Tehran University of Medical Sciences Iranian Journal of Psychiatry 1735-4587 18 3 2023 06 20 258 265 Seyed Ahmad Hosseini Department of Psychiatry, Kashan University of Medical Sciences, Kashan, Iran. Zahra Sepehrmanesh Department of Psychiatry, Kashan University of Medical Sciences, Kashan, Iran. Hamidreza Gilasi Department of Epidemiology and Biostatistics, Faculty of Health, Kashan University of Medical Sciences, Kashan, Iran. Fatemeh Sadat Ghoraishi‬ Department of Psychiatry, Kashan University of Medical Sciences, Kashan, Iran. 2022 05 06 2022 10 24 Objective: Schizophrenia, as one of the most severe psychiatric diseases, has a chronic and debilitating process. The majority of patients with schizophrenia do not respond adequately to treatment with common antipsychotic drugs. Therapeutic problems induced by drug side effects as well as undesired results are major challenging issues regarding this disease. This study aimed at evaluating the effect of memantine supplementation on the improvement of cognitive symptoms in patients with schizophrenia. Method: The present clinical trial was performed on 50 patients with acute schizophrenia who were admitted to Kargarnejad Psychiatric Hospital in Kashan in 2022 and who were diagnosed as schizophrenia cases at least three months ago. Patients were randomly divided into either the intervention group (n = 25) or the placebo group (n = 25). The intervention group received 5 mg of memantine per day for three months. The dose of memantine in this group was increased to the maximum of 20 mg per day. The placebo group received 1 mg of folic acid per day for three months. Moreover, an identical routine schizophrenia therapeutic regimen was administered to all patients. The effectiveness of memantine was evaluated using the Wechsler Adult Intelligence Scale (WAIS-III), which assessed cognitive ability in older adults over a 12-week follow-up period. Results: The WAIS-III score in the 12th week of the study was significantly different between the placebo and intervention groups (P = 0.004), such that the score of the memantine group was higher than that of the placebo group. No significant difference was observed between the two groups in terms of drug side effects. Conclusion: Memantine can be supplemented in the treatment of schizophrenia so as to improve the cognitive symptoms of this disorder. However, subsequent studies involving larger sample sizes and different doses seem to be necessary to provide more accurate results in this respect. https://ijps.tums.ac.ir/index.php/ijps/article/view/3235

Tehran University of Medical Sciences Iranian Journal of Psychiatry 1735-4587 18 3 2023 06 20 319 331 Zahra Mousavi Department of Psychiatry, Tabriz University of Medical Sciences, Tabriz, Iran. Nasrin Abolhasanpour Research Center for Evidence-Based Medicine, Iranian EBM Center: A Joanna Briggs Institute Center of Excellence, Tabriz University of Medical Sciences, Tabriz, Iran. Amirreza Naseri Student Research Committee, Tabriz University of Medical Sciences, Tabriz, Iran. Fatemeh Maghsoudi Department of Psychiatry, Tabriz University of Medical Sciences, Tabriz, Iran. Azizeh Farshbaf-khalili Physical Medicine and Rehabilitation Research Centre, Aging Research Institute, Tabriz University of Medical Sciences, Tabriz, Iran. Kavous Shahsavarinia Emergency Medicine Research Team, Tabriz University of Medical Sciences, Tabriz, Iran. Ali Mousavi Plastic Aesthetic Reconstructive Surgery Department, Iran University of Medical Science, Tehran, Iran. Rasa Beheshti Student Research Committee, Tabriz University of Medical Sciences, Tabriz, Iran. Ali Mostafaei Department of Psychiatry, Tabriz University of Medical Sciences, Tabriz, Iran. Hanieh Salehi-Pourmehr Department of Psychiatry, Tabriz University of Medical Sciences, Tabriz, Iran. 2022 02 15 2022 10 09 Objective: Having cosmetic breast implants increases a woman's chance of suicide, which is now a global challenge. This systematic review evaluated the possible risk of suicide among women who undergo cosmetic breast implants. Method: This meta-analysis was done based on Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA). In the current systematic review and meta-analysis, we systematically searched for all articles written in both English or Persian that estimated the prevalence of suicidal ideation in women who had cosmetic breast implants. We systematically searched different databases, including MEDLINE (PubMed), Web of Science, Embase, Cochrane, Library ProQuest, Scopus, and Google Scholar, from inception to March 2021. There was also a search for references. Suicidal ideation, a suicide plan, or suicide attempts were the outcomes. In order to determine the total pooled prevalence of suicidal ideation, we utilized a random-effects model. To examine the risks of bias in each study, we applied the Joanna Briggs Institute Critical Appraisal method. Results: We identified 218 citations in our initial search. After omitting duplicated citations and excluding irrelevant studies according to the title and abstract selection, 42 studies were chosen for the full text analysis. Finally, 11 research, examining a total of 324,332 women were incorporated into the systematic review and critical appraisal assessment. Eight of these studies were found to be eligible for meta-analysis. The frequency of suicide in women with cosmetic breast implant was 0.2% (95% CI: 0.1% to 0.4%; P < 0.001) (Q-value: 168.143, I2:95.83). Most of the included studies had moderate quality. Conclusion: There might be a correlation between cosmetic breast implants and suicide risk, which could be stronger in the presence of a history of mental illnesses. The evidence about the possible effects of breast implants on the risk of suicide is still inconclusive, and there is a need for future well-designed studies on this topic. https://ijps.tums.ac.ir/index.php/ijps/article/view/3136 https://ijps.tums.ac.ir/index.php/ijps/article/download/3136/1138

