Iranian Journal of Psychiatry and Clinical Psychology
Year:2012 | Volume:17 | Issue:4 (67)|Papers Count:12

Objectives: The aim of the current study was to evaluate the integration of mental health program into primary health care system.Method: In a cross-sectional, quantitative and qualitative study, the knowledge, attitude and performance of 1209 individuals of general population, 146 behvarzes, 35 health technicians and 51 general practitioners from rural health centers of Gilan, Tehran, Meshad, Iran, Kerman and Kermanshah universities of medical sciences who were undercoverage and out of coverage of mental health program in the rural areas of selected centers, were selected by randomized cluster sampling. The data was gathered using knowledge, attitude and performance questionnaires of behvarzes, general population and general practitioners toward mental health, behvarzes' performance on training, following up and referral of mentally patients based on primary health care (PHC) program, knowledge and attitude of general population toward mental illnesses, epilepsy, mental retardation, their causes and treatments, general physicians awareness about treatment, referral and integration of mental health program into PHC, general practitioners's performance of health centers and a semi-structured questionnaire for focus group discussion sessions (FGD). Thirty trained mental health experts from neighborhood of selected provinces, completed questionnaires and analyzed. Descriptive statistics and independent t-test were executed.Results: There was significant difference between behvarzes in areas under coverage and out of coverage in knowledge (p£0.01) and attitude (p£0.04), as well as between general population in areas under coverage and out of coverage in knowledge (p£0.001) and attitude (p£0.001). Although the knowledge of general practitionners in the coverage areas were high, the findings showed that %34.3 of them had difficulty in diagnosis and %48.6 had problem in treatment of psychotic patients.Conclusion: Integration of mental health programs into PHC is an effective and affordable method which with continuous monitoring and evaluation could be lead to valuable results.

Objectives: This study examined the effectiveness of psychodrama in improving social skills and reducing internet addiction among female students with addiction to internet in Isfahan university.Method: In a semiexperimental study, 36 subjects were selected via convenient sampling which randomly assigned in two groups: 18 as the experimental group and 18 as the control group. The experimental group had received ten sessions of social skills training with psychodrama approach. The internet addiction and social skills were assessed via the Yong's Internet Addiction Test and Social Skills Inventory. The applied intervention was evaluated in three stages: pretest, post-test and a one month follow-up. Data were analyzed by correlation coefficient and analysis of covariance tests.Results: The experimental group demonstrated a significant improvement in social skills (p<0.001) as well as a significant decrease in internet addiction (p<0.001) in comparison with the control group.Conclusion: The interactions between subjects in psychodrama's group, propund of problems in the presence of participants and discovering the ultimate solution with protagonist are critical factors of the mentioned intervention. The results also suggest that psychodrama interventions can be an effective intervention for improving social skills in persons with internet addiction.

Objectives: The purpose of the current study was to assess the effectiveness of multi-dimensional group therapy for symptoms of obsessive-compulsive disorder (OCD).Method: Among 53 patients with OCD referred to a hospital in Tehran, 12 patients to experimental group and 12 patients to control group were assigned. Not being affected to major depression, bipolar disorder and personality disorder was approved. The data was gathered using clinical interview based on Diagnostic and Statistical Manual of Mental Disorders, 4th edition, Text Revision (DSM-IV-TR), Cattel Personality Test and Yale-Brown Obsessive-Compulsive Scale (Y-BOCS). For evaluating the symptoms severity, Y-BOCS were executed before, during and after intervention. Multidimensional group therapy was performed in thirty 2-hour sessions based on Clark Therapeutic Program in accordance with Lazarus multi-dimensional treatment and Islamic-Iranian culture.Results: The severity of symptoms subscale decreased during treatment (p<0.001).Conclusion: Designed multi-dimensional group therapy based on Islamic culture was effective for treatment of OCD symptoms.

Objectives: The aim was to evaluate the validity and reliability of the persian version of Yale-Brown Obsessive-Compulsive Scale (Y-BOCS).Method: The sum of 140 patients with obsessive-compulsive disorder (OCD) and 30 individual participants without OCD were selected via convenient sampling as experimental and control groups respectively. Data gathering was done using Y-BOCS, Structured Clinical Interview for DSM-IV axis-I disorders (SCID-I) and Symptom Checklist-90-Revised Obsessive-Compulsive Symptoms (SCL-90-R-OCS). Reliability coefficients were calculated by Cronbach's alpha, split-half, and testretest reliability. For validity assessment, concurrent criterion-related validity in correlation with SCID-I and SCL-90-R-OCS, and construct validity (exploratory factor analysis) were executed. In order to normalize the YBOCS after insuring that the distribution is normal and does not have kurtosis and skewness, mean and standard deviation were used as the most appropriate central tendencies and deviation.Results: Optimal levels of internal consistency scores (symptom checklist 0.97, severity scale 0.95) split-half reliability (symptom checklist 0.93, severity scale 0.89), and test-retest reliability (0.99) were calculated. Concurrent reliability were examined and established by correlating the Y-BOCS with the SCL-90-R-OCS and SCID-I. Exploratory factor analysis was also examined, which indicated three factors for symptom checklist scale and two factors for symptom severity scale. Cutoff point value (9) was also determined.Conclusion: The results supported satisfactory validity and reliability of translated form of Yale-brown Obsessive-Compulsive Scale for research and clinical diagnostic applications.

