Psychometric properties of the Persian version of the somatic symptom disorder-B Criteria Scale (SSD-12) in community and clinical samples.

OBJECTIVE: In the DSM-5's diagnostic criteria of somatic symptom disorders (SSD), the presence of psychological problems (i.e., excessive thoughts, feelings, or behaviors) is emphasized more than the absence of the medical causes of patients' bothersome symptoms. In this regard, the Somatic Symptom Disorder-B Criteria Scale (SSD-12) is a screening tool for assessing these psychological features in somatic symptom disorder. This study aimed to validate the Persian version of SSD-12 in the Iranian community (non-clinical) and clinical samples. METHODS: Data was gathered from 291 individuals in a community sample (aged 18 to 54, M-age = 36.62, SD = 10.56, 79.7% females) and from clinical setting, including 118 patients diagnosed with major depressive disorder (MDD, aged 18 to 60, M-age = 36.52, SD = 11.39, 75.8% females) and 120 patients diagnosed with somatic symptom disorders (aged 18 to 60, M-age = 35.17, SD = 8.77, 73.7% females). To assess the convergent validity of SSD-12 in the clinical samples, participants were asked to complete measures assessing anxiety, depression, somatic symptoms, health anxiety, and emotional regulation. RESULTS: Confirmatory Factor Analyses (CFAs) showed that the three-factor model of the SSD-12 reached acceptable fit in the community and clinical samples and yielded excellent internal consistency across the samples. Also, test-retest reliability analysis results were good in the community sample. Convergent validity could be shown in the clinical samples. A cut-off score greater than 14 was in the optimal state with a sensitivity of 70.83 and a specificity of 70.07. CONCLUSION: The current study provides evidence on the factor structure, reliability, and validity of the Persian SSD-12 in the Iranian community and clinical samples. A sum score of 14 can be recommended as the cut-off point. Further studies are needed to assess SSD-12 in different clinical populations and larger samples.

Mental health and quality of life in different obesity phenotypes: a systematic review.

OBJECTIVES: It has been suggested that obesity phenotypes are related to mental health problems and health-related quality of life (HRQoL). However, there is no certain consensus. This systematic review aimed to evaluate the association between different obesity phenotypes with common psychiatric symptoms and HRQoL. METHODS: Electronic databases i.e. PubMed, Scopus, EMBASE, and google scholar were searched until September 2021, to identify studies that investigated associations between the obesity phenotypes with psychiatric symptoms and/or mental and physical HRQoL. Two researchers independently checked titles and abstracts, evaluated full-text studies, extracted data, and appraised their quality using the Newcastle-Ottawa Scale. RESULTS: Eighteen studies, with a total of 3,929,203 participants, were included. Of the studies included in this systematic review, 10 articles evaluated the association between obesity phenotypes and psychiatric symptoms, while six papers investigated the association between HRQoL and obesity phenotypes, and two studies assessed both. As a whole, the findings of these studies suggest that obese individuals with a favorable metabolic profile have a slightly higher risk of mental health problems and poor quality of life, however, the risk becomes larger when obesity is combined with an adverse metabolic profile. So, metabolically healthy obesity may not be a completely benign condition in relation to mental disorders and poor quality of life. CONCLUSION: According to published research, obesity is likely to increase the risk of mental health problems and poor quality of life when metabolic disturbances are present.

Psychological Status and Quality of Life Associated with Radioactive Iodine Treatment of Patients with Differentiated Thyroid Cancer: Results of Hospital Anxiety and Depression Scale and Short-Form (36) Health Survey.

