Cardiovascular risk factors and nutritional intake are not associated with ultrasound-defined increased carotid intima media thickness in individuals without a history of cardiovascular events

Carotid ultrasound appears to be useful in the assessment of cardiovascular risk. In this study, we have assessed the carotid intima-media thickness [CIMT] in a group of individuals without a history of cardiovascular events. A sample of 431subjects [189 [43.9%] males and 242 [56.1%] females] was obtained from an urban population using a stratified-cluster method in Mashhad stroke and heart atherosclerosis disorder study. None of the subjects had a history of the cardiovascular event. Carotid artery duplex ultrasound was used to determine the CIMT in all subjects, and to identify those with an abnormal value [CIMT [+]; i.e., CIMT >/= 0.8 mm]. Dietary intake of participants was assessed using a questionnaire for 24-h dietary recall. The relationship between anthropometric, biochemical and dietary data and CIMT were assessed. The mean age of subjects was 48.7 +/- 8.0 years. Of the 431 patients, 118 [27.4%] were found to be CIMT [+]. Of the cardiovascular parameters assessed, only age [odds ratio [OR] [95% confidence interval [CI]], 1.11 [0.56-4.34]; P < 0.01] and male gender [OR [95% CI], 1.14 [0.63-2.23]; P < 0.05] were significant independent predictors of ultrasound defined CIMT. Crude and total energy adjusted intake were not associated with the presence of CIMT [+]. It appears that within a relatively young Iranian population of individuals without a history of cardiovascular event, the presence of CIMT [+] defined by duplex ultrasound cut-off value of >/= 0.8 mm, did not associate with several modifiable cardiovascular risk factors or measures of dietary intake

The comparison of personality types in patients with vascular headache and tension-type headache

Objective: This is a study to evaluate the personality types based on Myers-Briggs Type Indicator (MBTI) in patients with chronic vascular or tension-type headache. Methods: This was a cross-sectional study conducted on 210 patients with tension-type and vascular headache in the Mashhad city, northeast of Iran. Patients were selected through convenience nonprobability method from December 2010 to January 2012. They were asked to fill demographic questionnaire and MBTI. Data were analyzed with SPSS using Mann-Whitney U, Chi-square and Fisher exact test. Results: The mean age of participants was 33.7 ± 8.2. Patients with vascular headache were mostly female, had higher levels of education, experienced more attacks per month and had shorter duration of headache until seeking treatment compared to the patients with tension-type headache. There was a significant difference in the distribution of personality types and frequency of each personality dimension between two groups. Patients with vascular headaches were significantly more introverted, sensing, thinking and judgmental, as compared to extraversion, intuitional, feeling, and perceiving among the tension-type headaches. Conclusion: Since there was a significant difference in the personality type of the different headache patients, further neuropsychological studies may throw light on the etiology of these chronic headaches.

Effect of citalopram on depression and cognitive functions of stroke patients

Aim: In this study, we evaluated personality traits and disorders among patients with CPS using Millon Test

Material and Method:This survey was a descriptive analytic study. We evaluated all of the patients with CPS in outpatients clinic of Avesina and Ghaem Hospital, Mashhad University of medical Sciences. Finally, 74 patients with CPS and 100 normal volunteers were recruited and Millon test was performed by apsychiatrist who was blind to the diagnosis

Finding:In this study, 74.2% of the patients and 31.5% of control group had at least one pathological personality trait [P<0.05]. Personality disorders were significantly higher in CPS comparing control group [27.2% Vs 8.4% respectively] . The most common personality disorders were schizoid and borderline. The prevalence of borderline and antisocial personality disorders were significantly higher in patients [P<0.05].All of the pathological personality traits were more common in CPS, and the difference was significantly higher for borderline, dependent and passive aggressive traits comparing control group. Personality disorders were more common in women

Conclusion: Results This study clearly showed the higher prevalence of some of the pathologic personality traits and disorders among patients with CPS. This finding might be related to abnormal pathological activity in temporal lobe, however CPS as a chronic disorder,r might also had sever impact on the personality changes

Comparing post-traumatic stress disorder in primiparous and multiparous women with Preeclampsia