Tehran University of Medical Sciences Iranian Journal of Psychiatry 1735-4587 18 3 2023 06 20 362 368 Hamzeh Rostami Department of Psychiatry, Golestan Hospital, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran. Farzaneh Babaali Department of Psychiatry, Golestan Hospital, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran. Leila Moradi Diabetes Research Center, Health Research Institute, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran. Fereshteh Golfakhrabadi Department of Pharmacognosy, School of Pharmacy, Medicinal Plant Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran. Leila Abdi Department of Psychiatry, Golestan Hospital, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran. 2022 12 14 2023 01 17 Objective: Metabolic syndrome is a potential side effect of atypical antipsychotics which are the current standard treatment for schizophrenia. Therefore, we aimed to examine the effect of barberry root (Berberis vulgaris) on the prevention of metabolic syndrome caused by atypical antipsychotic drugs in patients with schizophrenia. Method: Our research was a three-blind randomized clinical trial. The participants included all patients who were diagnosed with schizophrenia through the SCID-5 questionnaire and based on the DSM-5-TR criteria by two psychiatric experts. These patients were randomly divided into intervention and placebo groups. During a three-month treatment period, the intervention group received three 500 mg capsules of barberry root extract daily, whereas the placebo group received the same capsules containing 500 mg of starch powder. Metabolic syndrome variables including fasting blood glucose, serum lipids (triglyceride and cholesterol), blood pressure, weight and waist circumference were measured before and after the treatment as outcome measure. Chi-square and t-tests were used for data analysis using SPSS-22 software. Results: At the beginning of the study, there was no significant difference between the intervention group (n = 41) and the placebo group (n = 47) in terms of demographic factors, and pre-treatment assessments including weight, waist size, fasting blood HDL, fasting blood triglycerides and systolic and diastolic blood pressure and fasting blood glucose (P > 0.05). Within group analysis showed that some metabolic factors significantly increased in both groups after the treatment (P < 0.05). Indeed, in both groups, metabolic syndrome measures worsened after the three-month treatment period. The parameters of weight and waist size were significantly higher in the intervention group than the placebo group after treatment (P < 0.05). Conclusion: Barberry root extract was not able to control the Effects of antipsychotic drugs on metabolic syndrome in schizophrenia. https://ijps.tums.ac.ir/index.php/ijps/article/view/3460 https://ijps.tums.ac.ir/index.php/ijps/article/download/3460/1141

