental students: 1. More than one exam in the same day (2.76 (0.596)); 2.Insufficient time interval between exams (2.74 (0.581)); 3.Insufficient exam time (2.62 (0.693)); 4.Instructors humiliating students or showing their dissatisfaction of the procedure done by the students in front of patients (2.61 (0.618)); 5.Too many credits offered per semester (2.35 (0.849)) and 6. In appropriate behavior of the staff (2.33 (0.793)). Of all departments in Babol Dental School, departments of Prosthodontics, Radiology and Endodontics caused the highest level of stress and anxiety in students and had statistically significant differences in this regard with other departments.Conclusion: The stressors had greater impacts on female students particularly the fourth year dental students. Attempts must be made to modify the curricula and exam schedules particularly in the most stressful departments to decrease the level of stress in dental students

Pharmacological and Non-pharmacological Therapeutic Strategies for Improvement of State-Trait Anxiety: A Randomized Controlled Trial Among Iranian Infertile Women With Sexual Dysfunctions

Objective: To compare the effects of pharmacological and non-pharmacological therapeutic strategies for improvement of state-trait anxiety among Iranian infertile women with sexual dysfunctions (SDs). Material and Methods: In a randomized controlled clinical trial, 105 women with infertility suffering from SDs were randomly assigned to participate in a 2-hour group weekly session of psychosexual therapy (PST) (n = 35), took a tablet of bupropion ER 150 mg/d (BUP ER) (n = 35), or control (n = 35) for 8 weeks during 2014–2015. The Female Sexual Function Index (FSFI) and Spielberger State-Trait Anxiety Inventory (STAI) were completed before and after of the study. Results: State and trait anxiety levels had mean values of 47.80 ± 10.93 and 48.78 ± 11.34, respectively. Mean values of state and trait anxiety levels observed at baseline significantly decreased toward the end of the study in each of the treatment groups (PST, P < 0.0001 and P < 0.0001; BUP, P < 0.005 and P < 0.001, respectively), and the decrease was more significant in the PST group than in the BUP ER group (P < 0.001 and P < 0.007, respectively) and the control group (P < 0.0001) and P < 0.0001, respectively). Significantly high improvement in state and trait anxiety levels was observed in the PST group than the BUP and control groups. However, the decrease in the BUP group was not significant than the control group (P < 0.076 and P < 0.186, respecttively). Conclusion: PST compared to bupropion ER treatment was found to be a more favorable strategy for improvement of state and trait anxiety symptoms

General health, economic status, and marriage duration as predictors of marital commitment during reproductive age among Iranian married women

Background: One of the important factors involved in a successful marriage during reproductive age is marital commitment. The aim of this study was to find which factors predict marital commitment during reproductive age in Iranian married women. Methods: This cross-sectional, population-based study was performed on married women. Adams and Jones' Dimensions of Commitment Inventory (DCI) were used to assess marital commitment. In addition, their current mental health was assessed using General Health Questionnaire (GHQ). The socioeconomic status of the participants was calculated based on household income, employment status, and education level. A total of 160 married women, who were between 15-49 years of age and were from six districts of Babol, were selected using a systematic random sampling method. Stepwise multiple regressions were used to determine the effect of independent variables on marital commitment. Results: The results of multiple regression showed that general health, the duration of marriage, and the economic status with standard beta coefficients of (-0.324), (-0.259), and (0.173) had the highest regression effect on marital commitment, respectively. These variables accounted for a total of 33% of the distribution of marital commitment. Conclusion: These findings suggest that general health, economic status, and the duration of marriage are predicable variables for marital commitment. It is necessary to emphasize the benefit of improving general health and economic status in increasing the degree of marital commitment, especially among women with longer duration of marriage

Efficacy of different doses of ketamine as a bolus in major depressive disorder

Background: Major depressive disorder is a severe, heterogeneous, common medical illness and a leading cause of disability throughout the world that poses a significant public health issue. Previous studies have shown rapid antidepressant effects following a single administration of ketamine. This study aimed to assess the impact of route of administration and dose of ketamine for the reduction of depressive symptoms and compare the effects of different doses and methods. Methods: A double-blind clinical controlled trial was done on 100 patients with a primary diagnosis of major depressive disorder who were assigned into two groups of 50 subjects at a dose of 0.5 mg/kg and 0.75 mg/kg ketamine and each group was divided into two groups of 25 subjects following a single dose of intravenous bolus and infusion of ketamine. The patient’s severity of depression was evaluated with Hamillton Depression Rating Scale and Beck Depression Inventory scores after 2 days, 7 days, 30 days and 60 days of ketamine administration, then the results were compared between groups. Results: According to Hamilton and Beck score, the treatment response in investigated patients was 64% and 60%, respectively. Conclusions: These data suggest that ketamine effect is related to drug dose and type of administration. The dose of 0.75 mg/kg of ketamine is more effective than 0.5 mg/kg and a bolus injection of low-dose ketamine (0.5 mg/kg) is more effective than infusion and in high-dose ketamine (0.75 mg/kg), there was no difference between the methods of drug administration

Improvement in Cognitive Status and Depressive Symptoms Three Months after Cataract Surgery

