Short report of an Iranian Prenatal Methamphetamine Exposure effect cohort showed DNA methylation alteration of mitochondria function associated genes.

BACKGROUND: Use of Methamphetamine during pregnancy is significant public health concern since it affects the development of the brain and poor behavioral outcomes in children. Prenatal methamphetamine exposure (PME) may cause developmental disabilities and several gene expression and molecular pathways alterations. In the present study, DNA methylation of Propionyl-CoA Carboxylase subunit Beta (PCCB) and Protocadherin Alpha 12 (PCDHA12) genes were assessed in two groups of three-year-old children, those exposed to PME and healthy control children. AIMS: Clarification of PME role in methylation level of two mitochondria function associated genes; PCCB and PCDHA12. METHODS AND PROCEDURES: In this study, 2629 children with PME (1531male, 1098 female) and 3523(2077male, 1446 female) control children were recruited based on maternal self-report of prenatal exposure. Genomic DNA extracted from peripheral blood and pyrosequencing was used to determine the association between prenatal MA exposure and methylation in nine CpG sites of PCCB and PCDHA12 genes. OUTCOMES AND RESULTS: Prenatal methamphetamine exposure was associated with significant DNA hypomethylation of four out of five CpG sites in the PCCB gene and three out of four CpG sites in the PCDHA12 gene. Also, significant hypomethylation in the biding site of p53 transcription factor in PCCB gene was detected in children with PME. CONCLUSIONS AND IMPLICATIONS: Prenatal methamphetamine exposure is related to epigenetic alterations in PCCB and PCDHA12, as important mitochondria function associated genes. Detected hypomethylation in these genes was reported in neurodevelopmental and bioenergetics disabilities. It seems that PME could cause mitochondrial dysfunctions associated with developmental abnormalities. What this paper adds?

Dysregulation of Myt1 expression acts as a potential peripheral biomarker for major depressive disorder and bipolar disorder.

Major depressive disorder (MDD) and bipolar disorder (BPD) are among the most debilitating mental conditions. Diagnostic criteria for MDD include psychological and physical symptoms, such as low mood and changes in appetite or sleep, respectively. BPD in addition to periods of depression represents episodes of mania or hypomania, and elevation in mood and energy levels are associated with this condition. Dysregulation in adult neurogenesis and myelination have been reported in psychiatric disorders. As a key factor in neurogenesis, it was hypothesized that Myt1 gene expression may be altered in these conditions. Using Real-time PCR, Myt1 expression level in 100 MDD patients and 100 BPD patients, compared with healthy control (HC) individuals was evaluated. Results demonstrate significant downregulation of Myt1 in MDD and BPD. Logistic regression analysis and binary classification evaluation reveal potential risk factor and biomarker characteristics of Myt1, respectively. Moreover, forward and backward digit span results denote a significant reduction in the function of working memory (WM) of MDD and BPD subjects. Correlation analysis revealed a significant association between Myt1 downregulation and WM disruption in the affected individuals. In conclusion, due to its altered role in neurogenesis, downregulation of Myt1 can be associated with the pathology of MDD and BPD.

A comparison between the age patterns and rates of suicide in the Islamic Republic of Iran and Australia.

BACKGROUND: When planning interventions aimed at preventing suicide, it is important to consider how socioeconomic and cultural factors may affect suicide rates. There has been variability in the accuracy of recording suicide deaths, leading to varying levels of underestimation. Social, cultural and religious elements affect whether deaths resulting from suicide are reported as such and those responsible for reporting a death may avoid providing information that would suggest the death was due to suicide. AIMS: The aim of this study was to document Iranian suicide patterns in 2006-2010 and 2011-2015, compare them with those in a "Western" country (Australia) and explore whether differences point to factors that affect suicide rates. METHODS: Data were obtained from Iranian and Australian national statistics offices. RESULTS: Peak Iranian male suicide rates were in young adulthood. There was a modest increase between the 2 quinquennials studied. Australian male rates were much higher, with age peaks in middle age and very late life. From age 30, the female rate was twice as high in Australia, graphs of the age patterns being relatively flat in both countries. Male:female ratios were 2.34 (Islamic Republic of Iran) and 3.25 (Australia). CONCLUSION: The suicide rate in the Islamic Republic of Iran is low, as in most other predominantly Muslim countries. Higher rates in youth are of concern. A case-control psychological autopsy study comparing cases in Iran and Australia could help answer questions about suicide causation.

