Effect of probiotic and prebiotic versus placebo on appetite in patients with major depressive disorder: post hoc analysis of a randomised clinical trial.

BACKGROUND: Poor appetite and weight loss are common in melancholic depression. Probiotics and prebiotics have the capacity to affect host behaviour, appetite and weight change by modulating the gut microbiome. The aim of this post hoc analysis was to investigate the effect of supplementation with probiotic and prebiotic on appetite, in parallel with body mass index (BMI), weight and energy intake, in patients with major depressive disorder (MDD). METHODS: We extracted data from a clinical trial with 81 patients. The participants were randomly assigned to receive probiotic (Lactobacillus helveticus and Bifidobacterium longum), prebiotic (galactooligosaccharide) or placebo for 8 weeks. Appetite, weight, BMI, dietary intake, serum leptin and physical activity were measured. Subjective appetite rating was evaluated every 2 weeks using visual analogue scales (VAS) to assess satiety, hunger, fullness and desire to eat. Serum leptin was measured by an enzyme-linked immunosorbent assay. Physical activity was measured using the international physical activity questionnaire. A repeated measures analysis of variance model was used to analyse VAS data and analysis of variance/analysis of covariance models for dietary intake, BMI, weight and leptin data. RESULTS: VAS data analyses indicated no significant intervention-time interactions but did show a significant increase over time for desire to eat within the probiotic group (P = 0.025). No significant difference in either BMI or weight was seen among the groups. Energy intake and leptin were significantly increased in the probiotic group compared to the prebiotic. CONCLUSIONS: Overall, probiotic supplementation for 8 weeks among MDD patients resulted in improvement of appetite, whereas prebiotic administration had no significant effect on appetite.

The Impact of Mindfulness-Based Stress Reduction on Emotional Wellbeing and Glycemic Control of Patients with Type 2 Diabetes Mellitus.

OBJECTIVE: The aim of the study was to determine the effect of mindfulness-based stress reduction (MBSR) intervention on emotion regulation and glycemic control of patients with type 2 diabetes. MATERIALS AND METHODS: Sixty patients with type 2 diabetes were recruited for this randomized controlled trial from an outpatient clinic at Imam Hospital in Iran. The intervention group participated in 8 sessions of MBSR, and the control group continued the treatment as usual. Fasting blood sugar and HbA1c were measured as two indices of glycemic control. Overall mental health, depression, and anxiety were measured using the General Health Questionnaire (GHQ-28), Hamilton Depression Rating Scale (HDRS), and Hamilton Anxiety Rating Scale (HARS), respectively. All the assessments were performed at baseline and after 8 weeks and 3 months as follow-up. RESULTS: In comparison with the control group, the MBSR intervention group showed a significant reduction on all outcome measures including FBS, HbA1C, HARS, and HDRS scores (p < 0/05). CONCLUSION: MBSR had a remarkable improvement on emotional wellbeing and glycemic control of patients with type 2 diabetes.

Oral health-related quality of life in patients with temporomandibular disorders: A case-control study considering psychological aspects.

OBJECTIVES: This case-control study aimed to compare patients with temporomandibular disorders (TMD) and healthy controls in terms of oral health-related quality of life (OHRQoL) considering Graded Chronic Pain Scale (GCPS) scores, pain duration, psychological impairment and demographic characteristics. METHODS: A total of 75 patients with TMD and 75 healthy controls were recruited. The short version of Oral Health Impact Profile (OHIP-14) was administered for evaluating the OHRQoL. Psychosocial impairments were assessed using the General Health Questionnaire-28 (GHQ-28). The Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD) axis I and II were also used for patient diagnosis and collecting GCPS scores, pain duration, age and gender. Independent-sample t tests, Pearson's chi-square tests and multiple logistic and linear regression models were applied for statistical analysis. RESULTS: The mean age of the patients was 34.3±12.4 years. A female-to-male ratio of 6:1 was seen in the TMD group. The prevalence and severity of the OHIP were significantly different between the TMD and control groups (66.7% vs 12.0% and 18.0 vs 9.2, respectively). According to multiple logistic regression for OHIP prevalence and multiple linear regression for OHIP severity in the TMD group, GCPS scores and pain duration, followed by psychological impairment, were the most important predictors of the OHRQoL. CONCLUSION: TMD negatively affected the OHRQoL, particularly in patients with psychological impairments. Meanwhile, age and gender did not seem to have a serious effect. Hence, promoting the quality of life of patients with TMD requires emphasis on chronic pain management and maintaining good mental health.

Hydro-alcoholic extract of Crocus sativus L. versus fluoxetine in the treatment of mild to moderate depression: a double-blind, randomized pilot trial.

Depressive disorders are very common in clinical practice, with approximately 11.3 of all adults afflicted during any a year. Saffron is the world's most expensive spice and apart from its traditional value as a food additive, recent studies indicate several therapeutic effects for saffron. It is used for depression in Persian traditional medicine. Our objective was to compare the efficacy of hydro-alcoholic extract of Crocus sativus (stigma) with fluoxetine in the treatment of mild to moderate depression in a 6-week double-blind, randomized trial. Forty adult outpatients who met the Diagnostic and Statistical Manual of Mental Disorders, fourth edition for major depression based on the structured clinical interview for DSM-IV and with mild to moderate depression participated in the trial. In this double-blind, single-center trial and randomized trial, patients were randomly assigned to receive capsules of saffron 30 mg/day (BD) (Group 1) and capsule of fluoxetine 20 mg/day (BD) (Group 2) for a 6-week study. Saffron at this dose was found to be effective similar to fluoxetine in the treatment of mild to moderate depression (F = 0.13, d.f. = 1, P = 0.71). There were no significant differences in the two groups in terms of observed side effects. The results of this study indicate the efficacy of Crocus sativus in the treatment of mild to moderate depression. A large-scale trial is justified.

