Investigating the Relationship between Early Maladaptive Schemas and Sexual Self-Confidence and Sexual Self-Efficacy in Individuals with Gender Dysphoria.

Background: Due to the negative effects of sexual identity disorder and the lack of attention from family and society, this study aimed to investigate the relationship between Young's Early Maladaptive Schemas (YEMS) and sexual self-confidence and sexual self-efficacy in individuals with gender dysphoria (GD) after surgery. Materials and Methods: This cross-sectional study was performed on 45 individuals with GD undergoing sex reassignment surgery (SRS). Three of YEMS questionnaire (YEMSQ), sexual self-confidence, and sexual self-efficacy were completed. Results: The YEMSQ score had a significant inverse relationship with sexual self-efficacy (correlation = -0.333, P-value = 0.025). In addition, dimensions of emotional deprivation, failure to achieve, dependence/incompetence, vulnerability to harm and Illness, insufficient self-control/self-discipline, and subjugation had an adverse effect on the self-confidence and sexual self-efficacy in these individuals (P-value <0.05). Conclusion: According to the results of this study, YEMSQ score, sexual self-confidence, and self-efficacy were not significantly different between the two groups of male-to-female (MF) and female-to-male (FM). Also, the formation or development of these schemas in childhood in these individuals can be influential in reducing their sexual self-efficacy.

Investigation of Efficacy of Short-Acting Methylphenidate (Ritalin) and Long-Acting (Matoride) on Symptoms of Attention Deficit Hyperactivity Disorder in Children Aged 6-18 Years: A Single-Blind, Randomized Clinical Trial.

BACKGROUND: This study aimed to evaluate the efficacy and safety of long-acting versus short-acting methylphenidate on the symptoms of attention deficit hyperactivity disorder (ADHD) in children and adolescents aged 6-18 years. MATERIALS AND METHODS: This single-blind, randomized clinical trial was conducted on 150 children and adolescents aged 6-18 years with ADHD based on the Diagnostic and Statistical Manual of Mental Disorder-5 criteria. The patients were randomly assigned to two groups (Matoride or Ritalin). In the first group, Ritalin was prescribed 2/3 times a day, and in the second group, Matoride was prescribed once a day for 3 weeks. The Conner's questionnaire was completed by the parents of the participants for evaluation of the performance and symptoms of ADHD in both groups at the beginning and 3 weeks after treatment. In addition, the incidence of any drug complications at the end of 3-week treatment period was evaluated. RESULTS: There were no statistically significant differences between the two groups before the intervention (P > 0.05) in the dimensions of attention deficit, emotional reaction, behavioral disorder, learning disorder, and impulsivity. At the postinterventional periods, behavioral disorder of the Ritalin group was statistically significantly lower than that of the Matoride group (P = 0.001). This treatment did not have a statistically significant effect on the total score of Conners (P = 0.255). Complications were seen in 58 cases (77.3%) of Matoride group and 49 ones (67.1%) of the Ritalin group. Weight loss in the Ritalin group was higher than that of the Matoride group (P = 0.019). Compared to the Ritalin group, anxiety was higher in the Matoride group (P = 0.022). CONCLUSION: Given the similar effect of Matoride and Ritalin and no significant difference in drug complications, it seems that Matoride (slow release) can be used as an alternative to Ritalin (short acting).

Effect of Vitamin D and Magnesium Supplementation on Behavior Problems in Children with Attention-Deficit Hyperactivity Disorder.

