Iranian Journal of Psychiatry

Behavioral Change Approaches to Sleep Disturbance in Cancer Patients: The History and the Road Ahead

2024-10-21T09:45:24+00:00

The Article Abstract is not available.

Comparison of Brain Activity between Patients with Parkinson Disease Dementia and Patients Affected by Dementia with Lewy Body through EEG Analysis

2024-10-21T09:47:21+00:00

Objective: Parkinson's disease dementia (PDD) and Dementia with Lewy bodies (DLB) are two syndromes categorized under synucleinopathy, sharing comparable symptoms. The identification of biomarkers would offer an accurate approach for improved diagnosis, treatment, and monitoring of treatment efficacy for these distinct forms of dementia.

Method: This study utilized spectral analysis and nonlinear dynamic analysis to compare electroencephalogram (EEG) characteristics between PDD and DLB patients. EEG data was collected from 30 PDD patients, 36 DLB patients, and 36 healthy subjects at rest. Following a conditioning phase to minimize noise and eliminate artifacts, we derived spectral and complexity features using Welch's method and sample entropy. Analysis of variance with repeated measures was performed to compare spectral features and nonlinear dynamics of brain activity between the groups.

Results: Post hoc comparison showed that in the control group, the power of delta and theta bands was lower and the power of alpha and beta bands was higher than in patients with PDD and DLB. (P < 0.05). In the theta and alpha bands, the PDD group showed greater power than the DLB group (P < 0.05). Furthermore, there was a significant main effect of diagnosis (F = 4.67, P = 0.007), and also the diagnosis by region interaction for complexity values (F = 4.58, P = 0.009). Post hoc analysis showed that the EEG complexity of the control group was significantly higher than that of the PDD and DLB groups in the frontal, central, temporal and parietal regions (P < 0.05). Moreover, the EEG complexity of the PDD group was significantly higher than that of the DLB group in the central, temporal and parietal regions (P < 0.05).

Conclusion: Although both PDD and DLB had almost similar patterns compared to the control group, they showed differences in the EEG power spectrum and its nonlinear dynamics. Our findings indicated marked diffuse slowing and lower cortical complexity or activity in DLB patients compared to PDD in all regions, especially in the central, temporal and parietal areas.

Exploring Brain Activity in Different Mental Cognitive Workloads

2024-10-21T09:49:05+00:00

Objective: Understanding neural mechanisms underlying cognitive workload is crucial for advancing our knowledge of human cognition and mental processes. In this study, we utilized electroencephalography (EEG) analysis to investigate brain activity associated with varying mental cognitive workloads from a psychological perspective.

Method: We employed a publicly accessible EEG dataset consisting of a cohort of 36 healthy volunteers (75% female), aged 18 to 26 years, while the participants were at rest or engaged in an arithmetic task to explore mental cognitive workload. After preprocessing to reduce noise and various artifacts and to obtain a clean signal for every subject, functional connectivity and complexity features were calculated from EEGs through the coherence and permutation entropy algorithms, respectively. Then, repeated measures analysis of variance (ANOVA) was conducted to assess the differences in complexity and connectivity measures across various brain regions between the rest and task states.

Results: Brain sites showed significant within-subject effects, and the interaction between states and channels was significant for connectivity values (F = 3.68, P = 0.034). Post hoc comparisons indicated that FP1-F7, FP1-F8 and FP1-Fz connectivity were significantly lower during the task state compared to the rest state (P < 0.05). Moreover, F4-P3, F4-P4, FP1-O1, FP2-O2, F3-O1, F4-O1, F8-O1, C4-O1, F3-O2, F4-O2, F7-O2, F8-O2, Fz-O1, Fz-O2, Cz-O1 and Fz-P4 connectivity were significantly higher during the arithmetic task state (P < 0.05). Furthermore, brain sites showed significant within-subject effects and the interaction between states and channels was significant for entropy values (F = 3.50, P = 0.041). Post hoc comparisons indicated that the permutation entropy was significantly higher in the FP1, T3, T4, P4 and Pz channels during the arithmetic task compared to the rest state (P < 0.05).

Conclusion: During arithmetic tasks, the increased connectivity in the frontoparietal and frontooccipital networks and heightened complexity in the prefrontal, temporal and parietal lobes reflect the collaborative engagement of brain areas specialized in numerical processing, attention, working memory, cognitive control, and visual-spatial cognition. These changes in connectivity and complexity facilitate the integration of multiple cognitive processes essential for effective arithmetic problem-solving.

