Current Psychiatry Research and Reviews - Volume 18, Issue 2, 2022

Schizophrenia is one of the most common and devastating mental disorders. While control of positive clinical symptoms can be achieved relatively robustly, other clinical signs such as negative symptoms or cognitive problems can be more difficult to treat. This narrative review was undertaken to give an overview of how these and other factors impact a patient’s quality of life. Ample evidence shows that clinical symptoms of any kind have a negative impact on quality of life. Numerous factors, however, play an important role in the overall well-being of the patients in such a way that a mere focus on clinical symptom control is not enough to improve quality of life. These factors include psychological traits of the patient, socioeconomic factors such as education and employment status, gender ethnicity, medication side effects, stigma, and psychiatric comorbidities. Maximizing quality of life as the main treatment focus should, therefore, include a comprehensive approach that keeps all these factors and their complicated interplay in mind in order to deliver the best possible treatment.

Background: In recent years, there has been an emerging interest in the overlap between schizophrenia and autism. The co-occurrence between these two disorders may be seen not only at a diagnostic level but also as the presence of autistic traits in schizophrenia. There has been a rapid rise in the number of studies focusing on autistic traits in schizophrenia and their clinical associations. Objective: Here, we provide a review that summarizes the current findings and highlights gaps that may be addressed by future research. Results: Higher levels of autistic traits have been associated with earlier age of onset, longer duration of illness, resistance to treatment, and more severe cognitive deficit. However, regarding social cognition and psychosocial functioning, the findings are mixed. Conclusion: Patients with prominent autistic traits seem to be more affected. The effect of autistic traits on social cognition and psychosocial functioning remains unclear, as does their relationship with negative symptoms. Therefore, longitudinal studies are highly needed.

Background: Acceptance and Commitment Therapy (ACT) is one of the third wave therapies that came as a response to certain limitations of cognitive-behavioral therapies and other existent psychotherapeutic models, which emphasizes changing the context of cognition rather than the content. ACT has a fast-growing evidence base, and its literature among the adolescent population is in its infancy. Objective: The authors attempted to consolidate findings of ACT’s effectiveness for clinical problems among the adolescent population. Methods: Electronic databases of PubMed, PsycArticles, PsycINFO, Sage, and ProQuest were searched for published studies and unpublished doctoral dissertations until April 2021. After adopting a two-staged screening process, 19 studies were selected, which included randomized controlled trials, case reports, and other quasi-experimental studies reporting results from ACT or ACT-based intervention given to a population of adolescents for any clinical conditions or concern. The authors present a narrative systematic review of these 19 studies, including a methodological assessment. Results: Results showed ACT to be effective in reducing objectively measured clinical symptoms and interference caused by them. Subjective accounts by adolescents and caregivers also corroborated that. More rigorous RCTs and comparisons with other active treatments are needed to improve the evidence base as such studies were few and had some methodological flaws. The authors also discuss certain limitations in assessing the effectiveness of ACT in such studies. Conclusion: The ACT model could serve as a promising alternative approach to be used with adolescents across many concerns, with an emphasis on improving the quality of life and their engagement with valued goals.

Background: There is a shortage of clinical studies examining the efficacy of Nicotinamide Adenine Dinucleotide and Enkephalinase infusions (IV1114589NAD) in treating Substance Use Disorder (SUD). Objective: This study aims to provide evidence that IV1114589NAD infusions significantly attenuate substance craving behavior. Methods: The study cohort consisted of addicted poly-drug, mixed gender, multi-ethnic individuals resistant to standard treatment. The investigation utilized Likert-Scales to assess behavioral outcomes. Results: Using Wilcoxon signed-rank tests and sign tests, our team detected significant results by comparing baseline to post outcome scores after IV1114589NAD injections: craving scores (P=1.063E-9); anxiety (P=5.487E-7); and depression (P=1.763E-4). A significant reduction in cravings, anxiety, and depression followed a dose-dependent linear trend. Linear trend analyses showed a significant relationship between NAD infusions and decreasing scores for cravings (P=0.015), anxiety (P=0.003), and depression (P=8.74E- 5). A urine analysis was conducted on a subset of 40 patients midway through the study to assess relapse; 100% of the urine samples analyzed failed to detect illicit substance use. Discussion: The opioid crisis in America has claimed close to 800,000 lives since 2004; daily deaths are estimated to stand at 127, and in 2021, over 107,000 deaths were due to overdose. There is an urgency to find safe, side-effect-free solutions. Current interventions, such as Naltrexone implants, are invasive and may interfere with dopamine homeostasis leading to an anti-reward phenomenon. Larger randomized double-blinded placebo-controlled studies are needed to elucidate further the significance of the results presented in this study. The current pilot study provides useful preliminary data regarding the effectiveness of IV1114589NAD infusions in SUD treatment. Conclusion: This pilot study provides significant evidence that NAD infusions are beneficial in the treatment of SUD. This investigation serves as a rationale to extend these findings onto future research investigating the use of NAD/NADH as a stand-alone treatment, especially in patients showing high genetic risk as measured in the Genetic Addiction Risk Severity (GARS) test. Utilizing GARS will help provide a real personalized therapeutic approach to treat Reward Deficiency Syndrome (RDS).