Post-Traumatic Stress Disorder [PTSD] is one of the anxiety disorders which occurs in postpartum period. The prevalence of PTSD induced by preeclampsia has been already reported as 28%, however no study was found to compare PTSD in primiparous and multiparous women. This study was therefore conducted to compare PTSD in primiparous and multiparous women. This comparative descriptive study was performed on 100 pregnant women with preeclampsia including 56 primiparous and 44 multiparous women, who selected conveniently from labor wards of university hospitals in Mashhad, Iran in 2012. PTSD was diagnosed by psychiatrist and Perinatal Post-traumatic stress Questionnaire [PPQ] in 6th week postpartum. Social support was measured using modified Hopkins questionnaire in 2nd and 6th week postpartum. Data were analyzed with SPSS version16 using Spearman correlation coefficient and Mann-Whitney U test. The rate of PTSD was 24% in primiparous and 37.8% in multiparous women. There was no significant difference in relation to mean score of PTSD in primiparous and multiparous women. Mean score of social support in 2nd and 6th week postpartum was significantly higher in primiparous women [P

[ efficacy of developmental attachment-based play therapy on developmental trauma disorder symptoms in children from 3 to 9 years old]

The present study conducted to examine the effect of attachment based play therapy on developmental traumatic disorder [DTD] in children. This semi-experimental study with control group, conducted in 2008, in Mashhad. Fourteen kids [3-9 years], who were diagnosed as having DTD based on Vander Kolk criteria, were selected from child psychiatry clinic in Ibn-e-Sina and dr. Sheikh hospitals. Their parents permitted to involve in this study. Patients were divided to 2 groups of intervention and control groups. Mothers of children completed Yule's scale and for evaluation of children's stress parenting stress index-short form [PSI-SF] for evaluation of parents' stress. Ten sessions of play therapy were conducted for intervention groups. Then mothers in 2 groups completed the tests again. In the variables of age, sex and grade of children also in the age and education of mothers, patients in 2 groups did not have any significant differences [P>0.05]. There were not any significant differences in scores of Yule's scale, PSI-SF and parental distress at base- line between 2 groups [P=0.10, P=0.34 and P=0.58 respectively]. After play therapy these test in the intervention group was significantly different from the control group [P<0.001, P=0.01 and P=0.01 respectively]. The differences in scores of difficult child subscale between 2 groups, before and after intervention were not significant [P=0.86, P=0.14 respectively]. The differences in scores of malfunction in child-parent relation before and after treatment were significant in intervention group [P=0.01] but there were not meaningful differences in control group [P=0.52]. Attachment based developmental play therapy reduces the stress of children and their mothers

[Relationship between delivery method and postpartum depression]

Introduction: Postpartum depression is a prevalent disorder with different etiologies, among them mode of delivery. The present study was conducted to determine relationship between mode of delivery and depression in women at 2 and 8 weeks postpartum

Materials and Methods: In this prospective analytic study [2007-2008], a total of 420 women visited at health centers in Amol city who met inclusion criteria were recruited through non-probability sampling and filled the questionnaire of Edinburgh postpartum scale [EPDS] during the third trimester of pregnancy. Women who had EPDS score>12 were excluded. Three hundred cases were followed 2 and 8 weeks postpartum and completed questionnaires on demographics, delivery, postpartum, and infant characteristics and Edinburgh postpartum depression scale. Data were analyzed using by SPSS software, chi-square, T-test, Mann-Whitney, and Linear regression

Results: There was no significant difference between two groups in their education, occupation, economic status, and wanted/unwanted pregnancy, satisfaction from husband and family support. At 2[nd] week postpartum, prevalence of postpartum depression was 10.3% and there was no significant difference between 2 groups. At 8[th] week postpartum the prevalence of depression was 13% and there was no significant difference between the 2 groups in the mean score of postpartum depression at 2[nd], 8[th] weeks

Conclusion: Regarding the high prevalence of postpartum depression, the screening, recognition and assessment of this disorder is important. Health care providers should consider educating women during pregnancy and postpartum

