Iranian Journal of Psychiatry
Year:2010 | Volume:5 | Issue:4|Papers Count:8

Spinal cord injury (SCI) leads to loss of nervous tissue and consequently to catastrophic neurological deficits. Up to now there is no definite treatment available that restores the loss of function to a degree that an independent life can be guaranteed.This justifies the cost of research into the new modalities for a treatment of SCIs. In current paper, recent developments and new approaches in pharmacological therapy have been reviewed.

Objective: Bad news disclosure is one of the most complex tasks of physicians. Recent evidences indicate that patients' and physicians' attitude toward breaking bad news has been changed since few years ago. The evidence of breaking bad news is different across cultures. The aim of this study is to evaluate the attitude of medical staff toward breaking bad news to provide a clinical guideline in Iran.Methods: A descriptive study was conducted during 2008-2009 on a sample of 100 medical staff (50 physicians and 50 nurses) at Cancer Institute of Imam Khomeini hospital. The subjects' demographic characteristics and their attitudes toward the manner of revealing the diagnosis were registered in a questionnaire.Results: The majority of the physicians (86%, n=43) and nurses (74%, n=37), mostly the older and more experienced, tended to reveal the diagnosis to patients. Only a few physicians (8%, n=4) had been trained how to disclose bad news, which discloused diagnosis more than non-trained ones.Physicians and nurses preferred to inform the patients about the diagnosis when either the patients were alone or in the presence of their spouse respectively. Only a few physicians (14%) and nurses (24%) agreed to explain life expectancy to patients.Conclusion: Compared to past, physicians and nurses are more willing to share cancer diagnosis with patients. However, lack of adequate communication skills in caregivers, and their concerns about managing patients’ emotional reactions reduce their tendency to disclose bad news to the patients. Therefore, training physicians and nurses to expose bad news to the patients seems to be necessary.

Objective: The main aim of the current survey was to evaluate a hypothesized model on subjective quality of life (SQOL), and to survey the role of scale anchoring on satisfaction and dissatisfaction ratings.Method: The sample consisted of 456 volunteering students who were randomly assigned in to two different conditions, and rated their current overall life (dis) satisfaction and their (dis) satisfaction on six different domains of life. Each condition used one of the two rating scale formats; the formats differed in anchoring (-5 to +5 and 0 to 10). In order to find how the six different domains of life combine to produce an overall measure of subjective quality of life, a SQOL model was designed; and the strength of this hypothesized model of SQOL was examined using structural equation modeling.Results: The results of testing for multiple group invariance of the hypothesized model indicated a cross-validity for the studied model for measuring SQOL. Our results also indicated that comparing the two different response formats, only for scores derived from Horizontal (0 to 10) response format, all the paths in the model were found to be significant.Conclusion: The results of the confirmatory factor analysis (CFA) support the conclusion that the proposed model of SQOL fit the data well, and is able to predict SQOL.

Objective: This study has used Item Response Theory (IRT) to examine the psychometric properties of Health-Related Quality-of-Life.Method: This investigation is a descriptive- analytic study. Subjects were 370 undergraduate students of nursing and midwifery who were selected from Tabriz University of Medical Sciences. All participants were asked to complete the Farsi version of WHOQOL-BREF. Samejima's graded response model was used for the analyses.Results: The results revealed that the discrimination parameters for all items in the four scales were low to moderate. The threshold parameters showed adequate representation of the relevant traits from low to the mean trait level. With the exception of 15, 18, 24 and 26 items, all other items showed low item information function values, and thus relatively high reliability from low trait levels to moderate levels.Conclusions: The results of this study indicate that although there was general support for the psychometric properties of the WHOQOL-BREF from an IRT perspective, this measure can be further improved. IRT analyses provided useful measurement information and demonstrated to be a better methodological approach for enhancing our knowledge of the functionality of WHOQOL-BREF.

