Objective(s): This study aimed to evaluate the effect of SSRIs on the expression of miRNAs and their protein targets.Materials and Methods: In a 100 day open-label study of citalopram (n=25) and sertraline (n=25), levels of miRNA 16, 132, and 124 and glucocorticoid receptor (GR), Brain-derived neurotrophic factor (BDNF), and serotonin transporter (SERT) protein expression were measured by QRT-PCR and western blot in healthy control (n=20), patients with depression at the baseline, and same patients after 100 days of treatment.Results: Expression levels of GR and BDNF proteins were lower in the depressed group before treatment as compared with the healthy group (P<0.0001). The SERT level was higher among the depressed group before treatment in comparison with the healthy group (P<0.0001). The level of GR and BDNF significantly increased, and SERT expression decreased after receiving sertraline (P<0.05). When the depressed group received citalopram, only SERT and GR were altered (P<0.05). Among the microRNAs' expression investigated, mir-124 and mir-132 were higher, and mir-16 was lower among the depressed compared with the healthy group (P<0.0001). Individuals receiving citalopram only showed an increase in the expression of mir-16 while administration of sertraline led to a significant increase in the expression of mir-16 and a decrease in mir-124 and mir-132 (P<0.05).Conclusion: This elucidated the relationship between antidepressant treatment and the expression of different microRNA that control gene expression in various pathways involved in depressed patients. Receiving SSRI can affect the level of these proteins and their relevant microRNAs.

BackgroundInflammatory processes play a role in the etiopathogenesis of bipolar disorder type 1. Full therapeutic responses are seldom seen and the ongoing inflammatory processes in the brain could lead to neuronal loss. Curcumin, a relatively safe herbal compound, has been shown to have anti-inflammatory effects. The present randomized double-blind clinical trial study aimed to investigate the effect of adding curcumin to the treatment regimen of BID.Materials and methodsThis randomized double-blind clinical trial was conducted on 78 patients diagnosed with BID according to the Diagnostic and Statistical Manual of Mental Disorders (DSM 5) criteria. The sample were divided into two groups. Patients in both groups received sodium valproate starting at a dose of 600 milligrams per day and administered up to 20 milligrams per kilogram per day or the highest dosage of the patient’s tolerance. Patients in the intervention group also received curcumin as nanomicelle in soft gelatin capsules 40 milligrams per day. The control group received placebo tablets with the same characteristics as the curcumin tablets. They were assessed by a psychiatrist using the Young Mania Rating Scale (YMRS), Mini-Mental State Examination (MMSE), Clinical Global Impression (CGI), and a medication side effect questionnaire at the beginning of the study, as well as in the first, second, and fourth weeks of the study.ResultsAmong the 78 patients chosen to participate in the project, 54 people completed the trial. No specific side effect was observed in the two groups. Both groups showed an increase in their MMSE scores compared to the beginning of the study (value of p < 0.001). Although this increase was not statistically different between the two groups (value of p = 0.68). The YMRS score of both groups decreased significantly by the end of the study (value of p < 0.001); however, this decrease was not significantly different between the two groups (value of p = 0.64). In addition, the two groups experienced a significant increase in their CGI scores throughout the study (value of p < 0.001), this increase however was not statistically different between the two groups (value of p = 0.88).ConclusionThe present study suggested that curcumin may not be a useful adjuvant agent in the management of patients with BID receiving sodium valproate as treatment.Clinical trial registration: Iranian Registry of Clinical Trials (IRCT), identifier IRCT2016102530504N1.

Introduction Schizophrenia is associated with persistent cognitive deficits, which worsen treatment outcomes despite increasing antipsychotic doses. This study aimed to assess the effect of levetiracetam on the severity of schizophrenia symptoms and cognitive deficits in these patients. Materials and Methods In this randomized, controlled, three-blind randomized clinical trial approved by Mashhad University of Medical Sciences, Iran (IRCT20101130005280N31), forty chronic schizophrenic patients aged 18–60 years were randomly divided into two groups of levetiracetam and placebo. The levetiracetam group received levetiracetam for 8 weeks. The symptoms were evaluated by Positive and Negative Symptoms Scale (PANSS), Stroop test, Digit Span test and Wisconsin Test at baseline, 4th week, and 8th week. Data were analyzed through SPSS V. 23 software, descriptive tests and inferential statistics. Results At the end of the study, all subscales of the PANSS questionnaire reduced significantly (P < 0.05). Also, all subscales of the cognitive tests had significant changes. The trends of digit span tests, correct number of consonants and inconsonant were increasing. While the trends related to consonant errors, inconsistent errors, consistent reaction time and nonconsistent reaction time were decreasing. The changes in the number of classes were increased while changes in preservation error were decreased. Conclusion The results showed that levetiracetam has significant effects on clinical symptoms, especially negative symptoms. Also, it impacts significantly on cognitive functions. It is recommended that it be added to the pharmacological regimen of these patients to improve their clinical symptoms, quality of life and treatment outcomes.

