Iranian Journal of Psychiatry and Clinical Psychology
Year:2017 | Volume:22 | Issue:4 |Papers Count:14

Rapid technological progresses have affected different aspects of human life such as healthcare, and have resulted in formation of new medical terms such as “electronic health (e-health)” and “telemedicine”. E-health is providing healthcare services through electronic media, and “telemedicine” as one of the subsets of e-health, are those medical services which can be provided though live, interactive, and mutual televideo communication between the patient and the physician. The inclusion criteria have to be specified based on medical needs, applicability, cost-effectiveness, and the clinical condition of the patient. The allocated bandwidth, should also be considered. Researches have shown that effective optimal clinical care is the most important keyfactor in providing successful outcomes by telemedicine, and the role of updated equipment and facilities are insignificant in this regard.Telemedicine has also been successfully used in mental health care systems. “Telepsychiatry” is defined as the implication of telemedicine in mental health and psychiatric services, and “telepsychiatrist” is the psychiatrist who provides telepsychiatric services via electronic communication to residences of remote areas. Telepsychiatry is applicable in all age ranges and developmental and cognitive levels, and can be used in clinical evaluation and assessment, diagnosis, treatment, medical education, consultation, forensics, and emergency care, in a variety of mental disorders.Besides current barriers for implementing telemedicine in the mainstream of clinical practice, it seems that the rapid development of technology, will make the use of telemedicine in the medical and healthcare systems widespread and even inevitable.

Objectives: The aim of present study was to investigate the predictive role of Mindfulness, Emotion regulation, Distress tolerance, Interpersonal effectiveness (by controlling the effects of demographic variables, depression and anxiety).Methods: The study design was correlational. A total of 240 students of Tehran University of Medical Sciences were selected using stratified proportional sampling method. Data were collected using five facet mindfulness questionnaire (FFMQ), Distress Intolerance scale (DTS), Difficulties in Emotion Regulation Scale (DERS), Bar-On Emotional Quotient Inventory (BEQI), Depression, Anxiety and Stress Scale -21 (DASS -21), Obsessive- Compulsive Inventory – Revised (OCI-R) and demographic data questionnaire. The gathered data was analyzed using Pearson correlation and hierarchical regression.Results: The highest correlation relationships was between obsession sub-type with total score of mindfulness (r=-0.47), total score of emotion regulation (r=0.56), absorption sub-scale of distress tolerance (r=-0.38), total score of interpersonal effectiveness (r=-0.43), total score of depression (r=0.49), and total score of obsessive-compulsive symptoms with anxiety (r=0.5). The results of regression analysis indicated that control and predictive variables account for 43% of obsessive-compulsive symptoms variance, 27% of washing variance, 49% of obsessing variance, 22% of hoarding variance, 8% of ordering variance, 32% of checking variance, and 45% of neutralizing variance. So that their weight percentages in models of all OCDs were higher than the predictor variables. This highlights the necessity of considering these variables in research and treatment of the symptoms of obsessive-compulsive disorder. Theoretical and clinical implications of the results have been discussed in detail.Conclusions: Control and predictive variables play a role in the prediction of the total score of obsessive-compulsive symptoms and all sub-types. However, different variables involved in subtypes may be considered as distinctive pathology among sub-types. The highest correlation relationship and accounted variance through study variables were in the case of obsessing. The results also indicate the noticeable role of depression and anxiety in the prediction of all sub-types.

Objectives: The present study aims to determine whether the association between family function and suicidal ideation on one hand and correlation of family functions and hopelessness on the other hand can be supposed that hopelessness acts as a moderator in the association between family functions and suicidal ideation.Methods: For this, 373 accessible Shahid Beheshti students were selected and measured with self-reporting means. After performing Family Assessment Devices, Beck Hopelessness Scale and Beck scale for suicidal ideation, the gathered data were analyzed through simple correlation and hierarchical regression by SPSS 19.Results: There are significant positive correlations between understanding total family function and hopelessness, family function and suicidal ideation and also between hopelessness and suicidal ideation of students. Therefore, hopelessness has a moderating role in the association between understanding family function and suicidal ideation.Conclusions: The association between family function and suicidal ideation increases at higher levels of hopelessness while in lower levels of hopelessness, this association is not significant.

Objectives: The aim of this study was to examine the relationship between identity styles and dimensions of perceived parenting with the intensity of depression in adolescents.Methods: In a correlation design, 200 (100 girls and 100 boys) students aged 14-18 years were selected from Tehran high schools using cluster sampling. Participants were asked to complete Beck Depression Inventory-2 (BDI-2), Parenting Style Questionnaire (PSQ) and Identity Styles Inventory (ISI) questionnaires. Data were analyzed using Pearson correlation and step-by-step regression (stepwise).Results: Significant relationship was found to exist among the dimensions of perceived parenting and identity style along with depressive intensity. Additionally, predictor variables including identity commitment, dimensions of acceptance, and control parenting with correlation (r=0.50) could predict 0.25 percent of depressive intensity among adolescents (R2=0.52).Conclusions: It seems that identity commitment and parenting style based on parent acceptance among adolescents are two important variables in preventing depressive symptoms. Parenting style and adolescent parent communication are acceptable skills. In addition, the pathology resulting from depression among the adolescents was high, so it is important to address this problem practically.