Depression and anxiety in Iranian mothers of children with epilepsy

Epilepsy is a common neurological disorder in children. Parents with epileptic children have many psychosocial care needs. So the main goal of this study was to evaluate depression and anxiety in Iranian mothers with epileptic children. We identified 30 mothers of children with epilepsy and 30 mothers of children without epilepsy with children aged between 8 and 12 years who met the study criteria. In all children with epilepsy, the mothers were the main caregivers and all these children lived in two-parent families. Children in the control group were in the same age. Ninety-eight percent of children in the control group lived in two-parent families with the mother as the main caregiver. All mothers fulfilled the Beck Depression Inventory [BDI] and Spielberger State-Trait Anxiety Inventory. According to these data, BDI scores were significantly higher in the mothers of epileptic children [mean of Beck score=16.5] compared to the control group [mean of Beck score=9.8]. The total, Spielberger State-Trait Anxiety Inventory scores for mothers of children with epilepsy were 100.3, 51.7 and 48.6. However, these scores in the control group were 86.9, 45.1 and 41.8. These differences were statistically significant. In a second analysis, using the demographic data, we did not find any statistically significant relation between anxiety or depression and the mothers' job, children's medication and other demographic variables. Neurologists and psychiatrists need to develop better programs for adequate management of psychiatric disorders in mothers with epileptic children

[Relation between depression, anxiety, self-esteem, marital satisfaction, demographical factor and maternal complications with fear of childbirth in nulliparous women]

In the present study, the relation of depression, anxiety, self-esteem, marital satisfaction, demographical factor and early maternal complications with Fear of childbirth in primiparous women have been analyzed. This study which was done on 100 term primiparous women who referred for caring in last month of pregnancy to prenatal clinic of Omolbanin hospital. Women who had inclusion criteria and consented for participation in this study, filled the questionnaires include personal, demographic, and social characteristics. Fear of childbirth was assessed by a research designed questionnaire, satisfaction from matrimonial life, self-esteem, anxiety, and depression in participants were determined by using Enrich marital satisfaction questionnaire, Rosenberg scale, Spiel-berger test, Beck depression inventory. After delivery outcomes of their childbirth were recorded and data were analyzed by using SPSS software [version 13] and statistical tests [Pearson correlation, Spearman rating, Man-Whitney, Kolmogorov-Smirnov]. The average age was 22.54 +/- 3.7 within the range of 16-36 years. There was a positive and significant correlation between the level of individual's covert and overt anxiety and fear of childbirth [P<0.05]. There also was a negative and significant correlation between the level of knowledge about the process of natural childbirth, the rate of cooperation in childbirth, and Apgar score of the neonate with fear of childbirth [P<0.05]. There was no significant relationship between the rate of self-esteem, depression, satisfaction from matrimonial life, age, education, income, and early maternal complications with fear of childbirth [P>0.5]. Fear of childbirth in primiparous had a positive and significant correlation with covert and overt anxiety but a negative and significant relationship with level of knowledge about the process of natural childbirth, rate of cooperation in childbirth and Apgar score

[ effects of lavender oil inhalation on level of anxiety during first stage of labor in primigravida women]

Anxiety is the most prevalent emotional reaction of women during labor. The aim of this research is to determine the effect of lavender oil inhalation on level of anxiety during first stage of labor in primigravida women. This clinical trial which was done in 2008, 102 primigravida women was randomly accomplished on three groups. In lavender oil group, subjects inhaled oil by handkerchiefs smeared with oil for 15 minutes, in placebo group, subjects inhaled sweet almond oil for 15 minutes in the same way and in usual caring group, the routine care of maternity ward was done. The rate of anxiety was measured by Spiel-Berger anxiety questionnaire and compared before, immediately, and 60 minutes after intervention in groups. Data analyzed using chi square, one-way ANOVA and Kruskal-Wallis test. Result show significant decrease in the rate of state anxiety, before and immediately after intervention and before and 60 minutes after it in lavender group compared with placebo and usual care groups [P=0.001]. Also there was significant decrease in the rate of trait anxiety, before and immediately after intervention [P=0.021] and before and 60 minutes after it [P=0.049] in lavender group compared with placebo group. Lavender oil inhalation can reduce the rate of state anxiety during labor until 60 minutes after inhaling, so using the lavender oil for reducing the anxiety of women in each time of labor is suggested

