Comparing the effectiveness of transdiagnostic treatment with acceptance and commitment therapy on emotional disorders, rumination, and life satisfaction in patients with irritable bowel syndrome: a randomized clinical trial.

OBJECTIVE: The present study was conducted to compare the effectiveness of transdiagnostic treatment (UP) with the acceptance and commitment therapy (ACT) on the emotional disorders, rumination, and life satisfaction in the patients with irritable bowel syndrome (IBS). METHOD: The present study was a randomized clinical trial with a pre-test and post-test design. Between the winter of 2021 and the end of spring 2022, Taleghani Hospital in Tehran received referrals from the statistical population of IBS patients. Of them, 30 individuals (15 in each group) were chosen by convenience sampling and then randomly allocated to groups. UP (It is emotion-based and intervenes in comorbid symptoms), and ACT treatments were provided to the participants online. The participants in the UP and ACT groups received the desired treatments in eight weekly sessions of 45-60 min. RESULTS: There was no significant difference between UP pre-test and ACT regarding depression, anxiety, rumination, and life satisfaction (P > 0.05). There was no significant difference between UP and ACT post-test in terms of depression, rumination, and life satisfaction (P > 0.05), but due to anxiety, their difference was significant (P < 0.05). Besides, there was a significant difference between pre-test and post-test phases of UP and ACT regarding depression, anxiety, and rumination (P < 0.05). Still, they had no significant difference regarding life satisfaction (P > 0.05). CONCLUSION: Therefore, it is suggested that specialists use UP and ACT as effective psychological treatments for the emotional symptoms of IBS patients to improve psychological symptoms.

The effectiveness of mindful hypnotherapy on difficulties in emotion regulation, mindfulness, and mental health in patients with major depressive disorder.

BACKGROUND: More than 300 million people are affected by major depressive disorder, and despite advances in treatments over the past 50 years, this number is increasing worldwide. Due to the high prevalence and increasing numbers, along with problems in various aspects of the patient's life, new effective treatments are essential in this field. MATERIALS AND METHODS: This study was a single-blinded randomized clinical trial. Thirty-four patients with major depressive disorder who were referred by clinical psychologists in the clinical psychology clinic of the Taleghani Hospital, Tehran, Iran, were selected by purposive sampling method and randomly assigned to the intervention and wait-list control groups. The Difficulties in Emotion Regulation Scale, the Five Facet Mindfulness Questionnaire, and the Mental Health Continuum Short Form were administered during the baseline and post treatment. Analyses of covariance and the repeated measures analysis of variance (ANOVA) procedure were performed to determine the difference between study groups. RESULTS: The results of the analysis of covariance and repeated measures ANOVA showed a clinically significant decrease in difficulties in emotion regulation and a significant increase in mindfulness and mental health in the intervention group (P < 0.001). The mean score (standard deviation) of the difficulties in emotion regulation scores was 123.75 (21.10) in the experimental group at baseline and significantly decreased to 76.19 (26.45) and 68.00 (22.83) after the intervention and two-month follow-up, respectively (P < 0.001). Additionally, the mean scores (standard deviation) for mindfulness and mental health were 93.06 (8.23) and 19.63 (7.92), respectively, at baseline and significantly increased to 149.43 (16.99) and 51.62 (9.78), respectively, after the intervention and to 144.18 (20.55) and 48.50 (13.52) after a two-month follow-up (P < 0.001). CONCLUSION: The results show that mindful hypnotherapy is an effective treatment for improving difficulties in emotion regulation, mindfulness, and mental health in patients with major depressive disorder.

The Effectiveness of Mindful Hypnotherapy on Psychological Inflexibility, Pain Acceptance, Headache Disability and Intensity in Females with Chronic Migraine Headache: A Randomized Clinical Trial.

