سال:1391 | دوره: | شماره: |تعداد مقالات:23

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Objective: Postpartum depression (PPD) is a common health problem which affects women in the postpartum period. This is a brief note on its associated factors in women from different cultures.Methods: A literature review was performed in MEDLINE and Pubmed from 1991 to 2008 and Magiran from 1991 to 2009. Additional articles and book chapters were referenced from these sources.Results: The prevalence of postpartum depression has been reported to be from 0.5% to 60% globally, and from 3.5% to 63.3% in Asian countries, in which Malaysia and Pakistan had respectively the lowest and highest rates. One of the factors contributing to PPD in Asian societies can be that women may not have the empowerment to reject traditional rituals that are imposed on them by their caregivers. Unsatisfactory pre-existing relationships between the mothers and their caregivers resulting in mothers experiencing difficulties during their confinement period may be another factor. Thirdly, some features of these traditional rituals may be the cause of tension, stress and emotional distress. Emotional conflicts caused by insistence on practice of traditional rituals during the postpartum period may lead to mental breakdown.Conclusion: Health care professionals should be aware that the phenomenon in Asian cultures is as prevalent as European cultures. Moreover, further research needs to be conducted on the global prevalence of the experiences of childbearing women with depressive symptoms.

Objective: Type D personality is based on negative affectivity (NA) and social inhibition (SI). The purpose of this study was to examine the reliability and validity of the Persian version of 14-item Type D personality scale (DS14).Methods: The study included 191 normal participants and 176 patients with myocardial infarction (MI). They all filled out the Persian version of DS14, containing 7-item NA and SI subscales; 71 normal subjects completed the neuroticism and extroversion subscales of Eysenck questionnaire. Besides, 71 participants filled out the DS14 twice over a 2-month period.Results: In this study, 35.8 % of MI patients and 24.6% of healthy people were classified as Type D. Factor analysis of Persian version of DS14 yielded the two-factor structure; all of the NA and SI items loaded between 0.65 to 0.80 in patients and 0.48 to 0.79 in healthy people on their corresponding factor. Test–retest stability of the NA and the SI subscales were 0.86 and 0.77 respectively over a 2-month period. High internal consistency of Cronbach's alpha coefficient has been found to be 0.84 in patients and 0.87 in healthy people for the NA subscale and 0.86 in patients and 0.75 in healthy people for the SI sub-scale. The construct validity of NA and SI sub scales were confirmed against neuroticism (r=0.65) and extroversion (r=-0.62) subscales of Eysenck questionnaire respectively.Conclusion: Persian version of DS14 is an acceptable, reliable and valid measure of dimensions of Type D personality.

Objective: This study has been conducted to investigate the efficacy of short-term dynamic psychotherapy on Love Trauma Syndrome (LTS) in female students. LTS includes a constellation of intensive signs and symptoms which appear following the breakdown of a romantic relationship after a long time. It interrupts person's function in many areas (academic, social or professional) and leads to maladaptive reactions.Methods: This study was a multiple baseline single-case experimental study. The sample included five cases who were selected based on purposeful sampling procedure. The intervention was conducted based on McCullough's manual for short-term dynamic psychotherapy. In general, the study consisted of three stages including the baseline evaluation, the intervention period, and follow-up. The instruments included the Love Trauma Inventory (LTI), Beck Depression Inventory (BDI-II), Global Assessment Function (GAF) of DSM-IV and Millon Personality Inventory MCMI-II the data were analyzed using the clinical significance method and the recovery percent formula.Results: All subjects who completed the treatment showed significant improvement in their symptoms including depression and general functioning.Conclusion: It appears that McCullough's short term anxiety-regulating psychotherapy is effective in treating LTS.

Objective: Many studies evaluated the efficacy of exercise on some depression indices, but the effect of physical exercise in exhilarating milieu on urine6T36T15T - 6T15TMethoxy6T15T - 6T15T46T15T - 6T15THydroxyphenylglycol6T15T (15T MHPG) sulfate-the main metabolite of norepinephrine is not clear. The purpose of this research was to study the effect of a six-week intermittent walking in the water on 24-hour urine MHPG sulfate in depressed female teenagers.Methods: Twenty-four high school female students with depression were divided randomly into case and control group. Pool walking exercise program was implemented 3 sessions weekly for 6 weeks and with a rate of 60-70% of the maximum heart rate. The control group didn’t enter any exercise protocol and did not receive any other anti-depressant therapy. HPLC-fluorometric detection assay was used to measure 24-hour urine MHPG sulfate values. The data was analyzed with t-test and Pierson’s correlation tests.Results: Twenty hour urine MHPG sulfate increased from 1.93 (±0.59) to 4.66 (±0.85) micromole in case group (P£0.001), and in control group from 1.67 (±0.58) to 1.80 (±0.58) micromole. Increase of 24-hour urine MHPG sulfate and increasing of maximum oxygen consumption showed significant positive correlation (r=0.65), and a significant negative correlation (r=0.65) was observed between urine MHPG sulfate and Hamilton Rating Scale for Depression (Ham-D) score.Conclusion: Aerobics training in exhilarating environments shows desirable influence over reduction of depression. This reduction of depression is correlated with MHPG sulfate elevation.

