Self-stigma, religiosity, and perceived social support in people with recent-onset psychosis in the Islamic Republic of Iran: Associations with symptom severity and psychosocial functioning.

AIMS: Most evidence on psychosocial factors in recent-onset psychosis comes from high-income countries in Europe, Australia, Canada and the USA, while these factors are likely to differ under varying sociocultural and economic circumstances. In this study, we aimed to investigate associations of self-stigma, religiosity and perceived social support with symptom severity and psychosocial functioning in an Iranian cohort of people with recent-onset psychosis (i.e. illness duration of <2 years). METHODS: We used baseline data of 361 participants (N = 286 [74%] male, mean age = 34 years [Standard Deviation = 10.0]) from the Iranian Azeri Recent-onset Acute Phase Psychosis Survey (ARAS). We included assessments of self-stigma (Internalized Stigma of Mental Illness, ISMI), religiosity (based on Stark & Glock), perceived social support (Multidimensional Scale of Perceived Social Support, MSPSS), symptom severity (Positive And Negative Syndrome Scale, PANSS) and psychosocial functioning (clinician-rated Global Assessment of Functioning Scale, GAF, and self-reported World Health Organization Disability Assessment Schedule 2.0, WHODAS 2.0). Descriptive analyses were employed to characterize the study sample. Covariate-adjusted ordinal and multivariable linear regression analyses were performed to investigate cross-sectional associations of baseline ISMI, religiosity and MSPSS with concurrent PANSS, GAF and WHODAS 2.0. RESULTS: Higher self-stigma was associated with poorer self-reported functioning (B = 0.375 [95% Confidence Interval (CI): 0.186, 0.564]) and more severe concurrent symptoms (B = 0.436 [95% CI: 0.275, 0.597]). Being more religious was associated with poorer clinician-rated functioning (OR = 0.967 [95% CI: 0.944, 0.991]), but with less severe symptoms (B = -0.258 [95% CI: -0.427, -0.088]). Stronger social support was associated with poorer clinician-rated (OR = 0.956 [95% CI: 0.935, 0.978]) and self-reported functioning (B = 0.337 [95% CI: 0.168, 0.507]). CONCLUSION: This study shows that self-stigma, religiosity and perceived social support were associated with symptom severity and clinician-rated as well as self-reported psychosocial functioning in an Iranian cohort of people with recent-onset psychosis. The findings extend previous evidence on these psychosocial factors to one of the largest countries in the Middle East, and suggest that it may be worthwhile to develop strategies aimed at tackling stigma around psychosis and integrate the role of religiosity and social support in mental ill-health prevention and therapy.

Saffron aqueous extract prevents metabolic syndrome in patients with schizophrenia on olanzapine treatment: a randomized triple blind placebo controlled study.

OBJECTIVE: The aim of this study was to assess whether saffron aqueous extract (SAE) or its active constituent, crocin, prevents olanzapine-induced metabolic syndrome (MetS) and insulin resistance in patients with schizophrenia. METHODS: 66 patients diagnosed with schizophrenia who were on olanzapine treatment (5-20 mg daily) were randomly allocated to receive a capsule of SAE (n=22; 30 mg daily), crocin (n=22; 30 mg daily) or placebo (n=22) in a 12-week triple-blind trial. Patients were screened not to have MetS at baseline and further assessment was done at weeks 6 and 12. Measurement of fasting blood glucose (FBS) and serum lipids were repeated at weeks 2, 6 and 12. Fasting blood levels of insulin and HbA1c were also measured at baseline and week 12. HOMA-IR and HOMA-ß were determined to evaluate insulin resistance. RESULTS: 61 patients completed the trial and no serious adverse effects were reported. Time-treatment interaction showed a significant difference in FBS in both SAE and crocin groups compared to placebo (p=0.004). In addition, SAE could effectively prevent reaching the criteria of metabolic syndrome (0 patients) compared to crocin (9.1%) and placebo (27.3%) as early as week 6. CONCLUSION: SAE could prevent metabolic syndrome compared to crocin and placebo. Furthermore, both SAE and crocin prevented increases in blood glucose during the study.

Psychosocial disabilities in patients with schizophrenia.

BACKGROUND: This study aimed at revaluating the psychosocial disabilities in schizophrenic patients. METHODS: In an analytic-descriptive setting, schizophrenic patients were evaluated in Razi University Hospital during a one-year period (2009-10). The study group consisted of male and female patients aged 18-65 years, with the onset of disease for a minimum of 2 years and at least one psychological hospitalization in their medical record. The demographic data, as well as the results of the SANS, SAPS, GARF and SOFAS questionnaires were determined in each patient. RESULTS: Two hundred and eight patients, 53 females, and 155 males with the mean age of 36.96±11.55 (18-65) years were enrolled. Vocational, educational, social, familial, and self-hygiene related disabilities were seen in 63.5%, 21.2%, 93.8%, 13.9%, and 48.1% of the patients, respectively. Totally, psychosocial disabilities were reported in 98.1% of these patients. The mean age of the patients with educational or social disabilities was lower. Vocational problems were more common in male patients. Familial and social disabilities were positively related to the severity of positive and negative symptoms, with the predominance of the latter. Positive and negative symptoms were more frequent in patients with social and self-care related disabilities, respectively. The duration of the disease was significantly correlated with the positive symptoms and familial-social disabilities. CONCLUSION: The current study described the high prevalence of psychosocial disabilities in patients with schizophrenia and may have implications for public health interventions.

[Usefulness of biological markers in evaluation of smoking]. / Intérêt des différents marqueurs biologiques dans l'évaluation du tabagisme.

Tobacco exposure can be assessed by the measurement of several markers in biological fluids. These markers are more or less specific for tobacco and the different methods to measure them out differ in terms of sensibility, specificity, ease of use and cost. The clinician prescribing a dosage for a patient has to take all these parameters into account to make an accurate choice. In this article, we have analysed the usefulness of the main biological tobacco markers in the follow-up of smokers and compared their methods of dosage. We propose several indications and point out the interest of relevant markers to realize objective measurements of smoking habits.

[Prevalence of cannabis and tobacco use in patients attending a methadone center. Evaluation by urinary biomarkers]. / Prévalence de la consommation de cannabis et de tabac chez les patients d'un centre méthadone. Evaluation par dosages urinaires.

AIM OF THE STUDY: The aim of this study was to determine the prevalence of cannabis and tobacco use in a population attending a Methadone Center. METHODS: We studied 49 patients over a 3-month period. Urine samples were obtained at three different times from each patient for analysis. We measured urinary cannabinoids using an immunopolarization assay to identify cannabinoid use. Cotinine concentrations were quantified in urine using a colorimetric assay to assess total urinary nicotine metabolites. RESULTS: The prevalence of cannabis use was high in this population. Urinary cannabinoids were present in 63% of the samples. Similarly 90% had high-urinary cotinine concentrations. CONCLUSION: Measurement of urinary biomarkers showed that tobacco and cannabis use was high among patients attending a Methadone Center.