This study was a randomized controlled design and examined the feasibility and effectiveness of mindful hypnotherapy on psychological inflexibility, pain acceptance, headache disability, and headache intensity in patients with chronic migraine headaches. The sample consisted of 38 females with chronic migraine who were randomly assigned to mindful hypnotherapy and medical treatment as usual groups. Psychological inflexibility pain scale (PIPS), chronic pain acceptance questionnaire-revised (CPAQ-R), headache disability inventory (HDI), diary scale for headache, and short-form McGill pain questionnaire 2 (SF-MPQ-2) were administered at baseline and post-treatment in both groups. The psychological inflexibility mean (SD) score was 81.00 (12.15) at baseline, which significantly decreased to 53.28 (17.06) after the intervention (p < 0.001). Additionally, the mean (SD) score of the pain acceptance was 46.44 (11.16), which significantly increased to 73.61 (15.65) in post-intervention (p < 0.001). Furthermore, the mean (SD) score of headache disability was 73.55 (19.48), which significantly decreased to 23.33 (19.88) in post-intervention (p < 0.001). Finally, headache intensity was 7.33 (0.98) and 5.78 (1.83), which significantly decreased to 2.77 (2.04), and 1.38 (1.48) after the intervention based on the Diary Scale for Headache and McGill Pain Questionnaire (SF-MPQ-2), respectively (p < 0.001). In conclusion, the results show that mindful hypnotherapy is a feasible and effective treatment for chronic migraine.

The Effectiveness of Mindful Hypnotherapy on Depression, Self-Compassion, and Psychological Inflexibility in Females with Major Depressive Disorder: A Single-Blind, Randomized Clinical Trial.

The effectiveness of the novel intervention mindful hypnotherapy on depression, self-compassion, and psychological inflexibility in females with major depressive disorder was examined in a randomized, clinical trial. Thirty-four participants were randomly allocated into mindful hypnotherapy and waitlist control groups. The intervention group was treated in 8 face-to-face, 60-minute weekly therapy sessions along with mindful hypnosis audio tapes to be used daily. The results of analysis of covariance indicated that there were significant differences between the mindful hypnotherapy and waitlist control groups after intervention and at 2-month follow-up (p < .001). The between-subject test of repeated measures ANOVAs also indicated a clinically significant difference between groups across time (baseline, postintervention, and 2-month follow-up) in depression, F = 53.86, p < .001, effect size = .65, and in self-compassion, F = 33.18, p < .001, effect size = .53, as well as psychological inflexibility, F = 26.84, p < .001, effect size = .48. In conclusion, this study indicates that mindful hypnotherapy is an effective intervention for treating depression as well as reducing psychological inflexibility and improving self-compassion for patients with major depressive disorder.

Efficacy of emotion regulation training on pain intensity and life quality in patients with peptic ulcer disease (PUD).

Aim: Because gastric ulcer is a psychosomatic disease involving many psychological factors like assertiveness and cognitive beliefs, this study aimed to investigate the effectiveness of emotion regulation training on pain intensity and quality of life in patients with peptic ulcer disease. Background: Gastric ulcer, a recurrent and common disease worldwide, is associated with gastrointestinal symptoms and lower health-related quality of life. Psychological factors and stress have been recognized as important contributors to the onset and duration of gastric ulcer, highlighting the need for effective psychological interventions to improve pain intensity and quality of life in patients. Methods: The research method was semi-experimental and based on the pretest-posttest control group design, with follow-up after three months. The sample included 46 participants selected by a Purposive Sampling method and placed randomly in the experimental and control groups. At first, simultaneously, and under the same conditions, all the participants responded to the Chronic Pain Grade Questionnaire (CPG) and Quality of Life Questionnaire (SF-12). The emotion regulation training was performed on the experimental group. In the end, both groups were evaluated by posttests, and then they were tracked after three months. To analyze data, the ANCOVA test was applied through SPSS 22. Results: Findings showed that emotion regulation training was meaningfully effective in decreasing pain intensity and increasing life quality (p<0.01), but after three months interval, no significant changes were found in the results. Conclusion: Due to the results about emotion regulation training protocol that has successfully reduced pain intensity symptoms in PUD patients and increased life quality, it is suggested that this protocol can be added to other treatments for PUD patients.

An Epidemiologic Overview of Traumatic Vascular Injures in Emergency Department; a Retrospective Cross-Sectional Study.

