In order to diagnose a major depressive disorder, patients must have at least 5 depressive symptoms out of 9 criteria, present for at least two weeks. Depressive symptoms include absence of concentration, fatigue and suicidal ideation. The intensity of depression symptoms affects the severity of depression and the degree of the impact on the quality of life. Major depressive disorders (MDD) are defined as a significant health problem, and are estimated to rise in prevalence in the future years. Immune cytokine, associated with major depression for instance, is the interleukin IL-6 and tumor necrosis factor (TNF-α) which is defined as pro-inflammatory cytokines, can activate an inflammatory response. The effects of other inflammatory cytokines on the central nervous system are of controversy. There is an increasing interest about the effect of cytokines derived from innate immune system on the brain and behavior. Cytokines are defined as large sized proteins, mainly produced by immune cells. Two subtypes of cytokines exist: pro-inflammatory cytokines, facilitating inflammatory responses and neural activities; and anti-inflammatory cytokines, inhibiting inflammatory processes. Besides microglia and astrocytes, immune cells such as monocytes, macrophages, and lymphocytes also produce cytokines. At the times of immunological alterations, infections or inflammation, cytokines will be in an activated form. The main goal of the current review study is to investigate the role of the immune system in the depression disorder.

BackgroundDepression disorder is the most prevalent neuropsychiatric disorder associated with epilepsy, and a correlation has been detected between depression and suicide. There is a relationship between suicidal behavior and coping mechanisms; therefore, it is important to undertake psychoanalytic psychotherapy to reduce depressive symptoms.ObjectivesTo evaluate the Coping Mechanisms, Depression and Suicidal Risk among Patients Suffering from Idiopathic Epilepsy.Materials and MethodsThe present study is a cross-sectional pilot study in which 93 Iranian patients with idiopathic epilepsy were selected from Qaem hospital and neurological clinics. They answered three questionnaires: BDI, SSI, and a questionnaire of coping mechanisms. Patients were then interviewed and divided into two groups: patients with depression and suicidal ideation, and patients without depression and suicidal ideation. The two groups were compared in terms of coping mechanisms.ResultsAmong the patients who filled the questionnaires, only 74 were selected for the interview. 58.9% of the patients did not have depression or suicidal ideation and 23.3% of them had either depression or suicidal ideation. Findings of the study showed that the two groups had a significant difference in terms of repressive coping method efficiency (P = 0.022). However, there was no significant difference between the two groups in terms of problem-focused coping method (P = 0.25) and the emotion-focused coping method efficacy (P = 0.31).ConclusionsIranian patients with idiopathic epilepsy and with either depression or suicidal ideation, make significant improvement using repressive coping method in comparison to patients with idiopathic epilepsy who did not suffer from depression or suicidal ideation. The effect of other coping mechanisms was not significantly different between the two groups.

Introduction:There are complicated relations between child's psychiatric problems secondary to epilepsy, maternal stress and parenting style.Objectives:The aim of the present research is to study psychological and behavioral characteristics in children with epilepsy, study maternal stress associated with parenting these children, and parenting styles of these mothers.Method:Children aged 3 to 7 years old with an established diagnosis of epilepsy for at least 1 year without other neurological disorders or mental retardation and their mothers were selected from child neurology clinics in Mashhad, Iran. Eligible participants were 30 epileptic children. Control group of 30 healthy children from Mashhad kindergartens were matched with epileptic children in terms of age and sex. Strengths & Difficulties Questionnaires (SDQ), Parenting Stress Index (PSI), Parenting Style Questionnaire (PSQ) and a demographic questionnaire were used for data collection.Results:Mothers of children with epilepsy had higher levels of parenting stress (in both parent and child domains) compared to the other group (P < 0.001). Parents with epileptic children scored higher on permissive and authoritarian parenting scales. However, the score was lower for authoritative parenting style in comparison with the scores of the control group. In general, these differences did not reach a significant level (P>0.05). Children with epilepsy had significantly higher scores than normal children in terms of emotional symptoms, conduct problems, hyperactivity and hence, the total difficulty score (P< 0.05).Conclusion:Educational and psychological programs aimed at enhancing adjustment of parents with their children's epilepsy are greatly needed.

Introduction: Psychiatric emergencies are acute mental health disturbances, behaviors and social relationships that require immediate intervention. The major role of the psychiatric emergency services is to provide mental health care services for patients with acute mental health problems. Design in the emergency psychiatry core data set has improved the coordination and integration of services and improved the outcomes for patients with severe and persistent mental illness and with complex needs. So, the aim of this study was to design data elements in emergency psychiatry for Iran. Methods: This is an applied study. Emergency psychiatry data elements collected via literature review and then psychologist and psychiatrist (16 persons) according to the value of each data element, assign a score from 0 to 5 to them. Data elements selected as core Emergency psychiatry data elements were those which achieved a 4 or 5 score from 75% of the specialist. Results: From a total of 95 usability problems identified, three evaluators identified 82 problems (86.3%), 2 evaluators identified 6 problems (6.3%) and one evaluator identified 7 problems (7.3%). According to severity, problems were 23 minor, 19 severe, 16 cosmetic and 37 technical problems. Rate of problems in different areas were: visibility of system status 13.6%, match between system and the real world 12.6%, user control and freedom 14.7%, consistency and standards 11.5%, error prevention 6.3%, recognition rather than recall 12.6%, flexibility and efficiency of use 5.2 %, aesthetic and minimalist design 6.3%, help users recognize, diagnose, and recover from errors 7.3% and help and documentation 6.3%. Conclusion: Given the importance of psychiatric disorder and lack of a national system for gathering psychiatric information, performing a similar study about psychiatric data element is very important. The results of this study can be used for the design of psychiatric emergency forms and accurate and complete patient information gathering.