Experiences of Wives of Veterans with Post-Traumatic Stress Disorder: A Qualitative Study.

Background: Living with post-traumatic stress disorder (PTSD) veterans imposes severe stress on relatives especially their wives. Despite of these difficulties these stratum of women suffer insufficient support and less attention. This study aimed to explore the experiences of wives of veterans with PTSD. Methods: This study was conducted in 2021 using qualitative content analysis approach. Participants were selected purposely from PTSD veterans' wives. Data were collected using semi-structured interviews with 18 wives of veteran men with PTSD. All the interviews were transcribed verbatim. Data were collected using in-depth and semi-structured interviews, up to the point of data saturation, and were analyzed by Graneheim and Lundman's content analysis method with the support of MAXQDA software. Findings: Through analysis of transcribed interviews, one theme and 4 categories and 13 sub categories were emerged : The theme called "abandoned in miserable life stream" and categories consist of "living in the cage of grief and regret"; "insufficient support resources"; "marital burnout"; and "self-sacrifice to maintain family cohesion". Conclusion: The results of this study provide a broad range of context-specific challenges faced by wives of veterans with PTSD. In confronting with full of tensions life and lack of support, wives of veteran with PTSD are neglected and need more attention and support. It is essential for healthcare providers to be aware of the complex psychological and social conditions of wives of veterans with PTSD.

Oxytocin Effect in Adult Patients with Autism: An Updated Systematic Review and Meta-Analysis of Randomized Controlled Trials.

INTRODUCTION: The efficacy of oxytocin in the treatment of autism spectrum disorder (ASD) has not been fully characterized. This systematic review and meta-analysis study evaluated randomized controlled trials (RCTs) on the treatment of intranasally administered oxytocin for autism. METHODS: The study was conducted in accordance with the PRISMA statement. Two authors searched Scopus, PubMed/ Medline, Google Scholar, and Web of Science search engines and databases from inception through December 2020. Quality assessment was carried out by with the "ROB-2, Cochrane collaboration's tool". The random-effects model was used for pooled analyses. I2 and Q tests were used to investigate study heterogeneity. The visual inspection of funnel plots along with Egger's regression asymmetry test was used to assess the potential sources of publication bias. RESULTS: Ten RCTs were selected for the systematic review. No study corroborated the efficacy of oxytocin for the treatment of anxiety and repetitive behavior. One out of 4 studies reported clinical improvement in severity, and 1 out of 6 studies indicated improvement in social function. Our metaanalyses findings suggest that oxytocin shows no significant efficacy in the treatment of anxiety (SMD: -0.168, SE= 0.112; 95% CI: -0.387, 0.050, p = 0.132), repetitive behavior (SMD: -0.078, SE= 0.155; 95% CI: -0.382, 0.225, p = 0.614), social function (SMD: -0.018, SE= 0.133; 95% CI: -0.279, 0.242, p = 0.891) and severity (SMD: -0.084, SE= 132; 95% CI: -0.343, 0.175, p = 0.524) of autism. No significant heterogeneity nor publication bias were observed between studies. CONCLUSION: Our findings failed to corroborate the efficacy of oxytocin in the treatment of ASD. Nonetheless, given the several limitations of our study, the results should be interpreted cautiously and stimulate future research on this timely topic.

Evaluating the Effects of Experiencing Virtual Reality Simulation of Psychosis on Mental Illness Stigma, Empathy, and Knowledge in Medical Students.

Objectives: Applying technologies such as virtual reality (VR) in education has gained popularity especially in comprehending abstract and subjective phenomena. Previous studies have shown that applying a virtual reality simulation of psychosis (VRSP) is useful in increasing knowledge and empathy toward patients. Here, the efficacy of using VRSP in altering stigma, empathy and knowledge as well as side effects have been assessed in medical students in comparison with the routine education (visiting the patients). Method: After attending one session of lecture about positive psychotic symptoms, medical students were allocated to two groups: experiencing one session of VRSP or visiting patients under supervision as routine practice in the ward. Before and after the first session and after the second one, questionnaires of knowledge, empathy and stigma were filled by students. Finally, the results were compared in two groups. Results: Both interventions were effective in reducing stigma as well as increasing knowledge and empathy toward patients with psychotic experiences. VRSP could significantly reduce stigma and increase knowledge and empathy compared with the traditional visiting patients under supervision. The side effects were minimal and ameliorated right after the experience. Conclusion: VRSP is an effective tool in decreasing stigma and increasing empathy and knowledge of the students and can be incorporated in psychiatric education with minimal side effects.