Tehran University of Medical Sciences Iranian Journal of Psychiatry 1735-4587 18 3 2023 06 20 369 370 Remya Lathabhavan Indian Institute of Management, Bodh Gaya, Bihar, India. Zohreh Hosseini Marznaki Imam Ali Hospital, Mazandaran University of Medical Sciences, Sari, Iran. 2022 12 29 2023 04 25 No Abstract  No Abstract  https://ijps.tums.ac.ir/index.php/ijps/article/view/3477 https://ijps.tums.ac.ir/index.php/ijps/article/download/3477/1142

Tehran University of Medical Sciences Iranian Journal of Psychiatry 1735-4587 18 3 2023 06 20 266 274 Fatemeh Rajabi Department of Psychiatry, Isfahan University of Medical Sciences, Isfahan, Iran. Fatemeh Fozveh Department of Psychiatry, Isfahan University of Medical Sciences, Isfahan, Iran. Mohammad Reza Maracy Department of Epidemiology and Biostatistics, School of Health, Isfahan University of Medical Sciences, Isfahan, Iran. 2022 02 23 2022 10 08 Objective: Studies using standard neuropsychological instrumentation have shown memory deficits in posttraumatic stress disorder (PTSD) patients. We examined the efficacy and safety of memantine in new cases of combat-related PTSD in the military by conducting a 16-week prospective double-blind randomized controlled trial. Method: Twenty-six new combat-related PTSD cases were recruited from among the military personnel based on the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5). Patients were assigned to memantine and Placebo groups. They were monitored at baseline, week eight, and week 16. Memantine was added to each patient's current medication with an initial dosage of 5 mg/day, raised by 5 mg/day every week until it reached the maintenance level of 20 mg/day. The concurrent drugs were essentially kept unchanged during the trial. The primary outcome was PTSD severity as assessed by the Clinician-administered PTSD Scale (CAPS). The CAPS is a valid and reliable tool for the diagnosis of PTSD and measurement of its severity according to the DSM–4. Results: CAPS mean score in baseline (P = 0.811) and weeks eight (P = 0.389) and 16 (P = 0.066) did not show any significant differences between the two groups. The mean CAPS score in the memantine group significantly (P = 0.006) decreased (Mean differences = -8.79) compared to the placebo group, showing that intervention with memantine was effective. The mean total CAPS in weeks eight (Mean differences = -14.21) and 16 (Mean differences = -27) were less than the baseline, which was significantly meaningful (P < 0.001). Conclusion: Findings of this study suggest that add-on memantine can be effective in veteran patients with PTSD. So our data provide useful insight into the management of new cases of combat-related PTSD. https://ijps.tums.ac.ir/index.php/ijps/article/view/3150 https://ijps.tums.ac.ir/index.php/ijps/article/download/3150/1133

Tehran University of Medical Sciences Iranian Journal of Psychiatry 1735-4587 18 3 2023 06 20 332 351 Seyedeh Narjes Mousavizadeh Department of Psychiatric Nursing and Management, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran. Mohammad Amin Jandaghian Bidgoli Student Research Committee, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran. 2023 02 16 2023 04 18 Objective: New initiatives are needed to manage patients with mental health problems in the community. Among the core principal ideals of any healthcare system is transition from traditional services to community-based practices. The aim of this study was to assess community-based and recovery-oriented practices and interventions for individuals with mental health problems. Method: MESH keywords, including “mental health recovery”, “rehabilitation”, “aftercare”, “community psychiatry”, and “mental health service” were searched in scientific databases such as Medline, EMBASE, PsychInfo, CINAHL, and Cochrane up to July 2022. A snowball search was also conducted on eligible studies. The methodological quality of the studies was determined by Kmet standard criteria. Results: The systematic review included 32 studies, all of which demonstrated a moderate to high promising effect for community-based and recovery-oriented practices or programs on patients with severe mental illness. These practices could help patients to find suitable jobs, avoid isolation and stigma, improve communication skills, increase awareness of problems, and foster independence. The study also highlighted the pivotal role of nurses, artistic and sports activities, electronic (E)-mental health, home visits, psychoeducation, and special recovery programs. Conclusion: Community-based and recovery-oriented practices should be used as an effective means of normalizing the lives of psychiatric patients. In essence, by cultivating hope and empowering these patients, many of the concerns of health systems can be eradicated. https://ijps.tums.ac.ir/index.php/ijps/article/view/3529 https://ijps.tums.ac.ir/index.php/ijps/article/download/3529/1139

