مجله روانپزشکی و روانشناسی بالینی ایران
سال نوزدهم شماره 3 (پیاپی 74، پاییز 1392)

Service delivery through Community Mental Health Centers (CMHCs) is a strategy for improving urban mental health. The current paper presents the process of designing structure and planning the services for CMHCs through an evidence-based approach. Using a systematic review approach, the needs and available mental health services in urban areas, and effectiveness and cost-effectiveness of mental health services for addressing those needs were identified and accordingly urban mental health services plan was devised as CMHCs. Depression, schizophrenia and other psychotic disorders, bipolar disorders and anxiety disorders respectively comprise the top four psychiatric disorders, according to burden of diseases, in Iran. Urban areas have richer resources than rural areas in the country, though there are no out-of-hospital and out-of-office mental health services and the network system and the primary care for presenting mental health services are ineffective due to the current restrictions. Therefore, it was arranged that the CMHCs’ services being delivered to two groups of patients including patients with neurotic (depressive and anxiety) disorders and patients with severe mental and psychotic disorders. The services for neurotic patients were presented according to improving recognition style and the management of neurotic disorders conducted by general practitioners (GP) using collaborative care model and forming collaborative units. The services for patients with severe psychiatric disorders included home visiting and telephone follow up accompanied with the patient and the family psychological education provided by specialized team from the CMHCs. The CMHCs’ services based on scientific evidence available across the world and using national experiences and infrastructures was designed for two groups of disorders which comprised a large burden of disease in the country. These services are currently being piloted in Tehran and Zanjan.

The aim of this study was to determine the relationship between craving for methamphetamine and personality characteristics of patients under methadone maintenance treatment (MMT). Eighty patients under MMT were chosen from Iranian National Centers for Addiction Study، Aftab Society، Aftab-e-Mehrvarzi، and a private infirmary and thereafter answered to Temperament and Character Inventory (TCI) and Desires for Drug Questionnaire (DDQ). Data analysis was done by one-sample t-test and Pearson correlation coefficient. The results showed that the subjects obtained higher than the norm scores in novelty seeking and harm avoidance and lower than the norm scores in reward dependence، self-directedness، cooperativeness and self-transcendence. Furthermore، craving for methamphetamine had a positive correlation with novelty seeking (p<0. 002)، but negative correlation with cooperativeness (p<0. 001). Through recognizing personality traits and the amount of craving for drug in patient on MMT، it is possible to predict whether they stay in or leave the treatment.

The purpose of current study was comparison of transdiagnostic group therapy with classic group cognitive therapy on positive and negative affects and emotion regulation. Thirty-three college students with anxiety and depressive symptoms were randomly assigned to two groups and participated in eight two-hour sessions. In both groups، the treatment method was effective on emotion regulation components and positive and negative affects after interventions. Analysis of covariance showed the higher effectiveness of transdiagnostic on improvement of reappraisal (p=0. 01) and increase of positive affection (p=0. 001). The effectiveness of transdiagnostic group therapy in improving emotion regulation and positive affects was higher than classic group cognitive therapy. Clinical implications of findings are discussed.

The purpose of this study was to evaluate the role of topiramate in weight gain control in bipolar patients receiving lithium carbonate and antipsychotics during their manic episode. In current randomized controlled double-blind clinical trial, 46 patients with bipolar disorder in their manic episode were divided into two intervention and control groups. Both groups were treated with lithium and antipsychotics. Besides, the intervention group received topiramate and the control group received placebo. The maximum topiramate dose was 200 mg/day. The patients’ weights were assessed initially and afterwards weekly for eight weeks. Patients were evaluated using Young Mania Rating Scale (YMRS) and analysis was done by chi-square and repeated measures analysis of variance. There was no statistically difference between the mean of weights in two groups at the beginning and end of the investigation (p=0.948 and p=0.254, respectively) and comparing to the beginning, there was no difference between the two groups’ weights during eight weeks of observation. Adjunctive treatment using topiramate (200 mg/day) was ineffective in weight gain control in manic patients receiving lithium and antipsychotics.