PURPOSE: The objective is to investigate psychological status and quality of life (QoL) using Hospital Anxiety and Depression Scale (HADS) and Short-Form (36) Health Survey (SF-36) questionnaires in patients with proven differentiated thyroid cancer (DTC) who are referred for radioactive iodine (RAI) ablation before, during, and after treatment. METHODS: Of patients who underwent total thyroidectomy with a pathologically proven DTC (papillary and follicular types) referred for RAI treatment to our department in 2018, 150, in whom the diagnosis was newly established, were referred for the first course of RAI treatment and were consecutively enrolled in the study. The patients received an oral dose of radioiodine (3700 or 5550 MBq). For evaluation of anxiety, depression, and QoL, all patients are given two standard questionnaires, HADS, and SF-36 and are requested to answer them at four time points. First one was at 1 month before RAI, second was at the time of RAI treatment. Third and fourth ones were 1 week and 6 months later, respectively. RESULTS: The mean age of patients was 39.17 (±12.95) years and 121 (80.7%) were female and 29 (19.3%) were male. Values of HADS and SF-36 scores at corresponding time points were significantly correlated using Pearson correlation (HADS and SF-36 scores at 1 month before RAI: r = -0.56, P < 0.001; at time of RAI: r = -0.71, P < 0.001; 6 months after RAI: r = 0.19, P = 0.021). Using paired-sample t-test, for HADS, except for difference between time points of 1 month before RAI and time of RAI, pairwise difference between scores of other time points was statistically significant after Bonferroni correction. For SF-36, pairwise difference between scores of all three time points was statistically significant. Interaction of age, gender, RAI dose, and thyroid-stimulating hormone level at the time of RAI on HADS and SF-36 scores did not show statistical significance. CONCLUSION: Trend in scores over several-months' time discloses gradual improvement of QoL and merits close observation but limited psychiatric intervention.

Sleeve gastrectomy vs gastric bypass in improvement of depressive symptoms following one year from bariatric surgery, Tehran Obesity Treatment Study (TOTS).

BACKGROUND: The Beck Depression Inventory (BDI) has been frequently employed as a measure of depression in studies of obesity, with the majority of studies reporting an improvement in scores following weight loss after bariatric surgery. However, the effects of different bariatric techniques on depression score improvement is uncertain. METHOD: The study included 685 obese patients who underwent laparoscopic sleeve gastrectomy (SG) (n = 443) or gastric bypass (GB) (n = 242) and completed BDIs at baseline and 1 year after surgery. RESULTS: Mean age of the patients was 38.7 ±â€¯10.9 (84.8% female), and mean body mass index (BMI) was 45.1 ±â€¯6.0 kg/m2. One year after surgery, excess weight loss (EWL %) in the GB group was more than the SG group (65.4% vs 62.8% P = 0.02). At baseline, 29.9% of patients had BDI scores in the normal range (0-9), and respectively 32.4 %, 28.3 % and 9.3 % had mild (10-18), moderate (19-29) and sever (+30) depression score; these corresponding values after 1 year were 60.6, 23.2, 11.8 and 4.4%. Overall, BDI scores fell in both surgery groups after 1 year, in the GB group it was 17.2 ±â€¯10.5 vs 11.1 ±â€¯9.6, and for the SG group 16.1 ±â€¯10.2 vs 9.6 ±â€¯8.9. However BDI score change (ΔBDI) was not significantly different between two surgery groups (-6.04 ±â€¯10.6 vs -6.4 ±â€¯9.5, P = 0.149). CONCLUSION: Bariatric surgery had a beneficial effect on weight reduction and BDI score regardless of its type. Further studies with longer follow-up and more samples are needed to clarify the differences between bariatric procedures.

Comparison of Mirtazapine and Olanzapine on Nausea and Vomiting following Anthracycline-cyclophosphamide Chemotherapy Regimen in Patients with Breast Cancer.

We evaluated and compared the efficacy and safety of mirtazapine (MTZ) with olanzapine (OLP) for preventing chemotherapy-induced nausea and vomiting (CINV) following anthracycline plus cyclophosphamide (AC) regimen. Eligible participants were chemotherapy-naive early-stage breast cancer patients who were scheduled to undergo adjuvant AC. The patients were randomized to take oral MTZ or OLP in combination with aprepitant (A), dexamethasone (D), and granisetron (G), (ADG). The endpoints included rates of complete response (CR), complete control (CC), total control (TC), and adverse events during the acute, delayed, and overall phases in the two cycles of chemotherapy. The influence of CINV on the quality of life (QoL) was evaluated on day 6 of chemotherapy. Of 82 patients, 60 were randomized. In the first cycle, CR rates in cycle 1 were 83.3% and 76.6% during the acute period, 80% and 86.6% during the delayed period, and 66.6% and 63.3% during the overall period, for the ADG-M and ADG-O, respectively. High efficacy of both groups was maintained over 2 cycles. More patients in the ADG-M group noted minimal or no impact of CINV on daily life in cycle 2 (89.7% vs. 67.9%; p = 0.044). Incidence of somnolence and fatigue was more frequent with the olanzapine group. In this study, there was no substantial difference between mirtazapine and olanzapine in preventing CINV. Further large randomized trials are essential to demonstrate the anti-emetic effect of mirtazapine in chemotherapy.

