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

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

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

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

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

A Randomized Trial of Comparing the Efficacy of Two Neurofeedback Protocols for Treatment of Clinical and Cognitive Symptoms of ADHD: Theta Suppression/Beta Enhancement and Theta Suppression/Alpha Enhancement

Introduction. Neurofeedback (NF) is an adjuvant or alternative therapy for children with Attention Deficit Hyperactivity Disorder (ADHD). This study intended to compare the efficacy of two different NF protocols on clinical and cognitive symptoms of ADHD. Materials and Methods. In this clinical trial, sixty children with ADHD aged 7 to 10 years old were randomly grouped to receive two different NF treatments (theta suppression/beta enhancement protocol and theta suppression/alpha enhancement protocol). Clinical and cognitive assessments were conducted prior to and following the treatment and also after an eight-week follow-up. Results. Both protocols alleviated the symptoms of ADHD in general (p<0.001), hyperactivity (p<0.001), inattention (p<0.001), and omission errors (p<0.001); however, they did not affect the oppositional and impulsive scales nor commission errors. These effects were maintained after an eight-week intervention-free period. The only significant difference between the two NF protocols was that high-frequency alpha enhancement protocol performed better in suppressing omission errors (p<0.001). Conclusion. The two NF protocols with theta suppression/beta enhancement and theta suppression/alpha enhancement have considerable and comparable effect on clinical symptoms of ADHD. Alpha enhancement protocol was more effective in suppressing omission errors

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

Relationship between severity of depression symptoms and iron deficiency anemia in women with major depressive disorder

Introduction: Iron deficiency (ID) is a common nutritional problem lead to many unintended consequences such as decrease energy, immune system problems, and neurological dysfunction. The most common psychological disorder is depression. A patient with ID anemia (IDA) show signs and symptoms of behavioral and mood disorders like depression. Methods: In this study, 100 female patients with diagnosed major depression in years 2010 and 2011 were studied. In all patients standard Hamilton depression rating scale (HDRS) was used to evaluate depression severity. Blood samples were taken for complete blood count difference analysis and evaluating anemia and in those with hemoglobin (Hb) < 12 mg/dl, ferritin, and total iron binding capacity were checked to evaluate IDA. Results: Patients mean age was 36.34 ± 10.43 years old. Mean HDRS score was 32.20 ± 4.07. 19 had anemia, and among them 8% had IDA. Mean HDRS score in patients with IDA (33.37 ± 1.90) was higher than those without (32.09 ± 4.19), but the difference was not significant (P = 0.39). There was no difference between patients with and without anemia in HDRS score. The negative relation was observed between Hb levels, and HDRS score (Pearson correlation = -0.21, P = 0.03). Conclusion: We observed that the negative correlation between Hb levels and HDRS score. It demonstrates the effect of Hb decrease and anemia occurrence on depression severity; however, it needs more studies

Theory of mind in children with attention deficit hyperactivity disorder compared to controls

Introduction: Children with attention deficit hyperactivity disorder (ADHD) have serious social skill deficits and problems in relation with peers. This study aimed to compare theory of mind (ToM) in drug-naïve children with ADHD with those with no psychiatric disorders at the same age. Methods: This cross-sectional study was established in child and adolescent psychiatry clinic of the Tabriz University of Medical Sciences (Tabriz, Iran). Drug naïve, male children and adolescents with a diagnosis of ADHD were enrolled as well as age and intelligence quotient (IQ) matched healthy controls. Kiddie Schedule for Affective Disorders and Schizophrenia-Present and Lifetime Version ‎(K-SADS-PL)‎, Child Symptom Inventory-4 ‎(CSI-4)‎, and Conner’s Parents Rating Scales-Revised ‎(CPRS)‎ were used to measure psychiatric disorders and Sally-Anne False Belief Task, and The Reading the Mind in the Eyes Task (child) for components of ToM. Results: A total of 30 children completed the study in each group. Half of children with ADHD could not give the expected answer in Sally-Anne False Belief Task, which was significantly lower than controls. They also showed a significantly lower performance in The Reading the Mind in the Eyes Task. Severity of ADHD was not correlated with a score of The Reading the Mind in the Eyes Task. Conclusion: Children with ADHD have deficits in ToM compared with age and IQ matched controls in terms of social cognition and social sensitivity

Theory of mind in children with attention deficit hyperactivity disorder compared to controls

Introduction: Children with attention deficit hyperactivity disorder (ADHD) have serious social skill deficits and problems in relation with peers. This study aimed to compare theory of mind (ToM) in drug-naïve children with ADHD with those with no psychiatric disorders at the same age. Methods: This cross-sectional study was established in child and adolescent psychiatry clinic of the Tabriz University of Medical Sciences (Tabriz, Iran). Drug naïve, male children and adolescents with a diagnosis of ADHD were enrolled as well as age and intelligence quotient (IQ) matched healthy controls. Kiddie Schedule for Affective Disorders and Schizophrenia-Present and Lifetime Version ‎(K-SADS-PL)‎, Child Symptom Inventory-4 ‎(CSI-4)‎, and Conner’s Parents Rating Scales-Revised ‎(CPRS)‎ were used to measure psychiatric disorders and Sally-Anne False Belief Task, and The Reading the Mind in the Eyes Task (child) for components of ToM. Results: A total of 30 children completed the study in each group. Half of children with ADHD could not give the expected answer in Sally-Anne False Belief Task, which was significantly lower than controls. They also showed a significantly lower performance in The Reading the Mind in the Eyes Task. Severity of ADHD was not correlated with a score of The Reading the Mind in the Eyes Task. Conclusion: Children with ADHD have deficits in ToM compared with age and IQ matched controls in terms of social cognition and social sensitivity