2023 CiteScore: 4
pISSN: 1735-4587
eISSN: 2008-2215
Editor-in-Chief:
Mohammad Reza Mohammadi, MD.
This journal is a member of, and subscribes to the principles of, the Committee on Publication Ethics (COPE).
Vol 1 No 1 (2006)
Objective: This study was conducted to identify the characteristics of patients with psychosis who had escaped from hospital or were discharged prematurely and against medical advice.
Method: We carried out this retrospective study on 72 patients with psychosis who were discharged prematurely over a 38-month period and compared them to 76 patients with psychosis who were discharged according to the physician’s order, as the control group. In addition to the demographic factors, we assessed the following: the patient’s and their care giver’s level of education, in hospital stay, suicidal idea and attempt, smoking, substance abuse, psychiatric diagnosis, arrest record, imprisonment, positive history of psychiatric disorder in the first degree family members, first episode of psychosis, admission with police assistance, unemployment, and escape history (from hospital, school, military service, home, work and prison).
Results: The two groups of patients were comparable in regard to two factors: the in hospital stay, and a positive history of escape. The latter was defined as leaving home, quitting work, escaping from school and military service, and a positive history of escape from hospital.
Conclusion: Irregular discharge of patients with psychosis seems to be predictable by their positive escape history, and therefore preventable. Irregular discharge is more likely in the first few days of hospital admission. There is also a great tendency towards irregular discharge when in hospital stay gets long.
Objective: To describe a home care service developed in Roozbeh Hospital for patients with bipolar disorder and schizophrenia and report baseline and 6-month follow-up data.
Method: Roozbeh Home Care Program consists of home visits by multidisciplinary home care teams, including general practitioners, nurses, and social workers who are supervised by psychiatrists. Home visits are scheduled as biweekly for the first three months following discharge and then on a monthly basis and the care includes biopsychosocial assessments and interventions. Baseline and 6-month data were extracted using a chart review.
Results: After 10 months of the Program development, 53 patients were enrolled and a total of 349 home visits were made. Of these, 29 were followed for at least 6 months. More than 86% of the patients remained in the community throughout the follow-up period, most in full remission and a small minority (4 patients) with a mild to moderate relapse that was overcome with interventions made by the home care teams.
Conclusion: A home care service is a feasible mode of community-based aftercare for patients discharged from the hospital. Its effectiveness should be assessed by a randomized controlled trial.
Objective: Depression is a major health problem, which is not only underrecognized and undertreated, but is also associated with significant morbidity and mortality. It has been suggested that combination therapy rapidly reduces depressive symptoms in patients with moderate to severe depression and is more effective than monotherapy; but this suggestion remains controversial. Serotonergic and noradrenergic enhancement may be synergistic and more effective than serotonergic enhancement alone in the management of depression. The objective of this double blind, placebo-controlled study was to investigate the efficacy and tolerability of the combination of citalopram and nortriptyline for the treatment of moderate to severe major depression.
Method: 45 patients, who met the DSM-IV criteria for major depressive disorder based on the clinical interview, were included in the study. Patients had a baseline Hamilton Depression Rating Scale score of at least 20. In this trial, patients were randomly assigned to receive nortriptyline 50 mg/day plus citalopram 40 mg/day (group1) or placebo plus citalopram 40 mg/day (group2), for an 8 week, double-blind, placebo-controlled trial.
Results: Both protocols significantly decreased the score of Hamilton Depression Rating Scale over the trial period, but the combination of nortriptyline and citalopram showed a significant superiority over citalopram alone in the treatment of moderate to severe major depressive disorder (t = 3.34, d.f. = 36, P = 0.001). The difference between the two groups in the frequency of side effects was not significant.
Conclusion: The results of this study suggest that combination of nortriptyline and citalopram is more effective than citalopram alone in the treatment of depression. This advantage is probably the result of reuptake inhibition of both serotonin and norepinephrine
Objective: This study was conducted to compare the effects of clomipramine and fluoxetine on fasting blood glucose (FBS) in children with obsessive-compulsive disorder (OCD).
Method: Thirty nondiabetic children with OCD entered this randomized trial. Subjects were between 7 to 17 years of age and had not received any medication that could affect blood glucose level for at least 2 weeks prior to the initiation of the study. Patients were assigned to receive 20 to 60 mg/d of fluoxetine or 75 to 200 mg/d of clomipramine for 8 weeks. The exclusion criteria were pregnancy and lactation, history of diabetes mellitus, any liver and thyroid disorder, epilepsy and major heart disease. Additionally, none of the patients should have received electroconvulsive therapy within 6 months prior to the initiation of the study. FBS levels were measured at baseline, 4 and 8 weeks after the initiation of the trial.
Results: In the fluoxetine group, FBS level was decreased from 82.93 mg/dL (baseline) to 79.73 mg/dL at week 4 (P<0.001) and to 72.53 mg/dL at week 8 (P<0.001). On the other hand, in the clomipramine group, FBS level was increased from 84.93 mg/dL (baseline) to 87.00 mg/dL at week 4 (P<0.05) and to 95.33 mg/dL at week 8 (P<0.001).
Conclusion: This 8-week study demonstrated that FBS levels may decrease in children with OCD who received flouxetine, and may increase in those treated with clomipramine. Therefore, it is suggested that FBS levels should be monitored and taken into consideration when choosing between fluoxetine and clomipramine in the treatment of OCD.
2023 CiteScore: 4
pISSN: 1735-4587
eISSN: 2008-2215
Editor-in-Chief:
Mohammad Reza Mohammadi, MD.
This journal is a member of, and subscribes to the principles of, the Committee on Publication Ethics (COPE).
All the work in this journal are licensed under a Creative Commons Attribution-NonCommercial 4.0 International License. |