BACKGROUND: Attention-deficit hyperactivity disorder (ADHD) is a neurodevelopmental disorder characterized by the three main symptom domains including inattention, hyperactivity, and impulsivity. Recent findings suggested that nutrients might play an important role in the pathology of ADHD. The present study aimed to examine the effects of Vitamin D and magnesium supplementation on behavior problems in children with ADHD. METHODS: This double-blind, randomized controlled clinical trial study was conducted on 66 children with ADHD in Clinic of Noor and Ali Asghar Hospital in Isfahan, Iran, in 2016. Children were randomly allocated to receive both Vitamin D (50,000 IU/week) and magnesium (6 mg/kg/day) supplements (n = 33) or placebos (n = 33) for 8 weeks. Conners' Parent Rating Scale was used to evaluate children's behavior at baseline and at the end of the study. RESULTS: After 8 weeks of Vitamin D consumption as well as magnesium, the serum levels of 25-hydroxy-Vitamin D3 and magnesium increased significantly in the intervention group compared with placebo group. Supplementation with Vitamin D and magnesium caused a significant decrease in conduct problems, social problems, and anxiety/shy scores; but it had no significant effect on psychosomatic problems score. CONCLUSIONS: Vitamin D and magnesium supplementation in children with ADHD was effective on conduct problems, social problems, and anxiety/shy scores compared with placebo intake, but it did not affect psychosomatic problem scores, significantly.

Efficacy of Memantine as Adjunct Therapy for Autism Spectrum Disorder in Children Aged <14 Years.

BACKGROUND: Autism spectrum disorder (ASD) is a neurodevelopmental disorder with a recent increase in prevalence. A timely appropriate treatment for the disorder may play a crucial role in improvements in behaviors, interactions, and communications in an individual's life. It appears that evaluation of therapeutic approaches to the patients is essential and of importance. Thus, the aim of this study was to evaluate the efficacy of memantine as adjunct therapy in children with ASD. MATERIALS AND METHODS: This randomized single-blind clinical trial included 60 children with ASD aged <14. The children undergoing applied behavior analysis (ABA) were divided into two groups of placebo and memantine (5 mg/day: a half of tablet in the morning and a half in the evening). After a 3-month course, improvements in symptoms of ASD were evaluated in both groups based on Gilliam autism rating scale. The collected data were analyzed with SPSS (version 20) using independent samples t-test, paired samples t-test, Chi-squared test and Fisher's exact test. RESULTS: Both groups were similar in baseline characteristics including age, gender, and ASD symptoms (P > 0.05) but post intervention, total scores of ASD symptoms in both groups of memantine (mean score1 =95.20 ± 14.49; mean score2=73.50 ± 9.81) and control group (mean scorebefore = 91.50 ± 14.35; mean scoreafter = 89.63 ± 13.95) showed a decrease which was only significant in intervention group (P < 0.001). CONCLUSION: Accordingly, memantine administration as adjunct therapy can be more effective in improvement of ASD symptoms in children than ABA alone. Thus, it can be considered as a new selective adjunct therapy.

Evaluation of the Effect of Memantine Supplementation in the Treatment of Acute Phase of Mania in Bipolar Disorder of Elderly Patients: A Double-blind Randomized Controlled Trial.

BACKGROUND: This study aimed to evaluate the efficacy of memantine in the acute treatment of geriatric with bipolar disorder (BD) hospitalized for mania. MATERIALS AND METHODS: This study conducted on 70 patients older than 60 years with BD in the acute phase of mania. Oral sodium valproate was prescribed in both groups. The intervention group received memantine tablet and the placebo group received a placebo tablet based on a same procedure. Severity of mania, cognitive changes, and quality of life (QoL) were assessed and recorded 4 and 8 weeks after the beginning of the study. The collected data were analyzed with SPSS (version 20) using independent samples t-test, analysis of variance in repeated observations, Chi-squared test, and Fisher's exact test. RESULTS: Mania severity score had no significant difference at the beginning of the study, but 4 and 8 weeks after the intervention, it was reduced significantly in both groups (P < 0.001) that was higher in memantine group (P = 0.038). The mean increase in score of cognitive variations was 6.74 in the memantine group and 3.62 in the placebo group with a nonsignificant difference (P = 0.125). The scores of each dimension of QoL in the two groups showed that in all four dimensions, the patient's physical, psychological, social, and environmental status increased significantly by time (P < 0.001). CONCLUSIONS: According to the results of this study, memantine as an adjuvant to administration of sodium valproate may have a significant effect on decreasing the intensity of mania in the long run.