Tehran University of Medical Sciences Iranian Journal of Psychiatry 1735-4587 18 3 2023 06 20 275 284 Sara Banaha Student Research Committee, Babol University of Medical Sciences, Babol, Iran. Hajar Pasha Infertility and Reproductive Health Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran AND Social Determinants of Health Research Center, ;‘receiving less than 50% of annual leave’’ were associated with significantly higher levels of EE. Factors such as ‘‘not afraid of moving abroad’’ and ‘‘receiving 100% of annual leave’’ were associated with significantly higher levels of low Personal Accomplishments (PA). The principal component analysis yielded three principal components: ‘future insecurity’, ‘feeling secure while working’ and ‘working conditions associated with burnout syndrome. Conclusion: Several factors associated with austerity resulting from economic crisis significantly influenced prevalence of burnout syndrome among oncologists in Greece. Further studies need to be conducted to mobilize policy makers to develop and implement policies to improve oncologists' mental health. https://ijps.tums.ac.ir/index.php/ijps/article/view/2094 https://ijps.tums.ac.ir/index.php/ijps/article/download/2094/1053

Tehran University of Medical Sciences Iranian Journal of Psychiatry 1735-4587 17 2 2022 03 13 177 186 Malahat Amani Department of Psychology, Univeraity of Bojnoed, Bojnoed, Iran. Safoora Keyvanlo Department of Psychology, Univeraity of Bojnoed, Bojnoed, Iran. 2020 04 23 Objective: Obsessive-compulsive disorder is associated with cognitive and motivational deficits caused by abnormal activities in certain neural circuits. This study sets out to determine the contribution of each component of executive function and reinforcement sensitivity in prediction of obsessive-compulsive symptoms. Method: In this cross-sectional study, the study population consisted of all adult women living in Sabzevar city (Iran). Using cluster sampling, 365 women were selected as the study sample. Participants completed the Obsessive-Compulsive Inventory, Sensitivity to Punishment and Sensitivity to Reward Questionnaire - Revised and Clarified (SPSRQ-RC) as well as Behavior Rating Inventory of Executive Function (BRIEF). Data analysis was conducted using correlation and regression tests. Results: The results of stepwise regression analysis showed that inhibition, shift and initiation variables as well as sensitivity to punishment and reward were best predictors of obsessive-compulsive symptoms (adjusted R square = 0.34, F = 38.93, P < 0.0001). Conclusion: It seems that impaired executive functions in cognition and sensitivity to reinforcement in motivation contribute to the emergence or sustainability of obsessive-compulsive symptoms. https://ijps.tums.ac.ir/index.php/ijps/article/view/2129 https://ijps.tums.ac.ir/index.php/ijps/article/download/2129/1052

Tehran University of Medical Sciences Iranian Journal of Psychiatry 1735-4587 17 2 2022 03 13 187 195 Sanaz Bahrami-Samani Student Research Committee, Babol University of Medical Sciences, Babol, Iran. Mojgan Firouzbakht Department of Nursing-Midwifery, Comprehensive Health Research Center, Babol Branch, Isalamic Azad University, Babol, Iran. Alireza Azizi Social Determinants of Health Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran. Shabnam Omidvar Social Determinants of Health Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran. 2020 11 09 Objective: This study aimed to assess anxiety and depression during the COVID-19 outbreak among students aged 8 to 18 years and to determine related demographic and other related factors. Method: A descriptive and analytical cross sectional study was conducted through web-based data collection which included 348 students aged 8 to 18 years in the state of Mazandaran, Iran during the first peak of COVID-19. Demographic and Revised Children's Anxiety and Depression Scale (RCADS-P) questionnaires were used to collect the data. The statistical tests including independent sample t test, ANOVA as well as linear regression were employed. Results: The average age of the subjects was reported to be 12.2 ± 3.59 years. Age, father’s occupation, following COVID-19 related news, and also nervousness related to infection were predictors of anxiety (11%). Moreover, age, mother’s occupation, family communication and also the safety protocols practiced by the family were found to be predictors of depression in students (17%). A significant relationship was also found between the effect of quarantine on family communication and the anxiety and depression in students (P < 0.001). Conclusion: Demographic characteristics affect student mental health during the COVID-19 outbreak. Moreover, family preventive protocols can predict depression in students aged 8 to 18 years. Better preventive precautions encourage less anxiety and depression. https://ijps.tums.ac.ir/index.php/ijps/article/view/2435 https://ijps.tums.ac.ir/index.php/ijps/article/download/2435/1051

