Iranian Journal of Psychiatry and Behavioral Sciences
Year:2013 | Volume:6 | Issue:2|Papers Count:16

“Older people are an enormous asset to our societies, not only because a large majority of them continue to work in old age, but also because they convey social values to younger generations”Dr. WesumAsia/Pacific Regional Conference on Ageing 2012The population ages 65 and over is expected to grow very rapidly in all parts of the world. Over the next decades, the elderly population is projected to grow much more quickly than the total population in all parts of the world.At the global level, the number of those over age 60 is projected by the UN Population Division to increase from just under 800 million in 2011 (representing 11% of world population) to just over 2 billion in 2050 (representing 22% of world population). World population is projected to increase 3.7 times from 1950 to 2050, but the number of those aged 60 and over will increase by a factor of nearly 10. Among the elderly. “the oldest old” - i.e., those aged 80 and over - is projected increase by a factor of 26.Accompanying these projected increases in elder shares throughout the world is another salient trend: the “compression of morbidity”. Anti-aging technologies - from memory-enhancing drugs to high-tech joint replacements - and healthier lifestyles have not merely increased longevity but have also made old age healthier.Although population aging is occurring in both developed and developing countries, the most rapid aging is taking place primarily in relatively newly industrialized or developing countries.Population aging generates many challenges and sparks concerns about the pace of future economic growth, the operation and financial integrity of health care and pension systems, and the well-being of the elderly. The key is adaptation on all levels: individual, organizational, and societal.

Objective: The present study was conducted to compare the effectiveness of two therapeutic approaches, namely, Cognitive Behavioral Therapy (CBT) and Stages of Change Model (SOC) on improving abstinence self-efficacy in adolescent addicts.Methods: Forty five self-referred adolescent addicts were randomly selected to take part in this study. Initial assessment was made using the following questionnaires: The University of Rhodes Island Change Assessment (URICA), General Self-Efficacy Questionnaire (GSE), and Adolescent Self–Efficacy Scale (ASES). Subjects were placed in two experimental (CBT, SOC) groups and one control group (three groups in all). The two experimental groups received twice a week interventions for 12 weeks and then were post tested and once again reassessed in a two-month follow up.Results: Results clearly highlighted the effectiveness of the two models of intervention on general and special self-efficacy. The effectiveness of SOC proved greater than CBT on general self-efficacy in both posttest as well as the two-month follow up. Whereas CBT was more effective than SOC on special self-efficacy in posttest, SOC was more effective than CBT on dimensions of special self-efficacy in the follow up assessment.Conclusions: Both CBT and SOC improve general and situational self-efficacy. Hence SOC may have more permanent and long lasting effect on self-efficacy than CBT.

Objective: To determine the effect of group Cognitive Behavior Therapy (CBT) on psychological hardiness and coping strategies of infertile women undergoing Assisted Reproductive Therapy (ART).Methods: Two groups of infertile women who received ART consisted of experimental group (15 females) and control group (16 females) were compared. The participants in experimental group received 15 sessions of CBT group therapy. The control group received no psychological intervention. For gathering data Moss and Billing Coping Strategies Scales and AHVAZ Hardiness Scale for infertile women were used.Results: There was a significant difference in hardiness between the two groups after intervention. Coping strategies did not differ significantly between the two groups before intervention, nor after intervention but there was significant difference regarding cognitive-oriented coping style in terms of scores of pre- and post-test in experimental group (P<0.05).Conclusion: Group CBT developed psychological hardiness and cognitive-oriented coping style in experimental group.

Objective: Acceptance-based behavior therapy (ABBT) is a new psychotherapy for generalized anxiety disorder (GAD). The current study intended to compare severity of symptoms, worry and quality of life of GAD female patients between ABBT and control.Methods: This study was a randomized clinical trial. The sample included 18 women with GAD referred to psychiatrists in Isfahan, Iran. Patients were assigned in 2 groups randomly (ABBT and control group without any psychotherapy). Both groups received medication. The intervention in ABBT group was conducted based on Roemer & Orsillo's manual for Acceptance-based Behavior Therapy for GAD. 12 therapeutic sessions administered in Shariati psychiatric clinic of Isfahan. The instruments included the GAD-7 Inventory, Penn State Worry Questionnaire (PSWQ) and Short Form Health Survey -12 revised Version (SF-12V2). The data were analyzed using the Multivariate Analysis of Variance (MANCOVA).Results: Overall, clients receiving ABBT compared to control group reported a significantly decrease in severity of GAD symptoms, and improve in quality of life at post- treatment state. They reported decrease in severity of worry but it was not statistically significant compared to control group.Conclusion: ABBT was effective in alleviating symptoms of GAD.

