The present trial aimed to evaluate the effects of pioglitazone on the mental status of nondiabetic metabolic syndrome patients. From 145 patients screened, 104 eligible volunteers (57% female; age 20–70 years) were enrolled and randomly assigned to receive either pioglitazone (uptitrated to 30 mg/day; P = 53) or matching placebo (P = 51) for 24 weeks. Depression and anxiety were quantified using the hospital anxiety and depression scale and stress level using the general health questionnaire 12 at baseline, week 12, and endpoint. Homeostasis model assessment was used to estimate insulin resistance. At week 24, pioglitazone was superior in mitigating depression score (P = 0.011). In trend analysis, the effect of time (P < 0.001) and group (P = 0.023) as well as the time by group interaction (P = 0.032) on the mean depression score was considerable. In contrast, significant decrements in anxiety and stress levels (P < 0.001 and P = 0.012, resp.) were comparable between two groups. With respect to our findings, alterations in depression severity were not correlated with changes in insulin resistance level (P = 0.145). In conclusion, our findings suggest that pioglitazone might be able to improve mood in nondiabetic insulin resistant patients. (Registered at Australian New Zealand Clinical Trials Registry; ACTRN12611000351910.)

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Background: The present study aimed to investigate the association between dietary diversity score (DDS) and somatoform complaints profile.Methods: The current cross-sectional study was conducted on 2818 adults aged 19-65 years working in Isfahan province, Iran. A Dish-based 106-item Semi-quantitative Food Frequency Questionnaire (DS-FFQ) was used to collect dietary intake of participants. Somatoform symptoms were assessed using a validated comprehensive 31-items questionnaire.Results: After adjusting for the impacts of various confounders it was revealed that lower DDS is associated with higher risk of experiencing greater scores of psychological (OR=1.44, 95% CI: 1.06, 1.95; P=0.029) and pharyngeal-respiratory (OR=1.54, 95% CI: 1.17, 2.04; P=0.009) somatoform complaints. No significant association was found between DDS and neuro-skeletal and gastrointestinal somatoform complaints. In addition, stratified analysis by sex indicated that the lower DDS increased the risk of higher scores of psychological (OR = 1.73, 95% CI = 1.17, 2.56; P = 0.02) and pharyngeal-respiratory (OR = 1.75, 95% CI = 1.22, 2.49, P = 0.007) somatic complaints in women, but not in men.Conclusion: Present study indicated that the lower DDS is associated with higher risk of psychological and pharyngeal-respiratory somatoform complaints. Future prospective studies and particularly clinical trials are warranted to confirm these findings.

Background and objectives: Quality of Life (QoL) indicates individual's perception of the physical, psychological and social aspects of health. The association between QoL and all stressful life events 'dimensions has not been investigated among industrial employees. The present study aimed at investigating the association between stressful life events and QoL in a large sample of Iranian industrial employees.Methods: In a cross-sectional study, 3063 manufacturing employees in Isfahan, Iran were recruited. QoL was measured by Euro-QoL five dimensions questionnaire (EQ-5D). Stressful life events were assessed by an Iranian validated stressful life event questionnaire (SLE). Multilevel latent class regression was employed for classifying participants based on QoL and for determining its association with stressful life events.Results: Two classes of employees i.e. low (comprised 20% of participants) and high QoL (80%) were identified. Also, from 11 eleven dimensions of stressful life events two major domains i.e. socioeconomic and personal stressor profiles were identified. Multilevel latent class regression's results showed that the higher scores of social (OR:1.14, 95% CI: 1.12, 1.16) and personal (OR:2.36, 95% CI: 1.87, 2.98) stressor domains were significantly associated with increased risk of being in poor QoL class. Among personal and socioeconomic stressors, health concerns and daily life dimensions had higher significant association with poor QoL. Conclusions: Results of our study indicated that life stressors have negative impacts on QoL of employees. Personal stressors showed higher negative impacts than socioeconomic on QoL. Managing the stressors has an effective role on improving the QoL of employees, their physical and mental health and indirectly enhances the organizational performance and job productivity.

Background and objective: accumulating evidence based on scarce studies suggests that the relation between depression and functional constipation is possible. However, more studies in order to provide more reliable evidence are needed. About one-third of depressed people experience constipation and, it has a key role in reducing the perceived quality of life of the affected individuals. In the current study, therefore, we aimed to evaluate whether depression is associated with higher risk of functional constipation and whether it is gender specific.Methods: This cross-sectional study was carried out among 3362 adults aged 18–55 years. In this study, functional gastrointestinal symptoms were determined using a Iranian reliable and valid version of the modified Rome III questionnaire. The Iranian validated version of Hospital Depression Scale (HADS) was used to evaluate psychological health. Scores of 8 or more on depression subscale in the questionnaire were considered to indicate the presence of depression. Self-administered questionnaires have been used to collect information regarding age, sex, marital status, education level, anthropometric measures, smoking, physical activity, antipsychotic medications use, dietary intakes. History of any predisposing chronic diseases including diabetes mellitus and cardiovascular diseases was also asked. Simple and binary logistic regression were used for data analysis. Results: mean ± SD age of participants was 36.29 ± 7.87 years and 58.5% were female. The prevalence of depression and constipation in our study sample was 28.6% and 33.6%, respectively. In crude model, in total sample depressed people showed higher significant risk of constipation OR=1.97 (95%CI:1.66-2.33). Although, we observed a significant association between depression and constipation in both genders, however the association was stronger in men than women (OR: 2.64; 95%CI: 1.91, 3.64 vs. OR: 1.52; 95%CI: 1.24, 1.86).In the full adjusted model, in total sample depressed people showed higher significant risk of constipation Adjusted OR=1.69 (95%CI:1.37-2.09). Although, we observed a significant association between depression and constipation in both genders, however the association was stronger in men than women (AOR: 2.28; 95%CI: 1.50, 3.63 vs. AOR: 1.55; 95%CI: 1.21, 1.99).Conclusion: Our study showed depressed people are at higher significant risk affecting by constipation. Our study findings justify mental health evaluation in all patients with functional gastrointestinal disorders particularly among constipated individuals.