Sexual satisfaction in fertile and infertile women attending state clinics in mashad

Marital satisfaction is correlated with mental health, general happiness, professional achievements and successful social interactions. It seems that sexual satisfaction is one of the necessities for a healthy and sustainable marital relationship. Some studies have revealed that sexual dissatisfaction is the underlying cause of nearly 80% of marital conflicts, while, some other studies have suggested infertility as one of the key factors affecting sexual satisfaction. This study was undertaken to compare marital and sexual satisfaction in fertile and infertile women. In this cross-sectional analytical study carried out during 2007, one hundred fertile women attending the family planning units of Mashad Urban Health Centers, and one hundred infertile women, attending Montaserieh Infertility Center were chosen by quota sampling. The participants were 22-45 years old and had no extramarital relationships. The fertile women used a contraceptive method but the infertile ones had been unable to conceive a child after a year of regular and unprotected intercourse. The subjects who were willing to participate in the study were asked to complete two sexual satisfaction and general health questionnaires [GHQ28]. There were no significant statistical differences between the fertile or the infertile women regarding the demographic data and the general health status of the participants. Sexual satisfaction was not significantly different between the fertile and infertile groups and both showed average degrees of sexual satisfaction [59.66 +/- 12.23 and 61.65 +/- 11.62, respectively; p=0.24]. Average sexual satisfaction was noted in both fertile and infertile individuals, which depicts the inadequate sexual knowledge of the subjects and insufficient provision of pre- and post-marriage consultations. Holding educational sessions and providing consultations on subjects related to sexual satisfaction is suggested to increase the feeling in couples

Therapeutic drug monitoring of valproic acid in patients with monotherapy at steady state

The role of therapeutic drug monitoring [TDM] in patient care has grown rapidly since its introduction three decades ago. The aim of present study was to evaluate the possible relationship between serum levels and the clinical response of valproic acid [VPA]. In the present study we evaluated a homogeneous group of adult patients receiving VPA monotherapy. A total of 18 epileptic patients who fulfilled inclusion and exclusion criteria were entered this prospective study. Steady state trough plasma concentration was determined by fluorescence polarization immunoassay [FPIA]. The correlation between therapeutic response and VPA serum concentration was evaluated. Mean VPA dose and mean total VPA plasma concentrations were 8.35 +/- 1.49 mg/kg/day and 50.40 +/- 4.18 micro g/ml respectively. Mean VPA clearance was 8.84 +/- 4.43 [ml/kg/h]. Plasma levels within the therapeutic range were found in 33% of epileptic patients. Plasma levels were below the therapeutic range in 67% of study population. Of patients 75% and 17% with sub-therapeutic levels achieved complete control and partial control respectively. Poor correlation was found between the plasma concentration of VPA and its therapeutic effects. Therefore, this study showed that TDM of VPA will be useful only when individuals are non-responsive to treatment or vulnerable to adverse reactions with standard doses

Depression in the Iranian health employees and its correlation with self-esteem and social support

Depression is one of the most common mental disorders that is characterized by depressed mood, anhedonia, hopelessness, lack of energy and concentration. These symptoms cause impairments in social, individual and occupational functioning. Health workers are among the most vulnerable groups to depression as a result of their exposure to patients' suffering and health problems. The present study was designed to explore the level of depression and its associated psychosocial and occupational factors in health workers in Mashhad, Iran. The present study is a descriptive-analytic and cross-sectional research that has been carried out in Mashhad, the second largest city in Iran that is located in the north-east of the country with more than 3 million populations. The statistical population included the health workers in 31 heath care centers of Mashhad and hoome. The sample was 279 health workers who completed the questionnaires. The instruments of research were a demographic and personal questionnaire, Beck Depression Inventory, Cassidy social support scale, and Eysenk self-esteem scale. Collected data were entered to SPSS and were analyzed by appropriate descriptive and analytic statistical tests including chi-square. Results indicated that 67% of workers did not have depression and 23.9% had some degrees of depression. In this study, the rate of depression did not have a significant relation with sex and marital status of workers. There was a significant relation between levels of depression and quality of personal relationships with supervisors, colleagues and family members. Satisfaction from work environment, transportation and attitude of official workers also had a significant relation with depression. Results showed that depression has a high rate in health workers. High levels of social support and self-esteem were associated with lower degrees of depression. Therefore improving these factors could be used for decreasing depression

