Elevated IL-17 and TGF-beta serum levels: a positive correlation between T-helper 17 cell-related pro-inflammatory responses with major depressive disorder

Introduction: Depression is a mental disorder that highly associated with immune system. Therefore, this study compares the serum concentrations of IL-21, IL-17, and transforming growth factor beta [TGF-beta] between patients with major depressive disorder and healthy controls

Methods: Blood samples were collected from 41 patients with major depressive disorder and 40 healthy age-matched controls with no history of malignancies or autoimmune disorders. The subjects were interviewed face to face according to DSM-IV diagnostic criteria. Depression score was measured using completed Beck Depression Inventory in both groups. The serum concentrations of IL-21, IL-17, and TGF-beta were assessed using ELISA

Results: The mean score of Beck Depression score in the patient and control groups was 35.4 +/- 5.5 and 11.1 +/- 2.3. IL-17 serum concentrations in the patients and the control group were 10.03 +/- 0.6 and 7.6 +/- 0.6 pg/mL, respectively [P=0.0002]. TGF-beta level in the patients group was significantly higher than compare to the control group; 336.7 +/- 20.19 vs. 174.8 +/- 27.20 pg/mL, [P<0.0001]. However, the level of IL-21 was not statistically different between the two groups 84.30 +/- 4.57 vs. 84.12 +/- 4.15 pg/mL [P>0.05]

Conclusion: Considering pro-inflammatory cytokines, current results support the association of inflammatory response and depressive disorder. So, it seems that pro-inflammatory factors profile can be used as indicator in following of depression progress and its treatment impacts

efficacy of psycho-educational group program on medication adherence and global functioning of patients with bipolar disorder type I

Psycho-education is now considered as part of the integrated treatment for bipolar disorder. This study aimed to determine the efficacy of group psycho-education on medication adherence and global functioning of patients with bipolar disorder type I. 45 patients with bipolar disorder type I were allocated one of the three groups of psycho-education plus pharmacotherapy, pharmacotherapy and placebo plus pharmacotherapy. A psycho-educational program was conducted for the psycho-educational group during 9 weekly sessions. Medication adherence and global functioning of all the three groups were evaluated before the intervention, three months and six months after the intervention using Medication Adherence Rating Scale [MARS] and Global Assessment of Functioning [GAF]. ANOVA was performed to examine the data. In the first and second assessments, the mean score of medication adherence and gobal functioning for patients in the psycho-educational group was significantly higher than that in the control and placebo groups [P=0.001]. Medication adherence score of the psycho-educational group was increased from 6.27[0.88] to 7.92[1.38]. while the mean score of the psycho-educational group increased from 56.6 [3.58] to 64.17 [2.12]:, the global functioning reduced from 56.27[3.17] to 54.17[5.08] in the control group and from 56.67 [3.58] to 56 [4.36] in the placebo group. Psycho-educational program plus pharmacotherapy was effective in improvement medication adherence and global functioning of bipolar patients.

Psychometric characteristics of the persian [Farsi] version of attachment style questionnaire

Attachment relationship provides a secure base for the infants from which to explore the environment and a safe haven to return to in times of danger. Attachment style shapes the behavior of individuals in adulthood. There are many different measures of attachment and a lot of controversy about what they measure and how they relate to each other. Hence, we tried to evaluate the psychometric properties of one of such questionnaires on a sample of the Iranian population. [Attachment style questionnaire] designed by Van Oudenhoven measures four dimensions: secure, preoccupied, fearful and dismissing. Psychometric properties of the questionnaire were evaluated in a cross sectional study on 730 adults in Isfahan, Iran. Statistical analysis of data was performed by the explanatory factor analysis with the principal component method, Cronbach's alpha, Pearson correlation coefficients, and the multiple analysis of variance [MANCOVA]. The Cronbach's alpha for all items was 0.704. As a whole, the internal consistency was good. There was a high inter-scale correlation between preoccupied and fearful, also the secure style correlated negatively with fearful and preoccupied. The stability coefficient of the attachment scales were 0.625, 0.685, 0.777 and 0.605 for secure, fearful, preoccupied and dismissing styles respectively [P<0.001]. Regarding construct validity, factor analysis showed that some items require iterations to fit the Iranian population. This study showed that the Persian version of ASQ has a reasonable reliability and validity in general and the questionnaire is appropriate for use among the Iranian population in future studies

Association of ADHD symptoms severity with higher paternal and lower maternal age of a clinical sample of children