Identifying Key Genes and Approved Medications Associated with Major Depressive Disorder Using Network Analysis and Systems Biology

2024-10-21T09:53:17+00:00

Objective: Major depressive disorder (MDD) stands as one of the serious psychiatric conditions that detrimentally affect patients' quality of life and leads to a significant part of disability worldwide. Due to the limited understanding of the basic molecular mechanisms of depression and antidepressant medications, a clear understanding of the onset and development of MDD is unavailable. This study aims to figure out the pivotal genes and pathways implicated in the MDD development and identify medications that can potentially improve MDD treatment based on their relation with the key genes.

Method: Symbols of human coding genes were retrieved from the HUGO Gene Nomenclature Committee database. These symbols were then queried for MDD-related associations using a Python script in PubMed. Subsequently, genes with two or more related articles to MDD were selected. A union of our search data and MDD-related genes in the DisGeNET database was found. The gene interaction network was generated and analyzed utilizing the STRING and Cytoscape, respectively. Finally, a drug-gene network was constructed and medications that can affect multiple genes were selected.

Results: The union of our search data and DisGeNET data contained 1734 genes. Based on network analysis, TNF, IL1B, IL6, STAT1, and STAT3 were identified as the key genes in the MDD pathogenesis. Eleven drugs that affect more than one gene were detected through a drug-gene network. These medications include Acitretin, Adalimumab, Alteplase, Cisplatin, Digoxin, Etanercept, Infliximab, Insulin, Omeprazole, Pentoxifylline, and Rabeprazole.

Conclusion: In summary, our findings identified five genes as key genes in MDD development, as well as medications related to key genes. This study provides a new vision of the pathogenesis and treatment of MDD. However, further experimental and clinical studies are necessary.

Investigating the Association between Coping Styles and Social Identity in Adolescents of Marginal and Non-Marginal Areas

2024-10-21T09:51:45+00:00

Objective: This study aimed to investigate the relationship between coping styles and social identity among adolescents residing in marginal and non-marginal areas.

Method: A cross-sectional study design with a descriptive-analytic approach was utilized. The study population consisted of adolescents aged 12 to 19 from Kermanshah city, with 222 participants evenly distributed between marginal and non-marginal areas. Adolescents were enrolled in the study using a multi-stage sampling method (stratified cluster, simple randomized method). Data were collected using the Standard Social Identity questionnaire and Lazarus and Folkman's Coping Styles questionnaire. The data were analyzed statistically in the SPSS software environment (version 25) using appropriate statistical tests.

Results: The results of the study showed that there is a significant relationship between the components of social identity and coping styles in adolescents (P < 0.05). Emotion-focused and problem-focused coping styles had the ability to explain social identity in the adolescents of Kermanshah city. Also, in comparing the coping styles and social identity between adolescents from marginalized and non-marginalized areas in the city of Kermanshah, there was no significant difference (P < 0.05).

Conclusion: This study underscores the importance of understanding how coping strategies influence social identity among adolescents across different socio-environmental contexts. The findings highlight the need for further research to explore the mechanisms underlying these relationships and consider the role of contextual factors in shaping adolescent development.

Validity Study of an Emotional Face-Database in Iranian Community

2024-10-21T09:53:30+00:00

Objective: To investigate the accuracy of facial emotion recognition in the Iranian community, a face database validated in this community is required. To do this, we conducted a validation study on the Radboud face database. The primary objective of this study was to evaluate the accuracy of recognizing emotions through faces in an Iranian sample and then to choose the pictures with high agreement in terms of detecting emotions.

Method: This is a cross sectional study recruiting a total number of 142 males and females aged between 20 and 50 years old (Mean ± SD of age 31.7 ± 7.07). The participants were instructed to detect the type of emotion of each face as well as its valence and arousal. The percentage of participants’ agreement on evaluating each picture was assessed. To evaluate the effect of different variables on participants’ accuracy, one way and repeated measure ANOVA analyses were also used.

Results: Emotional faces were recognized by around 84% of the participants. The highest accuracy belongs to happy (Mean ± SD of 98 ± 6.1%) and the lowest one to neutral (75 ± 18.06%) faces. The accuracy for detecting other emotions were as follows: sad (91 ± 8.7%), surprised (87 ± 10.64%), angry (77 ± 15.6%), and fearful (76 ± 15.26%). Additionally, we found no differences between male and female participants in terms of recognizing emotions. Then we selected the pictures with high agreement (above 85 percent) in labeling emotions among the participants.

