Exploring the Therapeutic Effects of Transcranial Direct Current Stimulation on Sleep Quality Among Patients Under Methadone Maintenance Treatment

Background: Patients under Methadone Maintenance Therapy (MMT) are susceptible to several problems, including sleep disturbances and risk of relapse. The present study aimed to assess the effect of transcranial direct current stimulation (tDCS) on sleep quality of addicts under MMT.Methods: This clinical trial was conducted on 27 male patients who underwent maintenance methadone therapy in MMT clinics of Mashhad City, Iran. They were divided into the experimental and sham groups. The experimental group received seven 20-min sessions of tDCS every other day. In the sham group, the electrical current was delivered for a few seconds, but the electrodes were remained to the end of the session. Sleep quality was measured at baseline, during, and after the intervention by Pittsburg Sleep Quality Index (PSQI). The obtained data were analyzed by descriptive statistics such as mean and standard deviation and inferential statistics, such as t test, Chi-square, Mann Whitney, and Fischer exact test in SPSS v. 25.Results: The difference between the two groups after tDCS in sleep duration was significant (P=0.04). In the experimental group, the total score of sleep had a reducing trend (P<0.000), while in the sham group, the overall score in 3 phases of evaluation had no significant change (P=0.19). However, the rate of inappropriate sleep quality was not significant between the two groups after the intervention (P=0.12).Conclusion: This trial demonstrated the positive effect of tDCS on sleep quality in patients under MMT programs. Further studies are needed to confirm our findings

Methamphetamine psychosis, the efficacy of atypical antipsychotics

Worldwide growing methamphetamine abuse is one of the most serious health problems with several different consequences for victims, especially in developing countries. Chronic methamphetamine abuse is associated with several psychiatric problems in all countries which are faced to epidemic methamphetamine abuse. Methamphetamine-induced psychosis is a major medical challenge for clinical practitioner from both diagnostic and therapeutic viewpoints. Stimulant psychosis commonly occurs in people who abuse stimulants, but it also occurs in some patients taking therapeutic doses of stimulant drugs under medical supervision. The main characteristic of meth psychosis is the presence of prominent hallucinations and delusions. Other drugs, such as cocaine and marijuana, can trigger the onset of psychosis in someone who is already at increased risk because they have “vulnerability”.The current literature review attends to explain several aspects of MIP epidemiologically and clinically. Investigators proposed pharmacologically treatment based on recently published data

New cause of death in young adults: Association between illicit drug abuse and amyotrophic lateral sclerosis

Background: Neurodegenerative effects of illicit drugs have been proposed in many investigations. Amyotrophic lateral sclerosis is a fatal motor neuron disease characterized by degeneration of motor neurons, but the risk of amyotrophic lateral sclerosis among drug abusers is unknown. Methods: A nested case–control study was conducted in a teaching hospital to examine the association between drug abuse and amyotrophic lateral sclerosis. The study population included persons 18 to 40 years of age who were admitted in an electrodiagnostic medicine clinic for more than two year during the study period (January 2013 through April 2015) For each subject with ALS, 2 smoking-matched controls without ALS were randomly selected from the same population. Self-reported history of drug abuse was acceptable in both groups. Results: A total of 17 persons with ALS and 34 controls were identified, of whom 10 (58.8 percent) and 8 (23.5), respectively, had history of drug abuse. Persons with history of drug abuse had an increased risk of ALS (adjusted odds ratio, 2.6; 95 percent confidence interval, 1.2 to 5.7) as compared with controls. Conclusion: Drug abuse is an important risk factor for ALS, at least among young adults. The risk among drug abusers was at least or about double that among control group. The burden of mortality due to background ALS in drug abusers needs to be determined in future investigations

Depression and its Correlation with Self-esteem and Social Support among Iranian University Students

"nObjective: Considering the effects of the level of social support and self-esteem as risk factors in the onset and continuation of depression, the purpose of the current study (in addition to studying the demographic items of depression) was to investigate the correlation between depression and level of social support and self-esteem in Iranian university students studying non medical majors. "nMethod: The study was a cross-sectional descriptive-analytic research carried out on the students of Ferdowsi University of Mashhad in 2006. Self administered questionnaires on socio-demographic information (age, gender, marital status, and educational level), Eysenk self-esteem scale, Beck Depression Inventory and Cassidy social support scale were randomly given out to students who were selected by multi stage randomized sampling. The data were analyzed using SPSS version 14 using the χ2-test. "nResults: 1200 students responded to the anonymous questionnaires. A total of 57.2% of the participants had depression (36.3% mild, 14.4% moderate and 6.5% severe). Depression was significantly higher in males, singles and in 25-29-year-old students. Results showed that 9.4%, 18.3% and 72.3% of the participants reported low, moderate and high levels of social support respectively. 1.8% and 6.3% of the participants reported low and moderate levels of self-esteem respectively; while 91.9% reported high levels of self-esteem. "nConclusion: Depression has a higher rate in non-medical university students of Iran than general population. Levels of social support and self-esteem were negatively associated with frequency of depression

Does abstinence resolve poor sleep quality in former methamphetamine dependents?

