Current Psychiatry Research and Reviews - Current Issue

In psychiatry, anxiety disorders are the most prevalent conditions and a major contributor to disability, along with immunosuppression, endocrine conditions like diabetes mellitus and male impotence, cognitive impairments, cardiovascular disease, hypertension, peptic ulcer, migraine, and Alzheimer's disease. Anxiety and depression continue to be the leading causes of death.

This study presents data on the use of complementary and alternative therapies to treat anxiety.

SciFinder, Web of Science, Google Scholar, and PubMed were used to gather literature.

It has been observed that complementary and alternative therapies are used more than conventional therapies by people with self-defined anxiety attacks and severe depression. Most patients visiting conventional mental health providers for these problems also use complementary and alternative therapies. The evidence for the most effective integrative health methods for treating anxiety disorder is presented in this review, with a focus on the use of herbal medicine. Anxiety can be treated using a variety of psychotherapies as well as antidepressant medication, but the risks of overconsumption, as well as interactions with prescription medications and other drugs, are also factors to consider the herbal therapy.

This review highlights the management and treatment of anxiety. However, further larger-scale studies on alternative treatments are required.

Mental illness remains a global public health concern, affecting millions of individuals worldwide. However, barriers such as limited access to mental healthcare, stigma, and resource constraints hinder effective interventions and treatment. The fourth industrial age, marked by the integration of artificial intelligence technologies, offers innovative solutions to revolutionize mental health counseling and support.

This review explores the challenges faced in traditional mental healthcare and proposes the integration of AI-generated health counseling as a transformative approach. AI-powered chatbots and virtual assistants present accessible, cost-effective alternatives that overcome geographical barriers and combat stigma. These chatbots employ natural language processing and machine learning to engage users in personalized and interactive conversations. Chatbots also offer continuous support, psychoeducation, and coping strategies. Virtual Reality Therapy leverages AI to create realistic simulations for exposure therapy, proving effective in treating anxiety disorders and PTSD. AI-driven voice assistants and virtual coaches enhance mental health counseling by delivering behavioral therapy and improving symptoms of depression and anxiety.

They enhance accessibility, provide 24/7 support, and reduce stigma, offering personalized support tailored to individual needs. Integrating AI-generated health counseling in mental healthcare can bridge treatment gaps, improve accessibility, and strengthen the patient-provider relationship.

AI serves as a valuable supplement, working collaboratively with human therapists to provide comprehensive care. Embracing AI technologies responsibly holds promise for the future of mental health counseling and offers transformative possibilities to address the global burden of mental illness.

Bipolar disorder is a complex mental disorder with a multifactorial pathology. Meta-analyses have shown that bipolar disorder is associated with imbalanced oxidative status, which can contribute to disease progression. Therefore, restoring the oxidative imbalance could be beneficial in the treatment of bipolar disorder. The first-line pharmacotherapy for bipolar disorder is lithium, anticonvulsants (particularly sodium valproate), and atypical antipsychotics. In the present review, we sought to describe the effects of these first-line medications on oxidative stress in bipolar patients.

We systematically searched databases through January 2022, including the Web of Science, PubMed, Scopus, and Embase, with no language or time restrictions. Eligible articles that assessed oxidative markers in bipolar patients following standard pharmacotherapy were included.

According to Newcastle Ottawa and NIH scales, the overall quality of the included articles was low, and their heterogeneity prevented us from performing a meta-analysis.

We found that standard medications, especially lithium, can potentially alleviate oxidative imbalance based on a reduction in oxidative markers, such as TBARs and MDA, although randomized clinical trials are needed to unequivocally confirm these results.

This systematic review evaluated the prevalence of delayed post-traumatic stress disorder (PTSD) following road traffic crashes (RTC).

The sample was RTC survivors, and PTSD was assessed by clinician-administered measures for at least six months (in line with DSM-V standards).

The search resulted in 10089 unique records. Fourty-three studies were eligible to be included in the systematic review. Of these, 29 papers were related to the clinician-administered measures, and the rest were on self-reported cases. The total prevalence of PTSD was 13.5%. Delayed PTSD is common in RTC survivors either 60 months after the accident. Hospitalized patients were more prone to developing disorders.

The surveyed countries' demographics demonstrate the differences between them, necessitating a greater focus on survivors in those countries and financial assistance for their populations' therapeutic and social needs.

In 2021, more than 23 million people were in need of humanitarian assistance in Ethiopia, including four million internally displaced persons and returnees. Displaced populations face an elevated risk of mental health and psychosocial problems, yet they often have limited access to mental health and psychosocial support.

This study aimed to assess: 1) the mental health and psychosocial needs and resources among displaced persons in Ethiopia; and 2) examine barriers, and facilitators, and identify strategies to improve access to culturally appropriate mental health and psychosocial support in this population and context.

