Seyed Kazem Malakouti

Background: Understanding brain function in individuals who have recently attempted suicide is critical for improving diagnosis and treatment strategies. This study aimed to examine neural activity patterns in such individuals (who had attempted suicide 1–4 weeks before the study) using functional magnetic resonance imaging (fMRI) and the General Linear Model (GLM). Methods: Sixty participants were recruited and categorized into three groups: individuals with a recent suicide attempt and Major Depressive Disorder (SA + MDD), individuals with Major Depressive Disorder without a suicide attempt (MDD), and healthy controls (HC). Participants performed the Raven task, consisting of 24 trials with a 25-second time limit for each item. Brain activity was analyzed to identify regional differences among groups using ANOVA, followed by Tukey’s post-hoc pairwise comparisons. Results: Compared to the MDD and HC groups, the SA + MDD group exhibited significantly reduced activation in the left medial superior frontal cortex (SFC), left anterior cingulate cortex (ACC), and left precentral gyrus. Positive correlations were observed between the Scale for Suicidal Ideation scores and activity in the medial SFC and ACC, whereas a negative correlation was found with precentral gyrus activity. While task accuracy did not significantly differ among the groups, the SA + MDD group demonstrated significantly shorter response durations. Conclusion: Individuals with recent suicide attempts show diminished activation in key left-hemispheric regions involved in cognitive control and problem-solving, including the medial SFC, ACC, and precentral gyrus. These neural deficits may impair decision-making and problem-solving abilities, particularly when compounded by hopelessness and a diminished sense of purpose, potentially contributing to increased suicide risk.

Background and Objectives: Suicide remains a significant public health issue, resulting from a combination of psychological, emotional, familial, social, economic, and cultural factors. Understanding the complex needs of individuals with suicidal tendencies is crucial for the development of effective interventions. This study aimed to identify the needs of individuals with a history of ...

The COVID-19 pandemic has had far-reaching effects on societies globally, including significant psychological impacts. This study aims to address the research gap by examining the impact of the COVID-19 pandemic on mental health and suicidality among Iranian university students, comparing prepandemic and pandemic data. The data collection for this cross-national study involved 2 sections: prepandemic data from 11,515 records of new incoming students in 2019 and postpandemic data from 27,743 records of students studying in 2020. The data were merged, resulting in a total of 10,240 students for analysis. The instrument used was the "Iranian Mental Health Scale for Students (IMHS). The variables were compared before and during the pandemic using the McNemar and paired t tests. Multiple linear regression models assessed determinants of mental health, while logistic regression examined predictors of suicidal ideation during COVID-19. Risk factors and protective factors on students' mental health and suicidal thoughts during the pandemic were investigated. The mean mental health score of students during the COVID-19 pandemic was slightly higher than before the pandemic (P = 0.001). The number of suicide attempts among students decreased from 23 before the pandemic to 0 during the pandemic. However, the rate of suicidal ideation increased from 10.2% before the pandemic to 16% during the pandemic. Evaluating the mental health of university students is crucial to identifying potential issues early and providing appropriate interventions. Understanding the effects of the pandemic on this vulnerable population can inform strategies for supporting their well-being during these challenging times.

Background: Considering the limited information on suicide determinants, especially in low- and middle-income countries, the establishment and promotion of a suicide registration system are among the prominent strategies for suicide prevention programs around the world. The multicenter suicide registry is designed to collect standardized data from the two provinces of Iran according to the latest World Health Organization (WHO) guidelines. Methods: The Suicidal Behavior Registration Program is a multicenter study designed in five stages, including literature review, infrastructure establishment, database design, training, data analysis, and examining opportunities and challenges. The research samples cases of suicide attempts and self-harm from hospitals in the provinces of Tehran and Ilam. Results: The multicenter suicide registration program was carried out for 8 months in the two provinces of Tehran and Ilam. During the study period, data of 1382 people were registered, of which 7 cases in Ilam resulted in death. The study uncovered significant differences in socio-demographic, psychological status, and suicide characteristics in the two provinces. Conclusion: The design and implementation of the suicide registration program help researchers and policymakers make more innovative and effective interventions to prevent suicide by creating a comprehensive database of suicidal behavior determinants.

Background: This systematic review aims to comprehensively assess the diagnostic accuracy of cognitive screening tools validated for older adults in Iran, providing evidence-based recommendations for clinicians and researchers. Methods: A comprehensive search in March 2023 across Web of Science, PubMed, Scopus, ScienceDirect, SID, IranMedex, and IranDoc, enhanced by hand-searching references and Google Scholar, identified cross-sectional studies on cognitive screening in Iranian seniors. We assessed diagnostic accuracy, cognitive domains, and test strengths and weaknesses. A bivariate random-effects meta-analysis provided summary estimates and 95% confidence intervals, illustrated in forest plots. Results: Our review, derived from an initial screening of 38 articles, focused on 17 studies involving 14 cognitive screening tools and participant counts from 60 to 350, mostly from specialized clinics. The MMSE was the only tool examined in at least three studies, prompting a meta-analysis revealing its sensitivity at 0.89 and specificity at 0.77 for dementia detection, albeit amidst significant heterogeneity (I^2 > 80%). ACE-III demonstrated the highest diagnostic accuracy for MCI and dementia, while MoCA’s performance was deemed adequate for MCI and excellent for dementia. High bias risk in studies limits interpretation. Conclusion: This review identifies key cognitive tools for dementia and MCI in Iranian older adults, tailored to educational levels for use in primary and specialized care. It emphasizes the need for further validation to enhance diagnostic precision across diverse settings, within a concise framework prioritizing brevity and accuracy for clinical applicability.

Background: Severe mental illness (SMI) imposes a substantial worldwide burden of disability, highlighting the need for comprehensive and adaptable mental health services. This study aims to assess the efficacy and cost-effectiveness of community-based mental health services (CBMHS) in reducing relapse and rehospitalization rates among individuals with SMI in Iran. Method: A systematic review and meta-analysis were conducted. Medline, EMBASE, ISI, SCOPUS, and ProQuest were searched until December 2022. We focused on randomized controlled trials, quasi-experimental studies, or economic studies related to individuals with SMI. Out of 127 articles, 17 were selected for a full-text review. The primary outcomes were the severity of psychopathology, rehospitalization rates, and the mental health of caregivers. We also examined community-based interventions and their impact on various outcomes. Data extraction and risk of bias assessment were performed, and critical appraisal was conducted using JBI checklists. Meta-analysis was carried out using STATA software. (PROSPERO registration. CRD42022332660). Result: Rehospitalization rates among patients who received CBMHS were significantly lower, with an odds ratio of 2.14 (95% CI: 1.44 to 3.19), indicating a 2.14 times lower likelihood than those who received treatment as usual. A reduction in psychopathology accompanied this, SMD: -0.31, 95% CI: -0.49 to -0.13, I2 = 40.23%). Moreover, there was a notable improvement in social skills (SMD: -0.7, 95% CI: -0.98 to -0.44, I2 = 0.00%). The burden on caregivers also decreased (SMD: -0.55, 95% CI: -0.99 to -0.1, I2 = 63.2). The Incremental Cost-Effectiveness Ratio (ICER) for QUALY was acceptable, albeit with a wide range of 613 to 8400 Dollars. Conclusion: CBMHS has demonstrated effectiveness and efficiency in Iran as a developing country. Additionally, it shows promise in mitigating the shortage of acute psychiatry beds. Using multiple data collection tools poses a limitation regarding data consolidation and conducting a meta-analysis.