Introduction: Vascular system injuries (VSIs) are one of the main causes of preventable mortality and morbidity of trauma patients. This study aimed to evaluate baseline characteristics, presenting signs, managements, and outcomes of patients presenting to emergency department (ED) with traumatic VSIs. Methods: This retrospective cross-sectional study was conducted on patients with traumatic VSIs admitted to the ED of a referral tertiary trauma center, during one year. Using a pre-prepared checklist, demographics, pre-hospital care, type of VSIs, injury severity score (ISS), anatomical location of trauma, associated injuries, method of surgery, complications, and outcome were collected from patients' profiles and reported. Results: One hundred and twelve patients with the mean age of 33.5 ± 14.7 (range = 8 - 80) years were studied (90.2% male). Most of the patients were categorized as mild or moderate in terms of their ISS. 90 (80.4%) patients had at least one soft sign and 99 (88.4%) patients had at least one hard sign. Isolated arterial injury was diagnosed in 90 (80.4%) patients, isolated venous injuries in 12 (10.7%) cases, and combined arteriovenous injuries in 10 (8.7%) patients. The most common associated injury was tendon rupture (63.4%) and nerve injuries were present in 60.7% of patients. 1 (0.9%) patient died, 6 (5.4%) patients went through amputation, and 3 (2.7%) patients were discharged against medical advice. The rest of the patients were discharged in perfect health. There was a significant correlation between trauma type (p = 0.001), upper and lower extremity trauma (p < 0.001), presence of distal ischemia and lack of pulse (p = 0.041), penetrating injury close to a major vessel (p = 0.006), type of injured vessels and arteries (p<0.001), injury to nerve (p = 0.011) and tendon (p = 0.007), presence of open fracture (p = 0.005), multiple trauma (p < 0.001), method of surgery (p < 0.001), and number of postoperative complications (p< 0.001) with poor outcome. Conclusion: The findings showed that the majority of the studied patients were young males, most of whom were discharged in perfect situation. Those who presented with higher ISS, or were affected by blunt trauma or injury to lower limb arteries had worse outcome than the others.

COVID-19 infection in children with underlying malignancies in Iran.

OBJECTIVES: Although coronavirus disease 2019 (COVID-19) prognosis is mostly good in pediatric patients with no underlying diseases, there are a few reports on children with oncological underlying malignancies. This study aimed to describe the clinical and laboratory features of 20 children with COVID-19 who had underlying malignancies in an Iranian referral pediatrics hospital. METHODS: All children under 15-year-old of age with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) positive real-time polymerase chain reaction (PCR) and presence of an underlying malignancy were included in the study. RESULTS: In this study, among 20 patients, 11 were male (55%). The mean age of the patients was 6.0 ± 4.1 years. Twelve patients (60%) had acute lymphocytic leukemia, two had acute myeloid leukemia (10%), and six had solid organ tumors (30%). The most common symptoms were fever (65%) and cough (65%). We reported severe pneumonia in seven hospitalized patients (35%) and three patients (20%) required intensive care unit admission and mechanical ventilation. Procalcitonin was normal in 73% of the cases (11 out of 15), but it was highly elevated in four cases (27%). Five patients (25%) had positive blood cultures and a mortality of 20% was reported. CONCLUSIONS: This is the largest study on SARS-CoV-2 infected pediatric patients with underlying malignancies in Iran. Since the risk of exposure to SARS-CoV-2 and even death in children with malignancy, either in the hospital or community setting during the pandemic is high, special precautions to reduce the risk of transmission are highly suggested.

Protein Ions Generated by Native Electrospray Ionization: Comparison of Gas Phase, Solution, and Crystal Structures.

