Ashraf Tashakori

Background: The highly effective medications in treating attention deficit hyperactivity disorder (ADHD) symptoms are stimulants like methylphenidate. However, they have adverse effects like reduced appetite. We investigated the effects of folic acid on reduced appetite caused by the use of methylphenidate in children with ADHD. Methods: This randomized double-blind clinical trial evaluated 70 outpatients, aged between 6 and 12 years, with a diagnosis of ADHD. The children were recruited from the Outpatient Child and Adolescent Psychiatric Clinic of Golestan Hospital (Ahwaz, Iran) between 2016 and 2017. The study subjects were randomly assigned to 2 groups: Group 1 received an average dose of methylphenidate (1 mg/kg) plus folic acid (5 mg/d) and Group 2 received an average dose of methylphenidate (1 mg/kg) plus a placebo (5 mg of sucrose) for 8 weeks. Assessments, comprising the Conners Parent Questionnaire, anthropometric measurements, and appetite questionnaire, were conducted by a psychiatrist at baseline and then at 2, 4, 6, and 8 weeks after the medication was started using repeated measure analysis. The data were analyzed with the Mann-Whitney U and ANOVA tests using the SPSS statistical software (v. 18.0). Results: Age and gender were not associated with the groups. Weight, height, and the body mass index were not changed during the study in both groups. ADHD symptoms significantly decreased in both groups during the trial; however, no difference was observed between the groups. Moreover, appetite was significantly improved in Group 1. Both medications were well tolerated. Conclusion: It seems that folic acid improved the reduced appetite caused by the use of methylphenidate in our children with ADHD.

The main source of information about children’s masturbation is more on the basis of case reports. Due to the lack of consistent and accurate information. This study aimed to determine prevalence and underlying factors of masturbation and its comorbidity with psychiatric disorders in children. In this descriptive-analytical study, among the children referred to the Pediatrics Clinic of Psychiatric Ward, Golestan Hospital, Ahvaz, Southwest Iran, 98 children were selected by convenience sampling in 2014. Disorders were diagnosed by clinical interview based on the fourth edition of the Diagnostic and Statistical Manual for Psychiatric Disorders (DSM-IV) and the Child Symptom Inventory-4 (CSI-4). We also used a questionnaire, containing demographic information about the patient and their family and also other data. Data was analyzed using descriptive statistics and chi-square test with SPSS software version 16. Of the children who participated in this study (most of whom were boys), 31.6% suffered from masturbation. The phobias (p=0.002), separation anxiety disorder (p=0.044), generalized anxiety disorder (p=0.037), motor tics (p=0.033), stress disorder (p=0.005), oppositional defiant disorder (p=0.044), thumb sucking (p=0.000) and conduct disorder (p=0.001) were associated with masturbation. Masturbation was common in children referred to psychiatric clinic, and may be more associated with oppositional defiant disorder, or conduct disorder, some anxiety disorders, motor tics and other stereotypical behavior. Authors recommended more probing for psychiatric disorders in children with unusual sexual behavior.

Comparison between the efficacies of Risperidone with Haloperidol in the treatment of attention-deficit hyperactivity disorder (ADHD) among preschoolers: a randomized double-blind clinical trial

Biomedical and Pharmacology Journal (BPJ) is an international, open access, peer reviewed, quarterly research journal.

This study was designed to compare the Intelligence Quotient (IQ) among 3 to 7-year-old strabismic and nonstrabismic children in an Iranian population. In this cross-sectional study, 108 preschool children with equal numbers of strabismic/non-strabismic disorder (age 3-7 years) were randomly selected from exceptional strabismus clinics of Ahvaz and were evaluated with the preschool and primary scale of intelligence versions of Wechsler (WPPSI). In the current study, 108 children were evaluated. In strabismic patients the mean performance, verbal and total IQ were 89.46±19.79 , 89.57±21.57 and 91.54±22.08 respectively.These mean scores in normal children were 91.89±47.53 , 87.56±15.6 and 89.96±17.62consecuently .The results showed that these three different IQ subscales were not significantly different among 3 to 7 years old strabismic and nonstrabismic children ((P>0.05 for all comparisons). There was no significant difference in IQ between two sexes (P>0.05) while Persian tribe children had greater IQ score compared to other tribes (P0.05) In this evaluation, we did not found a significant negative interference of strabismus on IQ score of preschool children. It can be concluded that paternal educational level and tribe have a significant effect on intelligent quotient, while this is not the case on sex and ocular deviation. Keywords: Intelligence quotient, Strabismus, Deviation