Risk Factors of Suicide Death Based on Psychological Autopsy Method; a Case-Control Study.

INTRODUCTION: Investigation in each community can contribute to understanding the key factors involved in suicide death and its prevention. The present study aimed to investigate suicide death risk factors based on psychological autopsy method. METHODS: The present case-control study was conducted from April to September 2017, in Tehran, Iran, to compare two groups of people; those who died by suicide and controls (over the age of 18 years). Data were collected by one interviewer via Structured Clinical Interviews (SCID-I), questionnaires used in the SUPREMISS study, and the Dickman impulsivity scale. RESULTS: Each group consisted of 40 individuals. There was no significant difference between the case and control groups in terms of all demographic variables except for the level of education (p = 0.06) and occupational status (p = 0.009). The frequency of previous history of suicide attempt (p = 0.001), family history of suicide (p = 0.003), DSM IV Axis I disorders (p = 0.006), and substance and alcohol consumption (p = 0.01) were significantly higher in the case group. The most commonly diagnosed disorders included MDD (45%) and substance use disorders (30%), respectively. The most common methods used in suicide included hanging (32.5%), and Aluminum phosphide poisoning (32.5%) known as rice tablet. The strongest predictor of suicide death was the deceased person's Previous history of suicide attempt (OR= 9.3; p = 0.04), smoking (OR= 6.4; p = 0.006), unemployment (OR= 5; p = 0.02), and DSM IV axis I disorders (OR= 3.8; p = 0.04). CONCLUSION: Previous suicide attempt, smoking, unemployment, and suffering from at least one mental disorder were the significant predictors of suicide death. Among mental disorders, major depressive disorder and substance use disorder were the most prevalent mental health problems.

Feigned symptoms among defendants claiming psychiatric problems: Survey of 45 Malingerers.

OBJECTIVE: In many jurisdictions, psychiatric problems are intended for commutation. Therefore, a forensic psychiatrist has an important role in detection of malingering. While several studies evaluate diagnostic tests, it is less known what symptoms are more likely to be imitated by malingerers. METHOD: In a prospective study 45 malingerers, who were diagnosed according to interviews by two forensic psychiatrists, from defendants with a judicial order for evaluation of mental status and criminal responsibility during a period of eighteen months were examined in legal medicine center of Tehran. Participants were assessed in another interview to determine symptoms. Dichotomous symptoms in felony and misdemeanor groups were analyzed using fisher's exact test. The level of statistical significance was set at P < 0.05. RESULTS: Thirty-eight malingerers were charged with misdemeanors and seven with felonies. Behavioral symptoms were most frequently faked by 35 participants (77.8%). Participants charged with criminal accusation had a significantly lower mean age (P=0.032) and a higher level of education (P=0.008) than other non-criminal defendants. A statistically significant increase in memory function problems was demonstrated in the misdemeanor group (P=0.040). With regard to dual symptom imitation, statistically significant correlations were observed between thought content and perceptual symptoms (P=0.048) for felonies and mood & affect and thought process symptoms (P=0.034), mood & affect and behavioral symptoms (P=0.000) and cognitive function and behavioral symptoms (P=0.039) for misdemeanors. In general, many simulators attempted to mimic simple symptoms of behavioral disorders. Probably felony offenses need less accurate programming; therefore, their rates are higher in older, less educated participants. CONCLUSION: This study demonstrated that differences between presenting symptoms among different offenses may not be useful in detection of malingering,; however, unusual dual symptom imitations may be useful, particularly when standard tests are not performed.

Forensic psychiatry in iran.

In Iran, department of forensic psychiatry is one of the special units of Legal Medicine Organization concerned with individuals who demonstrate psychological and psychiatric problems. The duties of forensic psychiatrists in the department are, performing psychiatric examinations and determining mental competence of two major groups of referrals: Individuals who are involved in a legal problem related to civil law and individuals who are involved in criminal responsibility and/or forbearance of punishment such as offenders and prisoners. One of the worries of the Iran jurisdiction system is the absence of a secure mental hospital devoted to the irresponsible mentally ill criminals. In fact, there is no forensic inpatient unit available in the country.

A survey of self-mutilation from forensic medicine viewpoint.