A case-control study on the relationship between urine trace element levels and autism spectrum disorder among Iranian children.

Autism spectrum disorder (ASD) is a type of neurodevelopmental disorder characterized mainly by qualitative deficiencies in social communication skills, accompanied by repetitive and restricted behavior patterns. This study was conducted to investigate the associations between the risk of ASD development in children and exposure to trace elements (arsenic (As), cadmium (Cd), chromium (Cr), cobalt (Co), copper (Cu), lead (Pb), nickel (Ni), and zinc (Zn)). Two groups of children, including 44 ASD and 35 typically developing (TD) children, were selected, and their fasting urine samples were obtained. The concentration levels of trace elements were assayed using ICP-MS. The results showed that as compared to the TD group, the concentration levels of As (p = 0.002) and Pb (p < 0.001) and also Cr (p < 0.001), Cu (p = 0.001), and Ni (p < 0.001) were significantly higher among ASD children. In terms of gender, boys with ASD showed elevated levels of Cr, Cu, Ni, and Pb, whereas the urine levels of As, Cr, Cu, Ni, and Pb were markedly higher among girls when compared to the non-ASD children. Under the logistic regression model, the risk difference for As, Co, Cr, Cu, Ni, Pb, and Zn remained significant when adjustment was applied for age and gender confounders.

Trends of suicide attempts and factors related to completed suicide during the years 2014-2019 in South Khorasan province, Iran.

The aim of the present study is to investigate the trend of suicide and its attempt and the factors related to completed suicide during a 5-year period (2014-2019) in South Khorasan province, Iran. Data analysis was performed using chi-square, independent t-test and backward logistic regression in SPSS ver. 16. Cochran-Armitage test was used to evaluate the trends of suicide attempt and completed suicide. P-value < 0.05 was considered as the significance level. There was a significantly higher rate of suicide attempt among women and a significantly higher rate of completed suicide among men (p = 0.007). The incidence of suicide attempt (p = 0.001) and suicide deaths (p = 0.003) have also increased significantly during these years and the most common method of suicide attempt is drug poisoning. Also increasing age, rural residence, having a history of mental disorder, marital separation and lower level of education led to a significant increase in the rate of completed suicide (p < 0.001). The present study showed no significant relationship between the history of suicide attempt and completed suicide (p = 0.19). The rate of suicide attempt was higher among women and the rate of completed suicide was higher among men. The rate of suicide attempts and completed suicides has increased during these five years. Factors such as untreated mental disorders, living in rural areas, separation, and older age were considered as risk factors for completed suicide. On the other hand, higher education level has played a protective role in this regard.

Association between rs1344706 Polymorphism in the ZNF804A Gene and the Risk for Schizophrenia.

Objective: Schizophrenia is known as a severe mental disorder worldwide. Genome-wide association studies have revealed that rs1344706, located in ZNF804A, is a risk variant for schizophrenia among various populations. The current study was conducted to find correlation between rs1344706 polymorphism and schizophrenia in East of Iran. Method: This case-control study assessed 150 schizophrenia cases as well as 150 healthy controls. The single nucleotide polymorphism (SNP) was genotyped using the Tetra-Amplification Refractory Mutation System-Polymerase Chain Reaction (Tetra-ARMS-PCR) method. Analyses based on the Chi-square test and logistic regression were calculated by SPSS. Results: The TT, GT, and GG genotype frequencies at rs1344706 in schizophrenia cases were 48.0%, 40.0%, and 12.0%, whereas in controls, they were 49.3 %, 36.7 %, and 14.0 %, respectively. The T and G allele frequencies were 68 % and 32 % in cases and 67 % and 33 % in healthy controls. The results of logistic regression indicated that there is no association between rs1344706 alleles (P = 1.000) and genotypes (P = 0.647 for GT and P = 0.726 for GG) with susceptibility to schizophrenia. Conclusion: Overall, there was no significant relationship between rs1344706 SNP and schizophrenia in Iran's Eastern population. However, further research focusing on more SNPs of ZNF804A and larger samples in other ethnicities is necessary to confirm these results.

Birjand longitudinal aging study (BLAS): the objectives, study protocol and design (wave I: baseline data gathering).

