effect of atropine on post-ECT bradycardia in patients with major depressive disorder

Electroconvulsive therapy [ECT] is utilized for treatment of a range of psychiatric disorders including major depressive disorder [MDD]. One of the major complications in using ECT is cardiovascular problems i.e., bradycardia. The present study was designed to investigate the effect of atropine on the pulse rate [PR] of the patients under treatment with ECT. In this randomized clinical trial, 30 patients with diagnosis of MDD who received atropine before ECT treatment [control group] were compared with 30 patients with the same diagnosis without receiving atropine [experimental group] under ECT treatment. Both groups received ECT under the same term and condition. The PR of the patients were recorded 7 times [twice before anesthesia and ECT and 5 fixed one min intervals immediately after receiving ECT]; for 10 sessions of treatment with ECT [3 times a week]. The results were analyzed using repeated measure analysis of variance. The PR under 50 was the cut off point for differentiating the patients suffering from bradycardia and those without it. Slight increment in PRs for experimental group [patient who did not receive atropine] in contrast to control group were observed, but it did not reach a statistically significant level. The gender [male/female] did not have different PR. The age of the patients and initial PR [regarded as co-variances] did not show significant effect on PR for total sample. There seems to be not necessary to use atropine treatment for depressed patients receiving ECT

Mental health and depression after coronary artery bypass graft

Mental health of those with ischemic heart disease [IHD] has been a focus of attention of researchers since it has always been considered as a psychosomatic disorder. The present study was designed to investigate mental health status of a group of patients before and after coronary artery bypass graft [CABG]. In this longitudinal descriptive study 63 candidates for CABG, referred by cardiologist and cardiac surgeon in a 6 month period were asked to take part in the study if they didn't have any exclusion criteria. The patients were the out-patients of cardiac clinics in Shiraz, Iran. The patients were assessed by general health questionnaire [GHQ-28] and beck depression inventory [BDI] at 3 phases, before surgery, 1 month after surgery and three months after surgery. The analysis did not show significant statistical change in GHQ-28 and BDI measures before and after CABG. There were statistically significant differences in the mentioned measures between male and female participants in initial assessment, i.e., women scores were higher than men in distress scores measured by GHQ-28 and BDI. In our study, we observed no statistically significant differences between pre and post operation in general health and depression scales. However women showed higher degrees of depressed mood at any step of assessment

Frequency of djinnati syndrome among inpatient admissions at baharan psychiatric hospital in Zahedan, Iran

A culture-bound syndrome common in Baluchistan is Djinnati that is classified as trance and possession state, a sub-class of dissociative disorders NOS, in DSM IV-TR. The present study aims to determine the frequency of Djinnati syndrome among in-patients at Baharan psychiatric hospital in Zahedan, Iran. In this descriptive study, the statistical community includes all patients [N=773] who were admitted in Baharan psychiatric hospital during a 6 months period. After considering the inclusion and exclusion criteria, 150 subjects [61 males and 89 females] were selected. Semi-structural interview and Dissociative Experience Scale [DES] questionnaire were performed for them. Spearman's rank correlation coefficient, chi[2], and t-tests were employed for analysis of data in SPSS-18. Frequency of Djinnati syndrome among patients admitted in this referral psychiatric hospital was 4.1% and this syndrome showed a significant dominance in female sex [M/F=1/3]. There was also a positive and significant correlation between child abuse and dissociative experiences including Djinnati. The study has shown that dissociative disorders NOS, in the form of trance and possession states [such as Djinnati], are not rare especially in the eastern parts of Iran and among poor and young women. It is important to define Djinnati syndrome in this region and prepare medical students and psychiatric residents for diagnosing and managing this condition. Its relationship with child abuse should be considered in preventive medicine

Trauma, dissociation, and high-risk behaviors

Epidemiological studies and clinical findings have shown an association between trauma and dissociation; dissociative experiences are also more prevalent among select populations such as substance dependent individuals and criminal offenders. In the present non-systematic review, we explored the association between trauma, dissociation, and high-risk behaviors. We aimed to find if the presence of dissociative symptoms could lead us to better understand and recognize those who are prone to high-risk behaviors, among individuals exposed to psychological trauma. The present overview indicated a substantial relationship between dissociation and high-risk behaviors. We concluded that designing and establishing appropriate studies regarding the relationship between trauma, dissociation, and high-risk behaviors would enable health professionals to have a better understanding and recognition of people prone to high-risk behaviors, as well as implement more effective strategies to prevent high-risk behaviors among at-risk populations

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.