Background: There are few epidemiological data regarding the autism spectrum disorders (ASD) screening program in Iran, and as yet, screening for children at the age of 18 months has not been performed. Aim: The present study aimed to perform a screening program for children with ASD in Iran. Methods: This cross-sectional study was conducted for screening children with ASD. The age and stages Questionnaire-18 (ASQ-18) month questionnaire was sent to all parents of children via a mobile-based application.The Modified Checklist for Autism in Toddlers (MCHAT) questionnaire was mailed if the child's score was below the cutoff. For those with positive M-CHATs, the M-CHAT/F Follow-up interview was performed. Finally, children with ASD, according to The Autism Diagnostic Interview-Revised (ADI-R) and examination, were diagnosed. Results: Of these children, 1221 (48%) were girls and 1341 (52%) were boys. Of the parent respondents, 232 (9%) children had a positive ASQ-18 questionnaire. For this purpose, the MCHAT was sent to the parents of these children. Of the 232 children with ASQ positive, 179 (77.1%) parents completed M-CHAT. On the M-CHAT, 43 (24.0%) children screened positive and 136 (76.0%) children passed on M-CHAT-R screening. In this stage of the 43 screenpositive children, health care providers asked parents to refer to their children for performing the M-CHAT at follow up. For a total of 33 children, the M-CHAT follow-up was performed. Of these samples, 7 children had positive M-CHAT follow-up. Therefore, ADI-R was conducted for these children to diagnose ASD. In the end, based on ADI-R and diagnostic evaluation performed by the child and adolescent psychologists, 7 children had ASD. Conclusion: The findings of the present study show that a mobile-based application can be utilized for screening children at risk of ASD. Therefore, we suggest that the application be used for screening children with ASD.

Background: Considering the previous evidence regarding SARS/MERS outbreaks, ıt is expected that emergent psychiatric conditions such as mood disorders, anxiety, and depression disorders may occur in survivors of COVID-19. Objectives: In this study, the effects of clinical/neurological symptoms and sociodemographic characteristics of COVID-19 patients during the infection period on the level of anxiety/depression after recovery were investigated. Methods: Firstly, the socio-demographic characteristics of the participants and their clinical/ neurological symptoms during the infection period were determined. In addition, the Beck anxiety/depression scale was administered to the participants upon discharge. Then, the odds ratio of the variables was calculated by applying the Poisson regression method to determine the predictors affecting the level of anxiety/depression. Results: In this study, the clinical/neurological symptoms and the sociodemographic characteristics affecting the level of anxiety/depression were found to be associated with adults (mean age 45-years). The number of days of hospitalization was the only clinical feature that increased both anxiety and depression levels. In addition, post-discharge sleep disorder, headache, and alcohol use were found to be predictors of increased anxiety levels. In addition, smoking, the presence of a person with COVID-19 infection in the immediate vicinity, traveling in the last month before the illness, fever, and loss of smell during the infection period was found to increase the level of depression. Moreover, asthma was the only significant comorbidity that increased the anxiety level, while diabetes was the only comorbidity that increased the depression level. Conclusion: It is expected that this study will support social-psychological intervention and have some effects on reducing depressive/anxiety symptoms, which can vary widely in adults during stressful events.

Background: Differences in personality may have an impact on academic performance, however, academic assessments aim to measure knowledge, skills, and behavior domains rather than personality. Objectives: To investigate the relation between personality traits and academic performance of medical students and evaluate if correlations between personality traits and examination scores are affected by gender or stage of study (pre-clinical versus clinical). Methods: This cross-sectional study used an online questionnaire to identify Big Five Model personality traits of medical students at the Hashemite University, Jordan. A stratified sampling technique, according to the stage of study and gender, resulted in a sample of 307 medical students who completed the questionnaire. Grade Point Average (GPA) scores, as a measure of academic performance, were retrieved from the University database for each participant and data was analysed using SPSS 16.0. The correlation between personality traits and GPA score was investigated using Pearson coefficient. Two-way ANOVA testing investigated the effect of gender and stage of study and the interaction of these factors with personality traits on GPA. Results: Only conscientiousness had a significant positive correlation with GPA (r = .231, p < .001). Two-way ANOVA showed only conscientiousness had a statistically significant effect on GPA (F (1, n=307) = 10.353, p = .001). Investigating the interaction between gender, stage of study and personality traits on GPA, showed only a statistically significant interaction effect between stage of study and openness on GPA (F (1, n=307) = 10.297, p =.001). Conclusion: Overall, personality traits did not unduly influence the assessment procedures, except a positive correlation of conscientiousness with academic performance and interaction between openness and stage of study with academic performance. These findings, from a developing country, advance our understanding of correlations between personality traits and academic performance and may inform the development of equitable assessments in similar contexts worldwide.

Background: Internet addiction, which is a result of increasing inevitable use of the Internet and smartphones, causes discomfort and serious social and occupational problems that can consequently lead to some mental disorders, such as depression. On the other hand, depression and Internet addiction are factors affecting students' academic performance. Objective: This study aimed to investigate Internet addiction, depression and their relation with academic failure in students of Semnan Allied Medical Sciences. Methods: In this cross-sectional study, all students who were in the 3rd and higher semesters were examined. Three questionnaires (demographic, Beck Depression Inventory, and the Internet Addiction Test by Young) were used. The academic failure was assessed using the student's grade point average in the previous 3 semesters. Collected data were analyzed through descriptive and inferential statistics methods at the significance level of 0.05. Results: 170 students participated in this study. The correlation between depression and grade point average changes was found to be negative (r=-0.19) and significant (p=0.01). Moreover, a positive (r=0.39) and significant (p=0.01) correlation was observed between depression and internet addiction scores. Binary logistic regression analysis also indicated that students' depression score (P=0.04, OR1.04, CI 95%=1-1.08) and sex (P=0.008, OR=0.37, CI 95% = 0.17-0.77) can predict academic failure. Conclusion: Due to the observation of internet addiction and depression in the students and effects of these disorders on their academic performance, it is necessary to educate students and families, identify risk factors and provide solutions to deal with them.