Environmental factors influencing the risk of autism.

Autism is a developmental disability with age of onset in childhood (under 3 years old), which is characterized by definite impairments in social interactions, abnormalities in speech, and stereotyped pattern of behaviors. Due to the progress of autism in recent decades, a wide range of studies have been done to identify the etiological factors of autism. It has been found that genetic and environmental factors are both involved in autism pathogenesis. Hence, in this review article, a set of environmental factors involved in the occurrence of autism has been collected, and finally, some practical recommendations for reduction of the risk of this devastating disease in children are represented.

RORA and Autism in The Isfahan Population: Is There An Epigenetic Relationship.

OBJECTIVE: Autism is a neurodevelopmental disorder characterized by difficulty in verbal and non-verbal communication, impaired social interaction, and restricted and repetitive behavior. It has been recently introduced as a multigenic disorder with significant epigenetic effects on its pathology. Recently, epigenetic silencing of retinoic acid receptor- related orphan receptor alpha (RORα) gene (which has an essential role in neural tissue development) was shown to have occurred in autistic children due to methylation of its promoter region. This may thus explain a significant part of the molecular pathogenesis of autism. Therefore, we aimed to confirm this finding by implementing a case-control (experimental) study in the population of Isfahan. MATERIALS AND METHODS: The methylation status of a 136 bp sequence of a GpG island (encompassing 13 CpG sites) in the RORA promoter region (positions -200 to -64) as an experimental study was examined in the lymphocyte cells of 30 autistic children after sodium bisulfite treatment using the melting curve analysis-methylation (MCA-Meth) assay compared with normal children. Also, quantitative reverse transcriptase-polymerase chain reaction (qRT-PCR) analysis was used to estimate the level of mRNA transcripts and to evaluate MCA-Meth analysis results. RESULTS: This study revealed no methylation in the examined promoter regions in both autistic and normal children, with the melting curve of all studied samples being comparable to that of the non-methylated control. The results of MCA-Meth analysis were also consistent with qRT-PCR results. We therefore observed no significant difference in the levels of RORα transcripts in the blood lymphocytes between autistic and healthy children. CONCLUSION: The methylation of the RORA promoter region may not be considered as a common epigenetic risk factor for autism in all populations. Hence, the molecular pathogenesis of autism remains unclear in the population investigated.

Study of the effect of Memantine therapy on the treatment of dyslexia in children.

BACKGROUND: Reading disorder (RD) is one of the important complaints in children with learning disorders (LD) that is prevalent in 4% of children in the United States. Treating this disorder includes education of reading practices and treating psychological disorders, and there are no exact medications prescribed in these children. Memantine has been effective in treating memory problems in Alzheimer Dementia, obsessive-compulsive disorder, autism disorder, and other psychological diseases. The aim of this study is to evaluate the effect of memantine in improving RD in children. MATERIALS AND METHODS: In this randomized clinical trial, 62 children, with RD in Pediatric Psychiatry Clinics of Noor and Ali-Asghar Hospital in Isfahan from 2015 to 2016, were participated. They were randomly assigned to two groups of equal number, one receiving education plus memantine and the other education plus placebo. RD was evaluated at the beginning, 1 and 3 months after intervention by Iranian standard reading and dyslexia test (Nama). RESULTS: Mean (standard deviation) age of participants was 7.55 (0.60) years. Most of the participants were boy (55%), most having parents in 36-45-year-old age group (52% and 48% for fathers and mothers, respectively), and also most parents in diploma and bachelor educational group (61% and 60% for fathers and mothers, respectively). There were statistical significant difference in trend of total score (P = 0.034), word chain (P < 0.001), rhyming (P < 0.001), text comprehension (P < 0.001), and letter fluency (P = 0.002), subscale between two groups. However, the difference of time trend between two groups was not significant in word reading (P = 0.14), word comprehension (P = 0.06), phoneme deletion (P = 0.12), reading nonwords (P = 0.32), and category fluency (P = 0.06). CONCLUSION: Adding memantine to educational practices is effective in improving RD in school-age children with LD.