Impact of biofeedback therapy for pelvic floor-related constipation to improve sexual function.

AIM: The purpose of this study was to investigate the effect of biofeedback therapy on constipation to improve sexual function among the female population with pelvic floor hypertonicity. BACKGROUND: It appears that pelvic floor disorder could lead to sexual complaints. Unfortunately, there are few data on the correlation between pelvic floor-related constipation and sexual disorders. The biofeedback role as a conservative method in improving the health status in these patients is conflicting. METHODS: Forty-two eligible women were included in the study. The exclusion criteria were not being sexually active, not having functional constipation according to Rome IV criteria, and having other psychiatric issues, according to DSM4TR criteria. All participants were treated using biofeedback in eight sessions, during two months. Before and after the treatment, they were analyzed by pelvic floor impact questionnaire, pelvic floor Distress Inventory, and Short Scale Personal Experiences Questionnaire (SPE Q). RESULTS: Biofeedback significantly improved orgasm, arousal, and dyspareunia (respectively P = 0.001, P = 0.001, P = 0.001). However, there was no significant improvement in libido and partner satisfaction domains (respectively P = 0.132, P = 0.341). Significant negative correlations were detected between the age and sexual function. On the other hand, there was no negative relationship between vaginal delivery as well as cesarean delivery and different components of sexual function. CONCLUSION: It seems the improvement in pelvic floor muscle hypertonicity leads to sexual satisfaction. Nevertheless, more data are required to prove this correlation.

Effects of Intermittent Theta Burst Stimulation on Manual Dexterity and Motor Imagery in Patients with Multiple Sclerosis: A Quasi-Experimental Controlled Study.

BACKGROUND: Intermittent theta burst stimulation (iTBS) is a repetitive transcranial magnetic stimulation (rTMS) protocol that influences cortical excitability and motor function recovery. OBJECTIVES: This study aimed to investigate the effects of iTBS on manual dexterity and hand motor imagery in multiple sclerosis (MS) patients. METHODS: Thirty-six MS patients were non-randomly assigned into sham (control) or iTBS groups. Then, iTBS was delivered to the primary motor cortex for ten days over two consecutive weeks. The patients' manual dexterity was assessed using the nine-hole peg test (9HPT) and the Box and Block Test (BBT), while the hand motor imagery was assessed with the hand mental rotation task (HMRT). RESULTS: iTBS group showed a reduction in the time required to complete the 9HPT (mean difference = -3.05, P = 0.002), and an increase in the number of blocks transferred in one minute in the BBT (mean difference = 8.9, P = 0.001) when compared to the control group. Furthermore, there was no significant difference between the two groups in terms of the reaction time (P = 0.761) and response accuracy rate (P = 0.482) in the HMRT. CONCLUSIONS: When iTBS was applied over the primary motor cortex, it significantly improved manual dexterity, but had no significant effect on the hand motor imagery ability in MS patients.

Physicians' attitudes toward integrating consultation-liaison psychiatric services in four major general hospitals in Tehran.

OBJECTIVE: Our objective was to validate a scale for the evaluation of attitudes of physicians toward integrating consultation-liaison psychiatric services and then apply it among the nonpsychiatrist attending physicians of four major general hospitals in Tehran. METHOD: The eight-item Doctors' Attitudes toward Collaborative Care for Mental Health (DACC-MH) Scale was translated to Persian and back-translated to English by nonphysician translators and was presented for expert opinion to four psychiatrists for assessment of face validity. The validated questionnaires were presented to nonpsychiatrist attending physicians of four major general university-affiliated hospitals with consultant-liaison psychiatric services in Tehran, and the returned questionnaires were analyzed using the 21st version of SPSS software. The score for each physician was generated by counting positive responses of the eight items questioned. RESULTS: Of the 300 questionnaires presented, 193 (64.3%) were returned. The mean score of the respondents was 6.62 (±1.33) for the Farsi version of the DACC-MH which was significantly higher than the assumed mean score of 4, according to the independent-sample t test (P<.001). The mean score of the respondents for the first four items of the DACC-MH was 3.49, which was significantly higher than that of the second four items of the scale which was 3.13 (P<.01) according to the Wilcoxon test. CONCLUSION: The respondents have an above-average positive attitude toward integrating consultation-liaison psychiatric services for the management of psychiatric disorders among inpatients. They had a more positive attitude toward requesting psychiatric consultations than managing the patients' psychiatric disorders themselves.