OBJECTIVES: Currently little research exists examining self-mutilation (SM) in samples of forensic referrals. The present study provides a comprehensive review on the frequency, etiology, and morphologic characteristics of self-inflicted injuries in a sample of outpatients' forensic referrals. METHODS: In a prospective cross-sectional study, during 3 years, we examined 9874 outpatients' forensic referrals and found 1248 SM cases in Ghouchan (an urban and suburban area of Iran). RESULTS: Based on forensic medical examinations, it was found that 12.6% of all outpatients' forensic referrals had engaged in SM behavior at sometime. Males had significantly higher rates of SM than females (76.9 vs. 23.1%, respectively). The mean age was found to be significantly lower in patients with SM (23.6 +/- 8.5) than patients without SM (40.0 +/- 10.5) (P < 0.001). Rate of being single and unemployed was higher in the SM group (58.2, 56.1%, respectively) than in the group without SM (19.1, 22.8%, respectively). Superficial cuts and scratches were found to be the most common type of SM (79.5%), followed by bruises (10.8%), burns (3.4%), deep cuts (3.2%), fractures (0.6%), and other miscellaneous injuries (2.5%). Upper extremities including forearms, wrists, and arms opposite the dominant hand were the most common areas of injury. CONCLUSIONS: Nonsuicidal self-injury, the deliberate-direct destruction of body tissue without suicidal intent is a relatively common event in forensic referrals. It is very important to distinguish between this and other types from forensic point of view. Forensic practitioners must be expert and trained for this purpose.

A survey of sued physicians' self-reported reactions to malpractice litigation in Iran.

OBJECTIVE: To illustrate the psychological effect of grievances and negligence litigation on doctors sued by Legal Medicine Organization Complaints Commissions. METHODS: Retrospective survey regarding the views of a large sample of Iranian sued physicians by using a piloted anonymous questionnaire. RESULTS: The answer rate was 77.5%. Seventy-six per cent of participants encountered monitoring criteria for psychiatric disturbance. Rate of psychological morbidity in between study cluster was much higher than Iranian general population, Iranian non-sued general practitioners, interns and medical students. There was, however, minimal dysfunction of work, public or family life. The survey form to estimate the doctor's realization of lawful risk displayed that doctors yet misconceive medico-legal risk. Doctors being sued or having legal protests against them depict the process as an exceedingly demanding event. CONCLUSIONS: Grievance or legal action is unusual in the daily practice of doctors, but in today's medico-legal domain they face a continuous possible threat. The threat of, or real, legal process can cause psychological, corporeal and behavioral practice changes.

Prevalence of obsessive-compulsive disorder in Iran.

BACKGROUND: Estimates of the annual prevalence for Obsessive Compulsive Disorder (OCD) were consistent across the international sites range, 1.9%-2.5%. The nine population surveys, which used Diagnostic Interview Schedule, estimated a six-month prevalence of OCD ranging from 0.7% to 2.1%. This study performed in order to determine the prevalence of OCD in a population-based study among Iranian adults aged 18 and older and to study the association of them with factors such as sex, marital status, education, type of occupation and residential area. METHODS: A cross-sectional nationwide epidemiological study of the Iranian population aged 18 and older was designed to estimate the prevalence of psychiatric disorders and their association with the above mentioned factors. 25180 individuals were selected and interviewed through a randomized systematic and cluster sampling method from all Iranian households. Schedule for Affective Disorders and Schizophrenia (SADS) and Diagnostic and Statistical Manual of Mental Disorders-IV (DSM-IV) criteria were used in diagnosis of OCD. 250 clinical psychologists interviewed the selected subjects face to face at their homes. RESULTS: The prevalence of OCD in Iran is 1.8% (0.7% and 2.8% in males and females; respectively). 50.3% of the survey sample were men, 49.9% women, 29.1% single, 67.45% married, 0.4% separated or divorced, 2.5% widow/widower and 4% undetermined. All of the above-mentioned factors were examined in the univariate and multivariate logistic regression models. Although the data did not fit the models well, but in univariate models, sex, the category "single" of marital status, age, the categories "business" and "housewife" and residential areas showed significant effect adjusting for the factors, but the models didn't fit the data properly. CONCLUSION: The study suggests that the prevalence of OCD is not rare in the community of Iran and is within the range of other countries. Similar to prior studies in other communities, OCD is more common in females than males.