We conducted a sequential mixed-methods assessment of mental health and psychosocial needs and resources. First, we conducted 16 key informant interviews with those who had experience and knowledge regarding the mental health situation of displaced persons in Ethiopia, including mental health providers and humanitarian practitioners. Second, we conducted an assessment of available mental health services in 15 internally displaced persons (IDP) sites in Ethiopia along with 28 key informant interviews in this context to explore some of the challenges and strategies to improving access to mental health and psychosocial support.

Access to mental health services was limited in IDP sites. Participants identified numerous barriers to accessing services that ranged from limited supply and fragmentation of existing mental health services to an incongruence between formal mental health services and explanatory models of mental illness. Strategies to address these barriers included engagement of community members and key stakeholders (e.g., traditional and religious healers), improving mental health literacy, strengthening referral systems and mental health capacity, and improving coordination and integration of mental health within the national health system.

This study highlights several challenges and opportunities for improving access to mental health and psychosocial support among displaced persons in Ethiopia. Efforts to bridge gaps in access to mental health and psychosocial support must consider both systems-level factors that influence availability as well as community factors influencing perceptions and acceptability of services within this context.

The goal of the current study was to examine how specific recent stressors are related to electronic nicotine product use among young adults. Despite increases in electronic nicotine product use among adults, stressors shaping the use of these products remain largely unknown. The current study examined the types and average severity of stressors endorsed between young adults with past 30-day electronic nicotine product use and young adults with no lifetime use, as well as the association between frequency of recent electronic nicotine product use and average severity of stressors.

175 current electronic nicotine product users and 333 lifetime abstainers of electronic nicotine products and cigarettes reported recent stressful experiences that occurred in the past six months, as well as lifetime and past 30-day substance use. Chi-square, independent samples t-test, and regression analyses were performed.

There were no significant group differences in the primary type of stressor experienced (p = 0.320) or average stress of the three recent stressful experiences reported (p = 0.246). There was no significant relationship between electronic nicotine product use and average stress of the three recent stressful experiences, controlling for demographic and substance use covariates (p = 0.150). Both current electronic nicotine product users and lifetime abstainers endorsed school, family, and romantic relationship stressors most frequently as their top stressors.

To our knowledge, this is the first study to examine group differences in specific stressor categories and perceived stress between current electronic nicotine product users and lifetime abstainers of these products. Given the novel assessment of stressor types, the current study provides a critical starting point for research on this timely topic. In addition, due to the high overlap between stress and nicotine use, future studies should investigate different populations of electronic nicotine product users and other methods to assess stressful experiences.

Depression, a form of mood illness, is characterized by a lack of or diminished social life, melancholy, and symptoms linked to an uplifted or depressed mood. Vincamine and Melatonin combination may prove beneficial for treating depression because vincamine and melatonin have already been reported in the treatment of dementia. Dementia is a CNS disorder which is connected to the level of neurotransmitters at the synaptic cleft, which is similar to depression that is why it might be effective in the treatment of depression.

The aim of this research is to conduct an experimental study on the antidepressant activity of Vincamine alone and along with Melatonin and comparison with standard antidepressant drugs.

In this study, all animals are trained for the experiment, and then animals are divided into groups according to the treatment protocol. Animals were placed for the rest for 1 week. Vincamine and melatonin were administered to the treated groups on days 8 and 21 for the behavioral analysis using different kinds of models like elevated plus maze, forced swim test, open field test and sucrose preference test. Animals were sacrificed at day 22 for the estimation of biochemical (SOD) and neurotransmitters (Serotonin, Norepinephrine and Dopamine).

After extensive investigation, it has been established that Vincamine, alone and in combination with Melatonin, is beneficial in treating depression. Positive results are obtained. The group treated with Vincamine taken per oral route (10 mg/kg), Melatonin (10 mg/kg), Vincamine + Melatonin (10 mg/kg + 10 mg/kg) and std (10 mg/kg) treatment showed significant result which are followed as for all groups (a) p < 0.0001 vs. NC; (b) p < 0.0001 vs. disease control; (c) p < 0.05 vs. Std (10 mg/kg); (d) p < 0.001V vs. M (10 mg/kg); (e) p < 0.0090 vs. V+M (10 mg/kg+10 mg/kg). It was demonstrated by a number of behavioral (elevated plus maze, forced swim test, open field test, and sucrose preference test) and biochemical parameters (estimation of neurotransmitters such as serotonin, norepinephrine, and dopamine). Vincamine alone and in combination with Melatonin demonstrated positive results (p < 0.0001) in the evaluation of the SOD antioxidant defence system. Also, it significantly attenuated the alteration in locomotor activity, oxidative stress and neurotransmitters in rat brain.