This study examines the association of father's and mother's age with the severity of inattention and hyperactivity/impulsivity. Participants are 470 children with attention deficit hyperactivity disorder [ADHD] diagnosed according to DSM-IV diagnostic criteria. Moreover, parents reported the severity of ADHD symptoms through completing ADHD checklist. Mother's and father's age was associated with the score of hyperactivity/impulsivity. Lower father's age and advanced maternal age are associated with higher severity of hyperactivity/impulsivity in children and adolescents with ADHD. None of mothers' and fathers' age is associated with ADHD inattentiveness severity in children. Maternal and paternal education levels are not associated with ADHD severity. Older mothers and younger fathers have ADHD children with higher hyperactivity/impulsivity severity. It should be investigated whether the father's and mother's age are risk factors for ADHD

Effectiveness of cognitive-behavioral therapy in decreasing suicidal ideation and hopelessness of the adolescents with previous suicidal attempts

To evaluate the effectiveness of a Cognitive-Behavioral therapy [CBT] for suicide prevention in decreasing suicidal ideation and hopelessness in a sample of depressed 12 to 18 year-old adolescents who had at least one previous suicidal attempt. In a clinical trial, 30 depressed adolescents who attempted suicide in the recent 3 months were selected using simple sampling method and divided randomly into intervention and wait-list control groups. Both groups received psychiatric interventions as routine. The intervention group received a 12 session [once a week] of CBT program according to the package developed by Stanley et al, including psychoeducational interventions and individual and family skills training modules. All of the patients were evaluated by Scale for Suicidal Ideation, Beck's hopelessness Inventory, and Beck's Depression Inventory before the intervention and after 12 weeks. There were significant differences between the two groups regarding the scores of the above mentioned scales after 12 weeks. Fifty-four to 77 percent decreases in the mean scores of the used scales were observed in the invention group. There were no significant changes in the scores of the control wait-list group. The differences between pre- and post-intervention scores in the intervention group were significant. CBT is an effective method in reducing suicidal ideation and hopelessness in the depressed adolescents with previous suicidal attempts

symptom profile analysis of depression in a sample of Iranian patients

Background: In some cultures, including ours, direct explanation of inner psychic world is inhibited and stigmatized, therefore finding alternative modes of expression. The aim of this crosssectional study was to assess the frequency of somatization in the depressed patients

Methods: The present study comprised 500 patients referred to the outpatient clinic of Shiraz University of Medical Sciences, and diagnosed with major depressive disorders based on DSMIV- TR. The presenting complaints of these patients were assessed through psychiatric interview. The presenting symptoms were divided into three main categories including mental symptoms, pain, and physical symptoms without pain. Statistical analysis [chi-square and logistic regression] were performed to determine the relationship between presenting symptoms and some demographic variables such as age, gender, marital status, educational level and cultural background [urban or rural]

Results: Physical symptoms other than pain, mental symptoms, and pain were found in 193 [38.6%], 186 [37.2%], and in 121 [24.2%] patients respectively. Pain and physical complaints were more common in patients with rural cultural background, lower education, women and the married individuals. Headache [15.2%], irritability [10.6%] and pain in different parts of the body [10.4%] were the most frequent chief complaints of the patients. Hypochondriasis, suicidal idea, crying, irritability and insomnia were significant symptoms associated with the complaint of somatization

Conclusion: Somatic symptoms, especially pain, have a significant weight in the chief complaints of depressed patients. Physicians need to pay particular attention to this important issue in order to better understand these patients

Smell Identification Function in Children with Attention Deficit Hyperactivity Disorder

OBJECTIVE: Deficits in olfactory function are common features in neurodegenerative and neuropsychiatric disorders. Olfactory processing is related to dopamine metabolism and orbitofrontal cortex functioning, both known to be involved in the neurobiology of ADHD. Some investigations suggested alterations in olfactory processing (identification and detection threshold) in patients with ADHD. Despite increasing knowledge, controversy about this topic still exists regarding children with ADHD. This study was conducted to help elucidate some of this controversy. METHODS: 50 participants (8-15 years, mean=10.70+/-1.77) with ADHD were compared to 50 controls. The two groups were well matched for age, gender and Mean School Scores (MSS). We assessed odor identification and threshold through a smell test composed of two tests of identification and detection threshold. Odor detection threshold was assessed with the odorant phenyl ethyl alcohol solved in propylene glycol using a single staircase method. Odor identification was assessed with chemical essences of five common odorants. RESULTS: The mean Sensory Identification Score for children with ADHD and the control groups were 3.76 (1.06) and 4.46 (0.76), respectively (p<0.001). The mean for Sensory Threshold Score for ADHD and control group was 6.4 (3.35) and 9.75 (2.16), respectively (p<0.001). CONCLUSION: This study replicated altered olfactory performance in ADHD. Substantial olfactory deficits across the two domains of identification and detection threshold are observed in children with ADHD. These deficits do not seem to be a result of olfactory task difficulty and are not influenced by age, gender and MSS. Further studies are required to investigate whether olfactory function can be used as a biological marker for early diagnosis, treatment and prognosis of ADHD.

