Effect of Vitamin D Supplementation on Cardiometabolic Indices and the Severity of Symptoms in Male Patients With Chronic Schizophrenia

Objectives: Hypovitaminosis D is suggested to be related to the high risk of metabolic disorders and symptoms of schizophrenia. Therefore, this study aimed to evaluate the effect of vitamin D supplementation on cardio-metabolic indices and the severity of symptoms in schizophrenic patients. Materials and Methods: Patients with schizophrenia (N=42) were randomly assigned to 2 groups, i.e., intervention (2000 IU of vitamin D daily; n=21) and placebo groups (n=21). The intervention was administered for 8 weeks. Anthropometric, clinical, and laboratory measures were assessed at both baseline and end of the trial. The Positive and Negative Syndrome Scale (PANSS) was performed to assess the schizophrenia symptoms. Results: Vitamin D supplementation leads to a significant decrease in low-density lipoprotein cholesterol (LDL-C) levels (P=0.006). In addition, a significant improvement was found in the PANSS negative subscale score (PANSS-NSS) and PANSS total score (PANSS-TS; P=0.005 and P=0.015, respectively). At the baseline, there was a significant negative correlation between PANSS-NSS, PANSS positive subscale score (PANSS-PSS), and PANSS-TS with serum levels of vitamin D (r=-0.42, P=0.010; r=-0.34, P=0.041; and r=-0.47, P=0.004, respectively). Conclusions: Vitamin D supplementation may have helpful efficacy on some cardio-metabolic indices and schizophrenia severity

Comparison of the effect of pharmacotherapy and neuro-feedback therapy on oral health of children with attention deficit hyperactivity disorder

Attention deficit hyperactivity disorder (ADHD) is a chronic and progressive mental disorder related to the childhood period. This study aims to compare the oral health of two groups of ADHD children: those under pharmacotherapy and those under neuro-feedback therapy. 72 ADHD children (aged 6?12) were divided into two 36 member groups: The pharmacotherapy group and the neuro-feedback therapy group. Unstimulated salivary flow (USF), DMFT, and plaque index were assessed in these children. Statistical analysis was carried out on the data with the independent t-test, which was performed using SPSS 16. The significance level of the study was p<0.05. In this study, the USF of ADHD children who used Ritalin was found to be significantly less than that of the neuro-feedback group (1.25 ± 1.21 vs. 1.91 ± 1.16 ml/min; p=0.002). Also, the plaque index (5.9 ± 3.1 vs. 3.94 ± 1.9; p=0.018) and DMFT scores (39% ± 9% vs. 31% ± 9%; p=0.018) were significantly higher for the pharmacotherapy group. Neuro-feedback therapy is preferable to Ritalin treatment for ADHD children in terms of their oral health status

Association between Level of Vitamin D with Environmental and Bioelement Factors in Children with Attention Deficit Hyperactivity Disorder (ADHD)

Background: Attention deficit hyperactivity disorder (ADHD) is a behavioral disorder. The exact pathophysiology of ADHD is not completely recognized. Previous studies have shown the role of different genetic and environmental factors in it. This study investigates the relationship between vitamin D and environmental factors in ADHD. Methods: In this study, 182 children from 2 to 18 years with confirmed ADHD were allocated in this cross-sectional study. Patients with a history of any chronic disease, anticonvulsants and corticosteroids consumption were excluded from the study. The ADHD severity was assessed by Conners’ parent scale test. The level of serum vitamin D, ferritin, iron, total iron binding capacity, zinc, magnesium, calcium and routine complete blood count (CBC) were measured. Results: Although the results showed a U shaped pattern between vitamin D levels and ADHD severity, the correlation between vitamin D level did not show any significant relation with ADHD symptoms severity (p=0.786). Our data showed significant relation between level of vitamin D and ferritin in patients with ADHD (p=0.003). The analysis demonstrates significant relation between vitamin D level and duration of daily TV watching in children with ADHD (p=0.002). Conclusion: The vitamin D supplementation may improve ADHD symptoms in patients with vitamin D deficiency. In addition, due to the proved effect of ferritin level in ADHD and significant relation with vitamin D level in this study, treatment of vitamin D deficiency is necessary in children with ADHD. Replacing TV watching by more outdoor activity may improve ADHD symptoms

An Observational Cohort of First Episode Psychosis in Iran:The Azeri Recent Onset Acute Phase Psychosis Survey (ARAS Cohort) Study Protocol