Objective: Analog triptorelin is one of the effective agonists for the treatment of reproductive disorders, particularly prostate cancer. Due to results of previous studies, we hypothesized that obsessive-compulsive disorder (OCD can be effectively treated with the long-term administration of a gonadotropin-releasing hormone (GnRH) analog, namely triptorelin. The aim of this study was to evaluate the effectiveness of triptorelin injection in clients with OCD. Method: This randomized single-blind clinical trial was performed on 30 clients with OCD who had a Yale-Brown score of > 17 after 8 weeks of treatment. The participants were randomly assigned into two groups of triptorelin and placebo. The clients in the intervention group were treated with Selective serotonin reuptake inhibitors (SSRIs), including fluoxetine, in addition to triptorelin three times a month for at least 8 weeks. Clients in the control group received injection of distilled water as placebo three times in addition to the routine treatment. The outcome was evaluated by Yale-Brown OCD scale (Y-BOCS) at the baseline, as well as 4, 8, and, 20 weeks after the end of the treatment. Results: The mean scores of Y-BOCS in the intervention and control groups was 30.5 ±67.6 and 30.5 ±67.6, respectively, before intervention, indicating no significant difference between the two groups (P = 0.0.8). The comparison of Y-BOCS scores after the intervention showed a significant difference between the two groups in the scores 4 (P = 0.01), 8 (P < 0.005), and 20 (P < 0.005) weeks after the treatment. With regards to the side effects of the medicine, 6.7% (n = 1) of the clients in the control group developed headache and 66.7% (n = 10) had late period in intervention group. The results revealed a significant difference between the two groups in terms of side effects (P < 0.005). Conclusion: The results of this study showed triptorelin decreased the symptoms of OCD. The effectiveness of triptorelin in the treatment of symptoms in clients with OCD was confirmed in our study. However, due to the limited research addressing this domain, future studies are suggested to clarify this conclusion.

Background: OCD is the fourth psychiatric common disorder that is seen in 2-3% general population. OCD is a chronic and debilitating disease that has a negative effect on familial, social.educational & occupational function. On the other hand, Schizophrenia is the eighth debilitating disease in the world. Aim: The aim of this study was to assess the quality of life Qol of OCD patients and also to compare it with the schizophrenic patients Method:: In a cross- sectional study, held in Mashhad, Iran, quality of life in out-patients with Obsessivecompulsive disorder and schizophrenic disorder were compared. The sample size estimated 98 patients in each group. The WHO quality of life questionnaire was filled out through person to person interview. Results: There was strong evidence of the difference between the quality of life of OCD patients and schizophrenic patients. The quality of life in OCD patients was worse than schizophrenic patients. P-values were less than 0.000 in all aspects of quality of life, including physical health, psychological, social, relationships, and environment. Conclusion: The quality of life in OCD patients was significantly disrupted. Our study also showed that the quality of life in OCD patients was even worse than schizophrenic patients. These findings suggest a strong need for better management of these two disabling conditions in order to improve the Qol of patients.