relationship between dissociative experiences and the success of treatment through abstinence from opioid-use disorders

Dissociation is a defense mechanism by which people under stress detach their thoughts, emotions and behaviors from the normal stream of consciousness in order to protect themselves against the threats imposed on their ego. The phenomenon of dissociation is associated with a group of psychiatric disorders, including substance use disorders [SUDs], and leads individuals to incline towards drugs. This study examines the relationship between the dissociation symptoms prior to abstinence treatment and the abstinence success. 128 opioid dependent males were selected randomly and examined using Dissociative Experience Scale [DES] questionnaire and a selfadministered questionnaire. After two months, the subjects were divided, in terms of abstinence success, into three groups of rehabilitated [successfully-rehabilitated], recurrence, and non-referral groups. The three groups were compared to each other with regard to the DES mean score, demographic characteristics, drug use history, selfdestruction, and self-mutilation history, using statistical methods of chi-square, t-test, and one-way ANOVA. The results showed that 39% of the subjects obtained a dissociation score of 15 and above in DES scale. There was a significant negative correlation between the dissociation score and abstinence success [p=0.001]. There was no significant relationship between the DES score and demographic factors such as education level, residential location, and marital status. Moreover, the treatment follow-up of individuals showed that there was no significant relationship among the three groups in terms of age and education level. The extent of dissociative phenomena in drug dependent individuals who decide to discontinue drug abuse is effective in the sense of treatment outcome. Hence, the individuals are recommended to be examined for dissociative symptoms prior to drug treatment, and receive the proper treatment.

Sensory Processing Problems in Children with ADHD, a Systematic Review

One of the most common psychiatric disorders in children is attention deficit hyperactivity disorder (ADHD). Its course and outcome are heterogeneous. Sensory processing problems impact the nature of response to daily events. ADHD and sensory problems may occur together and interact. No published review article about sensory processing problems in children with ADHD were found. A systematic search, conducted on Pub-Med (up to January 2010), and Google Scholar, yielded 255 abstracts on sensory processing problems in children including 11 studies about sensory problems in children with ADHD. Sensory processing problems in children with ADHD is not a well studied area. Sensory processing problems in children with ADHD are more common than in typically developing children. Findings do not support that ADHD subtypes are distinct disorders with regard to sensory processing problems. However, co-morbidity with oppositional defiant disorder and anxiety are predictors of more severe sensory processing problems in children with ADHD.

Nail biting; etiology, consequences and management

Nail biting [NB] is a common, but unresolved, problem in psychiatry, psychology, medicine and dentistry. While it seems that NB is a simple behavior that can be stopped easily, many of the children with NB have already tried to stop it, but they have not been successful. The frustrations due to failed attempt involve others such as parents and siblings. The present review aims at providing an overview of prevalence, co-morbidities, education and counseling, and management for NB. Overall, the reviewed literatures suggest that co-morbidities of psychiatric disorders and other stereotypic behaviors in clinical sample of children with NB is more than 80%, and more than half of the parents suffer from psychiatric disorders mainly depression. Treatment of NB, however, is not as easy as it seems. The management of NB is much more complicated than just focusing on stopping it. Nail biting cannot be managed without considering its co-morbidities, antecedents and consequences. It might be concluded from the reviewed literature that children with NB, parents, siblings, and teachers should be educated about what to do and what not to do about NB. Punishment is not effective. Moreover, clinical randomized controlled trials are required to make available evidence-based behavioral and pharmacologic treatment protocols

Overlap of ADHD and oppositional defiant disorder DSM-IV derived criteria

One possible reason for being controversies regarding ADHD may be related to the validity and reliability of diagnostic criteria of attention deficit hyperactivity disorder and oppositional defiant disorder. Diagnostic criteria of oppositional defiant disorder include eight symptoms. This study examines the factor structure of oppositional defiant disorder symptoms, its discriminant validity from attention deficit hyperactivity disorder, its convergent validity and internal reliability. Parents of 111 referral children and adolescents with attention deficit hyperactivity disorder completed DSM-IV referenced based attention deficit hyperactivity disorder and oppositional defiant disorder checklists. Factor analysis indicated that the attention deficit hyperactivity disorder symptom of: "often has trouble organizing activities" and "often runs about or climbs when and where it is not appropriate" were a part of the oppositional defiant disorder component. These symptoms less often than other symptoms differentiate attention deficit hyperactivity disorder from oppositional defiant disorder. The convergent validity for oppositional defiant disorder symptoms ranged from 0.64 to 0.79. The parent-rating checklist of oppositional defiant disorder symptoms properly differentiates oppositional defiant disorder from attention deficit hyperactivity disorder. However, two items of the attention deficit hyperactivity disorder were listed as symptoms of oppositional defiant disorder. If the factor loading of the items is to be confirmed in further studies, it might be necessary to revise these symptoms criterion in future editions of DSM-IV diagnostic criteria

