Evaluating the effect of black myrobalan on cognitive, positive, and negative symptoms in patients with chronic schizophrenia: A randomized, double-blind, placebo-controlled trial.

Schizophrenia, as a chronic and disabling mental disorder, causes a wide range of symptoms, including cognitive impairments, positive, negative, and mood symptoms. There are no effective treatments for cognitive symptoms. Black myrobalan (Terminalia chebula Retz.), a medicinal plant of the Combretaceae family, exerts antioxidant, antiacetylcholinesterase, and anti-inflammatory effects. These effects can lessen the symptoms of schizophrenia. So, this study was conducted to evaluate black myrobalan's impact on cognitive impairments and negative/positive symptoms in patients with chronic schizophrenia. This was a randomized, double-blind, placebo-controlled clinical trial in which participants were divided into treatment and placebo groups. They received six 500 mg capsules of black myrobalan or placebo in two divided doses for 4 weeks. Patients' cognitive impairments, positive, negative, depression/anxiety, and excitement/activity symptoms were assessed using the Screen for Cognitive Impairments in Psychiatry (SCIP) and the relevant subscales of the Positive and Negative Syndrome Scale (PANSS) pretreatment and 4 weeks after treatment. Cognitive impairments (SCIP) (p value .004), negative symptoms (PANSS subscale) (p value .017), and excitement/activity (PANSS subscale) (p value .003) were significantly improved in the black myrobalan group compared with the control group after 4 weeks. No serious adverse effects were reported. Black myrobalan could improve cognitive impairments, negative and excitement/activity symptoms in chronic schizophrenic patients.

Development and Psychometric Assessment of the Methadone Therapy Experiences Questionnaire among Patients under Treatment.

BACKGROUND: Patient experiences play an important role in the quality of health care and gathering patients' experiences is common as part of quality measurement in health care. The present study was carried out with the aim of developing and psychometric analysis of the methadone therapy experiences questionnaire among patients under treatment with methadone. METHODS: This cross-sectional study was performed in 2018 and 200 patients referred to the addiction treatment clinics in Kerman, Iran, participated in this study. The convenient sampling method was employed. The validity was assessed using the opinions of 50 individuals similar to the target population and 8 experts. In addition, the Cronbach's alpha coefficient was utilized to examine the test-retest reliability. Data were analyzed using descriptive and inferential statistics in the SPSS software. FINDINGS: The face validity of the questionnaire was acceptable in the present study and the values for content validity were higher than 0.79, indicating the appropriate content validity of the questionnaire [content validity index (CVI) = 0.82 and content validity ratio (CVR) = 0.83]. Moreover, the results confirmed the reliability or reproducibility of the questionnaire (Cronbach's alpha = 0.83). CONCLUSION: The methadone therapy experiences questionnaire was of a good validity and reliability among the patients. In the clinical area, the psychiatrists, psychologists, authorities, and staff in addiction treatment clinics can identify the quality of treatment and its strengths and weaknesses using this questionnaire.

The Relationship between Extrinsic and Intrinsic Religious Orientation with Perceived Stress and Cigarette Addiction among University Students.

BACKGROUND: Psychological stress is associated with unhealthy lifestyles, including smoking. Moreover, religious beliefs can play a significant role in relieving mental disorders such as anxiety and stress. Due to the frequent exposure of medical students to stressful situations, this study was conducted with the aim to investigate the relationship of internal and external religious orientation with perceived stress and nicotine dependence. METHODS: This correlational study was carried out on medical students of Kerman University of Medical Sciences, Kerman, Iran, in 2015. The sample size was determined to be 224 individuals using the Morgan table. The participants were selected using stratified random ýsampling. The data collection tools consisted of a demographic information form, the Religious Orientation Scale (ROS) (Allport and Ross), the Perceived Stress Scale (PSS-14), and the Fagerstrom Test for Nicotine Dependence (FTND). Data were analyzed using multiple regression analysis, analysis of variance (ANOVA), Pearson correlation coefficient, and t-test in SPSS software. FINDINGS: The findings of the study showed that internal religious orientation had a significant negative relationship with perceived stress and nicotine dependence; however, no significant relationship was observed between external religious orientation and these variables. CONCLUSION: Based on the results of the study, it can be concluded that the religious beliefs of individuals have a preventive role in perceived stress and nicotine dependence.