Background: The relationship between depression and increased oxidative stress is well known. DNA damage by oxidation factors is an important cause of the aging process in psychiatric disorders. Aims: Owing to the scarcity of human studies and high inconsistencies in studies of the effects of antidepressants on DNA damage, the current study was undertaken to investigate the effects of depression and its treatment on DNA damage. Methods: In a 15-week open-label study of citalopram ( n = 25) and sertraline ( n = 20), levels of DNA damage were measured by comet assay, proinflammatory (Interlukin-6 (IL-6)) and oxidative DNA damage (8-hydroxy-2’-deoxyguanosine (8-OHdG)) markers by ELISA, and gene expression of base excision repair enzymes (8-oxoguanine glycosylase (OGG1) and poly (ADP)-ribose polymerase-1 (PARP1)) by quantitative real-time polymerase chain reaction in healthy control patients ( n = 14), with depression at the baseline and the same patients after week 15. Results: DNA damage, 8-OHdG, IL-6 and expression of PARP1 were elevated in patients with depression compared with the healthy controls ( p < 0.001). Selective serotonin reuptake inhibitor (SSRI) therapy could significantly reduce the depression score ( p < 0.01), DNA damage ( p < 0.001), as well as 8-OHdG and IL-6 ( p < 0.0001). Nevertheless, the expression of PARP1 and OGG1 showed no significant changes after treatment. Conclusions: This is the first study on the effect of SSRIs on the DNA damage and some of the repair enzymes in depression. Based on the results, depression can cause increased DNA damage. This damage is followed by activation of compensatory mechanisms whereby the expression of DNA damage repair enzymes is elevated. Finally, the treatment of psychiatric disorder by antidepressants can lower the level of oxidative DNA damage.

Objective Obesity is a medical condition that may have a harmful effect on health, leading to increased illness and reduced life expectancy. This study aimed to evaluate the relationship of psychiatric disorders in overweight and obese children and adolescents. Materials & Methods In this case-control study, 160 children and adolescent were enrolled refered to Clinic of Pediatric Endocrinology, Imam Reza hospital, Mashhad, Iran in 2009-2011. The sampling method of this study was non-probability and biased. Study instruments were SDQ, CDI, STAI, Peds QL. All questionnaires were self-administrating completed by subjects or their parents. Differences between groups were examined using t-test and chi-square tests as appropriate. Results There was no significant difference on scores of anxiety between two groups. However, significant difference was on scores of depression, quality of life, and strength and difficulty between two groups. In addition, there was no significant difference in gender effect on anxiety and depression. However, emotional symptoms were more in girl. In contrast, the conduct problems were more in boys. Anxiety and depression were more in adolescents. Conclusion Obesity has a negative effect on the anxiety, depression, and self-esteem of children and adolescents. It might be a more important risk factor for depression, anxiety, and other psychiatric disorders. This study also emphasizes the importance of prevention of obesity.

Background Empathy is one of the essential components of physician-patient relationship that has a significant effect on treatment outcomes. Objective The aim of this study was to assess the empathy score among medical students in Mashhad, Iran. Methods In this cross-sectional study in 2015, 624 medical students at Mashhad University of Medical Science (Iran) completed the Jefferson Scale of Physician Empathy (JSPE). Data were analyzed by SPSS ver. 16, using independent-samples t-test, Chi-square, MANOVA, Spearman correlation, and Confirmatory factor analysis. Results Of the 38.4% males and 65% females who participated in this study, the mean score of JSPE in the sample was 103.67 (±15.34) which was higher in women than in men. Also, the mean scores for each of the three factors of the scale were calculated. The total empathy score, compassionate care, and taking perspectives among different age groups were significant (p=0.000). Furthermore, students having high interest in their field were more empathic (p=0.008). Empathy of interns in relation to three areas of basic sciences (the first year, the second year and the first half of the third year), physiopathology (the second half of the third year, and the fourth year), and clinical trainings (the fifth year, and the first half of the sixth year), experienced significant reduction (p≤0.001). Conclusions This study showed that empathy was higher in women in their first medical year and who were of younger age. The overall rate of empathy in the basic sciences period was more than that in the clinical period. Therefore, the initial exposure to clinical education, especially patient education and empathy, has a very prominent effect on the ability of medical students.

Background: The psychological distress is a kind of mental stress that people experience due to various causes. This study was performed aimed to investigate the psychological distress in cancer patients.Methods: This cross-sectional study was performed during one year on the patients who referred to two academic hospitals of Mashhad University of Medical Sciences for treatment or follow-up. Psychological distress questionnaire was used to collect data. Results were analyzed using SPSS version 16. P