Objectives: The aim of the present study was to compare intolerance of uncertainty and worry among patients with generalized anxiety disorder (GAD), obsessive-compulsive disorder (OCD) and normal individuals.Method: Thirty one patients with GAD, thirty one patients with OCD and thirty one normal individuals were selected via inconvenient sampling. Data gathering was done using Intolerance of Uncertainty Scale (IUS) and Penn State Worry Questionnaire (PSWQ). The data were analyzed in multivariate analysis of variance model (MANOVA).Results: The results showed significant differences in the subscales “uncertainty leads to the inability to act” and “uncertainty is stressful and upsetting”, and in “worry” between three groups of GAD, OCD and normal (p<0.0001). The differences between OCD and GAD groups with normal group were significant in intolerance of uncertainty and two subscales: “unexpected events are negative and person should avoid them” and “uncertainty is unfair” (p<0.0001).Conclusion: Intolerance of uncertainty is a common feature of OCD and GAD. Coping strategies for decreasing uncertainty differentiate these two disorders.

Objectives: The present study aimed to investigate risk and protective factors of drug abuse among high school students.Method: The sum of 1124 high school students (573 boys and 551 girls) were selected based on the stratified random and cluster sampling from Tehran's high schools. A number of different scales, American Drug and Alcohol Survey (ADAS), Prevention Planning Survey (PPS), Blings-Moss Copying Responses (CR), Cooper-Smith Self-Esteem Inventory School Form (SEISF), Collins-Reed Revised Attachment Inventory (RAI), and Bar-On Emotional Quotient Inventory (EQI) were administered for data gathering. The data were analyzed using t-test, chi-square, logistic regression and odds ratio models.Results: There were significant differences between students with and without drug abuse in copying styles, self-esteem, attachment style, emotional intelligence, family atmosphere and family substance abuse. Odds ratio of drug abuse for students with family drug use for boys and girls was 11 and 1.63 times more than others respectively.Conclusion: In the recent years, the most important achievement in the areas of theorizing and policy-making for drug abuse preventive programs is to emphasis on risk and protective factors as a descriptive and predictive framework. This study findings emphasized family factors, self-esteem, emotional intelligence and coping styles in this regard.

Objectives: In most advanced countries, there are tissue, deoxyribonucleic acid (DNA) and ribonucleic acid (RNA) banks which have been made to provide samples for researchers in order to speed up genetic studies in different medical disorders. This may save time and materials in comparison to self-governing projects that usually spend months to collect samples independently. In these banks patients are cautiously diagnosed based on international diagnostic criteria. Thus, the results are more reliable than scattered studies and meta-analysis can be done with the data generated in different laboratories using the same samples.Method: For the establishment of a DNA bank for psychiatric disorders in Iran, after clarifying the aims and signing the consent forms, 300 saliva samples were collected using Oragene DNA Kit from the patients diagnosed based on the Structured Clinical Interview for DSM-IV Axis I Disorders (SCID-I). Related data to demographics, family history, date of disorder onset, duration of disorder, drugs in use and other variables were compiled and opportunity for future contacts was set to gather more information including the course of disorders.Results: A saliva bank for DNA extraction of 300 psychiatric patients suffering from schizophrenia, bipolar disorder, major depressive disorder, obsessive-compulsive disorder and attention deficit hyperactivity disorder, 30 ones relatives as well as 75 matched healthy control subjects for genetic and epigenetic studies was established.Conclusion: The opportunity for donation of DNA samples collected from Iranian psychiatric patients has been provided to be used in hundreds of national and international genetic studies.

Objectives: The aim of the current study was to report associated problems of Poland Syndrome in a patient.Method: A 5 years old son affected to Poland Syndrome was accurately assessed.Results: The results showed the patient had communication, verbal and behavioral problems besides Poland Syndrome. Also, he received attention deficit hyperactivity disorder diagnosis and had seizure history. After accurate assessment, autistic disorder was diagnosed and occupational and speech therapy was prescribed besides treating seizure and symptoms of other problems.Conclusion: When a patient is being referred because of hyperactivity, s/he should be accurately evaluated and assessed for other psychiatric problems.