Background: Most of our knowledge about the etiology, course, treatment, and outcome of schizophrenia spectrum and other psychotic disorders stems from Western countries. Data from populations living in other geographical areas and low- and middle-income countries, with different genomes (ethnicity) and exposomes (e.g., culture and social support, drugs of abuse, religion), will add to our knowledge of this complex disorder. Methods: The Azeri Acute phase/Recent onset psychosis Survey (ARAS) has been initiated to study the course of the disorder in patients with recent-onset psychosis using validated diagnostic tools and a comprehensive outcome monitoring system, aiming to reveal indicators for understanding the risk and resilience factors and for choosing the best-personalized treatment strategy. All participants will be evaluated for clinical signs and symptoms as well as risk and resilience factors and will be followed up for 1, 3, and 5 years for outcomes in several domains. A hierarchical cluster method will be applied to identify the number of clusters for each outcome. Defined models will be applied to assess the predictive value of cognition on symptomatic and functional outcomes at follow-up. Discussion: The ARAS cohort will yield significant academic- (research and education) and care-related achievements. ARAS data and experience will have value both in being a useful model for other parts of this region and in an expansion of the currently available knowledge

The relationship between attention-deficit/ hyperactivity disorder and trauma in adolescents

Objective: Attention-deficit/hyperactivity disorder (ADHD) is characterized by persistent and impairing levels of inattention, impulsivity and hyperactivity. Evidence shows that adolescents with ADHD are more exposed to trauma. This study aimed to investigate the relationship between ADHD symptom severity and trauma severity. Methods: In this descriptive correlational study, the study population included traumatic adolescents aged 12-18 years referred to Shohada hospital in Tabriz, Iran in 2016. Among this population, 91 subjects were selected. In order to exclude subjects with other psychiatric disorders, a psychiatrist performed clinical interviews with them. In this regard, the short form of Conner’s Comprehensive Behavior Rating Scales Revised Edition (CBRS-R) and Pediatric Trauma Scale were used. For data analysis, Pearson correlation coefficient and independent t test were applied. Data were analyzed using SPSS software version 22. Results: There was a significant positive relationship between trauma severity and ADHD score, hyperactivity, and oppositional/Impulsivity (P < 0.01). Conversely, no statistical significance was observed between attention deficiency and trauma severity. The severity of trauma was higher among ADHD group than normal individuals. There were also correlations between socioeconomic status (SES) and oppositional/impulsive patients. In this regard, higher scores of oppositional/impulsivity were observed among patients with lower SES. Conclusion: Traumas have significant effects on economic and humanistic aspects of life in modern era. Our findings showed that there was a statistically significant relationship between hyperactivity-inattention and trauma intensity in adolescents. Therefore, to prevent traumatic events, ADHD screening at schools is suggested. By the same token, informing parents through mass media can help reduce the consequences of inattention/ hyperactivity disorder in the society

Serum S100B is related to insulin resistance and zinc-α2-glycoprotein levels in patients with chronic schizophrenia

Abstract Background Elevated serum levels of S100B may associate with insulin resistance and other metabolic complication in schizophrenia patients. The aim of this study was to investigate the association of serum S100B levels with cardiometabolic parameters, serum levels of zinc-α2-glycoprotein (ZAG), and the severity of schizophrenia symptoms in schizophrenic patients. We recruited 42 patients with chronic schizophrenia. The participant's body weight (BW), waist circumference (WC), and blood pressure (BP) were measured. Serum levels of low and high-density lipoprotein cholesterol (LDL-c and HDL-C), triglyceride (TG), cholesterol (CHOL), fasting blood glucose (FBG), insulin, S100B, and ZAG levels were determined. The Homeostatic Model Assessment (HOMA) was used to quantify insulin resistance (IR) and the severity of schizophrenia was measured using a positive and negative syndrome scale (PANSS) score. Results The results showed that the mean serum S100B levels increased significantly with increasing HOMA-IR and ZAG levels (β = 0.595, 95% confidence interval (CI) (8.722 to 26.002), p < 0.001; and β = 0.334, 95% CI 0.067 to 0.525, p = 0.013 respectively). Patients under treatment with atypical antipsychotic medications (AAPM) had lower serum S100B levels (p = 0.035). Conclusion Our results suggest that alteration in glucose metabolism and ZAG secretion may increase serum S100B levels in patients with schizophrenia

A Comparison of Autistic Like Traits in the Relatives of Patients with Autism and Schizophrenia Spectrum Disorder

Objective: This study aimed to identify autistic like traits in relatives of patients with schizophrenia and autism spectrum disorder. Method: causal-comparative research design was utilized. Fifty individuals among the first degree relatives of patients with autism spectrum disorder and 50 individuals among the first degree relatives of patients with schizophrenia spectrum disorder were selected. Autistic-like traits were evaluated by Autism-Spectrum Quotient (AQ). Multivariate analysis of variance was used to compare the autistic like traits in two groups. Results: First degree relatives of individuals with autism spectrum disorder got higher scores in deficiency of social skill, deficiency of communication, deficiency of attention, and attention to details. As well as they got lower scores in deficiency of imagination, in comparison to relatives of individuals with schizophrenia spectrum disorder. Conclusion: Relatives of individuals with autism spectrum disorder compared to relatives of patients with schizophrenia spectrum disorder showed higher rates of autistic like traits. Only the exception was imagination subscal