Tehran University of Medical Sciences Iranian Journal of Psychiatry 1735-4587 17 2 2022 03 13 196 207 EN Seyed Morteza Hosseini Medicine, Quran and Hadith Research Center, Baqiyatallah University of Medical Sciences, Tehran, Iran. Saeed Hesam Medicine, Quran and Hadith Research Center, Baqiyatallah University of Medical Sciences, Tehran, Iran AND Department of Biostatistics and Epidemiology, School of Public Health, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran. Seyed Amirhossein Hosseini Student Scientific Reaserch Center, Tehran University of Medical Sciences, Tehran, Iran. 2021 01 05 Objective: Acknowledging the key role of hardiness, importance of health and its various dimensions, the present study aimed to investigate the simultaneous relationship between hardiness components and spiritual health, burnout, and general health, among Baqiyatallah University of Medical Sciences staff. Method: 307 Baqiyatallah University of Medical Sciences’ staff in Tehran with at least five years work experience participated in this cross-sectional study using simple random sampling. Four questionnaires were used to evaluate the participants: the 28-item General Health Questionnaire (GHQ) to assess general mental problems with four subscales, 22-item Maslach Burnout Inventory (MBI) with two aspects (frequency and intensity) and three subscales of emotional exhaustion, depersonalization and personal accomplishment, the 20-item Spiritual Well Being Scale (SWBS) Questionnaire with two subscales of religious well-being and existential well-being and the 50-item Kobasa Hardiness Questionnaire to measure psychological hardiness with three subscales of control, commitment and challenge. At the end, two conceptual models which have shown effect of hardiness and its subscales on general health, Spiritual health and burnout were evaluated by path analysis. Results: According to the path analysis results, it was found that hardiness and its subscales, which were approved by univariable and multivariable analyses, had significant relationship with general health (direct effect: -0.525, P < 0.001), spiritual health (direct effect: 0.555, P < 0.001) and burnout (direct effect of frequency aspect: -0.523, P < 0.001). Thus, by increasing hardiness and its subscales, spiritual health increases while symptoms of illness and burnout decrease. Conclusion: Spiritual health increases as hardiness and its subscales increase as well; therefore, symptoms of illness and burnout decrease as hardiness and its subscales increase. https://ijps.tums.ac.ir/index.php/ijps/article/view/2541 https://ijps.tums.ac.ir/index.php/ijps/article/download/2541/1050

