Iranian Journal of Psychiatry and Behavioral Sciences
Year:2011 | Volume:5 | Issue:1|Papers Count:12

There is increasing evidence of rapidly growing serious, pervasive, and expensive methamphetamine problems in Iran in recent years-a malicious social phenomenon with widespread psychological, familial and economic adversities-which contribute to theft, murder, suicide, violence, and divorce. Substantial cases of acute psychiatric problems are increasingly seen following amphetamine use in the emergency departments. Paranoid patients are more prominent. Many of these cases are characterized by anxiety, confusion, insomnia, mood disturbances, hallucinations, and out-of-control rages with extremely violent behavior and homicidal ideas. This serious tragedy which is one of the most important Iranian society’s problems is called for effective multidimensional control policies.

In the last two decades, the importance of developing strategies that reduce the burden of new onset psychosis on affected persons, their families, and the community has been recognized. This article reviews the literature on First-episode psychosis (FEP) in Iran. In the last decade, several studies on FEP have been published in Tehran concerning Duration of untreated psychosis (DUP), pathways to care, diagnostic stability, outcome predictors, treatment, aftercare services, psychosocial interventions, and Neurological soft signs (NSSs). However, the samples in most studies were small, and most participants were recruited from inpatient wards. Therefore, caution must be exercised when generalizing the results to patients with FEP in the community, particularly in other parts of the country. We conclude that it is necessary to conduct follow-up research with sufficiently large samples from the community to support the previously published longitudinal studies on FEP, as well as to help to inform the development of specialized FEP and early intervention services.

Objective: Depression among elderly in Iran has not been well studied. Little is known about the true rates of depression, it correlates or how well it is treated. This research is part of a series examining health status of older people using the Geriatric depression scale-15 (GDS-15).Methods: One thousand and nine hundred seventy five (1975) older people living in Razavi Khorasan province were studied using the cluster sampling method. The Persian version of GDS-15 was completed based on filling in questionnaires and after recognition of sample size of each city. Admission and data analyzing was followed by examining the relationship between depression and place of living (rural and urban), education, gender, type of living (alone or with family), occupation, source of income, and supporting system (such as charities, etc).Results: The subjects' mean (±SD) age was 71.14 (±7.78) years (range: 60-98) and 52.9% of the subjects were female. According GDS score, 23.5% of the subjects suffered from depression. The GDS score was significantly related to type of living (alone or with family), source of income, and supporting system (such as charities) (p<0.01). The depression scores in elderly with family support was significantly higher than those living with personal wealth and retirement salary (p<0.01).Conclusion: Depression may be related to some factors including living alone and to source of income, and supporting system. National programs should be developed in community centers focused on Finding and decreasing depression among the elderly population.

Objective: One of non-confrontative methods for treatment of difficult issues such as grief is movie therapy which is an advanced form of bibliotherapy. The present study aimed at evaluating the effectiveness of Group movie therapy (GMT) on reduction of intensity of grief experience in bereaved adolescent girls.Methods: This was a quasi-experimental design with pretest-posttest and a follow up test along with a control group.24 female university students in the city of Tehran aged 17-19 years who had lost a close family member in 2008-2009 were selected as the participants in the study through convenient sampling. They were then randomly assigned into a control and an experimental group of 12 persons each. The experimental group as an intervention received 90-minute weekly group movie therapy sessions for eight weeks. The intervention was comprised of watching the movie “Elina”, in one session followed by group discussions. Four subscales of GEQ indicating the intensity of grief experience was administrated on both groups as pretest-posttest and as follow up.Results: Mixed ANOVA showed that group movie therapy significantly decreased (p<0.001) the intensity of grief experience.Conclusion: GMT is an efficacious and enduring technique on the adolescents; this is afforded through providing insight, modeling loss coping skills, making emotional catharsis possible, and facilitating cognitive processing and accelerated learning in the participations.

Objective: Anxiety is one of the most common psychiatric disorders and almost 30% of the primary school children are affected by various kinds of it. Group play therapy has been reported to be a useful component of treatment of Generalized Anxiety Disorder (GAD). The goal of this research was to determine the efficacy of this treatment in children with GAD.Methods: In this quasi-experimental study, 30 youths with GAD aged between 5 and 11 referred from Isfahan child psychiatric clinics were randomly assigned to two groups (15 patients in each group). Parents’ form of CSI-4 questionnaire, GAD subscale, was used to diagnose the problem of these children with the help of a child psychiatrist. Case group got 1-hour weekly sessions for three months while no intervention was done for control group (waiting list). Analysis of covariance was used to compare two groups.Results: Analysis of covariance showed that group play therapy reduces GAD symptoms in posttest stage meaningfully (p=0.02). It also reduces GAD symptoms in follow up significantly (p<0.0001).Conclusion: The results of this study shows that group play therapy can be an effective method for reducing GAD symptoms in posttest and follow up stage.

Objective: This study explored the therapeutic outcomes of psychodynamic psychotherapy for Major depressive disorder (MDD) in comparison with pharmacotherapy.Methods: The focus of psychodynamic psychotherapy was on the superego pathology and its developmental backgrounds, while pharmacotherapy was done using SSRIs. A sample of 50 MDD patients was randomly selected by clinical interview using DSM-IV-TR. The presence and severity of the depressive symptoms were assessed using the MMPI-2 depression content scale as a symptom checklist, and the Beck Depression Inventory. Twenty five patients were selected for the psychoanalytic psychotherapy group and twenty five patients for pharmacotherapy. After 15 weeks, all the participants were assessed using the same instruments.Results: The results indicated a comparable symptom reduction in the two groups.Conclusion: Clinical observations confirmed the psychodynamic inferences about the role of the superego pathology in MDD.

