Introduction: Migration of medical professionals has been rapidly increasing in the past decades and it strongly affects origin and destination countries. Objectives: We aimed to explore the extent and the reasons of migration among psychiatric trainees and early career psychiatrists in Iran. Methods: Our semi-structured 61-items questionnaire inquired participants’ demographics, experiences of short-term mobility (from 3 months to 1 year), long-term migration (more than 1 year) and attitudes towards migration (current and future plans). Results: A total of 184 responses were received. Most (73.4 %) participants were female, and within the age range of 25–65 (Mean: 34.9). Only 15.2 % had a short-term mobility experience, mostly due to academic reasons (35.7 %). Most (75 %) stated that this short-term mobility experience influenced them in favor of migration. The majority (83.7 %) had ‘ever’ considered leaving Iran, and more than half (57.3 %) stated they ‘strongly agree’ or ‘agree’ to leaving the country ‘now’ (at the time of the study). The main reason to migrate from Iran was first political, followed by work, financial, social, religious, academic, and cultural reasons, and the least ranked were personal reasons. In relation to their 5-year plans, 67.3 % saw themselves in the country they currently live in, Iran. The main features reported for an attractive job were ‘pleasant work environment’ (97.3 %), ‘good welfare and social security’ (96.7 %) and ‘high salary ‘(96.2 %). Conclusions: This study calls for more support of psychiatric trainees and early career psychiatrists in Iran. Improvements in the political context, work conditions and finances might lower the rate of migratory intention and brain drain.

Background The Minimal Clinically Important Difference (MCID) is a crucial measure in clinical research, reflecting the smallest change in symptoms that patients perceive as beneficial. While MCID values have been established for various symptoms in Parkinson’s disease (PD), they remain underexplored in the context of depression. Objective This study aims to determine MCID values for three commonly used depression scales in PD: The Beck Depression Inventory (BDI-II), the Hospital Anxiety and Depression Scale – Depression subscale (HADS-D), and the 15-item Geriatric Depression Scale (GDS-15). Methods A total of 112 individuals with PD and depression (mean age = 70.91 ± 3.12 years) participated in a 10-week cognitive behavioral therapy program. The MCID values were estimated using both distribution-based and anchor-based methods. The Global Rating of Change (GRoC) scale was used as an anchor to assess perceived changes in depressive symptoms. Results MCID values were refined using the mean difference approach, resulting in the following: -5.79 points for the BDI-II, -3.52 points for the HADS-D, and − 3.05 points for the GDS-15, all with statistical significance (p < 0.001). Using Youden’s index, the optimal MCID cut-off values were ≤ -3 points for BDI-II, ≤ -2 points for HADS-D, and ≤ -2 points for GDS-15, with high sensitivity and specificity for each. The MCID values derived from the distribution-based method for the BDI-II, HADS-D, and GDS-15 were 5.57–3.55, 1.11–3.07, and 0.96–2.66 points, respectively. Conclusions This study establishes MCID thresholds for commonly used depression scales in PD. These benchmarks are essential for improving clinical decision-making and evaluating the effectiveness of interventions in both clinical and research settings.

Selective serotonin reuptake inhibitors (SSRIs) are the cornerstone of psychopharmacology. However, they cause side effects such as sexual dysfunction, leading to the discontinuation of treatment. We aimed to investigate the efficacy and safety of drug holidays for women experiencing sexual dysfunction Induced by SSRIs other than fluoxetine. This study was an 8-week randomized, open-label, controlled trial including married women aged between 18 and 50 years who had experienced sexual dysfunction while undergoing treatment with SSRIs. The intervention group implemented drug holidays by not taking medications on Thursdays and Fridays, while the control group continued regular medication use. The female sexual function index (FSFI) and the 28-question general health questionnaire (GHQ-28) were administered to assess sexual function and mental health, respectively. A total of 50 participants completed the trial. The drug holidays’ group showed significant improvements in arousal (p < 0.001), desire (p = 0.001), orgasm (p < 0.001), satisfaction (p < 0.001), lubrication (p = 0.021), and overall sexual health (p < 0.001). The between-group difference of pain was significant (p < 0.001), despite no significant within-group change. Mental health improved in both groups, despite no significant between-group difference. No major adverse effects were reported. Drug holidays did not introduce immediate safety concerns or significant adverse effects during the timeframe of eight weeks, suggesting that it may be a safe and effective strategy for managing SSRI-induced sexual dysfunction in women, alongside improving mental health. Further research is needed to reach a definitive conclusion.

Cognitive impairment (CI) is a significant non-motor symptom of Parkinson's disease (PD), necessitating effective assessment tools to evaluate treatment efficacy. Minimal Clinically Important Difference (MCID) thresholds provide critical benchmarks for interpreting cognitive intervention outcomes. This study establishes MCID values for PD Cognitive Rating Scale (PD-CRS), Scales for Outcomes in PD-Cognition (SCOPA-COG), and Montreal Cognitive Assessment (MoCA) in PD-CI. A total of 110 patients with PD-CI were recruited; 105 (mean age 71.96 ± 2.40 years) completed the 12-week Dual-Task Training (DTT) program and were included in the final analyses. Cognitive function was assessed using PD-CRS, SCOPA-COG, and MoCA at baseline and post-intervention, with the Global Rating of Change (GRoC) questionnaire serving as an anchor. The MCID value was determined using anchor-based and distribution-based approaches. Receiver Operating Characteristic (ROC) analysis was employed to evaluate these thresholds. Significant improvements were observed across all cognitive measures post-intervention. The anchor-based MCID values were 7.70 points for PD-CRS, 3.11 points for SCOPA-COG, and 2.05 points for MoCA, respectively. Additionally, ROC curve analysis further determined that MCID cut-off points were > 3 points for the PD-CRS, > 2 points for the SCOPA-COG, and > 1 point for the MoCA. The distribution-based MCID values ranged from 1.48 to 4.10 points for PD-CRS, 1.37 to 5.95 points for SCOPA-COG, and 0.54 to 3.71 points for MoCA. This study established MCID thresholds for PD-CRS, SCOPA-COG, and MoCA in PD-CI, providing essential tools for clinicians and researchers to assess clinically meaningful changes after cognitive intervention.