Experiments and molecular dynamics (MD) simulations in the literature indicate that gaseous proteins generated by electrospray ionization (ESI) can retain native-like structures. However, the exact properties of these ions remain to be explored. Focusing on ubiquitin and lysozyme, we examined several pertinent questions. (1) We applied solvent MD runs to test whether the X-ray structures of both proteins are affected by crystal packing. Main and side-chain orientations were retained in solution, providing a justification for the hitherto unscrutinized approach of relying on crystal data for "solution" versus gas-phase comparisons. (2) Most earlier gas-phase protein MD investigations employed short (ns) simulation windows. By extending this time frame to 1 µs, we were able to observe rare unfolding/folding transitions in ubiquitin. These predicted fluctuations were consistent with a semi-unfolded subpopulation detected by ion mobility spectrometry (IMS). (3) Most earlier modeling studies did not account for the high H+ mobility in gaseous proteins. For the first time, we compared static and mobile H+ simulations, focusing on both positively and negatively charged ions. The MD runs revealed a strong preference for retention of a solution-like backbone fold, whereas titratable/polar side chains collapsed onto the protein surface. This side-chain collapse was caused by a multitude of intramolecular salt bridges, H-bonds, and charge-dipole interactions. Our results generalize the findings of Steinberg et al. ( ChemBioChem, 2008, 9, 2417-2423) who had first proposed the occurrence of such side-chain contacts on the basis of short-term simulations with static H+. (4) Calculated collision cross sections of the MD conformers were in close agreement with IMS experiments. Overall, this study supports the view that solution-like protein structures can be retained because of kinetic trapping on the time scale of typical ESI-IMS experiments.

The role of fear of childbirth in pregnancy related anxiety in Iranian women: a qualitative research.

INTRODUCTION: Anxiety disorders have severe complications for a mother and her developing baby. A few studies have focused on pregnancy related anxiety and its risk factors including fear of childbirth. Therefore, the current study aimed to explore components and dimensions of this kind of anxiety. METHODS: This qualitative study (conventional content analysis) was conducted with mothers who referred to health care centers from May to December, 2015. In order to collect data, purposive sampling and face-to-face semi-structured in-depth interviews were used. Data analysis was conducted using MAXQDA software. RESULTS: Twenty eight pregnant women from different social backgrounds, educational levels and ethnicities aged 18-41 years old participated in this study and after analysis, fear of childbirth was classified into four categories including the process of delivery (fear of pain, prolonged labor, loss of control, being left alone during delivery, fear of her own incompetency), time of delivery (fear of preterm labor, fear of unknown delivery time, fear of late arrival to hospital), delivery complications (fear of bleeding, fear of death, postpartum depression, delivery accidents, genitalia injuries and fetal health problems) and healthcare quality (hospital facilities, lack of trust in maternity staff and lack of trust in obstetricians). CONCLUSIONS: The results suggest that supporting, reassuring and educating pregnant mothers and giving information about delivery room, labor and strategies for coping with fear of pain and childbirth are critical. Changes in maternity care policies are recommended to promote positive attitudes toward normal delivery.

Factors affecting adaptation to the role of motherhood in mothers of preterm infants admitted to the neonatal intensive care unit: a qualitative study.

AIM: The aim of this study was to explore factors affecting adaptation to the role of motherhood in mothers of preterm infants admitted to the neonatal intensive care unit. BACKGROUND: Transition to motherhood often causes significant issues in terms of adaptation to the role of motherhood. The main factors leading to parental stress, especially in the neonatal intensive care unit, have shown that the greatest source of stress is the loss of women's role as mothers. DESIGN: It was a qualitative study with content analysis approach. METHODS: Semi-structured in-depth interviews were used for data collection. Interviews were conducted with 17 mothers of preterm infants (under 36 weeks) who had been hospitalized for at least one week in the neonatal intensive care unit. Purposive sampling with maximum diversity was used to recruit mothers in Kermanshah province (west of Iran). Data was collected during 2013-2014. Interviews were recorded and transcribed verbatim. Data were analysed using conventional content analysis. FINDINGS: Explanation of the mothers' perspective towards factors affecting adaptation to the role of motherhood led to two main categories of individual factors (emotional distress, self-efficacy, interaction and alienation) and social factors (support, prejudice). CONCLUSION: Adaptation to the role of motherhood can be promoted through supporting mothers of preterm infants, empowering them and increasing their self-efficacy, to eliminate negative factors and emotions.

Mothers' Perception of Quality of Services from Health Centers after Perinatal Loss.