OBJECTIVES: The pace of population aging is growing rapidly around the world. Aging is associated with the emergence of different health status including geriatric syndrome such as frailty, diabetes, cardiovascular diseases, and dementia. These conditions are the most prominent challenges for health care systems and also elderly people. Therefore, understanding these changes can help scientists to prevent and treat significant health issues and also improve the functional ability of older adults. METHODS: This is a protocol of the first wave of Birjand Longitudinal Aging Study that is an ongoing community-based prospective cohort study with a following up at least 10 years. This study carries out on aged population ≥ 60 years which were residents in Birjand County (urban and rural older subjects). The selection of the participants of this study in urban areas is based on an age group weighted multistage stratified random sample while in the rural region the sample was selected from all ten rural regions of Birjand County by simple random sampling. The rural region sampling was based on the list of the aged population which were under the coverage of the rural health center. Sociodemographic, past medical history, lifestyle, sleep, activities of daily living, cognitive function, quality of life, and social capital were evaluated by interviewing with the participants and one of the informants. Anthropometric measures, electrocardiography, and interpretation of ophthalmologic examination were carried out by experts. Fasting Blood samples were collected and bio-banked in - 80 °C. then finally biochemical and hematologic markers were measured. RESULTS: This is the protocol of stage one baseline of Birjand Longitudinal Aging Study (BLAS). The BLAS is an enjoining study, the first phase of its baseline was carried out on a community- dwelling aged population sample ≥ 60 years who were residents in urban and rural regions of Birjand County. This is a community based prospective cohort study with at least 10 years follow up of participants. The data for 65% of older subjects (response rate = 65%) that lived in clusters were collected. CONCLUSIONS: This study can help scientists to recognize some risk factors related to the aging process and also aware policymakers about the necessity to create heath care services at regional and even national levels.

The Association of Major Depressive Disorder with Activation of NLRP3 Inflammasome, Lipid Peroxidation, and Total Antioxidant Capacity.

Increasing number of studies indicates that chronic inflammation and oxidative stress play an essential role in pathophysiology and some symptoms of major depressive disorder (MDD). In the present study, the inflammasome activity and oxidative stress status in untreated and antidepressant-treated MDD patients were compared to the healthy group. Blood samples were taken from 20 MDD patients receiving treatment, 20 first-episode MDD patients not receiving treatment, and 20 healthy controls. The expression level of NLRP3 and caspase-1 was measured by real-time PCR and the serum TAC and MDA were examined in the patients and the control groups. The results showed that the mRNA level of NLRP3 and caspase-1 genes was significantly elevated in MDD groups compared with that in the healthy volunteers (P < 0.005). The expression level of NLRP3 and caspase-1 has slightly decreased in the treated group compared with that in the untreated one, but it was not a meaningful decrease. Moreover, the serum MDA was significantly higher and TAC statistically was lower in untreated MDD patients compared with those in the healthy control group (P = 0.001, P = 0.001). It can be concluded that NLRP3 inflammasome is upregulated in MDD patients. Statistically significant reduction in the level of TAC along with increased lipid peroxidation was detectable in MDD patient's plasma. In contrast, there was no significant difference between the treated and non-treated groups in terms of oxidative stress (P = 0.6, P = 0.1). Our results suggested that inflammasome signaling pathway is a therapeutic potential for MDD.

Association between vitamin D receptor gene FokI and TaqI variants with autism spectrum disorder predisposition in Iranian population.

BACKGROUND AND AIM: Autism spectrum disorder (ASD) is one of the neurodevelopmental and cognitive conditions that involves 1 in 160 children around the world. Several studies showed that there is a relationship between vitamin D receptor (VDR) gene polymorphisms with the neurodevelopmental behavioral disorders. In the current study, we aimed to highlight the association of VDR gene polymorphisms (FokI and TaqI) with the risk of autism in Birjand population. MATERIAL AND METHODS: In this case-control study eighty-one patients recognized with ASD and one hundred-eight healthy controls were recruited to the study from 2017 to 2018. Genotyping was carried out by polymerase chain reaction followed by restriction fragment length polymorphism (PCR-RFLP) technique for all subjects. RESULTS: Calculated odds ratio and P-value for the alleles of VDR gene FokI and TaqI variants between autistic patients and controls did not show a significant difference (P > 0.05). However, calculated homozygous recessive (tt) for TaqI polymorphism was statistically significant (P = 0.015) in control group and there was also statistically meaningful difference in both case and control groups in ft haplotype (P = 0.04). CONCLUSION: These results provide preliminary evidence that genetic variants of the VDR gene (FokI and TaqI) might have a possible reduced risk of ASD occurrence in children. The additional examination is needed to acquire more decisive and precise results in this area.

The effectiveness of group training of cognitive behavioral therapy-based stress management on anxiety, hardiness and self-efficacy in female medical students.