It has been concluded that vincamine alone and along with melatonin is effective for the treatment of depression on the basis of behavioural and biochemical parameters. That’s why it might be useful for the future prospect.

Psychosis and neuroses are characterized by a state of mental imbalance and disturbances in thinking processes and have a significant impact on the lives of patients and their close environment. The article aims to study the assessment of the quality of life of people suffering from neurosis and psychosis using the Manchester Quality of Life Questionnaire, with components assessed using a seven-point Likert scale.

The study was conducted using sociological methods, such as questionnaire surveys. The study involved 519 people aged 18 and over, of whom 369 were diagnosed with neurosis (183 men and 186 women) and 150 with psychosis (75 women and 75 men). The survey participants came from Ukraine (223), Poland (80), Lithuania (41), the Czech Republic (66), and Slovakia (71). The socio-demographic indicators of the respondents and their subjective assessment of the quality of life are studied. Patients diagnosed with psychosis rate their quality of life worse (3.74-1.35) than patients diagnosed with neurosis (4.33-2.11).

The absence of influence of various socio-demographic indicators on the assessment of quality of life in those patients who were diagnosed with “neurosis” and the presence of such differences between some indicators in those patients who were diagnosed with “psychosis” were investigated. Patients diagnosed with neurosis were more likely to have higher education and employed than patients diagnosed with psychosis, have better living conditions, and were more likely to seek treatment voluntarily. However, the possibility of worsening symptoms in those patients who were diagnosed with neurosis should not be ruled out, and exacerbations should be prevented.

Awareness and conscious treatment of patients is important to improve their symptoms and quality of life. Employment opportunities for patients with diagnoses should be explored to improve their quality of life and possibly improve their symptoms.

The present qualitative study was carried out to clarify the experiences of mothers with respect to living with children with ASD.

Limited studies have been conducted on the experiences of mothers and their challenges in living with children with Autism Spectrum Disorder (ASD) in western Iran.

A qualitative study utilizing the content analysis approach was designed to elucidate the experiences of mothers living with children with ASD. Participants were purposefully selected based on predefined criteria. The study was conducted from March to September 2023 at the Autism Spectrum Disorder Research Center in Hamedan, Iran. Sampling continued until data saturation was achieved. Interview transcripts were analyzed using a content analysis strategy, and main themes and subthemes were identified. MAXQDA version 10 software was used for data management during analysis.

Twelve participants were enrolled in this study. Six main themes and 15 subthemes were identified, representing the challenges of mothers living with children with ASD in Iran. The study themes included personal development hindrance (constant engagement, reduced self-attention, limited personal activities), social non-acceptance (social isolation and others' judgmental behaviors), lack of support infrastructure (limited rehabilitation centers, limited care centers, and heavy financial burden), caretaking responsibility (constant worry for the child, stereotypical behaviors, and sleep disturbances in the child), constant attention requirement (continuous need for care and constant support), and unequal attention within the family (reduced attention to other children and decreased marital intimacy).

The results of this research have indicated that mothers of children with ASD experience high levels of physical and psychological stress and are vulnerable to harm. Therefore, providing supportive resources to ensure their mental well-being is essential.

Based on research evidence, intentional poisoning has a relatively high prevalence among people with psychiatric disorders, and the diagnosis of psychological disorders can be an important predictor of suicide attempts and their recurrence. Gender presents a determinant in the occurrence of psychiatric conditions and suicidal behaviors.

This study aimed to investigate the relationship between suicide attempts, psychiatric disorders, and gender in individuals hospitalized due to intentional poisoning.

This study used the data obtained from the disease registration program based on the data of the patients hospitalized due to intentional poisoning during a two-year follow-up (2021-2022), including a total of 658 patients. In this study, log-linear models were used to assess the relationships between the main variables that independently entered the model. The outputs of the log-linear model we reanalyzed as independent, two-way, three-way, and saturated models using relevant fit indices. Finally, the results of the best model were presented.

Based on the conditional values retrieved from the final model, the risk of intentional poisoning was lower in women than in men after adjusting for the variables of a history of suicide attempts and the results of psychological assessment (OR=0.25, 95% CI: 0.16-0.37, p = < 0.001). The risk of suicide attempts in women suffering from underlying psychiatric disorders (OR=1.57, 95% CI: 0.81-2.99, p = 0.188) and in women without underlying psychiatric disease, which was not statistically significant (OR=1.07, 95% CI: 0.47-2.69, p = 0.785). Also, the results showed that the risk of psychiatric disorders in people who had a prior suicide attempt (OR= 1.88, 95% CI: 1.05-2.25, p = <0.001) and in women (OR=1.92, 95% CI: 1.05-2.77, p = <0.001) was statistically significant.

