Hassan Khazraee; Abdollah Omidi; Reza Daneshvar Kakhki; Zahra Zanjani; Mojtaba Sehat
Volume 20, s1 , December 2018, , Pages 1-10
Abstract
Background: Chronic daily headache is a serious disease, causing significant problems such as disability. It is characterized by pain localized to the head (headache) and headaches occurring on 15 or more days per month for more than ...
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Background: Chronic daily headache is a serious disease, causing significant problems such as disability. It is characterized by pain localized to the head (headache) and headaches occurring on 15 or more days per month for more than 3 months (> 180 days per year). Programs for pain and health improvement in patients with painful diseases, such as headache, are not still fully developed. Acceptance and commitment therapy (ACT) is a new psychotherapy, which appears to be effective in the treatment of chronic pain. Objectives: This study aimed to examine the effectiveness of ACT in cognitive emotion regulation strategies, headache-related dis- ability, and headache intensity in patients with chronic daily headaches. Methods: In the current study, a semi-experimental method was applied. The study was conducted at Shahid Beheshti Govern- mental hospital of Kashan, Iran in 2016. The sample consisted of 40 patients with chronic daily headache, who were selected via convenience sampling. The participants were randomly allocated into medical treatment as usual (MTAU) and ACT groups (20 sam- ples per group) via block randomization. The ACT group received eight 90-minute weekly treatments, based on the ACT protocol. The cognitive emotion regulation questionnaire (CERQ), diary of headache severity, and headache-related disability inventory (HDI) were administered at pretreatment, posttreatment, and three-month follow-up in both groups. Results: In the current study, no significant differences were found between the groups in terms of demographic variables (P > 0.05). In the ACT group, the mean (SD) scores of emotional and functional aspects of headache disability were 26.87 ± 10.11 and 28.50 ± 9.04, respectively before the intervention, which decreased to 17.75 ± 8.32 and 18.12 ± 9.42 after the intervention and 21.37 ± 8.53 and 21.37 ± 9.87 in the follow-up, respectively (P < 0.05). In addition, the mean (SD) score of nonadjustment cognitive emotion regulation strategies was 54.31 ± 10.02 at pretreatment, which significantly reduced to 44.43 ± 7.7 at posttreatment and 49.78 ± 9.1 in the follow-up (P < 0.05). Furthermore, the mean (SD) score of adjustment cognitive emotion regulation strategies was 61.43±12.02 in the pretest, which significantly increased to 72.06 ± 8.66 in the posttest and 69.62 ± 11.84 in the follow-up (P < 0.05). The mean score of headache intensity decreased from 6.40 ± 1.19 to 5.00 ± 1.09, compared to the pretest (P < 0.05); however, there was no significant difference between the groups in the follow-up (P > 0.05). Conclusions: The results of the present study suggested that ACT is an effective treatment for reducing nonadjustment cognitive emotion regulation strategies, headache-related disability, and headache intensity and improving adjustment emotion regulation strategies in patients with chronic daily headache.
Zahra Sepehrmanesh; Abdollah Omidi; Narges Gholampoor
Volume 19, Issue 2 , February 2017, , Pages 1-8
Abstract
Background: Augmentation therapy involves the addition of a second drug, such as mood stabilizers, antipsychotics, and nutritional supplements, to a primary antidepressant treatment. Studies on adding folic acid to a preexisting antidepressive regimen as a form of augmentation therapy have had different ...
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Background: Augmentation therapy involves the addition of a second drug, such as mood stabilizers, antipsychotics, and nutritional supplements, to a primary antidepressant treatment. Studies on adding folic acid to a preexisting antidepressive regimen as a form of augmentation therapy have had different and even controversial results.Objectives: This study aimed to determine the effects that adding folic acid to a pharmaceutical diet with citalopram has on the treatment of depression.Methods: This double-blind randomized clinical trial was conducted in Kashan, Iran on 90 patients who suffered from depression. Patients were allocated to study groups using random permuted blocks. One group (n = 45) received a dosage of 20 mg citalopram in combination with 2.5 mg folic acid on a daily basis, and the other group (n = 45) received the same daily dose of citalopram with a placebo for eight weeks. To measure the severity of each patient’s depression, the Beck depression inventory II (BDI-II) questionnaire was used prior to starting the antidepressant therapy and was repeated four, six, and eight weeks after beginning the treatment. A reduction from the original BDI-II scores that was greater than 50% was considered to be a response to treatment.Results: The average depression scores before treatment were 30.11±10.41 in the intervention group and 31.24±10.26 in the control group (P = 0.6). At the end of the study, the depression scores in the intervention and the control groups were 13.31 ± 6.57 and 19.11 ± 8.59, respectively (P < 0.001). A reduction in the average depression scores of the intervention group was statistically significant after six and eight weeks (P = 0.01 and P = 0.001, respectively). At the end of the study, the frequency of response to treatment was 73.3% in the intervention group and 40.0% in the control group (P < 0.001).Conclusions: Folic acid, when used as a complementary therapy, can improve a patient’s response to antidepressants used for the treatment of major depression.