The aim of this study was to examine the effectiveness of therapeutic interventions on psychiatric problems of abused children. In current quasi-experimental study، 73 children (43 boy and 30 girl) referred to child and adolescent psychiatry clinic due to psychiatric problems or to the emergency unit، clinic and pediatric ward in Imam Hossien Hospital due to physical problems were examined and non-pharmaceutical interventions and treatments (play therapy، behavioral therapy، cognitive therapy، life skills training، occupational therapy، counseling actions and school counseling، anger management training، and parenting) were administered based on family and child needs. Parenting skills training was given during 8 weekly 90-minute group sessions based on a positive parenting program. However، 2 out of 8 sessions were dedicated to describing child abuse and physical punishment and their negative effects over child and the methods of anger management. A psychologist filled out the child abuse questionnaires by receiving information from parents and from a pre-intervention interview with child. Child Behavioral Checklists (CBCL) were completed by parents prior and in the third and sixth months after intervention. The length of therapeutical interventions for every individual was 3 months. Finally، 40 interventions were completed. The data analysis was by repeated measures analysis of variance. The results revealed examinees’ considerable improvement in subscales including attention problems، anxious-depressed problems، social problems، delinquent behaviors، aggressive behaviors، internalizing and externalizing problems، and general problems (for all subscales p=0. 0001). To reduce the consequences of child abuse، early recognition and continuous intervention seems effective.

The present research was aimed to determine the clock drawing pattern in children with and without dyscalculia, and to assess Clock Drawing Test (CDT) as a screening measure in Iranian children population. In current ex post facto study, 45 children with dyscalculia aged 9.5-11.7 years and 45 normal controls matched for age, gender, handedness, grades and IQ were selected through accessible sampling method. Participants were selected after completing the teacher’s and parent's form of Children Symptom Inventory (CSI), Wechsler Intelligence Scale for Children (WISC-R), Iran Keymath Mathematic Test (IKMT) and semi-structure interview according to American Psychiatric Association (DSM-IV-TR). Hereafter, CDT was administered. Conceptualization of time and construction of the clock face drawing were assessed separately using Cohen and colleagues scoring system. Data were analyzed using multivariate analysis of variance. The performance of children with dyscalculia was poorer than the normal children. The qualitative analysis of performance revealed errors that were subsequent to poor planning during execution of coordinative tasks. According to quantitative and qualitative analyses and the difference between clock drawing pattern in children with and without dyscalculia, the clock drawing test is a suitable screening measure, and a useful addition to comprehensive neuropsychological evaluation in Iranian children with dyscalculia.

This study aim was comparison of the personality characteristics of women with functional dysphonia (FD) with a healthy control group. Twenty-seven women with FD and 43 healthy women matched for age، education، occupation and marital status of FD group were investigated. Using videolaryngoscopic technique and interview، the perceptual appraisal of voice for standard or non-standard status was conducted. Both groups completed the NEO Five-Factor Inventory (NEO-FFI). Data were analyzed by independent t-test. The women with FD had higher scores in neuroticism (p=0. 002) and conscientiousness (p=0. 001) and lower scores in extraversion (p=0. 002) and agreeableness (p≤0. 000). The women with FD are differentiated from healthy women in some personality characteristics. These findings seem useful in identification of the etiology of functional dysphonia and presenting optimum treatment strategies.

The aim of the present study was to investigate the role of positive and negative perfectionism، self-efficacy، worry and emotion regulation in predicting behavioral and decisional procrastination. In current correlational study، 365 students from Tehran University completed General Self-Efficacy Scale (GSES)، Difficulties in Emotion Regulation Strategies Scale (DERS)، Worry Domains Questionnaire-Short Form (WDQ)، Positive and Negative Perfectionism Scale (PNPS)، Decisional Procrastination Scale (DPS) and General Procrastination Scale (GPS). The gathered data was analyzed using Pearson correlation and stepwise multiple regression. All variables were correlated with the behavioral and decisional procrastination (p<0. 01). The stepwise multiple regression analysis indicated that the predictive model for behavioral procrastination consisted of general self-efficacy، difficulties in emotion regulation، positive perfectionism and worry، respectively (p<0. 001). Negative perfectionism excluded from this model. For decisional procrastination the model included difficulties in emotion regulation، worry، positive and negative perfectionism (p<0. 001). Current study emphasized the multifaceted nature of procrastination and the importance of cognitive and emotional variables in understanding procrastination. The results also confirm the detrimental role of emotion regulation in psychopathology of procrastination. However، this research wasn’t based on an integrated theoretical model about procrastination.