Objectives: Sexual relationship is a mutual interaction, which its promotion requires appropriate contribution of both partners. Given the complaints of lack of female contribution in sexual relationships where the male is the initiator, this article aims at exploring the roots of not being responsive toward male sexual request in married women.Methods: This was a qualitative study with content analysis approach for exploring the concept of sexual behavior in married women of reproductive age. In-depth interviews and focus group discussions were conducted with 52 Iranian women in Rafsanjan and Isfahan. Fifty-two subjects from target group were in Rafsanjan and Isfahan cities that voluntarily took part in 4 individual deep interviews and 8 focused group consisted of 48 participants. All sessions and discussions were recorded and transcripted verbatim.Inspired by the Graneheim approach, content analysis was adopted to extract the meanings and perceptions.Results: From study data, we extracted three main themes: “attention and affection prerequisite, ” “deviation from sexual script” and “individual wishes.” Conclusions With respect to sexual and marital life quality promotion in women, it is essential for caregivers to take care of women expectations and sexual authority. We suggest these contents be mentioned in premarital consult.

Objectives: The study was performed to determine the factor structure of the Persian translation of Personality Inventory for DSM-5 (PID 5).Methods: After translation and back translation of PID-5, it was performed on 217 subjects, including 114 healthy students and 103 patients with personality disorders. Exploratory factor analysis was done using principal component analysis and direct oblimin rotation to determine the main factors of the inventory and factor loading of the facets. We used SPSS 20 for data analyses.Results: Using direct oblimin rotation, 5 factors were extracted. The 1st factor Depression-Anxiety includes 8 facets: anhedonia, anxiousness, depressivity, distractibility, emotional lability, impulsiveness, separation insecurity and submissiveness. The 2nd factor Antagonism includes 6 facets: attention seeking, callousness, deceitfulness, grandiosity, hostility and manipulativeness. The 3rd factor Detachment includes 4 facets: intimacy avoidance, restricted affectivity, withdrawal and suspiciousness. The 4th factor includes 5 facets: preservation, rigid perfectionism, impulsiveness, irresponsibility and risk taking. Finally, eccentricity, perceptual dysregulation, unusual beliefs, and experiences were categorized under the 5th factor.Conclusions: The Persian version of PID-5 has acceptable construct validity and could be used as an assessment tool for personality disorders in Iranian samples, if other types of validity and reliability of the tool are proved to be satisfactory.

Objectives: The aim of this study was to investigate the mediation role of ruminative response style in the relationship between dysfunctional attitudes and depression symptoms.Methods: This correlational and descriptive study was conducted on 200 undergraduate students (99 females and 101 males) who were selected by convenience sampling method out of Shiraz University students in academic year 2012-2013. To measure the study variables, the revised form of depression scale, short form of dysfunctional attitudes scale and ruminative response style scale were used. To examine the study hypotheses, the simultaneous multiple regression model according to Baron and Kenny (1986) and structural equation modelling were used. To study the fitness of the proposed model, the absolute, adjusted and comparative fit indices and to determine the significance of indirect effect of moderate variable, the snowball sampling were used by SPSS16 and Amos graphic.Results: The results showed that dysfunctional attitudes were negative and significant predictor of depression symptoms both directly and indirectly through ruminative response style. Moreover, the results of the absolute (RMSEA=0.06), comparative (CFI=0.97) and adjusted (AGFI=0.91) fit indices showed that the proposed model had a close relationship with data of fitness sample and the theoretical assumptions.Conclusions: Finally, the model parameters matched the model in terms of optimal fit.

Objectives: Mental illnesses are common among outpatient clinics, but only some of these patients receive adequate treatments and attend. The purpose of this study is to evaluate the dropout rate and identify the predictors of dropouts in outpatient clinics in Roozbeh Psychiatric Hospital.Methods: A questionnaire designed by expert psychiatrists was filled. The questionnaire consists of information collected from medical records of 400 patients who consulted outpatient clinics of Roozbeh Psychiatric Hospital. The data were analyzed using SPSS16.Results: The total dropout rate was 57.8% (males: 33.5% and females: 24.3%). The dropout rates in adult and child and adolescent clinics were 58% and 43.8%, respectively. A total of 11% of total dropout rate was in patients under 18 years, 41.8% was in patients aged 18 to 65 years, and 5% was in patients aged 65 years and over. There were significant relationships between drop-out rate and variables of patients' age, educational degrees, occupation, referral point, and type of diagnosis. However, no significant relationships were found between drop-out rate and gender or marital status of the patients.Conclusions: Dropout is a common barrier in delivering outpatient psychiatric treatments. There need to be proper interventions to reduce such dropouts.

Objectives: Social anxiety is one of the most common disorders of adolescence. Among the factors affecting the disorder to determine the sex (female or male) reported conflicting results, while the relation between gender role consistent with some anxiety disorders. The aim of this study was to compare social anxiety and its cognitive (AFNE) and behavioral (TISC) aspects based on different sex and gender roles (femininity, masculinity, androgyny and indistinct).Methods: Students (N=277) aged 12 to 13 years were selected using cluster sampling. They were asked to complete research questionnaires including Social Anxiety Scale for Adolescents (SASA) and Child Sexual Role Inventory (CSRI).Results: The results of T-test, correlation analysis and variance analysis showed significant positive relationships between femininity and social anxiety and its cognitive and behavioral aspects. Significant negative relationships between masculinity and these variables (P<0.5) were also found. More significant mean scores were observed for social anxiety and its cognitive and behavioral aspects in the group by feminine gender-role in comparison with other groups (masculine, androgen and indistinct). However, there was no significant difference in the scores of social anxiety and its cognitive and behavioral aspects in both sexes.Conclusion: The gender-role schema can be considered as a factor associated with social anxiety and its cognitive and behavioral aspects in adolescents.