Iranian Journal of Psychiatry
Volume:4 Issue: 4, Autumn 2009

Attention-Deficit/Hyperactivity Disorder (ADHD) is one of the most common mental disorders in childhood and it continues to adulthood without proper treatment. Stimulants have been used in treatment of ADHD for many years and the efficacy of methylphenidate (MPH) in the treatment of adults with ADHD has been proven to be acceptable according to meta-analysis studies. However, there are some concerns about stimulants. Finding other effective medications for the treatment of adult ADHD seems necessary. We tried a monoamine oxidase inhibitor, Selegiline, as there are some theoretical and experimental evidences for the efficacy of this medication. Forty patients were randomized to receive Selegiline or methylphenidate in an equal ratio for an 8-week double-blind clinical trial. Each patient filled the CAARS self report screening form before starting to take the medication and in weeks 2-4-6 and 8. Patients were also assessed by a psychiatrist at the baseline and on each 14 days up to the 8 weeks period. The mean score of the two groups- receiving Selegiline or methylphenidate- decreased over the 8 weeks. There was not a significant difference between the two groups. The most prevalent side-effect of methylphenidate was decrease of appetite and for Selegiline change in sleep pattern. Selegiline is as effective as methylphenidate in the treatment of adults with Attention-Deficit/Hyperactivity Disorder. Selegiline can be an alternative medication for the treatment of adult ADHD If its clinical efficacy is proven by other larger studies.

An assessment of nonoperative and operative intervention inregards to neurological improvement following traumatic closed cervical spinal cord injury (CSCI). A retrospective evaluation of a cohort of patients with a CSCI from C3 to T1 was reviewed. The analysis included a total of 13 eligible patients. The neurologic and functional outcomes were recorded from the acute hospital admission to the most recent follow-up. Data included patients'' age; level of injury, neurologic exam according to the Frankel grading system, the performance of surgery, the mechanism and timing of the CSCI decompression, and motor index score (MIS). Ninety-two percent of the patients were male with the mean age of 28.2 ± 11.5. Before treatment, 10/13 patients (77.0%) had functionally complete neurological deficits below the level of injury. The median interval from injury to surgery was 16 days. Eight patients underwent surgical intervention and five were treated nonoperatively. The median length of follow-up was 14 months after surgery (Range: 7 - 93 months). Spinal cord functional improvement was observed in 2/8 (25%) of the surgically managed patients and in 4/5 (80%) of the patients treated nonoperatively. Root recovery was observed in 6/8 (75%) of the patients who were treated surgically and 4/5 (80%) of the patients treated nonoperatively. Some degree of motor score improvement occurs following a closed cervical spinal cord injury with or without operative surgery in the follow up period.

The aim of this study was to evaluate the psychometric properties of the Persian version of Chicago Multi-Scale Depression Inventory (CMDI) in Iranian subjects. CMDI was translated into Persian according to the standard method. Two hundred and sixty two medical students (of whom, 114 were re-tested 5-10 days after the first test), Archibald 40 patients with major depressive episodes, 23 patients with multiple sclerosis, 21 patients with epilepsy, and 43 normal persons selected from acquaintances of the patients were included in the study. Samples were matched for age, sex, marital status, and education. Exclusion criteria were as follows: neurologic diseases (except multiple sclerosis or epilepsy) or head trauma, serious medical condition, alcohol or opioid abuse. Subjects were omitted if they did not answer any of the items in BDI-II or CMDI. Demographic questionnaire, BDI-II, and CMDI were given to the subjects. The mean scores of CMDI and its subscales for depressed people were significantly different from multiple sclerosis patients, normal people, and medical students. The mean score of mood subscale for epilepsy patients was significantly different from normal people. The mean score of CMDI and evaluative and vegetative subscales for epilepsy patients were significantly different from the normal subjects and medical students. Correlation coefficient between BDI-II and CMDI was 0.86. Reliability and internal consistency coefficients for CMDI were 0.92 and 0.95 respectively. Cut off scores for CMDI and mood, evaluative, and vegetative subscales were 123, 46, 36, and 44 respectively. The Persian version of CMDI has content, convergent, and discriminant validity and is reliable and internally consistent. These findings support the use of CMDI in Persian participants.

The purpose of this study was to adopt the Binge Eating Scale (BES) among the Iranian obese population. BES and a semi-structured interview based on DSM-IV criteria for binge eating disorder were administered among 60 obese subjects aged 20 to 50 years. In order to evaluate test-retest reliability, 30 obese subjects were asked to complete the BES again 9 to 20 days later. In addition, to assess the discriminate validity, 60 normal-weight control subjects were asked to complete the BES. The obese and the normal weight control group were matched for age and sex. The Persian version of the BES showed a sensitivity of 84.6% and specificity of 80.8% in identification of binge eating disorder. The test-retest reliability and internal consistency of BES were 0.71 and 0.85 respectively. The BES effectively discriminated obese persons from the normal weight subjects. These findings suggest that the Persian version of BES is a valid instrument for screening binge eating disorder in the Iranian obese population.