INTRODUCTION: Perinatal loss is one of the most stressful life events that parents and caregivers experience. Providing an empathetic, caring environment to support mothers who experience perinatal loss is necessary. The aim of this study was to assess mothers' perception of the quality of services received from health centers after perinatal loss. METHODS: This study was conducted in 2014-2015 using qualitative content analysis. Participants in the study were 40 women with a history of miscarriage, stillbirth, or neonatal death who live in Tehran and Shahrekord, Iran. Data were collected from the participants through semi-structured, in-depth interviews, and they were analyzed using qualitative content analysis. RESULTS: One theme and six main categories were developed, and they indicated the mothers' experiences and understandings of the quality of service received after perinatal loss. The major theme was 'dissatisfaction with the quality of care received.' The main categories included: 1) effective communication, 2) expecting responsiveness, 3) expecting to respect the patient's dignity, 4) expecting better care, 5) tension of medical expenses, and 6) insufficient facilities. CONCLUSION: The findings of this study highlighted the weaknesses, inadequacies, strengths, and opportunities in providing health services. They can help reproductive health policy-makers reduce the pain and suffering of the affected families with appropriate measures.

Association of depression and anxiety with diabetes mellitus type 2 concerning some sociological factors.

BACKGROUND: Diabetes is a metabolic disorder with a high worldwide prevalence. It has been reported that diabetic patients are more prone to depression and anxiety. OBJECTIVES: This study aimed to evaluate the prevalence of depression and anxiety among diabetic patients with regards to some factors such as age, gender, level of education and occupational status. MATERIALS AND METHODS: One hundred and eighty four diabetic patients have participated in this study. To assess the severity of depression and anxiety Beck depression inventory and Beck anxiety inventory questionnaire were used respectively. Binary logistic regressions were used to analyze the data. RESULTS: The results of the present study have shown that 70.7% of the diabetic patients were suffered from depression. Besides, 69.6% of them were diagnosed with anxiety. According to the result, diabetes related depression is affected by sex (OR: 2.767), age (OR: 2.222), level of education (OR: 4.145) and job status (OR: 3.901). It has been also resulted that gender (OR: 2.274), age (OR: 2.706) and Job Status (OR: 2.441) are the effective factors leading to anxiety. CONCLUSIONS: Depression and anxiety have higher prevalence among diabetic patients and some sociological factors such as age, gender, job and education are related to these psychological disorders.

The Brief Fear of Negative Evaluation Scale (BFNE): translation and validation study of the Iranian version.

BACKGROUND: The Brief Fear of Negative Evaluation Scale (BFNE) is a commonly used instrument to measure social anxiety. This study aimed to translate and to test the reliability and validity of the BFNE in Iran. METHODS: The English language version of the BFNE was translated into Persian (Iranian language) and was used in this study. The questionnaire was administered to a consecutive sample of 235 students with (n = 33, clinical group) and without social phobia (n = 202, non-clinical group). In addition to the BFNE, two standard instruments were used to measure social phobia severity: the Social Phobia Inventory (SPIN), and the Social Interaction Anxiety Scale (SIAS). All participants completed a brief background information questionnaire, the SPIN, the SIAS and the BFNE scales. Statistical analysis was performed to test the reliability and validity of the BFNE. RESULTS: In all 235 students were studied (111 male and 124 female). The mean age for non-clinical group was 22.2 (SD = 2.1) years and for clinical sample it was 22.4 (SD = 1.8) years. Cronbach's alpha coefficient (to test reliability) was acceptable for both non-clinical and clinical samples (alpha = 0.90 and 0.82 respectively). In addition, 3-week test-retest reliability was performed in non-clinical sample and the intraclass correlation coefficient (ICC) was quite high (ICC = 0.71). Validity as performed using convergent and discriminant validity showed satisfactory results. The questionnaire correlated well with established measures of social phobia such as the SPIN (r = 0.43, p < 0.001) and the SIAS (r = 0.54, p < 0.001). Also the BFNE discriminated well between men and women with and without social phobia in the expected direction. Factor analysis supported a two-factor solution corresponding to positive and reverse-worded items. CONCLUSION: This validation study of the Iranian version of BFNE proved that it is an acceptable, reliable and valid measure of social phobia. However, since the scale showed a two-factor structure and this does not confirm to the theoretical basis for the BFNE, thus we suggest the use of the BFNE-II when it becomes available in Iran. The validation study of the BFNE-II is in progress.