The Therapeutic Effect of Electroconvulsive Therapy in Obsessive-Compulsive Disorder Patients: A Quasi-Experimental Study

Background: Electroconvulsive therapy (ECT) is demonstrated to be an effective treatment in some psychiatric disorders. It is postulated ECT should primarily be considered for patients with treatment-resistant obsessive-compulsive disorder (OCD) in the context of major depression. Therefore, we aimed to evaluate the efficacy of ECT in OCD patients without comorbid psychiatric disorders. Methods: This quasi-experimental study was conducted on 12 adult patients with severe OCD (Yale-Brown test score above 25) and no comorbid psychiatric disorders referred to a tertiary care hospital for psychiatric disorders. Treatment was administered three times a week for up to three to four weeks (a minimum of 8 sessions and a maximum of 12 sessions). We completed the Yale-Brown test for all the patients exactly before ECT, on the exact day after applying ECT, and two months after the final ECT session in order to evaluate the effect of therapy. Results: Yale-Brown score of patients significantly decreased after the ECT sessions from 28.08 ± 2.50 to 17.17 ± 3.78 (P-value, 0.043). After treatment, the severity of OCD improved in all patients and reduced to mild and moderate levels in 4 (33.3%) and 8 (66.7%) patients, respectively. After two months the mean Yale-Brown score slightly increased to 18.08 ±1.62 (P-value, 0.125) and the severity of OCD in all 12 patients (100%) became moderate. Nevertheless, in none of them, the Yale-Brown score increased up to the baseline value in this period. None of the patients developed significant side effects during/after ECT sessions. Conclusion: ECT was a safe and effective therapeutic strategy for patients with treatment-resistant OCD with no comorbid psychiatric disorders in our study. However, further randomized controlled trials are required to validate the efficacy of ECT for OCD treatment before implementing it into routine clinical practice

The effect of self-management strategies on improving task performance in students with learning disabilities

Introduction: Behavioral self-management approach offers some promising implications for improving independent task performance in all students particularly ones with learning disabilities. The purpose of this study was to investigate the effects of self-management training on task performance in students diagnosed as learning disabled. Methods: The participants were five students with learning disabilities attending in sub-specialty psychological clinics in Tabriz, Iran. Changing criterion design as a type of single-subject design applied, and data were gathered during each baseline and treatment sessions. Results: Training in self-management strategies was conducted in 12 sessions of 45 minutes. The self-management training improved students’ task performance and increased their academic productivity and accuracy. Conclusion: Practical implications and recommendations for school psychologists, teachers, and clinicians for appropriate application of self-management strategies are discussed

Psychiatric comorbidities in a sample of Iranian children and adolescents with epilepsy

Introduction: Epilepsy is a common disorder worldwide, commonly starting during childhood. Despite the high impact of psychiatric comorbidities in these patients, little is known about Iranian children with epilepsy. Methods: This cross sectional study was carried out in the tertiary clinics of the Tabriz University of Medical Sciences, Tabriz, Iran. All of the children (aged between 6 and 18) with a diagnosis of epilepsy were enrolled in this study. A semi-structured psychiatric interview was carried out using the Farsi (Persian) version of the Kiddie Schedule for Affective Disorders and Schizophrenia-Present and Lifetime Version (K-SADS-PL). Results: From a total of 298 participants, 270 (90.6%) completed the process, including 120 (44.4%) girls and 150 (55.6%) boys. At least one psychiatric diagnosis was made in 222 (82.2%) patients. The most prevalent psychiatric disorders in children and adolescents with epilepsy were attention deficit/hyperactivity disorder (34.4%), major depressive disorder (MDD) (29.6%), social phobia (14.8%) and oppositional defiant disorder (ODD) (14.8%). Agoraphobia and anorexia nervosa were significantly more prevalent among girls. The following disorders were more prevalent in children aged between 13 and 18: MDD (47.5%), psychotic disorder (2.5%), social phobia (23.7%), generalized anxiety disorder (GAD) (15.3%), conduct disorder (13.6%), chronic motor tic disorder (13.6%) and substance related disorders (4.8%). Separation anxiety (15.1%) and enuresis (1.5%), on the other hand, were more prevalent among younger children. A logistic regression model showed that psychiatric disorders in parents or siblings could independently predict at least one psychiatric comorbidity in children with epilepsy.Conclusion: Iranian children with epilepsy face a high burden of psychiatric and behavioral comorbidities compared to same aged general population that should be considered for comprehensive care