Objective: There is evidence to show an increase in use of stimulant substances among university students. This study is a qualitative assessment of the existing situation and the underlying reasons for stimulant use among the students of Tehran University of Medical Sciences in 2006.Methods: Three qualitative methods have been used: focus group discussions with 7 groups (60 individuals) consisting of male and female students in the dormitories and in the university environment, in-depth interview with 20 drug user students, and interview with 20 key informants including counselors, managers and guards of dormitories, staff of the office for Culture and Welfare Affairs of students and members of students' organizations. Purposeful or opportunistic method was used for sampling.Results: Ecstasy and methylphenidate (Ritalin) were mentioned as the stimulants used by the students. The main declared reasons for ecstasy use were desire to have fun and excitement, desire to modernity, participation in parties, curiosity and living without family. The high expense of ecstasy pills and the training provided by media were mentioned as the main protective factors. Most respondents believed that use of methylphenidate was more prevalent than ecstasy use. In contrary to the drugs used for fun and enjoyment, methylphenidate is used for increasing learning abilities and academic achievement. Other pointed- out factors were ease of use and being stigma- free.Conclusion Increasing risk perception via training, social alternatives to risky activities and parental training for continuing care and advice in the college period are recommended.

Objective: The current research tested the differences in reading attitude and reading comprehension in the dyslexic students between the control group and the experimental group following the Barton intervention program.Methods: Dyslexia screening instrument and reading text were employed in order to identify dyslexic students. The population of the study included 138 dyslexic students studying in schools in Ham, Iran. From this population, 64 students were randomly selected and assigned to an experimental group as well as a control group. The experimental group was taught for 36 sessions, using the Barton's method at two levels, and ten lessons were provided to improve the reading skill. The reading comprehension and reading attitude instruments were employed for the measurement of the attitude and comprehension before and after the intervention program.Results: The analysis of covariance showed a significant difference between the control group and the experimental group following the Barton intervention program.Conclusion: This study showed that dyslexic students learned to read, and a more direct instruction related to decoding could influence their progress more than the general exposure to education.

Objective: To investigate the pharmacokinetics (PK) and PK- pharmacodynamic (PD) relationship of methadone in a cohort of outpatients undergoing methadone maintenance treatment (MMT).Methods: Sixty male patients undergoing MMT with a mean ±SD methadone daily dosage of 58±34 mg were enrolled in this study. A 5-ml blood sample was collected before the daily intake of methadone. As a PD measure, the Subjective Opioid Withdrawal Scale (SOWS) form was completed immediately after obtaining the blood sample. Blood samples were taken and the forms were completed 4-5 times more (up to 24 hr) after the daily intake of methadone. Plasma methadone was analyzed using HPLC. Population PK/PD analysis was performed using population pharmacokinetics modeling software P-Pharm.Results: Significant decreases (p<0.05) were observed in the SOWS scores during 10 hours after methadone intake. The SOWS had returned to baseline by 24 hr after using methaodone (p=0.98). A considerable interindividual variability in the CL/F (16 fold), EC50  (3 fold) and Emax (6 fold) for methadone was observed.Conclusion: Withdrawal symptoms were significantly improved in MMT patients after taking methadone and the PD measure was substantially affected by fluctuations in plasma methadone concentration. However, The SOWS had returned to baseline by 24 hr after using mathadone. Thus, a once daily dosing of methadone may not be suitable for those MMT patients who experience a significant withdrawal disturbance in the latter part of the interdose interval. This may increase the perceived severity of withdrawal and induce a craving for additional opioids.