Background: Autism spectrum disorders (ASD) are early onset conditions characterized by significant impairment in social interaction and communication. Objectives: The purpose of this study was the assessment of Atomoxetine effectiveness and tolerability in the treatment of autistic features in patients with ASD. Methods: A total of 44 children, aged 6 to 17 years, diagnosed with ASD, enrolled in a 8 week randomized clinical trial. The study conducted at the outpatient clinic of Ibne-sina hospital and Dr. Sheikh hospital affiliated to the Mashhad Medical University in Iran, between August 2015 to September 2016. Subjects were randomly allocated to Atomoxetine (0.5 to 1.2 mg/kg/day) plus risperidone or Placebo plus risperidone. The primary outcome was assessed by the childhood autism rating scale (CARS) and clinical global impression (CGI). Patients were evaluated at baseline, 4 weeks and 8 weeks after the administration of the drug. Mixed ANOVA test is used for the outcome of evaluation. The clinical trial registration number is: IRCT2016022826802N1. Results: Atomoxetine augmentation comparison to placebo augmentation showed significant improvement in global impression and severity index in CGI, and also in total score of CARS and 7 subscales of CARS including relationship to people, emotional response, body use, listening response, fear and nervousness, nonverbal communication, and activity level (all P value <= 0.05). The most common adverse effects of Atomoxetine were mood change, irritability, and GI disturbance. Conclusions: The results showed that Atomoxetine add-on therapy maybe effective in symptoms of ASD while adverse effects tend to subside. The authors suggest further studies for clarifying this conclusion.

Introduction: Adolescence is a critical period in life, which is associated with tumultuous transitions and “storm and stress. The present study aimed to evaluate the correlation between depression, anxiety, and stress with the high-risk behaviors among the adolescents in Torghabeh and Shandiz towns, Iran. Materials and Methods: This cross-sectional study was conducted on 90 adolescents from the high schools. Participants were selected via two-stage sampling. Data were collected using the validated Depression, Anxiety, and Stress Scale (DASS-21) and history of high-risk behaviors in the students. Data analysis was performed in SPSS version 16. Results:Variable degrees of depression, anxiety, and stress were reported in 43.3%, 43.3%, and 38.9% of the students, respectively. Although the difference was not statistically significant, female students were more affected by the mentioned disorders compared to the male students. Among the high-risk behaviors, smoking cigarettes was significantly correlated with the depression, anxiety, and stress subscales. In addition, a significant association was observed between opium consumption and stress. However, no significant correlation was observed between smoking hookah and the DASS-21 subscales. Regular alcohol consumption was found to be significantly correlated with the higher rate of depression in the studied adolescents. Also, premarital sexual behaviors had a significant association with the stress and depression subscales. Conclusion: Lack of attention to depression, anxiety, and stress and their risk factors in adolescents may lead to variable degrees of life dissatisfaction in the community. Therefore, it is recommended that on-school mental screening programs be performed for high-school students in order prevent these complications.

Omega-3 fatty acid (FA) supplementation has been reported to improve several cardio-metabolic risk factors. We aimed to assess the efficacy of omega-3 fatty acids on metabolic and inflammatory indices in patients with schizophrenia who were taking clozapine and sodium valproate. All patients were on a stable dose of 300-400 mg of clozapine for 3 months. Subjects were randomized to treatment with either omega-3 fatty acid (4 gr/day) or a placebo for 8 weeks. Height, weight, abdominal circumference, serum lipid profile, fasting blood glucose (FBG), and serum high sensitivity-C-reactive protein (hs-CRP) were determined at baseline and after 8 weeks of treatment. Fifty six subjects were recruited into the study. Patients with schizophrenia who were in the group receiving omega-3 FA capsules had an improvement in some anthropometric indices including weight, BMI, wrist and waist circumference, compared to the placebo group. Only changes in waist circumferences remained significantly different after adjustment for serum fasted TG. Our results showed omega-3 FA supplementation can improve some anthropometric indices in patients with schizophrenia who are taking clozapine pharmacotherapy.

According to the literature, schizophrenia is associated with the components of metabolic syndrome. This mental disorder has such manifestations as visceral obesity, impaired lipid metabolism, hyperglycemia, and hypertension. The prevalence rate of schizophrenia varies in different countries. There is a body of evidence about the higher incidence of cardiovascular events in the schizophrenic patients with metabolic syndrome. Therefore, the prevention or treatment of this condition in sthese patients is a matter of fundamental importance. Fish oils, commonly used by people, contain omega-3 fatty acid. Omega-3 has been demonstrated to be effective in the patients with metabolic syndrome.

