Transition to psychosis: Evaluation of the first-degree relatives of patients with schizophrenia

Objective: Schizophrenia and other psychoses have devastating personal and social impacts and many efforts have been devoted to study prodromal syndromes for psychosis in order to achieve earlier detection and interventions. However, only few studies have been performed in developing countries on this subject, and there is a dearth of evidence in the Iranian population. In this study, we focused on conversion rate to psychosis and changes in prodromal symptoms in a group of first-degree relatives of patients with schizophrenia and to compare the conversion rate in those with and without prodromal symptoms as assessed by the Structured Interview for Prodromal Syndromes (SIPS) and Scale of Prodromal Symptoms (SOPS). Method: Participants were the first-degree relatives of hospitalized patients with schizophrenia at Roozbeh Hospital, Tehran, Iran. At baseline, a trained psychiatrist interviewed the participants using the SIPS and the SOPS and assigned them to high- or low-risk groups either based on the presence of prodromal criteria or seeking mental health services. After 12 months, the same examiner re-evaluated the participants in order to determine the changes in their symptoms and identify the probable transitions to psychosis. Results: One hundred participants, 50 participants within each of high- or low-risk groups, were recruited at baseline. Eight participants dropped out of the study. At the follow-up, the rate of transition to full psychosis among high-risk group was 13 (95 CI 0.029, 0.23), whereas none of the low-risk participants developed psychosis. None of the high-risk participants demonstrated attenuation in their prodromal states after a one-year follow-up. In contrast, of the 50 low-risk participants, three experienced prodromal symptoms for psychosis during this period. High-risk participant's illustrated higher severity in almost all of the SOPS items compared to the low-risk participants at both baseline and follow-up evaluations. Conclusion: Prodromal syndrome for psychosis based on the SIPS and the SOPS was a predictive factor for transition to psychosis after a 12-month period in a group of first-degree relatives of patients with schizophrenia admitted to a psychiatric hospital in Iran. Conducting further studies on this at-risk population is highly recommended in order to provide practical methods for early screening and therapeutic interventions

Woman�s perceived stress during pregnancy; stressors and pregnancy adverse outcomes

Background: Stress perceived by mothers during pregnancy is dependent on several factors and can lead to adverse pregnancy outcomes threatening mother and child physical and mental health. Objective: The purpose of the present study is measuring perceived stress of pregnant women by 14 items Cohen�s perceived stress scale (PSS), detecting stressors surrounding pregnant women including male partner�s role, intimate violence, socioeconomic situation, etc., as well as investigate the effect of perceived stress on pregnancy adverse outcomes. Method: Two hundred first gravid pregnant women between 18 and 35 years old at post labor ward entered our cross-sectional study. They were asked to fill out the PSS questionnaire and an information gatherer filled out the checklist for exposures and baseline characteristics. Result: Mean ± SD of participants� PSS was 25.5 ± 8.6. Mothers� PSS was significantly higher in group reported father�s verbal aggression against mother (N = 71, 38) (23.7 ± 9 versus 28.2 ± 7.2; p <.001) and father�s physical aggression against mother (N = 28, 15) compared to nonexposed one (24.9 ± 7.7 versus 28.4 ± 8.7; p:.04). Mothers� PSS score was significantly correlated with mothers� satisfaction from both fathers� emotional (r: �0.30, p:.001) and financial support (r: �0.34, p <.001) during pregnancy. Moreover, the mother�s satisfaction from father�s concomitance in prenatal care (PNC) visits was significantly correlated with the mother�s perceived stress (r: 0.24, p:.001). Conclusion: Male partner�s role during pregnancy directly affects the pregnant woman�s perceived stress. © 2019 Informa UK Limited, trading as Taylor & Francis Group

Woman�s perceived stress during pregnancy; stressors and pregnancy adverse outcomes