Efficacy of parenting education compared to the standard method in improvement of reading and writing disabilities in children.

OBJECTIVE: The present study aimed to evaluate the effect of parenting education on improvement of reading and writing disabilities in children. METHODS: A randomized controlled trial was done on primary school students with reading and writing disabilities and their mothers. The subjects were divided into three groups with 26 members in each group. The first group (mothers' education group) received 6 one-hour new educational sessions. The second group (standard group) received 12-15 standard educational sessions for learning disability, and the third group (control group) which consisted of students with learning disability did not receive any treatments. Research instruments included reading and writing tests, and demographic questionnaire. The three groups were evaluated via pretest and posttests at baseline and after one and three months of educational interventions. Data were analyzed using the chi-square, t-test, and repeated measures multivariate analysis of variance (MANOVA). RESULTS: The mean reading speed had the most progression in the mothers' education group. Comparison among reading speed, reading accuracy, and spelling scores has been statistically significant (F 2, 6 = 90.64;p < 0.001) but the mean of these scores has been insignificant among the three groups (F 2, 67 = 0.583;p > 0.05). The mean reading accuracy, mostly increased after 3-month interventions in the mothers group. The control group had the lowest mean reading accuracy scores. CONCLUSION: Parenting education in mothers had a positive effect on the treatment of children with reading and writing disabilities. DECLARATION OF INTEREST: None. Clinical Trial Registration-URL: http://www.irct.ir. Unique identifier: IRCT201101205653N1.

High level increase in liver enzymes and severe thrombocytopenia in a male case of anorexia nervosa(*).

BACKGROUND: Anorexia nervosa (AN) is a difficult-to-treat psychosomatic disease. Very few cases of acute liver failure associated with AN have been described. We describe one patient who was affected by AN and presented high level increase of serum liver enzymes, along with sever thrombocytopenia. Then, we discuss the possible etiopathogenic factors. METHODS: A 14-year-old boy with AN was admitted in the pediatric psychiatric emergency department of Alzahra Hospital with impaired electrolyte levels, bradycardia, hypotension, liver dysfunction, and thrombocytopenia. RESULTS: A ten-time increase in liver enzymes and thrombocytopenia were observed on admission. After two months of treatment, the levels were within the normal range. CONCLUSIONS: Improvement of initial clinical symptoms and recovery of liver enzymes and thrombocytopenia after the treatment suggested that liver dysfunction and thrombocytopenia may be observed in AN patients and should be taken care of by physicians.

A comparative study of the effectiveness of nonattendance and workshop education of primary school teachers on their knowledge, attitude and function towards ADHD students in Isfahan in 2010.

BACKGROUND: Attention deficit hyperactivity disorder (ADHD) is the most common childhood behavioral disorder causing hyperactivity, attention deficit and education decline among students. The teachers may not have enough knowledge about this disorder and are in a real need in this field. Teachers' education is one of the ways to get knowledge about this disorder. Nowadays, finding a way like a short term nonattendance education method is highly in demand. Therefore, the aim of the study was to compare effectiveness of nonattendance and workshop education of primary school teachers on their knowledge, attitude, and function towards ADHD students. METHODS: Sixty seven primary school teachers from the First Districts of Education Department of Isfahan were randomly selected and put into two groups of workshop education (33 participants) and nonattendance education (34 participants). At first, both groups filled demographic date questionnaires and then, were given a pretest. Post tests were given after a two day education in workshop group and after ten days in nonattendance group who had studied the related booklet. Finally, the mean post test scores of knowledge, attitude and knowledge of function were compared between the two groups using ANCOVA analysis. RESULTS: After intervention, the mean scores of knowledge between the two groups was not significantly different whereas the mean scores of attitude and the mean scores of knowledge of function showed a significant difference between the two groups. CONCLUSIONS: Nonattendance education was as effective as workshop education in promotion of teachers' knowledge, but workshop education was more effective in attitude change and promotion of teachers' knowledge of function about dealing with ADHD students.