Physical effects of methadone maintenance treatment from the standpoint of clients.

BACKGROUND: Studies have shown that methadone maintenance treatment (MMT) iseffective in improving the client's quality of life and physical health.This study aimed to describe the nature and structure of drugdependents' experiences and the physical effects of MMT. METHODS: The present study is a qualitative and a phenomenology study on 32clients referred to methadone clinics in the city of Kerman in 2008.Colaizzi's method was used for data analysis and to evaluate the data,validity and reliability criteria were used. FINDINGS: Encoded concepts were categorized in general groups of effectiveness ongeneral health, sleep, appetite and weight, sexual desire, appearance andother effects. These six categories showed the main structure of experienceand physical effects of MMT. CONCLUSION: The clients' viewpoints towards this treatment had a role in theirexperience expression and feelings, but MMT had an overall positivephysical effect on the clients.

Opiate dependents' experiences of the therapeutic relationship in methadone centers; a qualitative study.

BACKGROUND: Methadone maintenance therapy is a treatment of choice for opiate addiction. Understanding opiate dependents' experiences of patients' treatment is a key to continue the treatment and can provide help to revise the standards of methadone centers and improve the quality of treatment. This study aimed to describe the essence and structure of opiate dependents' experiences with methadone maintenance therapy. METHODS: It was a qualitative phenomenological study, in which participants were selected from opiate dependents referred to methadone centers in Kerman city in 2007. Sampling was purposive and continued until data saturation, which was achieved at 32 participants. Data were collected by in-depth interviews. Colaizzi's method was applied for data analysis. The rigor of the present study was assessed based on the criteria of confirmability and credibility. FINDINGS: A total of 26 themes were extracted and categorized into three main themes including positive therapeutic alliance, negative therapeutic alliance and therapeutic alliance requests. CONCLUSION: Client-centered therapy in methadone clinics creates a positive therapeutic alliance, and persuades patients to continue their treatment. Establishing a good relationship with patients during their treatment procedure is an effective way to meet the goals. Individual and group counseling sessions and advices on family and career related issues during the treatment should be considered as well.

Comparative Evaluation of Psychiatric Disorders in Opium and Heroin Dependent Patients†This article has been published in the Journal of Rafsanjan University of Medical Sciences in Persian language.

BACKGROUND: Opium dependency is an important health problem in Iran. Several studies show that most opium dependent patients have concomitant psychiatric disorders. The aim of this study was evaluation of psychiatric disorders in opium dependency in comparison with heroin dependency. METHODS: This is a descriptive study on 192 male opium dependent patients who were admitted in dual- diagnosis ward of Beheshti Hospital in Kerman for detoxification. After evaluation of their demographic data, they were assessed by means of SCL-90-R test. FINDINGS: The mean age of subjects was 33.92±7.67 years. All scales of SCL-90-R were evaluated as borderline or sick. The scores of obsession-compulsion, anxiety, phobia, psychosis, PST, and GSI were significantly higher in heroin dependents compared to opium dependent patients (P < 0.05). CONCLUSION: It is recommended that all patients with opium dependency should be evaluated for co-morbid psychiatric disorders. This may improve the outcome and management of their dependency.

Rare variant of lycanthropy and ecstasy.

BACKGROUND: Lycanthropy is an unusual belief or delusion in which the patient thinks that he/she has been transformed into an animal. In rare cases, the patient believes that another person has been transformed into an animal. CASE REPORT: We report a patient with an uncommon variant of lycanthropy is introduced. The symptoms appeared after consumption of ecstasy. This shows the occurrences of uncommon and rare psychosis after ecstasy drug use especially in patients susceptible to schizophrenia. Ecstasy drug can induce paranoid psychosis similar to schizophrenia. In the presented case, ecstasy seemed to have a role in patient's underlying susceptibility to schizophrenia.