Background: Cataract induced vision impairment can lead to loss of older people’s independence and self-esteem and limit their daily activities. Moreover it has comorbid cognitive impairment and depression. Cataract surgery may be one way to attenuate these comorbidities. The aim of this study was to compare pre-operative and postoperative depressive symptoms and cognitive impairments of patients who underwent cataract surgery. Methods: This study was a before - after clinical trial. Participants completed the following validated surveys one day before and again three months after surgery. Dependent variables were preoperative to postoperative within-patient difference in Geriatric Depression Scale (GDS) and Mini-Mental State Examination (MMSE) scores. Independent variable was improvement of visual acuity. Results: Mean age was 71.77±8.08, 54% were females. Mean postoperative visual acuity improvement was 0.7720±0.1758, mean GDS score difference was -1.49±1.72 and mean MMSE score difference was 0.28±0.88. Postoperative improvement of visual acuity, GDS and MMSE scores were statistically significant (p=0.001). The mean visual acuity improvement in the participants with age over 80 years was lower than the younger subjects; while improvement in MMSE scores in this age group was significantly higher than them. There were no significant relationship between visual acuity, GDS and MMSE scores before and after surgery based on BMI and educational level. Conclusions: It was concluded that cataract surgery is effective for relieving depressive symptoms in the elderly. Improved visual acuity at older ages has far more effects on reducing cognitive impairment

Mental and personality disorders in infertile women with polycystic ovary: a case-control study

Background: Polycystic Ovarian Syndrome (PCOS) is one of the most common causes of infertility in women. Objective: The current study investigated mental and personality disorders in infertile women with and without PCOS. Methods: This case-control study evaluated 400 infertile women who referred to the Infertility Center in Babol city (North of Iran). Participants were categorized into the case group (201 PCOS) and the control group (199 without PCOS). All of the participants completed the Millon Clinical Multi-axial Inventory-III (MCMI-III). Results: The mean scores for clinical personality patterns were significantly higher for six personality disorders (schizoid, avoidant, antisocial, depressive, sadistic, and negativistic) and for three classes of severe personality disorder patterns (schizotypal, borderline, and paranoid) in infertile women with PCOS than in women without PCOS. The mean scores for eight clinical disorders (somatoform, manic disorder, dysthymia, alcohol-dependence, drug-dependence, post-trauma stress disorder, major depression, and delusion disorder) were also higher in infertile women with PCOS than in women without PCOS. Conclusion: The scores of many mental and personality disorders are higher in infertile women with PCOS than in women without PCOS. Thus, clinicians should prioritize recognizing and treating psychological problems of infertile women with PCOS

Psychosocial Predictors of Cognitive Impairment in the Elderly: A Cross-Sectional Study

Objective: Cognitive impairment is a major public health problem among elderly population. The aim of this study was to assess some psychosocial predictors of cognitive impairment (age, education, living alone, smoking, depression and social support) in the Iranian elderly population. Method: A total of 1612 elderly (over 60 years) were enrolled in this cross-sectional study. Cognitive function was assessed using Mini Mental State Examination (MMSE). In addition, data from psychological tests and demographic characteristics were analyzed. Results: Older age, low education level, living alone, smoking, depressive symptoms, and lower social support were associated with an increased risk of cognitive impairment. Ages 70 to 74 (OR = 3.47; 95% CI, 2.13-5.65), 75 to79 (OR = 3.05; 95% CI, 2.11-4.41) and 80 to 85 (OR = 5.81; 95% CI, 2.99-11.22) and depression symptoms (OR = 1.64; 95% CI, 1.27-2.13) were significant positive predictors, whereas social support with scores ranging from 26 to 30 (OR =0. 32; 95% CI, 0.16-0.62) and 31 to 33 (OR =0.29; 95% CI, 0.14-0.61) and more than 5 years of education (OR = 0.19; 95% CI, 0.14-0.27) were the negative predictors of cognitive impairment. Conclusion: The findings suggest older age and depression as positive predictive factors and higher education level and social support as negative predictive factors of cognitive impairment in the elderly population

Prevalence and Factors related of psychiatric symptoms in low risk pregnancy

Background: Psychiatric disorders are associated with poor pregnancy outcomes both for mother and child. This study aimed to determine the prevalence and related demographic risk factors of psychiatric symptoms among the pregnant women in Babol City. Methods: This cross-sectional study was conducted in five private and public obstetrics clinics of Babol city. During routine appointments of prenatal care, 176 pregnant women filled in three questionnaires including; sociodemographic questionnaire, Edinburg Prenatal Depression Scale (EPDS), and Symptom Checklist-25 (SCL-25). Wilcoxon test, Spearman correlation, and multivariate logistic regression tests were used to interpret the data. Results: The prevalence of depressive disorders was 15.4 for Edinburg scores &#8805;13.&#160; The overall rate of maternal psychiatric symptoms (global severity index or GSI scores &#8805; 1.75) was 48.5. The prevalence of psychiatric symptoms was high; for 25 somatization, 258 anxiety, obsession-compulsion disorders or OCD 6.4, 8.8 interpersonal sensitivity, 5.3 phobia, 7.6 paranoid ideation, and 1.2 psychoticism. Multivariate logistic regression revealed that pregnant women with history of abortion in previous pregnancy were at risk of depressive symptoms more (&#946;=3.18, CI 1.28-7.93, p=0.01) than those without history of abortion. Also, the only demographic factor related to psychiatric symptoms was the age of pregnant women; younger age was associated with higher symptom levels for GSI ((r=-0.17). Conclusion: The high prevalence of psychiatric symptoms, especially depressive symptoms, in pregnant women highlights the need for continued research on screening, identifying the risk factors, and developing effective treatments for mental disorders in pregnant women