Conclusion: The current study provided a valid emotional face database based on Iranian participants’ responses in terms of recognizing basic emotions. The selected pictures can be used in designing tasks to evaluate emotion recognition ability in clinical and nonclinical populations. It can also be used in designing applications to improve detecting emotion in clinical samples such as individuals with autism spectrum disorder.

The Psychometric Properties of the Persian Version of Emotional Abuse Questionnaire

2024-10-21T09:54:57+00:00

Objective: Intimate partner emotional abuse is a serious issue that can lead to catastrophic outcomes for victims. Emotional abuse involves psychological tactics to control, manipulate, and degrade a person within an intimate relationship. This research aimed to translate the Emotional Abuse Questionnaire (EAQ) developed by Jacobson and Gottman into Persian for use among Iranian university students.

Method: The translation of the 66-item EAQ involved a meticulous forward and backward translation process, linguistic matching, and a pilot review. In this cross-sectional study, 346 university students from Rasht, Iran, completed the EAQ. The mean age of participants was 26.78 ± 8.10 years, with most being female (89.0%). Reliability was evaluated using Cronbach's alpha and test-retest analysis while content and face validity were assessed by a panel of experts. Construct validity was examined through confirmatory factor analysis (CFA) and internal consistency measures. Divergent validity was assessed by comparing the EAQ with the ENRICH Marital Satisfaction Scale (EMS).

Results: Impact scores for face validity ranged from 2.33 to 3.92, based on respondents' ratings of frequency and importance. Content validity assessment led to removing four items with a CVR below 0.62, resulting in 62 valid items. The EAQ showed strong internal consistency, with a Cronbach’s alpha of 0.97, exceeding the acceptable threshold of 0.70. CFA results confirmed the validity of the second-order factor model of the EAQ (χ²/df = 4.34, CFI = 0.95, RMSEA = 0.098, SRMR = 0.077). The EAQ demonstrated a strong correlation with EMS measures, confirming divergent validity.

Conclusion: The Persian version of the EAQ is a reliable instrument for assessing emotional abuse among Iranian university students. Future research should explore the cultural sensitivity of the questionnaire and investigate associations between emotional abuse and other variables of interest, such as mental health outcomes or relationship dynamics. These avenues promise valuable insights into the frequency and effects of emotional abuse across diverse cultural contexts.

Checking the Validity and Reliability of the Delirium-O-Meter Questionnaire in the Persian Language

2024-10-21T09:56:08+00:00

Objective: Compiling and designing short and practical psychometric tools are among the benefits and strengths of a good standard test. The Delirium-O-Meter questionnaire measures patients' delirium status. Accordingly, the main aim of this research was to check the reliability and validity of the Persian version of this questionnaire.

Method: This exploratory psychometric study was conducted from 2021 to 2022 at the therapeutic research training centers of Tabriz University of Medical Sciences. The study population included patients diagnosed with delirium. Content and construct validity were assessed using exploratory factor analysis and confirmatory factor analysis. Exploratory factor analysis was performed using SPSS 18, which helped identify the underlying factor structure, while confirmatory factor analysis in Smart PLS was employed to confirm the structure's fit. Pearson correlation was used to evaluate the consistency between different raters, and Cronbach's alpha was calculated to assess internal consistency. These methods were selected for their robustness in evaluating the instrument's psychometric properties, ensuring the reliability and validity of the Persian version of the Delirium-O-Meter questionnaire.

Results: The Persian version of the Delirium-O-Meter questionnaire, consisting of 11 items, demonstrated strong psychometric properties. The average impact factor was 3.24, indicating a high relevance of the items. The content validity ratio was 0.78, and the content validity index was 0.87, both above the acceptable thresholds, confirming the content validity of the questionnaire. Cronbach's alpha coefficient for the entire questionnaire was 0.77, reflecting good internal consistency. The Kaiser-Meyer-Olkin index was 0.88, and Bartlett's sphericity test was significant (χ² = 278.45, P < 0.001), indicating the appropriateness of the data for factor analysis. Exploratory factor analysis revealed two factors that explained 76.09% of the total variance, supporting the questionnaire's construct validity. Additionally, Pearson’s correlation coefficient between the assessments of two nurses was 0.91, signifying inter-rater solid reliability.