Based on our findings, men suffering from underlying psychological disorders and prior suicide attempts had a higher risk for intentional poisoning. On the other hand, among people without a history of suicide attempts and without underlying psychological disorders, the risk of intentional poisoning was higher in women. Moreover, a positive history of suicide attempts in both genders significantly increases the risk of having a psychological disorder. Therefore, it seems that underlying psychological disorders and a positive history of suicide attempts render women more vulnerable to intentional poisoning than men. Overall, it is suggested to consider screening for psychological disorders as a preventive measure in individuals proven to have intentional poisoning and suicide attempts, especially in men.

Clinical observations advocate for increasingly depressive disorders in children in Tunisia. However, no studies evaluating the prevalence of depression in Tunisian children have been published because of the lack of validated Arabic depression scale for children.

Thus, we aimed to validate the Children’s Depression Inventory in its second edition (CDI-2).

The present study was conducted on a representative sample of school-based Tunisian children in the city of Sfax. The sample was composed of 500 children aged 8– 12 years. The study took place in two phases. The first phase consisted of testing scales for participating children. During the second phase, children with depressive symptoms, according to the CDI-2, were invited for psychiatric interviews. Statistical evaluation included an assessment of the CDI-2 internal consistency, test-retest reliability and concurrent validity. Multi-trait scaling analysis was used to examine item convergent and discriminant validity. The CDI-2 was reliable in terms of internal consistency (0.887), with item-total score correlations ranging from 0.311 to 0.674. All items exceeded the 0.4 criterion for convergent validity in all subscales.

The mean total score of the CDI-2 for the whole sample was 12.59 (SD=9.28). CDI-2 and DSRS-C scores correlated 0.775. Correlations between DSRS-C scores and CDI-2 subscales ranged from 0.66 to 0.783.

We concluded that the CDI-2 Arabic version has satisfactory psychometric properties and is reliable for use in the Tunisian pediatric population.

Given the importance of anxiety management in pandemics, this study evaluated the effectiveness of telepsychiatry in reducing anxiety in outpatients with COVID-19 and their satisfaction.

This RCT was conducted in a health center in which 188 COVID-19 outpatients participated. First, anxiety level was measured in both the intervention (IG) and control (CG) groups using the Beck Anxiety Inventory (BAI). Then, the IG was offered four educational contents via WhatsApp for four consecutive weeks. One month later, participants completed the BAI questionnaire again, and the CG completed a satisfaction questionnaire. Descriptive statistics and Wilcoxon and Chi-square tests were applied.

Psychosomatic complications were significantly reduced only in IG, but physical complications were reduced in both groups. Total anxiety also decreased significantly in both groups, but more significantly in IG (p < .001 for IG and p < .039 for CG). The efficacy of telepsychiatry in reducing anxiety in healthcare workers was greater than in other occupational groups. There was no significant relationship between other demographic variables and telepsychiatry effectiveness. Seventy-eight percent of IG participants had a high level of satisfaction and 70.3% expressed a high desire to receive telepsychiatry in the future. The most important advantages of telepsychiatry were observing social distance, saving time, and reducing costs. In addition, The most important challenges were the lack of face-to-face contact, the lack of previous experience, and the late response of the psychologist.

Telepsychiatry effectively reduced moderate anxiety related to COVID-19 and provided high satisfaction.

IRCTID: IRCT20211223053500N1.

Drug and stimulant abuse is especially common in low and middle-income countries, such as Iraq and certain populations, such as highway drivers. Moreover, Iraq has high rates of traffic and road accidents.

Our objective was to assess the associations of using stimulants with traffic events among highway drivers in Iraq.

We used a cross-sectional study design, in which a self-administered questionnaire was distributed online on different social media platforms. The study included male highway drivers who used drugs from all provinces of Iraq. The questionnaire consisted of demographic questions and an addiction questionnaire about stimulants specially validated for the Arabic language. We followed a convenience sampling method to recruit participants.

A total of 1700 participants from 18 provinces were included with a median (IQR) age of 34 (24:55) years. Around 58% used drugs for reasons other than medical indications, while 81% reported abusing prescription drugs. Amphetamine and cocaine were used by 52% and 20% of the participants, respectively. Around 84% of the drivers had at least 56 driving hours per week, while 87% were involved in illegal activities due to drug use. Most of the participants (78%) had accidents at least three times per month. Most of the participants had social and medical issues.

Drug use, especially stimulant use, is a major contributor to road accidents and thus, increased morbidity and mortality rates in Iraq. Urgent policies and regulations are needed regarding the dispensing of drugs and the working hours of the drivers.