Iranian Journal of Psychiatry

Validity and Reliability Assessment of the Arabic Version of the Social and Emotional Competencies Questionnaire in a Moroccan Nursing Student Population

Jamal Ksiksou — 2024-12-14

Objective: The Social and Emotional Competencies Questionnaire (SEC-Q) represents one of the existing tests for assessing these competences in students. The purpose of the present research was to examine the psychometric properties of the SEC-Q in Moroccan nursing students.

Method: A sample of 320 Moroccan nursing students, including 190 women and 130 men, was selected using a stratified convenience sampling method. Methodology consisted of forward and backward translations, linguistic adaptation, and pilot revision. Structural validity was investigated using exploratory factor analysis (EFA) and confirmatory factor analysis (CFA). Reliability was assessed through test-retest analysis using Pearson's correlation.

Results: Factor analyses produced a four-factor version of 16 items with a range of factor loadings from 0.72 to 0.89. Cronbach's alpha values were 0.92 for the self-awareness factor, 0.91 for the self-management factor, 0.90 for the social awareness factor, and 0.92 for the decision-making factor. These high values indicate excellent reliability. The test-retest coefficient for a 20-day interval between two assessments gave an rtt value of 0.92, demonstrating excellent response reliability. A strong correlation between the SECQ-AV, WLEIS and PSS-CP was found, demonstrating satisfactory convergent and divergent validity (P < 0.05).

Conclusion: The Arabic version of SECQ demonstrated its validity and reliability for assessing social and emotional competencies in Moroccan nursing students. However, the sample selected was drawn from a single nursing training institute, which limits the representativeness of the entire student population, and makes it difficult to generalize the results. A cross-sectional study will therefore produce much more varied results, by including a very large sample from different regions and different nursing training institutes in Morocco.

Neurocognitive Deficits in Individuals at Ultra-High-Risk for Psychosis: An Overview of Systematic Reviews

Farnaz Asadiof — 2024-12-14

Objective: Identifying individuals at ultra-high risk for psychosis (UHRP) is crucial for early intervention and prevention strategies. Neurocognitive deficits have been increasingly recognized as potential predictors of psychosis onset. This overview aims to consolidate current evidence and elucidate the role of neurocognitive predictors in identifying UHRP individuals.

Method: we systematically searched three scientific databases, i.e., PubMed, Scopus, and Google Scholar using predefined keywords related to predictive neurocognitive markers and ultra-high risk psychosis. By following the PRISMA procedure, we included all relevant systematic-reviews and meta-analyses in our data-synthesis.

Results: Neurocognitive deficits, including impairments in working memory, attentional control, verbal learning, and executive functions, have been consistently identified as predictors of psychosis conversion in individuals at UHRP. Structural and functional neuroimaging studies have further revealed aberrant brain connectivity, reduced gray matter volume, and altered neural activation patterns in key brain regions to be involved in psychosis. Moreover, the combination of neurocognitive and clinical risk factors has been shown to enhance the accuracy of predicting psychosis onset and inform personalized intervention strategies.

Conclusion: Neurocognitive deficits serve as valuable predictors of the risk of psychosis in individuals with UHRP, offering insights into the underlying neurobiological mechanisms and potential targets for early intervention. Future research should focus on refining predictive models, elucidating the neurodevelopmental trajectories, and evaluating the efficacy of targeted interventions in mitigating the psychosis risk.

A Serial Mediation Model of Perceived Social Class and Cyberbullying: The Role of Subjective Vitality in Friendship Relations and Psychological Distress

Hadi Samadieh — 2024-12-11

Objective: The link between individuals' perceptions of social class (PSC) and various forms of bullying, including cyberbullying, has not been extensively studied. Additionally, the mechanisms through which PSC impact aggressive behaviors like cyberbullying remain unclear. Therefore, this study aimed to explore the influence of perceived social class on cyberbullying, considering subjective vitality and psychological distress as serial mediators.