Objectives: Diagnosis of the psychiatric diseases is a bit challenging at the first interview due to this fact that qualitative criteria are not as accurate as quantitative ones. Here, the objective is to classify schizophrenic patients from the healthy subject using a quantitative index elicited from their electroencephalogram (EEG) signals.Methods: Ten right handed male patients with schizophrenia who had just auditory hallucination and did not have any other psychotic features and ten age-matched right handed normal male control participants participated in this study. The patients used haloperidol to minimize the drug-related affection on their EEG signals. Electrophysiological data were recorded using a Neuroscan 24 Channel Synamps system, with a signal gain equal to 75K (150 xs at the headbox). According to the observable anatomical differences in the brain of schizophrenic patients from controls, several discriminative features including AR coefficients, band power, fractal dimension, and approximation entropy (ApEn) were chosen to extract quantitative values from the EEG signals.Results: The extracted features were applied to support vector machine (SVM) classifier that produced 88.40% accuracy for distinguishing the two groups. Incidentally, ApEn produces more discriminative information compare to the other features.Conclusion: This research presents a reliable quantitative approach to distinguish the control subjects from the schizophrenic patients. Moreover, other representative features are implemented but ApEn produces higher performance due to complex and irregular nature of EEG signals.

Objective: Attention Deficit Hyperactivity Disorder (ADHD) is one of the most prevalent psychiatric disorders in children. According to concern regarding the growth of these children, this study was carried out to compare height and weight between 5-6-year-old boys with ADHD and those without ADHD in Ahvaz, IranMethods: In this cross-sectional study, 32 5-6-year-old ADHD boys with the Conners’ rating scale (CRS) of ³15 were compared to 32 non-ADHD same-age boys with CRS of<15. Exclusion criteria were some special disease with negative effect on growth and psychostimulant treatment. Centers for Disease Control and Prevention (CDC) curves were used to determine the growth status.Results: Comparison between ADHD and non-ADHD boys regarding mean height (111.95±6.12 vs. 110.77±6.22 cm), weight (19.39±3.65 vs. 19.19±3.75), and body mass index (15.44±1.82 vs. 15.54±1.67) showed no statistically significant difference (P>0.05).Conclusion: Our study does not support an association between problems in growth outcomes and ADHD in 5-6 years old boys.

Objective: This research was conducted to study the relationship between attribution and academic procrastination in University Students.Methods: The subjects were 203 undergraduate students, 55 males and 148 females, selected from English and French language and literature students of Tabriz University. Data were gathered through Procrastination Assessment Scale-student (PASS) and Causal Dimension Scale (CDA) and were analyzed by multiple regression analysis (stepwise).Results: The results showed that there was a meaningful and negative relation between the locus of control and controllability in success context and academic procrastination. Besides, a meaningful and positive relation was observed between the locus of control and stability in failure context and procrastination. It was also found that 17% of the variance of procrastination was accounted by linear combination of attributions.Conclusion: We believe that causal attribution is a key in understanding procrastination in academic settings and is used by those who have the knowledge of Causal Attribution styles to organize their learning.

Objective: Previous studies have suggested that anxiety disorders are more prevalent among women than men. The purpose of this study was to compare the metacognitive perspective of Generalized Anxiety Disorder (GAD) in females with males.Methods: A cross sectional study was conducted on the high school girls and boys who have been affected by GAD. The sample consisted of 100 high school students (50 boys and 50 girls) selected by Generalized Anxiety Disorder Scale (GADS) and semi-structured interview. They filled the Metacognitive Thought Control Questionnaire (TCQ), and Anxiety Thoughts Inventory (AnTI).Results: Significant differences were observed between girls and boys in anxiety thoughts (health anxiety, social anxiety, and meta-worry). Anxiety thoughts affect girls more than boys; they have more metacognitive beliefs about uncontrollability of worry and believe that worry must be avoided. On the other hand, positive beliefs in worry are more common in girls and punishment and meta-worry are being implemented as control strategies in girls more than boys.Conclusion: Metacognitive beliefs in uncontrollability, advantages and avoidance of worry may contribute to the higher prevalence of anxiety in females than males.