The Predictors of Parent Reported Behaviors Related to Olfactory Information Processing in Children with ADHD

OBJECTIVE: Attention deficit hyperactivity disorder (ADHD) is a heterogeneous disorder with contradictory findings about smell detection function. It is not clear if the parent perceived behavior related to olfactory function is associated with age, gender, severity of ADHD, and cooccurring symptoms of anxiety and oppositional behavior in children with ADHD. METHODS: Participants were a clinical sample of 104 children and adolescents with ADHD using DSM-IV diagnostic criteria by a semi-structured interview. Parent perceived behavior related to olfactory processing function was assessed trough a questionnaire. The parent reported Olfactory Functioning Checklist was used to evaluate "seeking behavior and over-responsiveness to smell (SSBO)" and "smell detection ability (SDA)". RESULTS: ADHD and separation anxiety symptoms count (severity) predicted the SDA scale score. None of the variables of gender, age, ADHD subtypes, co-morbidity with oppositional defiant disorder (ODD), and symptom count of ODD predicted SSBO and SDA scales' scores. CONCLUSION: Parent reported behavior related to olfactory detection impairment increased with higher ADHD and anxiety severity. It is independent of age and gender.

Children and their parents' perceptions of symptom severity and treatment preference for Tourette syndrome

This study surveys children and their parents' perceptions, and their treatment preference of significant/bothersome symptoms in children with Tourette syndrome. Thirty five children and adolescents who referred to an out-patient clinic of a Child Psychiatry Clinic were selected as subjects for this study. The children and their parents were interviewed about their perception of significant/bothersome symptoms of motor tics, vocal tics, learning difficulties, attention deficit disorder, hyperactivity, obsessions, compulsions, and rage attacks. About two thirds of the subjects had symptom of rage. Inattentiveness and hyperactivity were observed in more than half of the children. There was a statistically significant difference between parents and their children in frequency of motor tics and rage attacks. Children reported the necessity for controlling and management of these symptoms less than their parents. The rates of motor, vocal tics and rage attacks in the Iranian sample are similar to other studies. Rage attack is one of the most common significant/bothersome symptoms reported that should be treated. While motor tics were not rated among the most common features that should be treated in a study in Canada, it was the most common significant/bothersome symptom in Iran. Parents perceive motor tics and rage attacks as more significant/bothersome symptoms compared to children

Clinical approach to motor stereotypies in autistic children

This is an overview of stereotypic behavior in autistic spectrum disorder [ASD]. This repetitive, nonfunctional, fixed pattern of behavior is associated with autism severity but it is not specific for ASD. There are a wide range of behaviors mentioned as Stereotypies. It usually starts in 1 early childhood and its severity is associated with outcomes and severity of autism in j adolescence and adulthood. It is usually co-morbid with other psychiatric problems and its pathophysiology is not exactly known. Management is most likely behavioral. There are some | reports regarding efficacy of antipsychotics for its management Further studies should be J conducted to improve our knowledge about it and our ability to differentiate it from tics

Prevalence of mood disorders in Iran

To study the prevalence and demographic characteristics of mood disorders among Iranian adults. In this cross-sectional population-based epidemiological study [age 18] in Iran, 25180 individuals were selected through a randomized cluster sampling method for a diagnosis using the Schedule for Affective Disorders and Schizophrenia [SADS]. They were then interviewed at home by 250 trained clinical psychologists. The estimated lifetime prevalence of Major Depressive Disorder [MOD] and Minor Depressive Disorder [mDD] were 3.1% and 0.3% respectively. Also, the estimated lifetime prevalence of Bipolar Mood disorder [BMD] type I and type II were 0.1% and 0.7% respectively. The current prevalence of MDD, mDD, BMD-I and BMD-II were 1.8%. 0.2%, 0.04%, and 0.3% respectively. Mood disorders were associated with female gender, lower education, being married, being middle-aged, living in cities, and not being a homemaker. The prevalence of mood disorders was lower among Iranian adults than reported in Western studies, and a number of demographic associations differed from those reported in Western studies: Important cultural differences in the nature or manifestation of depression are implied by these results