Tehran University Medical Journal

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Background: Behavioral changes in patients with epilepsy could cause comorbid psychiatric disorders such as anxiety disorders. This study is concerned with investigation of obsessive-compulsive disorders and assessment of obsessionality as a personality trait in patients with complex partial seizure. Methods: Seventy six patients with complex partial seizure, 74 patients with generalized epilepsy that referred to Shiraz psychiatric professional center during three month (from July to September 2009), and 76 matched healthy controls were randomly selected and evaluated using the Yale-Brown obsessive compulsive scale (Y-BOCS), short form of Minnesota multiphasic personality inventory (MMPI) and clinical interview. Results: Complex partial seizure and obsessive-compulsive disorder (%13.15) are significantly more prevalent than generalized seizure (%2.70) and than control groups (%1.31) (p<0.001), and mean of psychasthenia scale (Pt scale) scores in patients with complex partial seizure is more than mean of Pt scores in generalized epilepsy and control groups (p<0.001). There is significant relationship between total score of Yale- Brown scale and Pt scale in MMPI (r=0.79, p<0.01). Conclusions: Patients with complex partial seizure are suffering from obsessive- compulsive disorder more than healthy persons and patients with generalized epilepsy, and obsessionality can be a personality trait in patients with complex partial seizure. So,in addition to drug therapy, psychological intervening for treatment of anxiety disorders in patients with complex partial seizure seems necessary

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Normal 0 false false false EN-US X-NONE AR-SA MicrosoftInternetExplorer4 Background: Recent evidence suggest that group A ß-hemolytic streptococcal (GABHS) infection may increase the risk of pediatric autoimmune neuropsychiatric disorders (PANDAS) composed of the clinical signs of obsessive-compulsive and attention deficit hyperactivity disorders. The objective of this study was to compare the titer of antibodies against GABHS between children with PANDS and the controls.
Methods : This cross-sectional, case-control study was done in Hazrat Rasoul Hospital, in Tehran, Iran during 2008-2010. We compared serum antibodies streptolysin O, deoxyribonuclease B, and streptokinase against GABHS quantitatively in 79 cases with PANDAS and 39 age-matched controls. The area under ROC curve, sensitivity, specificity and positive predictive value (PPV) of tests were calculated.
Results : Most cases were studied in summer (57%) and spring (23%). The three aforesaid antibodies were higher in the cases (P=0.001). Antisterptolysin O (cut-off point 195) had a 90% sensitivity, 82% specificity and a 92% PPV, (CI=95%, 0.99-0.91). Anti streptokinase (cut-off point 223) had an 82% sensitivity, 82% specificity and a 95% PPV, (CI=95%, 0.934-0.735). Anti-DNase (cut-off point 140) had an 82% sensitivity, 82% specificity and a 95% PPV, (CI=95%, 0.99-0.91).
Conclusion: The study demonstrated a possible role for streptococcal infection in PANDAS. We found a significantly higher antibody titer against GABHS in OCD and ADHD cases in comparison with healthy children. Treatment of streptococcal infection is achievable by the use of long-acting penicillin. Use of aggressive treatment schedules like plasmaphresis, IVIG, etc needs further RCT studies.

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Background: Migraine is the most common cause of headache which affects 15% of female and 6% of male populations. Patients with migraine may have psychological problems, thus, association of migraine with depression, anxiety and other psychological disorders should be considered for choosing the best management approach.

Methods: In this case-control analytical study, one hundred and twenty patients with migraine were recruited among patients who attended the Psychiatry Clinic of Farshchian Hospital in Hamedan, Iran during 2008- 2009. The patients met the IHS criteria for migraine and none had disorders, such as Huntington disease, that are associated with obsessive-compulsive disorder (OCD). The people who accompanied patients attending the Internal Medicine Clinic of the Hospital and had no history of migraine headaches were recruited as the controls. Maudsley's inventory was used for the diagnosis of OCD. Finally, the data were analyzed by SPSS software.

Results: In the control group, 3 (2.5%) and in the case group 11 (9.17%) people had OCD (P=0.024). All of those with OCD in the control group and 9 out of 11 in the case group were female. There were no cases of OCD among patients with mild migraine. Among 36 patients with moderate headache 5 (13.89%) people had OCD and among 62 people with severe migraine 6 (9.68%) had OCD (P=0.510).

Conclusion: The prevalence of OCD in patients with migraine was significantly higher than the normal population. Special attention to comorbid conditions such as OCD is necessary in the management of migraine headaches.

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Background: Although sexual dysfunction is a common problem in patients with obsessive-compulsive disorder (OCD), there are sparse clinical research on the study of the correlation between OCD subtypes and different phases of sexual response cycle. This study was undertaken to assess sexual function and its different phases in a group of Iranian patients with OCD. Methods: This was a descriptive cross-sectional study. The subjects consisted of 56 married OCD patients (36 female, 20 male) who suffered from OCD according to a psychiatric interview and DSM-IV questionnaire based on structured clinical interview for DSM (SCID). Patients were between 18 to 50 year age that had been referred to the outpatient clinic of Roozbeh Psychiatric Hospital and three private psychiatric clinics in Tehran (from September 2011 to February 2013). Five Questionnaires were used in this study: Iranian validated form of Female Sexual Function Index (FSFI), International Index of Erectile Function (IIEF), Maudsley Obsessional Compulsive Inventory (MOCI), Obsessive Compulsive Inventory-Revised (OCI-R) and a questionnaire which has provided demographic data and other relevant information regarding sexual function and OCD. Results: The prevalence of sexual dysfunction among female was 80.6% and the frequency of disorders in different subscales of FSFI including sexual desire, sexual arousal, lubrication, orgasm, satisfaction and sexual pain were 50%, 58.3%, 36.1%, 44.4%, 41.7% and 52.8% respectively. Sexual disorder is reported in 25% of male OCD patients which subscales' evaluation of IIEF shows low sexual desire in 10%, erectile disorder in 20%, orgasmic disorder in 25%, sexual dissatisfaction in 40% and 50% decreased in the total sore of IIEF. Moreover, the correlation coefficients between the total score of OCI-R with erectile and satisfaction subscales of IIEF were statistically significant. The score of washing subscale in OCI-R and sexual satisfaction was significantly correlated. Conclusion: High prevalence of sexual dysfunction in OCD women and significant correlation between male sexual dysfunction and OCD (r= -481.0 between total score of OCI-R with erectile dysfunction and r= -458.0 between total score of OCI-R and sexual satisfaction) could confirm a relation between OCD and sexual disorders. So, evaluation of sexual function in all patients with OCD is recommended.