Background and objective: Among substances that have a significant effect on sleep are stimulants, including amphetamines. As there are few studies assessing sleep quality in methamphetamine withdrawal this study aims to evaluate changes in sleep quality of methamphetamine dependent patients during early remission period by controlling depression and anxiety as confounding variables. Methods: This study was conducted in Mashhad, Iran. Ninety amphetamine dependent patients, who were admitted in residential centers during 2012–2014 and met our inclusion criteria, were chosen by purposive nonprobability sampling method. Sleep quality was assessed by Pittsburg sleep questionnaire, in the first, second, and after the fourth week of abstinence. Additionally all participants were assessed by Beck Depression Inventory-2 and Beck Anxiety Inventory for controlling depressive and anxiety symptoms. Results: The prevalence of improper quality of sleep was very high (97.8%) within the first week of withdrawal, but it reduced considerably four weeks after abstinence (52.2%), which was statistically significant (P=0.00). The variations of depression and anxiety levels within four weeks after quitting methamphetamine, have low impact on variation of patients' sleep quality (adjusted R2<0.5). Furthermore, the effectiveness of these two intervening variables on patients' quality of sleep was dwindled over time after abstinence. Conclusions: This study showed that the patients' quality of sleep improved significantly four weeks after abstinence and its variation was independent from variations in anxiety and depressive symptoms

Effects of abstinence from opioids on self-reported craving and sleep

Abstinence-based treatment of opioid use disorder has always been faced with the probability of an increase in craving, which potentially results in relapse. Moreover, sleep problems are predominant among patients with abstinence treatment. A sample of twenty-six male subjects with opioid use disorder were selected from a residential treatment center for substance use disorders in 2017 in Mashhad, Iran. Opioid craving was evaluated using obsessive-compulsive drug use scale (OCDUS) at four-time points (days 1, 10, 20, and 30) during abstinence. Also, they were asked to report their total sleep time. The participants with an average age of 32.5 ± 8.0 years reported the use of opium and heroin to be as high as 2.0 ± 1.2 g per day and 1.5 ± 0.9 g per day, respectively. Abstinence induced a non-significant gradual decrease in self-reported craving during one month (p > 0.05). Also, they experienced significant declines in total sleep time over the first ten days (p = 0.008). The univariate analysis of variance showed no significant changes in craving after adjustment for total sleep time (p > 0.05). Insignificant reductions in opioid craving after detoxification persisted throughout the 30 days of abstinence

پروفایل سرشت های عاطفی به عنوان یک عامل زمینه ساز برای پسوریازیس پلاک مزمن

مقدمه: اگرچه رابطه نزدیکی بین پسوریازیس و مسائل روانی از جمله سرشت عاطفی وجود دارد، اما مطالعات کمی به این ارتباط پرداخته اند. این مطالعه با هدف بررسی پروفایل سرشت عاطفی در بیماران مبتلا به پسوریازیس پلاکی مزمن انجام شد.روش‌ کار: این مطالعه مقطعی در سال 98-1397 در کلینیک سرپایی پوست بیمارستان امام رضا (ع) مشهد انجام شد. در مطالعه حاضر، 40 بیمار پسوریازیس و 40 داوطلب سالم همسان از نظر جنس و سن شرکت کردند. ابزارهای تحقیق شامل پرسشنامه  ممفیس، پیزا، پاریس و سن دیگو  (TEMPS-A)، پرسشنامه اضطراب بک (BAI) و پرسشنامه افسردگی بک II (BDI-II)  بود. برای مقایسه متغیرهای اسمی و طبقه‌ای از آزمون‌های تی، من-ویتنی و مجذور خی استفاده شد. برای ارزیابی همبستگی ها از آزمون های اسپیرمن و پیرسون استفاده شد.یافته‌ها: در مجموع، 36 نفر از 80 بیمار (45%) مرد بودند. خلق و خوی افسرده، سیکلوتایمیک و مضطرب در گروه پسوریازیس به طور معنی‌داری برجسته‌تر بود (001/0 P<)، در حالی که نمره هیپرتایمیک در گروه شاهد به‌طور قابل‌توجهی بالاتر بود (023/0=P). بین شدت بیماری (نمره PASI) و سرشت عاطفی مختلف ارتباط معنی داری وجود نداشت. مدت درگیری پسوریازیس با تمام سرشت های عاطفی همبستگی منفی متوسطی داشت (05/0 P<) به جز سرشت هیپرتایمیک. شیوع اضطراب (80 درصد در مقابل 30 درصد، 40=n؛ 001/0 P<) و افسردگی (60 درصد در مقابل 5/32 درصد، 40=n؛ 009/0= P) در بیماران پسوریازیس به طور معنی‌داری بیشتر از گروه شاهد بود.نتیجه گیری: به نظر می رسد سرشت سیکلوتایمیک، افسرده و مضطرب و همچنین اضطراب و افسردگی در بیماران پسوریازیس به طور قابل توجهی شیوع بیشتری داشته باشد. با این حال، این ها با شدت بیماری همبستگی نداشتند

Crosstalk between Sleep Disturbance and Opioid Use Disorder:A Narrative Review

Recent studies have revealed a growing number of patients affected by opioid use disorders (OUDs).Comorbid disorders are suspected to increase the risk of opioid-related adverse effects or treatment failure.The correlation of opioid use with sleep disturbances has been reported in many different studies andsuggested to be linked to the brain regions involved in reward processing. This narrative review was intendedto discuss the most recent developments in our understanding of the intricate interaction between sleepdisturbance and OUD. In addition, in this study, the effects of sleep problems on the occurrence ofunpleasant consequences in addiction management, such as craving and relapse in OCD patients, werehighlighted. It has been shown that drug use may trigger the induction of sleep disturbances, and thosesuffering from difficulties in sleeping are prone to relapse to drug use, including opioids. Moreover,pharmaceutical sleep aids are likely to interfere with opiate use