Objectives: This study aims to assess the validity and reliability of the Persian version of Simons and Gaher `s Distress Tolerance scale (DTS) by administering it to nicotine dependent students of Tehran University.Method: In a descriptive cross-sectional study, 317 nicotine dependent students of Tehran University who were selected, using available sampling method, completed DTS, Coping with Stress- Revised (CS-R), Positive and Negative Affect Scales (PANAS) and Fagerstrom Test for Nicotine Dependence (FTND). Data were analyzed using descriptive statistic methods and correlation coefficient.Results: The alpha coefficients for Tolerance, Absorption, Appraisal and Regulation subscales were 0.75, 0.77, 0.70 and 0.75, respectively. The test-retest correlation coefficients with two months interval for Tolerance, Absorption, Appraisal and Regulation subscales and the total scale were 0.71, 0.69, 0.77, 0, 73 and 0.79, respectively; all of which were statistically significant (p<0.001). The correlation coefficient of DTS with problem-focused, emotional-focused, less useful and insufficient coping with stress were found to be: 0.213, -0.278, -0.337 and -0.196. In addition, the correlation coefficient of DTS with positive emotion, negative emotion and smoking-dependency were 0.543, -0.224 and -0.653 which were also significant (p<0.05).Conclusion: the DTS is valid and reliable and suitable to use for assessing distress tolerance.

Objective: Tardive Dyskinesia (TD), is one of the important problems of the patients with schizophrenia. The emergence of these side effects depends on so many factors such as the patients' age and the duration of antipsychotic treatment. By discovering new drugs (Atypical), there has been an outstanding decrease in the emergence of these side effects. The present study investigates the symptoms of TD in the Patients with schizophrenia who were under treatments for more than 6 months. Method: The sample of this study was 200 Patients with schizophrenia of four wards in Razi hospital (two acute and two chronic wards) who were hospitalized in the winter of 2006 and were qualified for this study. The subjects were 101 males and 99 females who were younger than 60 and had received antipsychotic drugs for at least 6 months. After psychiatric interview and filling the demographic questionnaire by the patients, the required information about the drugs and the intensity of the symptoms was acquired. Then clinical and physical examinations of tardive dyskinesia were done. Next, the tardive dyskinesia disorders' check list (AIMS) was used. Findings of this cross-sectional, descriptive study were analyzed by SPSS.Results: There was a high ratio of 95% between TD and the age factor (P=0.05). There was no relationship between symptoms frequency and duration of treatment (P=0.68). Facial muscles and oral zones were mostly involved in T.D disorder (72%).Conclusion: No significant difference was observed between nine fold symptoms of T.D in patients who were using traditional drugs and those who were using the new ones (typical and atypical). Findings showed that in the intensity of the symptoms, gender does not play a major role.

Objective: Based on findings of previous studies, those men on Methadone Maintenance Therapy (MMT) have a high prevalence of Erectile Dysfunction (ED), related to hypogonadism and depression. We conducted this study to evaluate the efficacy of Trazodone (an antidepressant which can improve sexual function) on this sexual dysfunction.Method: A structured interview was administered by the clinical staff.The interview contained questions about the subjects' socio-demographic characteristics, their drug use and sexual behavior.In addition to the socio-demographic survey, erectile function was assessed using erectile dysfunction (ED) intensity scale. Of the 157 subjects, 95 suffered from ED. The subjects were informed about the study. Then, seventy five patients voluntarily received 50mg of Trazodone for four days, and the dosage was increased to100 mg and maintained for 6 weeks. Fifty five patients who completed the treatment course were assessed by ED questionnaire again at the end of study. Statistical analysis was performed using Stata 8 software.Results: The prevalence of ED was 60.5% in our sample. The mean erectile dysfunction (ED) intensity scale was 12.21, and 16.78 before and after the treatment course respectively. (P<0.05) ED severity had no significant relation with age and type of substance dependency (P>0.05); but it had a significant relation with duration of Methadone therapy and Methadone daily dosage. (p<0.05) Conclusion: Trazodone may be effective in the treatment of methadone induced ED. Further studies with control groups and greater sample sizes are warranted.

Physical disorders can be seen in psychiatric patients. In addition, a delayed diagnosis can cause a serious complication of the physical disorder among such patients. In this report, a case of appendicitis in a psychiatric case with drug withdrawal symptoms was reported.