Development of day center in Roozbeh hospital: A teamwork experience

Introduction: Team working is an important part of psychiatry but psychiatry delivery services with teamwork approach were limited in our country. Providing rehabilitation services in a coordinated and comprehensive manner requires a professional team consists of psychiatrist, psychologist, occupational therapist, social worker and their collaborative approach. The aim of this study is to present a team work experience in development of a rehabilitation service and team service providing. Materials and Methods: We explained the experiences of 4 academic members who were involved in set up or development of day center. Furthermore, a group discussion session with staff held and their experiences in team working especially in day center were discussed. Results: The results of these interviews emphasize on the important role of social structures, responsibility, time commitment, the need to be patient in team work, the need to create and strengthen a sense of trust between group members, the need to maintain members’ motivations and to find solutions to resolve the interpersonal conflicts. Conclusion: Finding some solutions for enhancement of responsibility, building sense of trust and dissolve interpersonal conflict is very important in team working

A Short Course Computer-assisted Cognitive Remediation in Patients with Schizophrenia Spectrum Disorders: A Randomized Clinical Trial

Introduction: Cognitive Remediation Therapy (CRT) is used to improve cognitive functioning in patients with Schizophrenia Spectrum Disorders (SSDs). Most of the previous studies had incorporated a long rehabilitation program. This study aimed to evaluate the effects of a short and easy to implement computer-based CRT on cognitive performance in patients with SSDs using a randomized controlled trial design. Methods: Sixty-Two patients with SSDs were enrolled in Roozbeh Hospital (Tehran City, Iran); they were randomized to either receive a CRT program added to the standard pharmacological treatment (n=31) or the standard treatment alone (n=31). The remediation consisted of 10 sessions of CRT provided 2-3 times a week applying the Cogpack software. The cognitive performance was assessed in attention, memory, and executive functions before and after the intervention using the respective tests of the Cambridge Neuropsychological Test Automated Battery (CANTAB). Results: This study did not demonstrate any significant improvement in attention and executive function between the experimental and control group. However, we observed modest improvements in some aspects of visual memory (first trial memory score, F=9.152, P<0.001, Cohen’s d=0.40; mean errors to success, F=6.991, P=0.011, Cohen’s d=0.14; stages completed on the first trial, F=7.155, P=0. 010, Cohen’s d=0.71; total errors, F=5.730, P=0.020, Cohen’s d=0.53). Conclusion: We observed only modest improvements in the patients’ cognitive functioning after a short course of CRT. The short duration of the training and lack of a comprehensive rehabilitation plan may explain the obtained findings

Depression is associated with the nonmotor symptoms of Parkinson's disease: A comparative analysis

Abstract Background and aims The nonmotor symptoms (NMS) of Parkinson's disease (PD) and their potential role in early diagnosis are recent debates. Herein, we aimed to investigate the association between depression and NMS of PD including sleep disorders, hyposexuality, hyposmia, constipation, and orthostatic hypotension. Methods A total of 93 PD patients with depression and 67 PD patients without depression were included in the study, and NMS were compared between the two groups. Furthermore, the possible associations between depression severity measured by Beck Depression Inventory (BDI) and NMS were investigated using linear regression or binary logistic regression models controlled for possible confounders. Eventually, we performed a subgroup analysis in each mild, moderate, and severe depression group. Results Orthostatic hypotension, constipation, and hyposexuality showed a significant difference between PD patients with and without depression (p < 0.001, p = 0.029, and p < 0.001, respectively). The BDI score was significantly associated with hyposexuality, Montreal cognitive assessment (MoCA), and Pittsburgh Sleep Quality (p = 0.016, p = 0.010, and p = 0.011, respectively); however, after adjustments for possible confounders, the associations of the BDI score with the MoCA score and hyposexuality remained significant (p = 0.015 and p = 0.019, respectively). Considering subgroup analysis, a similar pattern of significant results was observed particularly in the severe group. Conclusions This study suggests a possible association between depression in PD patients and some NMS observed in the course of PD. These findings could be beneficial for early diagnosis of the disease, which eventually could make a considerable difference in the management of PD patients. Additional interventional longitudinal studies are warranted to explore how controlling depression could impact the NMS of patients with PD

Comparing Effects of Melatonin versus Trazodone on Sleep Quality in Major Depressed Patients Receiving Sertraline

Background_ Sleep disturbance is a common complaint in major depressive disorder (MDD) including impairment of both subjective and objective parameters, Also SSRIs as antidepressant drugs can affect sleep architecture (SA). Aim _This randomized trial was designed to compare the effects of trazodone with melatonin on sleep quality (SQ) of patients with MDD based on Diagnostic and Statistical Manual for Mental Disorders –5th edition (DSM-5) criteria. Method_ Sixty patients who have the study criteria were entered in this study and were divided into two groups receiving either trazodone or melatonin. They were evaluated for sleep quality and depression severity by using Pittsburgh Sleep Quality Index (PSQI) and Hamilton Depression Rating Scale (HAM-D) at baseline and after 4 and 8 weeks. Result_ Thirty two patients complete the study. Fourteen patients received 3mg of melatonin and eighteen patients received 50mg of trazodone before sleep time. After 4 and 8 weeks treatment with melatonin or Trazodone, significant improvements in SQ were showed in both groups. Additionally, a significant reduction in sleep latency (SL) was showed after 4 weeks of treatment with melatonin but not with trazodone. Conclusion_ This study demonstrated that both Melatonin and Trazodone improved SQ in outpatients with MDD after 8 weeks of treatment but melatonin created greater reduction in SL than trazodone after 4 weeks