Background: Stress perceived by mothers during pregnancy is dependent on several factors and can lead to adverse pregnancy outcomes threatening mother and child physical and mental health. Objective: The purpose of the present study is measuring perceived stress of pregnant women by 14 items Cohen�s perceived stress scale (PSS), detecting stressors surrounding pregnant women including male partner�s role, intimate violence, socioeconomic situation, etc., as well as investigate the effect of perceived stress on pregnancy adverse outcomes. Method: Two hundred first gravid pregnant women between 18 and 35 years old at post labor ward entered our cross-sectional study. They were asked to fill out the PSS questionnaire and an information gatherer filled out the checklist for exposures and baseline characteristics. Result: Mean ± SD of participants� PSS was 25.5 ± 8.6. Mothers� PSS was significantly higher in group reported father�s verbal aggression against mother (N = 71, 38) (23.7 ± 9 versus 28.2 ± 7.2; p <.001) and father�s physical aggression against mother (N = 28, 15) compared to nonexposed one (24.9 ± 7.7 versus 28.4 ± 8.7; p:.04). Mothers� PSS score was significantly correlated with mothers� satisfaction from both fathers� emotional (r: �0.30, p:.001) and financial support (r: �0.34, p <.001) during pregnancy. Moreover, the mother�s satisfaction from father�s concomitance in prenatal care (PNC) visits was significantly correlated with the mother�s perceived stress (r: 0.24, p:.001). Conclusion: Male partner�s role during pregnancy directly affects the pregnant woman�s perceived stress. © 2019, © 2019 Informa UK Limited, trading as Taylor & Francis Group

Evaluating the effects of copper supplement during pregnancy on premature rupture of membranes and pregnancy outcome

Objective: To evaluate the effects of copper (Cu) supplementation during pregnancy on the rupture of membranes and pregnancy outcomes. Methods: Study was conducted as a triple-blind randomized clinical trial. In one group, Cu in a dose of 1000 mg per day, and in the other group, placebo was prescribed orally from 16th week of pregnancy. Results: The women of the two groups did not have significant difference according to age, gestational age at recruitment, BMI, and socioeconomic conditions. There was no statistically significant difference between case and control group regarding the incidence of PPROM, PROM, preterm labor, vaginal bleeding during pregnancy, preeclampsia, and the incidence of placenta abruption. There was a 75 and 90 decrease in depressive symptoms in 2nd trimester and 3rd trimester in supplemented group, respectively. Also, there was a 45 and 80 decrease in anxiety symptoms in 2nd trimester and 3rd trimester in the supplemented group, respectively The rate of infection during pregnancy was significantly higher in control group (p = 0.046). There was no difference between the two groups according to neonatal outcomes. Conclusions: Cu supplementation during pregnancy could not influence positively on ROM; however, it could improve some mood status of the women. © 2017 Informa UK Limited, trading as Taylor & Francis Group

Evaluating the effects of copper supplement during pregnancy on premature rupture of membranes and pregnancy outcome

Objective: To evaluate the effects of copper (Cu) supplementation during pregnancy on the rupture of membranes and pregnancy outcomes. Methods: Study was conducted as a triple-blind randomized clinical trial. In one group, Cu in a dose of 1000 mg per day, and in the other group, placebo was prescribed orally from 16th week of pregnancy. Results: The women of the two groups did not have significant difference according to age, gestational age at recruitment, BMI, and socioeconomic conditions. There was no statistically significant difference between case and control group regarding the incidence of PPROM, PROM, preterm labor, vaginal bleeding during pregnancy, preeclampsia, and the incidence of placenta abruption. There was a 75 and 90 decrease in depressive symptoms in 2nd trimester and 3rd trimester in supplemented group, respectively. Also, there was a 45 and 80 decrease in anxiety symptoms in 2nd trimester and 3rd trimester in the supplemented group, respectively The rate of infection during pregnancy was significantly higher in control group (p = 0.046). There was no difference between the two groups according to neonatal outcomes. Conclusions: Cu supplementation during pregnancy could not influence positively on ROM; however, it could improve some mood status of the women. © 2017 Informa UK Limited, trading as Taylor & Francis Group