Background: Mothers of children with attention deficit hyperactivity disorder (ADHD) may have distinctive parenting attitudes and mental health problems. Objectives: This study examined the parenting attitudes, general health, and some other related factors in mothers of children with ADHD. Materials and Methods: Sixty mothers of children with ADHD who referred to psychiatric outpatient clinic of Ahvaz Golestan Hospital were selected by convenience sampling method. The parenting attitude, general health, and demographic data questionnaires were used. Results: Forty two (70%) mothers were healthy and 18 (30%) were unhealthy. The Pierson coefficient and the Fisher’s exact test showed only a significant relationship in maternal age with the total score of general health questionnaire (GHQ) (r = -0.350, P = 0.05) and the score of anxiety subscale (r = -0.429, P = 0.05). The scores of different attitudes were 29.45 ± 5.71 for dominating, 29.13 ± 6.08 for ignoring, and 27.8 ± 5.8 for possessive attitudes. Mothers with elementary school education level had fewer possessive attitude than higher educated mothers (P = 0.017). The ignoring attitude was significantly higher in staff members than others (P = 0.043). Logistic regression model also showed that the GHQ score was significantly related to maternal age (P = 0.027) and number of children (P = 0.011). Conclusions: Dominating, ignoring and possessive attitudes are frequent in mothers of children with ADHD. Parenting attitudes in mothers of children with ADHD may have relationships with job and education level. Mothers of children with ADHD, especially in younger ages and more offsprings may be predisposed to mental health problems, especially to anxiety. Keywords: Parenting; Attitudes; Attention Deficit Hyperactivity Disorder; Health, Mothers

Some previous studies have reported that ADHD is often comorbid with anxiety disorders. The aim of the present study was to evaluate the effectiveness of reboxetine in treating outpatient children and adolescents with ADHD and comorbid anxiety disorders. In this open-label study, 25 outpatient children and adolescents, aged 6-16 years were selected by convenient sampling and underwent treatment with 4mg reboxetine for four weeks. Data were collected at baseline, two weeks and four weeks after the start of the medication using Conners’ Parent Questionnaire, Hamilton’s Rating Scale for Anxiety, Clinical Global Assessment Scale, Clinical Global Impression-Severity Scale and Side Effects Form. Data were analyzed using repeated measure, analyses of variance (ANOVA), Tukey post hoc test and paired t-test. There were significant reduction in the total score of ADHD (F = 31.441; P <0.001) at the end of the treatment compared to baseline (Table 1). The differences between T0 and T2 in the subscales of attention deficit, hyperactivity and confrontation (F = 20.691; P <0.001, F = 28.810; P < 0.001, and F = 17.463; P <0.001, respectively) were also significant. Findings also indicated significant differences between T0 and T1 (P<0.01) and T1 and T2 (P<0.01) in all of the subscales except for confrontation. A significant improvement was observed in the severity of ADHD and anxiety disorders during different courses of the treatment (p<0.001). No significant changes were observed in systolic and diastolic blood pressure and pulse and weight of the patients during the study. The most common complications were headache and anorexia. The short-term treatment with reboxetine was effective in improving ADHD with comorbid anxiety disorders. Therefore, reboxetine could be used as a treatment option for ADHD in those children who experience comorbid anxiety disorders or in those who are non-responsive or intolerant to methylphenidate.

There is a relationship between infant feeding method and maternal postpartum depression (PPD). This study was carried out in an Iranian population to compare the prevalence of PPD symptoms between breast feeding and non-breast feeding mothers for first time. Four health centers in Ahvas were selected by random sampling in 2009. At first 78 non-breast feeding mothers at two months postpartum were recruited in the study and then 78 breast feeding mothers were recruited through random sampling. They were re-assessed in six months postpartum period. Demographic and obstetric data questionnaire and Edinburgh Postnatal Depression Scale (EPDS) were used. There was a significant difference in prevalence of Edinburgh Postnatal Depression Scale positive between breast feeding (2.5%) and non-breast feeding mothers (19.4%) (p = 0.004). Infant feeding method may be related to maternal mood disorder and breast feeding mothers are less depressed. Breastfeeding may decrease PPD.