Patterns and correlates of substance use among university students in Iran

Substance use, especially among young generation, is a public health concern. The aim of the current study was to explore the interrelation between certain variables including demographic characteristics and family history of drug abuse and history of depression among Iranian University students. In a cross-sectional study, 843 college students of the Azad University of Torbat Jaam [Khorasan province] completed a questionnaire containing data on demographic characteristics, lifelong and past month history of substance use, family history of substance use and different types of substance used by students. Participants also completed the Beck Depression Inventory. Fifty seven point five percent of those who took part in the study were male. About thirty one percent of the participants revealed a lifetime history of substance use [209 males and 55 females]. Use of alcohol, cigarette, cannabis, and opium was significantly higher among men. About fifteen percent of participants had used substances in the past month and 15.1% in the last year. Cigarette was the most commonly used substance [19.2%]. The second and third most commonly used substances were opium [15.4%] and alcohol [10.8%]. Beck Depression Inventory score was significantly higher among students with a history of substance use [p=0.000]. Substance use was commonly reported by the university students. This was significantly associated with a diagnosis of depression

Comparing the efficacy of add-on nortryptiline with triiodothyronine in the management of citalopram-resistant depression

To manage a treatment resistant depression, clinicians may add a second medication to the first antidepressant drug. The aim of the current research was to study the outcome of augmentation of citalopram with nortryptiline or triiodothyronine in a randomized clinical trial. We selected 48 adult outpatients with a diagnosis of non-psychotic major depressive disorder who had not responded to 12 weeks citalopram therapy [40 mg per day]. They were randomly allocated to two groups. One group received nortryiptiline [at a dose of up to 150 mg per day] and the other triiodothyronine [T3] [at a dose of up to 50 micro g per day]. The remission of depression was defined as a score of 7 or less on the 17-item Hamilton Rating Scale for Depression [HRSD-17]. After 8 weeks, the nortriptyline group had a higher remission rate [33.33%] than the triiodothyronine group [17.64%]. The nortriptyline group, however, had a higher drop out rate due to experiencing more side effects. Augmentation of citalopram with nortryptiline seems to be effective in the management of treatment resistant depression. However, one should strike a balance between the efficacy and the tolerability of this approach, as there is a higher chance of experiencing side effects by the patients

relationship between eating disorder and depression in patients with diabetes-type II

Diabetes mellitus-type II is a common chronic illness that limits the patients' lives in many ways. Several studies have shown the high prevalence of eating and depressive disorders in diabetic patients. Regarding to the frequency and probable adverse effects of associated psychiatric disorders on the course and prognosis of the chronic diseases such as diabetes, the present study was designed to investigate the relationship between eating disorders and depression in subjects with Diabetes-type II. Analytic descriptive. This research has been done in Mashad city-Khorasan province-Iran, in 2006. Our subjects were 200 patients with Diabetes-type II between the ages 45-65 years old [mean +/- SD was 52.2+5.8] who were randomly selected from the referred patients to "Khorassan Research Center of Diabetes ". 15% of subjects had eating disorder [based on BES] while remaining 85% were without eating disorder. "Beck Depression Inventory" [BDI] and "Binge Eating Scale" [BES] were performed for the selected subjects. In addition to the assessment of prevalence of eating and depressive disorders we also compared the prevalence of depression in the patients with and without eating disorder. The prevalence of depression [Beck score equal or more than 9] in overall sample was 58% in subjects with eating disorder it was significantly higher [p<.05] than others [70% versus 55.88%]. In the present study, the prevalence of eating disorder and depression were higher in patients with Diabetes Mellitus than general population. Because of the relationship between eating disorder and Diabetes-type II, physicians who treat diabetic patients should be careful about these psychiatric symptoms. The relationship between depression and eating disorder is also notable and shows the importance of considering it in the overall management of these patients