Psychosocial and biological paternal role in pregnancy outcomes

Background: Pregnancy outcomes are affected by many different factors. One of the influential factors on pregnancy outcomes is the male partner as an important person to mother�s wellbeing. Objective: The aim of the present study was to investigate the effects of male partner�s role including socioeconomic support, emotional support, accompanying pregnant women during prenatal care visits (PNC) and labor, and the level of pregnant women�s satisfaction from their partners� support and involvement during pregnancy on pregnancy outcomes. Method: Two hundred first gravid pregnant women with mean age of 23.2 ± 4.3 were studied. Primary outcomes were total maternal and neonatal adverse outcome (TMNAO), total maternal adverse end result (TMAE), and total neonatal adverse outcome (TNAO), regardless of the type of outcomes. Preterm labor and delivery; premature rupture of membrane (PROM) and preterm premature rupture of membrane (PPROM); preeclampsia and eclampsia; placental abruption; chorioamnionitis; stillbirth; meconium passage; maternal death; postpartum hemorrhage; poor progression labor; abnormal vaginal bleeding in third trimester of pregnancy; low birth weight and neonatal need for CPR or intubation, neonatal anomaly, NICU admission, and neonatal mortality were also analyzed as subgroup outcomes. Results: One hundred twenty-seven (63.5) participants showed a kind of total maternal and neonatal adverse outcome (TMNAO), 72 (36) deliveries resulted in a kind of neonatal adverse outcome (TNAO), and 104 (52) of participants had a kind of maternal adverse end result (TMAE). Iranian fathers showed a significantly higher rate of TMNAO than Afghan fathers did (82 versus 69, odds ratio: 2.9, 95 CI 1.0�7.8, p:.01). Mother�s nationality showed the same result (82 versus 64, odds ratio: 2.6, 95 CI 0.9�6.8, p:.03). Iranian fathers showed a significantly higher rate of TMAE than Afghan fathers did (79 versus 58, odds ratio: 2.7, 95 CI 1.1�6.3, p:.01). Mother�s nationality showed the same result (78 versus 60, odds ratio: 2.4, 95 CI 1.0�5.6, p: 0.02). Neonates with Iranian fathers showed significantly more TNAO than those with Afghan fathers (50 versus 31, odds ratio: 2.21, 95 CI 0.9�5.5, p:.04). The same trend was observed among Iranian mothers in comparison to Afghan mothers (50 versus 32, odds ratio: 2.11, 95 CI 0.9�4.6, p:.06). Of mother�s age, mother�s BMI, father�s age, father�s BMI, and mother�s nationality, only father�s BMI contributed significantly to the binary logistic regression model (n = 116, R2: 9, p:.028). It was found that for each decreased unit in BMI, the risk of TNAO was increased by 16, p:.03. Moreover, Father�s family history of preeclampsia resulted in a higher prevalence of total neonatal adverse outcome (TNAO) in comparison with lack of such family history (87 versus 43, odds ratio: 8.9, 95 CI 1.1�74.5, p:.02). Besides, mothers� participation in prenatal care (PNC) visits, assessed by caregivers, was significantly more satisfactory in neonates without any adverse outcome than those with neonatal adverse outcomes (median (IQR) = 2 (1�2) versus 2 (2�3), p:.04). PROM, pre-eclampsia, NICU admission, neonatal intubation, low Apgar score minute 0, and low Apgar score minute 5 were significantly more prevalent in participants revealing positive father�s family history of pre-eclampsia. Regarding psychosocial exposures, placental abruption was more prevalent in mothers with exposure to verbal aggression versus non-exposed ones (9 versus 2, odds ratio: 4.0, 95 CI 0.9�24.6, p:.04). Moreover, a weak positive association between neonatal gestational age at birth and quality of mother�s participation in PNC visits (r: +0.3, p:.01) as well as mother�s satisfaction from father�s commitment to PNC visits was found (r: +0.1, p:.03). Conclusion: Male partners may play a key role in pregnant women and fetus�s heath. © 2018, © 2018 Informa UK Limited, trading as Taylor & Francis Group

Antipsychotic drugs attenuate aberrant DNA methylation of DTNBP1 (dysbindin) promoter in saliva and post-mortem brain of patients with schizophrenia and Psychotic bipolar disorder

Due to the lack of genetic association between individual genes and schizophrenia (SCZ) pathogenesis, the current consensus is to consider both genetic and epigenetic alterations. Here, we report the examination of DNA methylation status of DTNBP1 promoter region, one of the most credible candidate genes affected in SCZ, assayed in saliva and post-mortem brain samples. The Illumina DNA methylation profiling and bisulfite sequencing of representative samples were used to identify methylation status of the DTNBP1 promoter region. Quantitative methylation specific PCR (qMSP) was employed to assess methylation of DTNBP1 promoter CpGs flanking a SP1 binding site in the saliva of SCZ patients, their first-degree relatives and control subjects (30, 15, and 30/group, respectively) as well as in post-mortem brains of patients with SCZ and bipolar disorder (BD) versus controls (35/group). qRT-PCR was used to assess DTNBP1 expression. We found DNA hypermethylation of DTNBP1 promoter in the saliva of SCZ patients (�12.5, P=0.036), particularly in drug-naïve patients (�20, P=0.011), and a trend toward hypermethylation in their first-degree relatives (P=0.085) versus controls. Analysis of post-mortem brain samples revealed an inverse correlation between DTNBP1 methylation and expression, and normalization of this epigenetic change by classic antipsychotic drugs. Additionally, BD patients with psychotic depression exhibited higher degree of methylation versus other BD patients (�80, P=0.025). DTNBP1 promoter DNA methylation may become a key element in a panel of biomarkers for diagnosis, prevention, or therapy in SCZ and at risk individuals pending confirmatory studies with larger sample sizes to attain a higher degree of significance. © 2015 Wiley Periodicals, Inc