Tehran University of Medical Sciences Iranian Journal of Psychiatry 1735-4587 17 2 2022 03 13 208 216 Azadeh Mesripour Department of Pharmacology and Toxicology, School of Pharmacy and Pharmaceutical Sciences, Isfahan University of Medical Sciences, Isfahan, Iran. Shirin Golchin Department of Pharmacology and Toxicology, School of Pharmacy and Pharmaceutical Sciences, Isfahan University of Medical Sciences, Isfahan, Iran. 2020 12 29 Objective: Bacillus-Calmette-Guerin (BCG) inoculation in mice produces an acute period of illness followed by a chronic depressive-like behavior period that lasts for few weeks. The aim was to evaluate vitamin B6 antidepressant effect in comparison with common antidepressants. Method: BCG (0.2 ml/mouse) single dose was intraperitoneally inoculated in male mice. Vitamin B6 (100 mg/kg), fluoxetine, imipramine, or venlafaxine (10 mg/kg each) were intraperitoneally injected for 14 consecutive days following BCG administration. Illness was evaluated following inoculation and depressive-like behaviors were assessed on days 7 and 14. Results: Illness was induced by BCG since mice lost weight and locomotor activity was reduced. Illness was prevented by vitamin B6 similar to antidepressant drugs. Despair was measured by immobility time during the forced swim test and BCG increased it compared to control (193 ± 3s vs 151 ± 7s, P < 0.01) on day 7, and (200 ± 5s vs 147 ± 6s, P < 0.001) on day 14. Vitamin B6, like antidepressants, reduced despair. BCG clearly induced anhedonia evaluated by sucrose preference test (47.5%), and it was soothed by B6 and the antidepressants. Novelty-suppressed feeding test evaluated long term depressive behavior after 14 days. BCG increased the latency to first feeding (222 ± 41s vs control 87 ± 2.6s, P < 0.001) and reduced food consumption per body weight (13 ± 1 mg/g vs control 19 ± 2 mg/g, P < 0.001) while B6 like antidepressants reduced latency and improved food consumption. Conclusion: Vitamin B6 efficiently prevented BCG sickness and depression that was comparable to common antidepressant drugs. Therefore, B6 supplement for preventing depression in high-risk individuals is suggested for further clinical research. https://ijps.tums.ac.ir/index.php/ijps/article/view/2529 https://ijps.tums.ac.ir/index.php/ijps/article/download/2529/1049

Tehran University of Medical Sciences Iranian Journal of Psychiatry 1735-4587 17 2 2022 03 13 217 223 Ankur Sachdeva Department of Psychiatry, ESIC Medical College & Hospital, Faridabad, Haryana, India. Vipin kumar Department of Department of Psychiatry, SHKM Government Medical College, Nuh, Mewat, Haryana, India., SHKM Government Medical College, Nuh, Mewat, Haryana Harsh Nandini Department of Psychiatry, ESIC Medical College and Hospital, Faridabad, Haryana, India Faisal Shaan Department of Psychiatry, SHKM Government Medical College, Nuh, Mewat, Haryana, India 2021 06 04 Objective: The Coronavirus‑19 (COVID‑19) pandemic has perpetrated a significant mental health burden amongst health care workers (HCWs) and their families. Families of HCWs are at significant risk of various mental health problems due to concerns regarding the wellbeing of the HCW, fear of contacting the virus from HCWs, staying isolated during periods of quarantine and being the passive recipient of public stigma directed towards HCWs. The objective of this study was to assess the perceived stress, resilience and coping tendencies of families of HCWs managing the COVID 19 crisis. Method: A cross sectional study was conducted at a tertiary care hospital in India, where close relatives of 150 HCWs managing COVID-19 patients (directly or indirectly involved in patient care) were selected using systematic random sampling. They were evaluated using the Perceived Stress Scale, Brief Resilience Coping Scale, and the Hospital Anxiety and Depression Scale. Pearson’s correlation and Independent t-test were used for statistical analysis using the SPSS software. Results: Majority (75%) of the family members associated with frontline HCWs had moderate to high level of perceived stress, while23% and 17% had clinically significant anxiety and depressive symptoms, respectively. More than 50% had low resilience and coping scores. High levels of stress, anxiety and depression were seen in female respondents, those less than 40 years old, having a child or an elderly family member and when the HCW had direct involvement in COVID-19 patient care. Conclusion: Families of HCWs suffer from significant psychological burden due to the COVID-19 crisis. They face significant risk of depression and anxiety associated problems, which are augmented by low resilience and impaired coping. Mental health of HCWs and their family members should be given due attention with a focus on early identification, providing psychological support and improving resilience. https://ijps.tums.ac.ir/index.php/ijps/article/view/2761 https://ijps.tums.ac.ir/index.php/ijps/article/download/2761/1048

Tehran University of Medical Sciences Iranian Journal of Psychiatry 1735-4587 17 2 2022 03 13 224 229 Mohammed Ghalib Qutishat College of Nursing, Sultan Qaboos University, Muscat, Oman. Khloud Al Dameery College of Nursing, Sultan Qaboos University, Muscat, Oman. Omar Al Omari College of Nursing, Sultan Qaboos University, Muscat, Oman. Mohammad Al Qadire