Objective: Aim of this experimental study is evaluating the effectiveness of two different approaches towards the treatment of major depressive disorder (MDD): Positive-oriented psychotherapy and group cognitive-behavior therapy.Methods: Eighteen out-patients suffering from major depression were randomly divided into two groups to be treated according to either of these two approaches. Both groups undertook the treatments for 12 weeks. All the subjects were tested by Beck Depression Inventory, Subjective Wellbeing Scale, Oxford test of Happiness, and the scale of Subjective Units of Distress before and after the treatments.Results: The results show significant differences between the two groups in terms of the variables of happiness and mental distress, suggesting that effectiveness of positive psychotherapy is more than cognitive-behavioral therapy in increasing happiness. These two approaches were significantly different in neither decreasing the acuteness of depression symptoms nor increasing subjective wellbeing.Conclusion: As a whole, the results of this comparative study indicate that positive psychotherapy is more effective in increasing happiness among MDD patients.

Background: More psychiatric visits, especially non-emergency ones, to emergency departments (EDs) of general hospitals have been observed in recent years. The aim of this study was to determine the characteristics of psychiatric visits to the ED of Rasoul-e-Akram Hospital, Tehran, Iran.Methods: In this cross-sectional study, during a two-month period, all psychiatric presentations and consultations to the ED of the studied hospital were included. The required data were gathered by psychiatry chief residents and were documented in pre-designed checklists.Results: About 0.01% of all patients presenting to the ED needed the psychiatric visits. Men consisted 50% of the total patients with mean (±SD) age of 36.41 (±14.7) years. About 51% of them had the indication of the emergency psychiatric visit while 47% had the indication of hospitalization in the psychiatric ward. Non-emergency visits were not related to demographic characteristic, previous psychiatric disorders, substance abuse and physical diseases.Conclusions: Non-emergency visits take a high percentage of psychiatric visits in ED and regarding limited sources for psychiatric emergencies and Long visiting time, this percentage can hinder the process of giving services to real emergency psychiatric patients.

Objective: Electroencephalogram is a reliable reflection of many physiological factors modulating the brain. The Bispectrum is very useful for analyzing non-Gaussian signals such as EEG, and detecting the quadratic phase coupling between distinct frequency components in EEG signals. The main aim of this study was to test the existence of nonlinear phase coupling within the EEG signals in a certain psycho-physiological state; meditation.Methods: Eleven meditators and four non-meditators were asked to do meditation by listening to the guidance of the master, and 10 subjects were asked to do meditation by themselves. Bispectrum estimation was applied to analyze EEG signals, before and during meditation. EEG signals were recorded using 16-channel PowerLab. ANOVA test was used to establish significant changes in Bispectrum parameters, during two different states (before and during meditation).Results: Mean Bispectrum magnitude of each channel increased during meditation. These increments of phase coupling are more obvious in occipital region (Pz channel) than frontal and central regions (Fz and Cz channels). Besides that phase coupled harmonics are shifted to the higher frequencies during meditation.Conclusion: Bispectrum methods can be useful for distinction between two states (before and during meditation).

Objective: To determine the reliability and validity of the Revised Dyadic Adjustment Scale (RDAS) with 14 items (short form) in Iranian population.Methods: The English version of the RDAS was translated into Persian. Then, Persian version was retranslated to English. To study factor structure 338 questionnaires were filled out by parents of elementary students. Other measurement tools were The Marital Happiness Scale (MHS), Enrich Marital Satisfaction Questionnaire (ENRICH).Both English and Persian forms were completed by 35 married undergraduate English students. The Cronbach's alpha coefficients of the RDAS, MHS, and ENRICH were 0.79, 0.87. and 0.76-0.91, respectively.Results: The content validity of the backward translation of the original version was confirmed. The findings confirmed the factor structure. Also, the validity was confirmed by retest and internal consistency. There was relationship between RDAS with marital happiness and satisfaction in anticipated direct, between husband and wifeadjustment scores.Conclusion: The reliability and validity of the RDAS with 3-factor structure in Iranian population was confirmed with an appropriate validity and reliability.

Objective: The aim of this study was to compare problem solving strategies between peoples with high and low emotional intelligence (EI).Methods: This study is a cross sectional descriptive study. The sample groups include senior BS& BA between 20-30 years old into two with high and low emotional intelligence, each group had 30 subjects. Data was analyzed with non-parametric chi square test for main dependent variable (problem solving strategies) and accessory dependent variables(manner of starting and fulfillmentof the test).The Independent two group T-test was used for analyzing other accessory dependent variables(Number of errors and total time used for fulfillment of the test).Results: There was a significant difference between two groups in “number of errors” (t=-3.67,p=0) and “total time used for fulfillment of the test”(-6.17,p=0) and there was significant relation between EI and “problem solving strategies” (X2=25.71, p<0.01) and (Cramer's v = 0.65, p<0.01) .Also there was significant relation between EI and “fulfillment of test” (X2=20.31, p<0.01) and (j=0.58, p<0.01). But the relation between EI and “manner of starting the test” was not significant (X2=1.11, p=0.29). Subjects with high EI used more ‘insightful’ strategy and subjects with low EI used more ‘trial- error’ strategy. The first group completed the test more rapidlyand with fewer errors, compared with the second group. In addition the first group was more successful in performing the test than the second one.