Background: The behavioral and psychological problems associated with chronic constipation include a wide range of disorders, which lead to impaired quality of life. The purpose of the current study was to evaluate psychiatric disorders and quality of life in children and adolescents suffering from chronic functional constipation. Materials and Methods: In a case-control clinical trial, 55 children and adolescents with functional constipation and 55 individuals without constipation were included into case and control groups, respectively. After taking medical history and physical examination, three questionnaires including demographic information, pediatric quality of life (PedsQL) questionnaire, and strengths and difficulties questionnaire (SDQ) were provided to parents, children, and adolescents. Collected data were coded and analyzed using SPSS software. Results: The mean child self-reported and parent-reported scores of PedsQL were 54.67±3.9 and 49.86±3.2 in the case group, while it was 63.26±4 and 66.09±3.4 in the controls. Only parent-reported quality of life score was statistically different among case and control participants ( p =0.014). The emotional performance of quality of life was statistically different based on both self and parents’ reports ( p =0.016 and 0.024, respectively). Total SDQ score was in abnormal levels in 93% and 83% of the case and control participants, which was insignificant ( p =0.631). There was no statistically difference in SDQ subgroups between the two groups. Conclusion: Quality of life and emotional performance are impaired in children with functional constipation and they should be screened for consequent disorders. Treatment and management of these patients can be improved through evaluating constipation related indices, quality of life, and referring at risk patients to related specialists.

Introduction: Empathy, an essential component of the physician–patient relationship, may be linked to positive patient outcomes. This study aimed to determine the empathy score among student residence assistants (RAs). Methods: In this descriptive design (cross-sectional study), 102 Iranian RAs participated in the study during 2015, completing the Jefferson Scale of Empathy (JSPE). Data collection was analyzed using SPSS version 17. MANOVA, independent-samples t-test, Spearman correlation and confirmatory factor analysis (CFA) were used for data analysis. Results: Mean score of JSE in the sample was 87.06 (±15.14). The mean scores for perspective taking, compassionate care, and standing in the patients shoes were 38.90 (±13.11), 39.27 (±7.94), and 8.89 (±2.80) respectively. Among the three specialties, (psychiatric, internal medicine, surgery) results showed significant differences in total empathy score (p=0.001) and perspective taking score (p= 0.008). Conclusions: this study showed significant differences in total empathy score and perspective taking in three specialties. We suggest that the curriculum in Iranian RAs include more teaching on empathy and communicational skills

Attention-deficit/hyperactivity disorder is one of the most common psychiatric disorders in childhood. The medications which inhibit the reuptake of noradrenline and dopamine including psychostimulants such as methylphenidate and dextroamphetamine and non-stimulating pre-frontal cortex noradrenaline reuptake inhibitor such as atomoxetine, are the standard treatment of ADHD. Adverse effects of stimulants have been reported in thirty percent of patients with attention-deficit/hyperactivity disorder. More than fifty percent of the parents of these children have tried one or more complementary or alternative medicines including vitamins in their children. Ginkgo biloba has been described to be effective for various neuropsychiatric symptoms. It was assumed that ginkgo biloba might improve some symptoms of attention deficit disorder as well. Nevertheless, no systematic study reported a possible efficacy of ginkgo biloba in attention deficit disorder. This review article evaluates the available evidence on the efficacy of ginkgo biloba medication in Attention-deficit/hyperactivity disorder children to present an appropriate guidance for this common child disorder.

Background: One of the major causes of death in schizophrenia is a metabolic syndrome. The clozapine has the highest rate of weight gain among antipsychotics. It has been shown that metformin can promote weight loss. We aimed to investigate the effect of metformin as an adjunctive therapy with clozapine to prevent metabolic syndrome in patients with schizophrenia. Materials and Methods: A total of 37 patients consisting metformin group (19 cases) and a group of placebo consisting of 18 cases were evaluated. A brief psychiatric rating scale score (BPRS) and metabolic profiles was determined for all patients. All of the variables were also determined at 2, 8, 16, and 20 weeks after the onset of the study. Results: The mean age of the group of metformin was 47.2 ± 10.4 compared with 45.8 ± 10.2 for the group of placebo. The difference in mean waist circumference and serum level of triglyceride at baseline compared with the end of study showed a statistically significant difference between two groups (P = 0. 000). A statistically significant difference was also observed in a comparison of mean difference of weight and body mass index at baseline compared with end of study (P = 0. 000). There was a statistically significant difference of fasting blood sugar (P = 0.011) and serum high-density lipoprotein (P = 0.000) between two groups but this difference was not significant for mean BPRS scores, mean systolic and diastolic blood pressure, serum level of triiodothyronine, thyroxin and thyroid stimulating hormone, serum low-density lipoprotein and serum cholesterol. Conclusion: Metformin could be considered an adjunctive therapy with clozapine to prevent metabolic syndrome in schizophrenic patients.