Objective: The Child behavior checklist (CBCL) is a comprehensive symptom rating scale in child and adolescent psychiatry and a major instruments being used in cross-cultural studies. This study was done to determine the symptom profile of a community sample of Iranian youths using the CBCL-Persian version.Methods: Through a random probability sampling, five clusters in four central geographic regions of Tehran were selected. After obtaining parents' informed consents, the parents accomplished CBCL forms and the demographic questionnaires. Their children were interviewed by two board certified child and adolescent psychiatrists to evaluate any psychiatric disorders in them. Statistical analysis was done using the T-test and regression analysis. Calculation of sensitivity, specificity, and, Overall misclassification error (OMR) was used to find the appropriate cut-off point.Results: Two hundred three children and adolescents were evaluated (46.3% female) with mean age of 12.01 years (SD=3.63). Of them, 21.2% had psychiatric disorders. Boys had significantly higher scores in Attention Problem, Delinquent Behavior, Aggressive Behavior, and Externalizing (p=0.01). The scores of Somatic Complaints, Thought Problems and Internalizing were significantly higher in boys (p=0.05). The cut point of 35 had the best sensitivity and specificity, and of the least OMR.Conclusion: Most results of our study were consistent with the literature on CBCL in diverse countries. This confirms the validity of the CBCL to be used in child and adolescent psychiatry studies.

Objective: The Mood disorder questionnaire (MDQ) has been designed as a screening self-report inventory for diagnosing bipolar mood disorders. This study investigated the validity and the optimal cut-off threshold of the Persian version of MDQ in a group of Iranian depressive patients.Methods: One hundred and twenty patients with probable diagnosis of mood disorders attending psychiatric clinics were recruited to this cross-sectional study. The structured clinical interview for DSM-IV (SCID) was employed as the gold standard of diagnosis to discriminate between unipolar and bipolar depressions. Translated version of MDQ in Persian was completed by the patients and the final scores were summed up by a physician. The sensitivity and specificity of MDQ were calculated and compared with the diagnosis made by SCID. The ROC curve was used to determine the optimal cut-off point for diagnostic accuracy.Results: Ninety patients with bipolar depression and 30 patients with unipolar depressive disorder completed the MDQ. Internal reliability of MDQ was good with a Cronbach's alpha coefficient of 0.773. Regarding the original scoring criteria (symptoms and supplementary questions), the sensitivity and specificity of MDQ for bipolar disorder were 70% and 100% respectively. In current study, the optimal cut-off score without applying the supplementary questions was calculated to be 6 or more, with a sensitivity of 80% and a specificity of 93.3%.Conclusion: MDQ appears to be a useful screening tool for bipolar depression in Iranian psychiatric practice. Conflict of Interest: This paper is not related to financial profits of the authors and was supported by Tabriz University of Medical Sciences.

Objective: The goal of this study was achieving a better understanding of the Bowen family systems theory, especially regarding the relationships between differentiation of self, quality of relationship with parents and health dimensions in a sample of Iranian college students.Methods: A convenient sample of 210 students (102 female and 108 male) participated in the present study. They were selected from the college students who were studying in Tehran. Standard and hierarchical regression analyses were used in this correlational study.Results: The results indicated that differentiation of self influences the relationship with parents, physicalpsychological health and social relationships. Besides, the obtained results regarding moderating and mediating mechanisms indicated that persons who are more differentiated experience less conflict with parents and report better quality of social relationships than those who are less differentiated.Conclusion: These results supported the initially cross-cultural validity of Bowen theory and extended it by supporting some mechanisms that explain how differentiation of self leads to individuals’ quality of specific and social relationships and physical and psychological health.

Objective: We mainly sought to understand the relationship among college students' spiritual well-being, life satisfaction, economic status, and alienation.Methods: A sample of 292 undergraduate students (187 females and 105 males) between the ages of 18 and 26 years were selected using the cluster sampling method. Then, they completed measurement questionnaires of alienation, satisfaction with life and spiritual well-being scales.Results: Correlation coefficient indicted that each subtype of spiritual well-being (religious and feeling meaning and purpose in life) were inversely related to alienation. Life satisfaction had positive correlation with spiritual well-being, but had negative correlation with alienation. On the other hand, home and family income level was associated negatively with alienation and positively with spiritual well-being and life satisfaction.Conclusion: In conclusion, use of Structural equation modeling (SEM) method showed that meaning and purpose in life and alienation were more related to life satisfaction than to the spiritual well-being. It is also demonstrated that SEM is a feasible technique for modeling the relation between spirituality, life satisfaction and alienation.

Kleine-Levin syndrome (KLS) is a rare syndrome characterized by periodic hypersomnia, hyperphagia, behavioral disturbances, and in some instances hypersexuality. This report depicts a17-year-old boy with KLS. He has experienced long periods of hypersomnia, sometimes up to 40 days. During these periods he was impatient, aggressive, depersonalized, suffering from hyperphagia, and amnesia. He did not have abnormal neurologic sings and his brain CT, EEG, and routine laboratory tests were normal. Fluoxetine, lithium and carbamazepine were given to him to reduce the signs of his disease. In conclusion, Kleine-Levin syndrome should be considered in patients with periodic hypersomnia.

Detoxification of children who are born from substance dependent mothers or those who are substance dependent themselves as a result of being abused by their families is a major concern. This report describes withdrawal symptoms and the way of abstinence in a 2.5 year-old girl who was dependent to opium. After that she was given opium for nearly two years suppress withdrawal symptoms, methadone-aided opium detoxification started for her and after 65 days she left the hospital with no symptoms of withdrawal syndrome.