Objective: One of the main cultural issues in universities is relationships between male and female students. Due to the adverse consequences of this issue, explaining of the beyond the causes of friendship with opposite-sex, is one of the first steps in planning for youth issues.Methods: This qualitative research was conducted based on content analysis. Nineteen female university students were enrolled. Semi-structured questions through four sessions were used to gather required data. Two themes were extracted. One was the behaviors leading friendship which consisted of 5 subsets including self and extra-self, meso, exo-, and macro-systems. The other theme was the actions against with consequences of sex which are made of 2, subsets of the quality and the consequences of sex.Results: Various factors such as person attitude, felling lonely, and community atmosphere, including the university environment, family, friends, religious beliefs and media that promote the Western culture can be effective in friendship before marriage.Conclusion: Since the society of our country is considered a young populated one and the culture of the West, through the media currently influences on our culture, reproductive health programs should be developed in a high priority focusing on youth fitted with their current needs according to Islamic-Iranian culture.

Objective: Considering the association between medical school dropout and psychiatric distress, we aimed to assess the prevalence of psychiatric distress among medical students at Dubai Medical College.Methods: One hundred and three medical students were chosen randomly and were assessed by the General Health Questionnaire (GHQ).Results: The mean age for the students was 18.85 year (Minimum: 17, Maximum: 22), and 90.3% were between 18 and 20 years old. The mean of GHQ score was 16.46. Of the participants, 47 (45.6%) were found to be in normal range (GHQ mean < 16). A total of 33 (32.1%) of the students reported evidence of psychiatric distress. Only 23 (22.3%) were found to have severe psychiatric distress.Conclusions: Early detection of psychiatric distress is important to prevent psychiatric morbidity and its unwanted effects on medical students and young doctors. Our results reveals that although a low percentage of Dubai Medical College students reported a significant level of psychiatric distress, however, it should not be underestimated, and actions should be taken to encourage Dubai Medical College students to get help from for psychiatric services for their emotional problems. The risk factors as well as the protective factors must be identified in nation-wide studies to promote mental health of medical students.

Objective: The objectives of the study were to find out the prevalence of depression and to identify associated risk factors among community dwelling elderly in Karachi.Methods: It was a cross-sectional, descriptive study involving 284 community-dwelling elderly residing in Karachi, Pakistan. A non-probability convenience sampling was done. The Geriatric Depression Scale (GDS-15) was used to assess depression. Descriptive statistics was performed using SPSS version 12. Cross tabulation for different variables was done and Chi-square was used as test of significance. The level of significance was set as p < 0.05. An informal (verbal) consent was taken. Anonymity and confidentiality was assured.Results: Among 284 respondents, 74% were males while 26% were females. The mean age was 68.44 ±7.59 years. The study found that 16.5% respondents were depressed while 23.6% were suggestive of depression. Depression was more among men than in women. Depression was statistically significant among married respondents (p<0.05) and illiterate (p<0.001). Although a large proportion of the participants were satisfied with their income, this was statistically significant (p<0.001) for depression among those who were not satisfied with their income. Similarly, sleep was significantly disturbed (p<0.001) among the depressed respondents.Conclusion: A significant prevalence of geriatric depression was reported. In order to reduce its prevalence, general physicians and other health care professionals need to be sensitized about geriatric depression and its risk factors.

Objective: The aim of this study was to compare the mental health of mothers of children with autism and those of control group.Methods: Sample of this study consists of 32 mothers of Children with Autistic disorder and 29 mothers of children without Autism; referring to hospitals of Ahvaz city using Convenience sampling. All subjects were asked to complete Demographic questionnaire and General Health Questionnaire (GHQ). Data were analyzed using Multivariate Analysis of variance (MANOVA).Results: Result sindicated that significant differences exist in mental health (F=5.69, P=0.02) and anxiety/ insomnia (F=4.82, P=0.03), between mothers of children with Autismand control group. There were not any other significant differences in the other subscales.Conclusion: It is essential using some mental health improving interventions for mothers of children with Autistic disorder.

We present a 19-year-old patient with hematologic and neurologic manifestations associated with Wilson’s disease. Idiopathic thrombocytopenia was diagnosed in October 2009. Bone marrow aspiration was normal. Gradually her neurologic and psychiatric symptoms emerged, dysarthria, writing apraxia, learning difficulties, emotionalism and eventually dystonia of hands. The serum ceruloplasmin was low, and the Kayser Fleischer's ring was positive. MRI of the brain showed abnormality in the bilateral basal ganglia, brain stem and superior cerebellar peduncles without post-contrast enhancement.

Transvestic fetishism is having a sexual or erotic interest in cross-dressing. This case report describes a 17-year-old male with transvestic fetishism who suffered from obsessive thoughts and subsequent masturbation compulsion. He was managed successfully with fluoxetine.

Fahr’s disease is a rare syndrome characterized by symmetrical and bilateral intracranial calcifications. We report a 21-year-old male who presented with aggression, talkativeness, restlessness, and insomnia of recent onset. His neurological examination was normal. Mental status examination and clinical investigation revealed mania. Brain revealed symmetrical large areas and foci of calcification in bilateral basal ganglia and subcortical regions of cerebral hemispheres. This is the first reported case of mania associated with Fahr’s disease in a Kashmiri patient. The description highlights the importance of considering organic causes when encountering patients with mania. The patient was put on mood stabilizers and his abnormal behaviors improved within 4 weeks.