Objective: Self-efficacy beliefs determine how people feel, think, motivate themselves and behave. Regarding to similar findings it is supposed that concept of self efficacy has a general role on mental health. The present study focused on examining the relationships between self-efficacy and symptoms of depression, anxiety, worry and social avoidance in a large sample of normal students (n=549).Methods: The sample included of 266 female and 283 male high school students from schools of distinct areas 6, 8 and 9 (Tehran, Iran). The schools were chosen randomly. Participants completed the Self-Efficacy Questionnaire for Children and Social Avoidance & Distress Scale and also the scales measuring trait anxiety, depression, worry and social avoidance. Stepwise regression analyses were used as methods of analysis.Results: Main results distinguished that there is a significant and negative relationship between total self-efficacy, physical self-efficacy and academic self-efficacy and depression. Also significant and negative relationships were found between total self-efficacy, physical self-efficacy and emotional self-efficacy and anxiety. Emotional self-efficacy and physical self-efficacy had significantly a negative relationship to worry. On the other hand, social self-efficacy and physical self-efficacy were significantly and negatively related to social avoidanceConclusion: According to what is discussed the various aspects of mental health is influenced by the sense of self efficacy appraisal. So low self efficacy usually increases some problems such as emotional and social problems which involves in mental health.

Objective: Impulsivity appears to play an important role in suicidal behavior. The aim of this cross-sectional study was to compare the impulsivity, substance abuse, and family/friends history of suicide attempt between suicide-ideated and non suicide-ideated university students.Methods: The research population consisted of all the students of the University of Isfahan in the academic year of 2009-2010. Three hundred and forty students (136 boys and 204 girls) were selected randomly through cluster sampling, of whom 53 participants were suicide-ideated and the rest were non suicide-ideated. The instruments used in this study were the 11th version of Barratt Impulsivity Scale, Suicide Ideation Questionnaire, and the demographic questionnaire. Descriptive statistics and multivariate analysis of variance were used to examine hypothesis.Results: There was a significant difference between suicide ideated and non-suicide ideated subjects in impulsivity (F=3.83, p<0.001). Accordingly, significant differences were observed between two groups in attentional (F=8.12, p<0.005), motor (F=7.67, p<0.006), and non-planning (F=4.60, p<0.033) impulsiveness. The results showed a higher incidence of substance abuse, and family/friends suicide attempt among suicide-ideated compared with non suicide-ideated students.Conclusion: A higher level of impulsivity is probably related to various indices of suicidal behavior. Substance abuse is probably associated with suicidal behavior and this association may involve an interaction with impulsivity. This study provides an initial evidence of familial linkages of suicide ideation and suggests that the loss of an important person in life would be an important predictor of suicide ideation in university students.

Objective: Having a good quality of life has always been desirable for humans and the concept of a good life and the ways of achieving it have been focused over the years. Personal wellbeing is the mental component of quality of life. Thus, the current study was conducted to estimate psychometric characteristics of “personal well-being index-adult” (PWI-A) in mothers of mentally retarded students of exceptional schools in northern districts of Tehran.Methods: From 358 mothers of mentally retarded students in north of Tehran (districts 1, 2 and 3), 200 mothers were selected by systematic random sampling. The collected data using PWI-A was analyzed by inferential statistics (Cronbach’s alpha coefficient for test reliability and linear multivariate regression for test validity).Results: Results showed acceptable reliability and validity for PWI-A in mothers of mentally retarded students of exceptional schools in north districts of Tehran. The Correlation between seven items was significant (P<0.001) and this index had the most extensive coverage of construct validity.Conclusion: This study showed that this scale could be applied to measure personal wellbeing in mothers of mentally retarded students.

Objective: Emotional intelligence (EI) is a set of competencies that enable us to engage in sophisticated information processing of emotions and emotion-relevant stimuli and to use this information as a guide for thinking and behavior. Prefrontal cortexes (PFC) of brain and related regions have an important role in emotion and emotional regulation. Accordingly, we conducted a study to investigate the relation between EI and performance in Wisconsin Card Sorting Test (WCST) (a neuropsychological test, used to evaluate some of the frontal lobe functions).Methods: In this quasi-experimental study, 250 volunteers from BS and BA students of universities of Tehran were recruited using available sampling method. Bar-on EI, general health questionnaire (GHQ-28) and Raven's Progressive Matrices were completed by the participants. They were categorized into two groups; each group contained 40 students with high and low EI, whose performance in WCST were evaluated thereafter individually. Data was analyzed by MANOVA.Results: Our results showed that the high EI group had a better performance in WCST than the low EI group.Conclusion: It can be concluded that people with better EI may have better PFC functions.