Conclusion: The Persian version of the Delirium-O-Meter questionnaire demonstrates acceptable reliability and validity, as confirmed by the comprehensive psychometric evaluation conducted in this study. The strong internal consistency, significant content and construct validity, and high inter-rater reliability underscore its effectiveness in assessing delirium in Persian-speaking patients. These findings highlight the questionnaire's suitability for clinical use, providing a reliable and valid instrument for accurately diagnosing and managing delirium in diverse healthcare settings.

Estimating the Heritability of Hoarding Symptoms: Insights from a Classical Twin Study “New Insights on the Nature of Clutter”

2024-10-21T09:57:30+00:00

Objective: Hoarding disorder is a complex condition that significantly impacts individuals' lives, characterized by excessive acquiring, difficulty discarding, clutter, distress, and impairment. This study aimed to examine the extent to which genetics and environment influence difficulty discarding, excessive acquisition, and clutter through the implementation of a classical twin study.

Method: This classical twin study, conducted between April and September 2021, enrolled 194 twins (97 pairs) from Isfahan, recruited through the Isfahan Twins Registry (ITR). A total of 194 twins, consisting of 100 monozygotic (MZ) and 94 dizygotic (DZ) twins, participated in this study. Participants aged 16–50 were invited electronically and completed an online consent form and questionnaire. Hoarding symptoms were assessed using the saving inventory-revised. Zygosity was determined using a self-report method based on Song et al.'s questionnaire. To estimate the heritability of hoarding symptoms, the classical univariate twin model was employed.

Results: Based on the univariate analysis, the heritability estimates for difficulty discarding and excessive acquisition were found to be 0.43 and 0.52, respectively. However, the results did not provide support for the role of genetics in clutter. Instead, it was indicated that the common environment accounted for 0.54 of the variance in clutter, while the specific environment contributed 0.46 to this symptom.

Conclusion: The difficulty discarding and excessive acquisition were found to be moderately heritable. On the other hand, considering the contribution of genetics and environment to clutter, the results raise doubts about the association of clutter with hoarding. The relatively low genetic influence suggests that this trait may overlap with other behaviors rather than hoarding.

Predictors of Attitudes toward Aging in Middle-Aged Individuals: A Cross-Sectional Study

2024-10-21T10:07:15+00:00

Objective: Attitudes toward aging (ATA) are among the most important determinants of well-being in old age. However, little research has examined factors contributing to their formation in middle-aged individuals. This study aimed to investigate predictors of attitudes toward aging among Iranian middle-aged individuals in 2022.

Method: This study recruited 330 people with a mean age of 56.5 ± 5.6 using multistage cluster sampling. Data were collected using a three-part questionnaire, including demographic factors, an attitude toward aging questionnaire (AAQ), and a multidimensional scale of perceived social support (MSPSS). The obtained data were analyzed using SPSS (v.22) statistical software to conduct t-tests, ANOVA, Pearson correlation, and linear regression.

Results: According to bivariate analysis, perceived social support (PSS), age, level of education, and perceived income adequacy (PIA) had a significant relation with the total ATA score (P < 0.05). According to regression analysis, family support (β = 0.288, P < 0.001), friend support (β = 0.188, P < 0.001), significant others support (β = 0.130, P = 0.04), age (β = 0.118, P = 0.002), and PIA (β = 0.290, P < 0.001) were the predictor factors of ATA and explained 41% of the variance. PSS and PIA were the predictors of all dimensions of ATA.

Conclusion: The results highlight the role of potentially modifiable factors, such as PSS, PIA, and level of education, in shaping ATA. This requires interventions and policies that effectively promote social and financial support in middle-aged individuals.

Investigating the Relationship between Schizophrenia and Incidence Risk of Breast Cancer: A Systematic Review and Meta-Analysis of Cohort Studies

2024-10-21T10:01:53+00:00

Objective: Schizophrenia seems to have a complex association with various types of cancer, exerting a protective effect against some cancers while being a risk factor against some others. Therefore, we intended to conduct an updated systematic review and meta-analysis in order to examine the relationship between schizophrenia and the risk of breast cancer incidence.

Method: We did a systematic search of databases, namely Web of Science, Scopus, Embase, PubMed, and PsycINFO up to August 15, 2024. Screening and data extraction were performed independently. Data was analyzed using Stata16 software. We used the random effect model to pool the results, while the heterogeneity between studies was calculated using Cochran's Q test and (I²) index.