Previous research has linked self regulation and parenting styles separately to academic procrastination. This article investigates the impact of the dimensions of parenting styles, behavioral self regulation and short term self regulation on procrastination of students. A sample of 249 adolescents (174 females and 75 male) aged 19 - 21 years completed measures of Parent as Social Context Questionnaire- Adolescent Report, Self-regulation Questionnaire (SRQ), Adolescent Self- Regulatory Inventory (ASRI) and Procrastination Tendency scale. Correlation coefficient indicted that in contrast to harsh or unsupportive parenting (rejection, chaos, and coercion), authoritative parenting (warmth, structure, and autonomy support) was inversely related with procrastination. The results of hierarchical multiple regression analyses showed a clear negative relationship between a students'' short term self regulation, dimensions of parenting styles (structure and warmth) and procrastination consistent with the literature. Surprisingly, in contrast to behavioral self regulation of Miler& Brown, short term self regulation was found to be negatively related to procrastination.

The main objective of this study is to compare the efficacy of social skill training as a classroom program in schoolgirl students of a primary school with a control group. The 4th grade school girls of two classes in a primary school and at least one of their parents or caregivers participated in this study and they were allocated in the case and control groups. The student''s age range was 9-11 years. The social skill education program was designed for primary school children by child and adolescent psychiatry department of Shahid Beheshti University of Medical Sciences. Demographic characteristics were recorded in a designed questionnaire, and included name, age, prior history of psychiatric and medical condition, and prior history of participation in a social skill education program. Achenbach Child Behavior Check List parent''s report form (CBCL) was used before and after the study in the case group to evaluate the efficacy of the program interventions and, it was also used for the controls at the same times. The change of mean scores, inter and intra groups, and the categorical shifts were compared using repeated measure ANOVA and Chi square statistical methods of analysis by the SPSS-15 statistical software. The total number of 66 students with the mean age of 9.80±0.49 years participated in the study: 39 students were assigned to the experimental group and 27 students to the control group. The comparison of the mean age revealed no statistically significant differences between the two groups. The results showed an increment in internalizing problems and total competence and also in affective, anxiety, oppositionality and conduct problem scores which are statistically significant. The percentage of change in behavioral problems was compared between the cases and controls after the interventions. Based on the results, 25.6% of the intervention group got worse in internalizing problems after the intervention compared to the 3.7% in the control group which is statistically significant.Social skill training in classroom settings may worsen some behavioral problems in girls; therefore, this type of training needs standard settings

The major objective of this study was to determine the means and 95% confidence interval of normal 6 years old children''s motor-verbal skills. Based on the results of this study we could develop a measure to diagnose abnormal motor skills. In addition, in this follow-up study, we compared the first-graders'' motor-verbal skills to their own skills one year earlier. In this follow-up study, the development of motor-verbal skills was studied in 220 normal readers in the first-grade after 1 year. We administered naming speed test and word and phrase repetition to assess motor-verbal skills. Data were analyzed by descriptive statistic and paired t-test. The mean of the 6 years old first-graders'' speed naming was 87 words per 100 second. In addition, means and standard deviations of word and phrase repetition were 8.41(2.92) and 6.51(1.73) respectively. In addition,, paired t-test showed a significant difference between naming speed, word and phrase repetition first-grade and 5 years old children score(naming speed: t=10.95, p<0.001, word repetition: t= 14.23, p<0.001, phrase repetition: t=12.11, p<0.001). In general, 5 years old children''s motor-verbal skills significantly improved after one year. Furthermore, the results of this study provide the norm for speech and language pathologists and other professionals. It is important to note that if 5 years old children''s motor-verbal skills are under this norm, it will be anticipated that they are at the risk of literacy problem and dyslexia.

The aim of this report was to study the gender role on autismsymptoms distribution and severity in a clinical sample from Iran. Then, the results were compared with the published study from the same community population sample, Iran. The subjects of this retrospective study were a convenient clinical sample of the referrals of children with pervasive developmental disorders. The diagnosis was made according to DSM-IV diagnostic criteria. Most of the subjects were boys. Boys were referred for evaluation more frequently than girls. The sample included 61 children and adolescents aged 2.1 to 15 years; of whom, 49 had autism. The mean age of children with autism was 7.2(SD=3.2) years. The mean of age, the diagnosis and severity of the symptoms were not related to gender. Usually, those with severe cases of autism refer to clinics for treatment. Therefore, the clinical sample of children with autism is just the tip of the iceberg and they may not be the actual representative of community sample of children with autism. Preventive programs should be more focused on the screening and referring of inflected girls for service utilization.