Psychosocial and biological paternal role in pregnancy outcomes

Background: Pregnancy outcomes are affected by many different factors. One of the influential factors on pregnancy outcomes is the male partner as an important person to mother�s wellbeing. Objective: The aim of the present study was to investigate the effects of male partner�s role including socioeconomic support, emotional support, accompanying pregnant women during prenatal care visits (PNC) and labor, and the level of pregnant women�s satisfaction from their partners� support and involvement during pregnancy on pregnancy outcomes. Method: Two hundred first gravid pregnant women with mean age of 23.2 ± 4.3 were studied. Primary outcomes were total maternal and neonatal adverse outcome (TMNAO), total maternal adverse end result (TMAE), and total neonatal adverse outcome (TNAO), regardless of the type of outcomes. Preterm labor and delivery; premature rupture of membrane (PROM) and preterm premature rupture of membrane (PPROM); preeclampsia and eclampsia; placental abruption; chorioamnionitis; stillbirth; meconium passage; maternal death; postpartum hemorrhage; poor progression labor; abnormal vaginal bleeding in third trimester of pregnancy; low birth weight and neonatal need for CPR or intubation, neonatal anomaly, NICU admission, and neonatal mortality were also analyzed as subgroup outcomes. Results: One hundred twenty-seven (63.5) participants showed a kind of total maternal and neonatal adverse outcome (TMNAO), 72 (36) deliveries resulted in a kind of neonatal adverse outcome (TNAO), and 104 (52) of participants had a kind of maternal adverse end result (TMAE). Iranian fathers showed a significantly higher rate of TMNAO than Afghan fathers did (82 versus 69, odds ratio: 2.9, 95 CI 1.0�7.8, p:.01). Mother�s nationality showed the same result (82 versus 64, odds ratio: 2.6, 95 CI 0.9�6.8, p:.03). Iranian fathers showed a significantly higher rate of TMAE than Afghan fathers did (79 versus 58, odds ratio: 2.7, 95 CI 1.1�6.3, p:.01). Mother�s nationality showed the same result (78 versus 60, odds ratio: 2.4, 95 CI 1.0�5.6, p: 0.02). Neonates with Iranian fathers showed significantly more TNAO than those with Afghan fathers (50 versus 31, odds ratio: 2.21, 95 CI 0.9�5.5, p:.04). The same trend was observed among Iranian mothers in comparison to Afghan mothers (50 versus 32, odds ratio: 2.11, 95 CI 0.9�4.6, p:.06). Of mother�s age, mother�s BMI, father�s age, father�s BMI, and mother�s nationality, only father�s BMI contributed significantly to the binary logistic regression model (n = 116, R2: 9, p:.028). It was found that for each decreased unit in BMI, the risk of TNAO was increased by 16, p:.03. Moreover, Father�s family history of preeclampsia resulted in a higher prevalence of total neonatal adverse outcome (TNAO) in comparison with lack of such family history (87 versus 43, odds ratio: 8.9, 95 CI 1.1�74.5, p:.02). Besides, mothers� participation in prenatal care (PNC) visits, assessed by caregivers, was significantly more satisfactory in neonates without any adverse outcome than those with neonatal adverse outcomes (median (IQR) = 2 (1�2) versus 2 (2�3), p:.04). PROM, pre-eclampsia, NICU admission, neonatal intubation, low Apgar score minute 0, and low Apgar score minute 5 were significantly more prevalent in participants revealing positive father�s family history of pre-eclampsia. Regarding psychosocial exposures, placental abruption was more prevalent in mothers with exposure to verbal aggression versus non-exposed ones (9 versus 2, odds ratio: 4.0, 95 CI 0.9�24.6, p:.04). Moreover, a weak positive association between neonatal gestational age at birth and quality of mother�s participation in PNC visits (r: +0.3, p:.01) as well as mother�s satisfaction from father�s commitment to PNC visits was found (r: +0.1, p:.03). Conclusion: Male partners may play a key role in pregnant women and fetus�s heath. © 2018, © 2018 Informa UK Limited, trading as Taylor & Francis Group