Method: Utilizing a cross-sectional design, the research involved 584 Iranian students (Mage = 20.59, SD = 1.99) from several universities who completed questionnaires assessing Subjective Social Class (SSC), Subjective Vitality Scale (SVS), Psychological Distress Scale (K6), and Cyberbullying Involvement Scale (CIS). Hayes' PROCESS macro (Model 6) in SPSS was employed to analyze the chain mediation effects.

Results: The Results demonstrated that the direct impact of PSC on cyberbullying was significant (Effect = -0.229, 95% CI: -0.294 to -0.164). Subjective vitality and psychological distress serially mediated the link between PSC and cyberbullying (Effect = -0.022, 95% CI: -0.035 to -0.012). In addition, both subjective vitality (Effect = -0.046, 95% CI: -0.080 to -0.017), and psychological distress (Effect = -0.09, 95% CI: -0.123 to -0.059), independently mediated the association between PSC and cyberbullying.

Conclusion: This research not only broadens the theoretical understanding of how individuals' perceptions of their social rank influence cyberbullying behaviors, but also provides actionable strategies for officials and experts to deploy effective interventions in higher education to mitigate cyberbullying.

Investigating the Relationships between Internet Addiction and Suicidal Ideation in Adolescent Girls

Zeynab Akbari — 2024-12-11

Objective: Suicidal ideation (SI) signifies a psychiatric crisis, and individuals with SI are at a significantly higher risk of suicide attempts compared to those without. According to previous research, three factors that affect SI in adolescent girls are externalization problems, alexithymia, and perceived social support (PSS). As a result, the present research aimed to examine whether internet addiction (IA) is associated with SI through the mediating roles of PSS, externalizing problems, and alexithymia among adolescent girls in Tehran, Iran.

Method: The current correlational study employed a structural equation modeling approach. Model fit indices such as the Chi-square to degrees of freedom ratio (CMIN/DF), normed fit index (NFI), root mean square error of approximation (RMSEA), Tucker-Lewis index (TLI), and goodness-of-fit index (CFI) were reported to assess the model’s adequacy.

A total of 441 adolescent girls were selected from high school and between the ages of 11 and 19 using a convenience sampling method. Participants completed the Multidimensional Scale of Perceived Social Support (MSPSS), the Beck Scale for Suicidal Ideation (BSSI), the Cell-Phone Over-Use Scale (COS), the Youth Self-Report (YSR), and the Toronto Alexithymia Scale-20 (TAS-20) in a written manner. Data analysis was done using SPSS 25 and AMOS 22.

Results: Results revealed a significant positive correlation between IA and SI (P < 0.001). The study's most significant findings indicate that PSS, externalizing problems, and alexithymia significantly mediate the relationship between SI and IA. The coefficient of determination for the SI variable was 0.33, which means that predictor variables can explain 33% of the variance in SI (IA, PSS, alexithymia, and externalizing problems).

Conclusion: IA showed direct and indirect effects on SI. Using these findings, we can elucidate the mechanism of how IA affects individual SI, providing critical information for the development and implementation of targeted strategies and interventions to reduce SI among Iranian adolescent girls. Psychological interventions that address the role of externalizing behaviors, alexithymia, and PSS in adolescents with IA may help reduce SI.

Potential Antidepressant Effects of Omeprazole Introduced through Network Analysis and Systems Biology Should Be Interpreted with Caution in the Clinical Environment

Seyed-Ali Mostafavi — 2024-12-11

Dear Editor,

I am writing about an article published in the Iran J Psychiatry 2024; 19: 4: 367-383 titled "Identifying Key Genes and Approved Medications Associated with Major Depressive Disorder Using Network Analysis and Systems Biology" (1). The authors presented important findings about potential therapeutic candidates for Major Depressive Disorder (MDD) using Network Analysis and Systems Biology. One of the medications introduced as a candidate to have potential antidepressant effects was Omeprazole, based on its association with key genes identified in the pathogenesis of MDD. The authors have introduced the Omeprazole’s association with Tumor Necrosis Factor-α (TNF), and Interleukin-1β (IL-1 β) genes as the underlying mechanism for this proposal. Although I do appreciate the innovation with which the authors were able to use network analysis and systems biology to identify these potential relationships, I felt quite urged to present a more critical perspective before interpreting the findings of network analysis and systems biology into clinical practice.