Objective: Recently, quality of life is a concern of health in psychiatry. Schizophrenia is a disorder that has the most regressive effects in societies’ and patients’ behavioural, occupational and psychiatric aspects. The main purpose of this study was to evaluate the quality of life and global function of schizophrenia patients.Methods: A hundred schizophrenia patients (with DSM-IV-TR) who had a history of at least 10 years from the beginning of the disorder were collected. Demographic characteristics, type of schizophrenia, living condition and the quality of life scale (QLS) including: interpersonal relationship, instrumental role, intra psychic foundations and common objects and activities, were gathered. Patients' general functions were evaluated with Global Assessment of Functioning (GAF). Statistical analysis was performed by SPSS statistical software using Fisher’s exact test, analysis of variance (ANOVA), Dunken and Pearson’s correlation test.Results: In this study 67% of patients were male and 51% were female. They were comprised of residual (55%), paranoid (11%) and undifferentiated (33%) schizophrenia. They lived in institute (67%) and with their families (28%). There was a moderate correlation between QLS and GAF (p<0.01, r=0.2). A significant association was found between married and single patients in instrumental role (F: 2.97), P<0.05) but there was not a significant association in other domains. Correlation were found between undifferentiated and paranoid patients in interpersonal relationship (F: 2.97), P<0.05). However there weren’t any correlation in intra psychic foundation and common objects and activities domains. Also there were significant associations in GAF (F: 3.98), P<0.05) between uneducated and educated participants. There was not an association between the Mean of five domains and genders.Conclusion: Schizophrenia patients' quality of life is low which shows the value and reliability of Global Assessment Functioning that is usually used for every psychiatrics’ patients for V axis clinical diagnosis and indicated the clinical value of this scale. For this reason rehabilitation, social skill training of patients and supportive therapy in family are important.

Objective: To assess the prevalence of opioid abuse in a sample of male population in Shiraz, Iran.Methods: A representative sample of 1219 subjects (aged 16 years or older) who were referred for urine opioid screen (UOS) as a mandatory test before marriage in Shiraz in 2005 were enrolled in this study.Results: Mean age of the participants was 26.17 years (SD=6.12), ranging from 16 to 75 years. From them, 121 participants (9.93%) had positive urine opioid test. They were retested at least few days later by thin layer chromatography (TLC). The results showed that 22 (1.80%) had positive urine opioid test (based on TLC), whose mean age was 25.7 years, ranging from 19 to 32 years.Conclusion: It can be concluded that at least 1.80% of men referred for UOS as a mandatory test before marriage used opioids. These results should be considered when preventive and therapeutic programs are being planned.

Objective: A depressive disorder is an illness that involves the body, mood, thoughts and behaviors. This study was performed to identify the presence of depression among medical students of Urmia University of Medical Sciences.Methods: A descriptive cross-sectional study was conducted on 700 undergraduate medical and basic sciences students. Beck depression inventory (BDI) used for data gathering.Results: Mean score of BDI was 10.4±0.8 and 52.6% of students scored under the depression threshold. Four of them had severe depression. Results showed no significant relationship between depression and age, education, sex, rank of birth or duration of education.Conclusion: Prevalence of depression that can affect the students’ quality of education and social behavior was high in Urmia University of Medical Sciences.

We present a case report of bupropion-induced diplopia in a 26-year-old woman who suffered from atypical depression. After four weeks of taking bupropion (225 mg per day) she complained of headaches, blurred vision, and diplopia. No neurological and ophthalmologic abnormal signs were found. Her brain magnetic resonance imaging (MRI) and magnetic resonance venography (MRV) were normal as well. After tapering off and discontinuing bupropion, her diplopia resolved within a week.

Priapism is a prolonged and usually painful erection which is not associated with the sexual desire. It is an uncommon urologic emergency with variety of known etiologies such as the use of psychotropic medications. Priapism under concurrent treatment with chlorpromazine and risperidone has not been reported so far. Herein, a psychotic patient who developed priapism during chlorpromazine and risperidone therapy will be reported.

Bipolar disorder is a mental disease that can be presented as irritable mood P P with affective storms, mixed symptoms of depression and mania, rapid cycles, emotional labiality and irritability during all episodes. A confirmed positive familial history of the disease is the single most robust risk factor for developing the illness. This report presents 5.5 years-old girl with the symptoms of bipolar disorder and with the purpose to draw attention to the diversity of possible symptoms of mood disorders in childhood.

This case report describes a 34-year-old female patient who suffered from chronic vomiting. Different diagnostic and therapeutic procedures were noncontributory. Eventually, psychiatric interviews specified that she has a dependent, self-hurting and attention-seeking personality. She wanted to assume the “sick role”. Malingering and conversion disorder were ruled out and Münchausen’s syndrome was proposed. She received sertraline, emotional ventilation, and cognitive-behavioral therapy and her symptoms resolved.