Results: We found 15 studies, among which 12 were included in this meta-analysis. The results indicated that the risk of breast cancer development is significantly increased in women with schizophrenia (SIR: 1.43, 95% CI: 1.08-1.85, P < 0.01; IRR: 1.19, 95% CI: 1.13-1.26, P < 0.01). Subgroup analysis revealed significant differences in the incidence of breast cancer rates among women with schizophrenia based on geographic location and duration of follow-up.

Conclusion: The results indicate that schizophrenia increases the risk of developing breast cancer. Therefore, taking preventive measures concerning breast cancer among women with schizophrenia is crucial. Additionally, regular screening programs should be implemented to ensure early diagnosis and treatment in case breast cancer is detected.

A Theory on the Nonlinear Relationship of Sexual Behavior and Aggression

2024-10-21T10:02:00+00:00

Objective: Claims have been made that more sexual liberalism in society than what generally existed in human history is necessary to promote societal tranquility and reduce violence. This research was conducted to investigate the real relationship between sexual behavior and aggression based on scientific data especially from the perspective of physiological psychology.

Method: This study was a narrative review and utilized evidence-based findings from neuropsychology, psychophysiology, laboratory research, and field studies. Databases were explored for related terms until sufficiency was reached. The findings were categorized and analyzed descriptively and interpretively to establish connections between the findings. Ultimately, a comprehensive conceptualization was developed to conclude a theory on the relationship between sexual behavior, sexual satiety, and aggression.

Results: The study indicated that unrestrained sexual behavior leads to an escalation of the behavior, rather than satiation, and aggression rather than calmness. This may be due to positive feedback in the nervous and hormonal systems, specifically mediated by the medial preoptic area (MPA) and testosterone, leading to aggressive behavior. However, since sexual deprivation can potentially lead to aggression, it is advisable to view the relationship between sexual activity and violence as a non-linear one.

Conclusion: This paper establishes that the intensification of sexual behaviors leads to increased violence and aggression in society, ultimately elevating levels of public insecurity. Therefore, limiting sexual behavior within the framework of the relationship of married couples may serve as a moderating factor for this phenomenon.

The Impact of Chronic Exercise on Cognitive Function: An Overview of Reviews

2024-10-21T10:03:28+00:00

Objective: Understanding the associations between cognitive function and chronic exercise has gained significant attention in the last decade. This overview aims to consolidate current knowledge and shed light on potential benefits of long-term exercise on cognitive abilities.

Method: Relevant databases, including Scopus, PubMed, and Web of Science, were searched through predefined keywords related to chronic exercise and cognitive function. We included all relevant systematic-reviews and meta-analysis in our data-synthesizing.

Results: We identified 74 references across PubMed (33), Scopus (35), and Web of Sciences (6). After deduplication, 52 unique references remained. Screening by title and abstract yielded 28 relevant studies. Full-text review based on inclusion criteria resulted in nine eligible articles. Most were meta-analyses, examining 10 to 71 randomized controlled trials on executive functions across various age groups and health statuses. Both acute and chronic exercises demonstrated small to moderate positive effects on cognitive functions, with chronic exercise outcomes influenced by type, duration, frequency, session length, age, and cognitive status.

Conclusion: Extensive research underscores a robust and compelling link between involving in regular, long-term physical exercise and enhancement of cognitive functioning. This connection emphasizes the critical role that consistent physical activity plays in safeguarding mental well-being and maintaining sharp cognitive abilities throughout various life stages. Positive effect of sustained physical exercise on cognitive functioning serves as a compelling reason to integrate exercise as a fundamental component of a holistic approach to mental wellness and cognitive longevity.

Evaluation of Prescription Patterns in Management of Agitation in Patients Referred to the Emergency Department

2024-10-21T10:05:36+00:00

Objective: This research aims to evaluate patterns of prescription of medications used to manage acute agitation in adult Iranian patients at the emergency department (ED) of Roozbeh Psychiatric Hospital in Tehran.

Method: The study analyzed data from the medical records of 252 patients who received pharmacotherapy for agitation.

Results: The findings revealed that 181 patients (71.82%) were given typical antipsychotics, with haloperidol being the most commonly prescribed medication. Atypical antipsychotics were administered to 24 participants (9.52%), primarily olanzapine, and 52 patients (20.63%) received benzodiazepines, predominantly lorazepam. The treatment response was also assessed as appropriate in 224 patients (88.89%) and inappropriate in 28 patients (11.11%).

Conclusion: The study recommends providing new-generation medications to developing countries and underscores the importance of updating student educational programs.