Objective: Bipolar disorders are among the most common chronic mental disorders. Despite the recent improvement in controlling psychiatric disorders, treatment of bipolar disorders remains a challenge.
The aim of this study was to determine the effect of consuming probiotics in patients with bipolar disorder-type 1 compared to the placebo group.
Method: This was a permuted blocked randomized clinical trial conducted in Shahid Beheshti mental hospital in Kerman, Iran, from October 2017 to October 2018. Two psychiatrists diagnosed and hospitalized all 38 patients with type 1 bipolar disorder based on the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). Using blind randomized blocking method size 4, patients were divided into 2 groups of placebo and probiotic. Young Mania Rating Scale (YMRS) and Hamilton's Depression Rating Scale (HDRS) were completed at the beginning, week 4, and week 8 of the study by a psychiatry resident. Independent t test, Mann-Whitney and repeated measures ANOVA tests were used. Data were analyzed using SPSS software version 20.
Results: There was no significant difference between the 2 groups in age, sex, and severity of mania and depression. Consumption of probiotics reduced the scores of YMRS and HDRS over time in the probiotic group more than the placebo group, but it was not significant.
Conclusion: Consumption of probiotics had non-significant effects on improvement and treatment of bipolar type 1 patients. It is suggested that future studies be conducted with different probiotic microbial strains and longer period of treatment.
Purpose: The Bam earthquake was one of Iran's worst natural disasters. As a reason of limited sample size, prevalence and risk factors of PTSD and depression were still unclear after a huge earthquake in Bam. Patients and Methods: A total of 1500 participants selected from the survivors by multistage sampling. Instruments included the demographic questionnaire, the PTSD Checklist-Civilian Version and the Beck Depression Inventory-2. Bivariable and multivariable logistic regressions were used to analyze the data. Results: The prevalence rates of PTSD and depressive symptoms were 38.7% (n = 581) and 40.1% (n=597), respectively. The most commonly occurring symptoms of PTSD were distress at reminders (73.7%), fear of recurrence (70.3%) and sleep disturbance (68.4%). Age (OR=1.5, 95% CI= [1.03, 1.74], P < 0.001) and being injured (OR=1.68, 95% CI= [1.09, 2.61], P=0.02) are positive risk factors of PTSD. The risk factors for depressive symptoms were old age (OR= 1.46, 95% CI= [1.02, 1.64], P < 0.001), female gender (OR=1.42, 95% CI=[1.14, 1.77], P=0.002), and death of work colleagues (OR=4.03, 95% CI= [1.54, 6.54], P=0.005). Conclusion: Professional and effective mental health services should design programs in order to aid the psychological wellbeing of the population focusing on older adults, females, those who lost work colleagues, and those who lost their family members.
Introduction: Inflammatory bowel disease (IBD) prevalence is increasing in Asia. Clinicians are faced with misdiagnosis for IBD even with classic symptoms. This case report shows that how a delayed diagnosis of IBD can produce significant problems for patient. Case Presentation: A 45 year-old man and known case of IPSID (Immunoproliferative small intestine disorder) was referred for follow-up to our GI (Gastrointestinal) clinic. He presented with a history of intractable watery diarrhea along with slight weight loss for the last 22 years. He was admitted with an episode of severe abdominal pain and acute peritonitis 10 years ago. At the time, laparotomy was performed due to a suspicious appendicular mass; however, the surgeon discovered a cecum mass and extended adhesion during laparotomy. According to IPSID diagnosis, he was then referred to an oncologist who treated him with chemotherapy and patient was advised to attend an annual colonoscopy checkup as follow-up. He was gradually complicated by renal stones, arthritis, hypoalbuminemia and bone disease during the follow-up. We as gastroenterologists reviewed his history again and requested a revision for all histopathology results by GI pathologist. Pathologist confirmed IBD (Crohn's disease) from the first pathology and his treatment was started immediately. Discussion: Several diseases can mimic IBD symptoms but with careful consideration of patient's symptoms, endoscopic findings and pathology results one should be able to diagnose IBD. Correct diagnosis of IBD can affect the quality of life of patient.
Keywords:Inflammatory Bowel Diseases; Diagnostic Errors; Intestine, SmallImplication for health policy/practice/research/medical education: This case report shows that how a delayed diagnosis of IBD can produce significant problems for patient.
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