Rate of hepatitis B seropositivity following mass vaccination in the Islamic Republic of Iran.

Universal vaccination of all neonates against hepatitis B virus has been implemented in the Islamic Republic of Iran since 1993. To evaluate the efficacy of the programme, 2 large seroepidemiologic surveys were conducted before and after mass vaccination on a representative sample of 1/1000 of the population. The overall seropositivity rate showed no significant decline between 1991 and 1999 but in the age group 2-14 years the rates reduced significantly (1.3% versus 0.8%, P < 0.05). Interestingly, we observed a significantly higher decline in hepatitis B virus carrier rate in rural (1.5% versus 0.6%) than urban areas (1.1% versus 0.9%). Universal vaccination significantly decreased the carrier rate among young children in this country.

Rate of hepatitis B seropositivity following mass vaccination in the Islamic Republic of Iran

Universal vaccination of all neonates against hepatitis B virus has been implemented in the Islamic Republic of Iran since 1993. To evaluate the efficacy of the programme, 2 large seroepidemiologic surveys were conducted before and after mass vaccination on a representative sample of 1/1000 of the population. The overall seropositivity rate showed no significant decline between 1991 and 1999 but in the age group 2-14 years the rates reduced significantly [1.3% versus 0.8%, P < 0.05]. Interestingly, we observed a significantly higher decline in hepatitis B virus carrier rate in rural [1.5% versus 0.6%] than urban areas [1.1% versus 0.9%]. Universal vaccination significantly decreased the carrier rate among young children in this country

Mental health survey of the adult population in Iran.

BACKGROUND: No national data on the prevalence of mental disorders are available in Iran. Such information may be a prerequisite for efficient national mental health intervention. AIMS: To determine the mental health status of a population sample aged 15 years and over. METHOD: Through random cluster sampling, 35 014 individuals were selected and evaluated using the 28-item version of the General Health Questionnaire. A complementary semi-structured clinical interview was also undertaken to detect learning disability ('mental retardation'), epilepsy and psychosis. RESULTS: About a fifth of the people in the study (25.9% of the women and 14.9% of the men) were detected as likely cases. The prevalence of mental disorders was 21.3% in rural areas and 20.9% in urban areas. Depression and anxiety symptoms were more prevalent than somatisation and social dysfunction. The interview of families by general practitioners revealed that the rates of learning disability, epilepsy and psychosis were 1.4%, 1.2% and 0.6%, respectively. Prevalence increased with age and was higher in the married, widowed, divorced, unemployed and retired people. CONCLUSIONS: Prevalence rates are comparable with international studies. There is a wide regional difference in the country, and women are at greater risk.

Piracetam in the treatment of schizophrenia: implications for the glutamate hypothesis of schizophrenia.

OBJECTIVE: There is a growing interest in investigating the role of glutamate receptors in the pathophysiology of schizophrenia. Indeed, the hyperdopaminergic theory of schizophrenia can explain only the positive symptoms of schizophrenia, whereas the glutamate hypothesis may provide a more comprehensive view of the illness. We undertook a trial to investigate whether the combination of haloperidol with piracetam, a nootropic agent which modulates the glutamate receptor positively was more effective than haloperidol alone. METHODS: Thirty patients who met the DSM IV criteria for schizophrenia completed the study. Patients were allocated in a random fashion, 14 to haloperidol 30 mg/day plus piracetam 3200 mg/day and 16 to haloperidol 30 mg/day plus placebo. RESULTS: Although both protocols significantly decreased the score of the positive symptoms, the negative symptoms, the general psychopathological symptoms and the total score of PANSS scale over the trial period, the combination of haloperidol and piracetam showed a significant superiority over haloperidol alone in the treatment of schizophrenic patients. CONCLUSION: Piracetam, a member of the nootropic class of drugs and a positive modulator of glutamate receptor, may be of therapeutic benefit in treating schizophrenic patients in combination with typical neuroleptics. However, a larger study to confirm our results is warranted

Combination of clomipramine and nortriptyline in the treatment of obsessive-compulsive disorder: a double-blind, placebo-controlled trial.

OBJECTIVE: There is growing interest in investigating noradrenergic functions in obsessive-compulsive disorder (OCD) because some antidepressants with strong effects on serotonin reuptake blockade fail to relieve obsessive-compulsive symptoms. We undertook a trial to investigate whether the combination of clomipramine with nortriptyline was more effective than clomipramine alone. METHOD: Thirty patients who met the DSM-IV criteria for OCD completed the study. Patients were allocated in a random fashion, 15 each to clomipramine 150 mg/ day plus nortriptyline 50 mg/day and clomipramine 150 mg/day plus placebo. RESULTS: Although both protocols significantly decreased the scores of the Yale-Brown obsessive-compulsive scale over the trial period, the combination of clomipramine and nortriptyline showed a significant superiority over clomipramine alone in the treatment of OCD. CONCLUSION: As this study indicates, a rapid onset of action is one of the advantages of this combination. This study supports further investigation of the noradrenergic-serotonergic hypothesis in OCD.