Background:: Thalassemia is an inherited blood disease. It is a serious public health problem throughout the Mediterranean region, the Middle East and the Indian subcontinent, as well as in Southeast Asia. Objectives:: Thalassemia is an inherited blood disease. It is a serious public health problem. In this study we assessed psychological aspects in Iranian children and adolescents with thalassemia major. Patients and Methods:: In this case-control study sixty healthy subjects aged 7-18 years and Sixty Patients with confirmed diagnosis of major thalassemia were enrolled. After obtaining informed consent from parents of all participating thalassemia patients and healthycontrols, we assessed psychological aspects and quality of life by Pediatric Quality of LifeTM (PedsQL™), Strengths and Difficulties Questionnaires (SDQ), State and Trait Anxiety, Children's Depression Inventory (CDI). Results:: The results of this study indicate that there are significant changes in depression, anxiety, QOL and behavioral screening between children with thalassemia major compared with healthy subjects by means of both parents and children reports. According to the results, children with thalassemia major have more psychological problems than healthy ones. Patients with thalassemia have a lower QOL than their peers (P = 0.001), the rate of depression is higher in this group (P = 0.015), Also behavioral problems in these children are more than healthy subjects (P = 0.009). Conclusions:: We recommend appropriate treatment and counseling procedures in addition to specific treatment of thalassemia. According to the results we suggest to establish pediatric psychiatric clinics beside thalassemic clinics to cure psychological aspects of the disease.

Introduction:Determining the effect of stress on strock in benficial. If there is a relationship between them, using public education can lead to decrease the risk of stroke. This study investigate the effect of stress on cerebrovascular accident. Methods: This study was a prospective case-control, which was performed on the patients with stroke referred to nerve clinical Ghaem Hospital, and the control group were selected among the staff of the university with no history of stroke during winter 2015. The persian translation of questionnaire of Holmes and Rahe stress scale related to the last month was completed among all of the participants in both groups. Diagnosis of stroke and determination of its etiology was made by neurologist. Results: By considering the frequency of serve stress, 361 patients with stroke were investigated and from these 190 patients were in the control group. The relative frequency of stress and stroke and intracerebral homorrhage and subarachnoid hemorrhage were meaningful(p<0.001, p<0.001, p=0.006). There was no significant relationship between the relative frequency of serve stress among the patients with ischemic stroke, cryptogenic infraction, and cardioembolic with atherosclerotic and the control group (p=0.637, p=0.311, p=0.439, p=0.109,). There were a significant relationship between serve stress and atherosclerotic stroke(p=0.026). While, high stress score was significantly more frequent in atherothrombotic subtype of brain infarction than controls, p=0.046. Conclusion: There was a meaningful relationship between stress as an important risk factor in the patients with hemorrhagic stroke and atherothrombotic brain infarction. Based on this research stress could be considered as a risk factor of stroke.

Constipation is one of the most common gastrointestinal problems among children. The behavioral and psychological problems associated with chronic constipation include a wide range of disorders that reduce quality of life. The objectives were to evaluate psychiatric disorders and quality of life in children and adolescents with constipation.In a case–control clinical trial, 55 children and adolescents with functional constipation and 55 without constipation were assigned to case and control groups, respectively. After taking the medical history and physical examination, we provided 3 questionnaires to parents, children, and adolescents: a demographic questionnaire, a pediatric quality of life questionnaire, and a strengths and difficulties questionnaire (SDQ). Collected data were coded and analyzed with SPSS (IBM SPSS Statistics, IBM Corporation).The mean child self-reported and parent proxy–reported scores on the quality of life questionnaire were 54.67 ± 3.9 and 49.86 ± 3.2 for the case group and 63.26 ± 4 and 66.09 ± 3.4 for the control group. Only the parent-reported quality of life score was statistically different between case and control patients (P = .014). The emotional performance quality of life score was statistically different on both self-reported (P = .016) and parent-reported (P = .024) questionnaires. The total SDQ score was abnormal for 93% and 83% of case and control participants, respectively, which was an insignificant difference (P = .631). There was no statistically significant difference in SDQ subgroups and impact scores between the 2 groups.Quality of life and emotional performance are impaired in children with functional constipation, and they should be screened for consequent disorders. Referring at-risk patients to related specialists might improve treatment and help control constipation.