New investigations explore the role of long-term administration of proton pump inhibitors (PPIs), including Omeprazole, and their potential link to mood disorders, major depressive disorder, and even suicidal ideation. Pedro Fong et al. (2) in a cross-sectional study of more than sixteen thousand adults found that PPIs are associated with suicidal ideation OR = 2.34 (95% CI 1.66–3.31). Another large-scale cohort study on elderlies revealed that PPIs could increase the risk of dementia (hazard ratio: 1.44; 95% CI 1.36–1.52) (3). Still another study on elderlies associated the PPI intake with the Geriatric Depression Scale (OR: 2.38; 95% CI 1.02–5.58) (4).

Recently, a case report study presented a 34-year-old female patient with a history of gastroesophageal reflux disease (GERD) treated with PPIs, who developed significant symptoms of depression without any distinguishable history of mental disorders (5). Further evaluation suggested that she had a profound deficiency of tyrosine, which is an amino acid necessary for the production of neurotransmitters such as dopamine and norepinephrine which play consequential roles in mood. Subsequently, withdrawing PPIs along with amino acid supplementation led to the disappearance of depressive symptoms within several months.

While the authors identified various medications as well as Omeprazole that potentially interact with genes related to MDD including IL-1β and TNF, it seems that the link between chronic use of Omeprazole and amino acid deficiencies, which are the precursors of anti-depressant neurotransmitters, is stronger than the link between olanzapine, IL-1β, TNF and MDD. While the authors of the study targeted certain genes and medicine interactions for proposing new antidepressant agents and suggesting potential beneficial medications, talking of Omeprazole as a therapeutic agent for depression might be overemphasized without considering the complications it logically comes with.

The effect of Omeprazole on depression can be more explained by the gut-brain axis. Even though Omeprazole treats GERD, there are possibilities of changing the gastric PH and the gut microbiota. Chronic Omeprazole consumption may lead to overgrowth of Streptococcaceae and decrease of the Lactobacillus family in the patient’s gut (6). These alterations could affect protein/amino acid malnutrition and eventually lead to increased signs of depression. Furthermore, malabsorption of magnesium, calcium, and B vitamins may occur, which are all important in maintaining optimal brain function and mood stability. Literature has shown that a deficiency in B vitamins could be a possible cause of depressive symptoms (7). This emphasizes the controversy on long-term prescription of PPIs without proper concern on micronutrient malabsorption and the resulting chronic impact on patients’ mood.

Hence, the hypothetical identification of medications like Omeprazole to treat MDD is indeed a progression; however, it is important to take a more careful analysis of such results and findings, and translate such findings into clinics when it is possible. The likely side effects of long-term PPI administration, especially on micronutrient absorption and patients’ mood and depressive symptoms, should be discussed when we are outlining the association of Omeprazole with MDD. Therefore, since long-term administration of Omeprazole might have a link with depression among its side effects, this creates some worry over suggesting Omeprazole for the treatment of MDD.

In conclusion, the methodology for the identification of the link between genetic markers and medications initially proposed in this paper provides a strong groundwork for subsequent research; while also pointing at the need to pay sufficient care to the side effects of medications like Omeprazole on the patient’s mental state. Subsequent clinical investigations must critically look at the consequences of long-term administration of PPIs. They should focus on the biopsychosocial model of depression and hence need a multi-disciplinary approach.

I appreciate your time and patience in considering this critical topic concerning the impact of Omeprazole and its suitability in MDD treatment. I hope that the gut-brain axis and the complexity of the effects of pharmacological treatments and their interaction with nutrients in the patients gastro intestinal system would be taken into account when suggesting anti-depressant agents; noting that sufficient clinical research is needed before interpreting the effects of therapeutic agents in the clinical environment.