INTRODUCTION: The present study aimed to investigate the effectiveness of cognitive behavioral therapies (CBTs) for anxiety, hardiness, and self-efficacy in female students of Birjand University of Medical Sciences. MATERIALS AND METHODS: This was an interventional study. A sample of 30 participants were selected through the available sampling method and randomly assigned into experimental (CBT) and control groups (each group, 15 female student). The data collection instrument was the Beck Depression Inventory questionnaire. The questionnaires of Beck Anxiety Inventory, Ahvaz Hardiness Inventory, and Schwartz's General Self-Efficacy Scale were completed by all participants in two stages (pretest and posttest). A 6-session protocol of cognitive behavioral group therapy was performed only on the experimental group. The data were analyzed using Kolmogorov-Smirnov, Levene's F, Mbox, analysis of variance, and multivariate analysis of variance tests. RESULTS: The intervention group showed that the mean of anxiety decreased, whereas (P < 0.001) the means of hardiness and self-efficacy increased in the posttest for the experimental group (P < 0.001). CONCLUSION: Based on the obtained results, it can be concluded that CBT is an effective treatment for anxiety, hardiness, and self-efficacy. Therefore, through managing anxiety, the levels of hardiness and self-efficacy can be increased in students of university to be able to cope with the different challenges in their life.

The effectiveness of stress-management-based cognitive-behavioral treatments on anxiety sensitivity, positive and negative affect and hope.

BACKGROUND AND OBJECTIVE: Anxiety sensitivity, positive and negative affection and hope are the important factors in promoting mental health of students. The purpose of this study was to investigate the effectiveness of stress-management-based cognitive-behavioral treatments on anxiety sensitivity, hope, positive and negative affect in female students of Medical Sciences. MATERIALS AND METHODS: This research was a trail study with pre-test, post-test and control group. A sample of 30 subjects, were selected by available sampling and were randomly assigned using Block Randomization Method of two groups (experimental and control groups). Schneider's hope questionnaire, Watson's positive and negative affect questionnaire, Clarke and Tolgman's questionnaire, Reiss et al.'s anxiety sensitivity of the revised index questionnaire, were completed in two stages (pre-test and post-test) by all subjects. A 6-session protocol of cognitive-behavioral group treatment was performed only on the experimental group. The data were analyzed using ANOVA and MANOVA analysis of variance. RESULTS: Two experimental and control groups with the mean 22, standard deviationl. 13, average age is 22 years. Stress-management-based cognitive-behavioral treatments were effective on the level of anxiety sensitivity and hope (p <0.016), however, it had no significant positive effect on the amount of positive and negative affect (p <0.016). CONCLUSION: According to the results, it can be concluded that cognitive-behavioral treatments are effective on anxiety sensitivity and hope. Therefore, stress-management-based cognitive-behavioral training can reduce students' anxiety sensitivity and increase their hopes for coping with challenges.

The Role of Peer Support Group in Subjective Well-Being of Wives of War Veterans with Post-Traumatic Stress Disorder.

This study aimed to investigate the effect of peer support group on subjective well-being (SWB) of wives of war veterans with post-traumatic stress disorder (PTSD). Selected participants were randomly assigned into intervention and control groups (n = 40 for each group). The intervention group was divided into four subgroups, with each participating in 8 weekly based 1.5 hr peer support group sessions. SWB and its dimensions in the intervention group increased significantly higher than those in the control group (p < 0.001). Peer support group can be a useful tool to enhance SWB in spouses of war veterans with PTSD.

The effect of peer support groups on family adaptation from the perspective of wives of war veterans with posttraumatic stress disorder.

OBJECTIVE: The aim of this study was to examine the effect of peer group support on family adaptation of wives of war veterans suffering from post-traumatic stress disorder (PTSD). DESIGN AND SAMPLE: In this randomized controlled trial, 80 wives of war veterans with PTSD were incorporated, and selected participants were randomly assigned into intervention and control groups (n = 40 per group). The intervention group was divided into four subgroups, with each participating in eight weekly based 1.5-hr peer support group sessions and the control group received no intervention. MEASURES: Demographics form and Family Adaptation Scale (FAS) developed by Antonovsky and Sourani (1988) were applied. RESULTS: The total mean scores of family adaptation increased significantly more in the intervention group than in the control group (p = .033). Furthermore, the time × group interaction effects were significant for internal family fit (p = .013) and a combination of both family fit and family community fit (p = .020) dimensions. Nonetheless family fit dimensions mean scores had no significant increase in the intervention group than the control group over time (p = .948). CONCLUSIONS: Peer support group can be a useful tool for health care professionals to enhance family adaptation in spouses of war veterans with PTSD.