Iranian Journal of Psychiatry
Volume:9 Issue: 1, Winter 2014

This 7-year observational study examines the hours of TV-watching, phone conversation with friends, using the internet, and physical activity as predictors of mental health among adolescents in south of Iran. At the baseline (in 2005), the participants were 2584 high school students in the 9th to 11th grade. At the baseline, 30% of the available participants (n = 775) were selected in the follow-up (2012) using convenience sampling method. This study used the path analysis to examine the predictors of mental health and to obtain direct, indirect and total effects of the independent variables. At the baseline (2005), female gender, internet use, maternal education, physical activity and father''s education were associated with mental health (p<0.05). Baseline mental health, internet use and physical activity predicted mental health of the participants in the follow up (p<0.05). The findings of the study revealed that better mental health in later life is associated with better mental health at baseline, male gender, higher physical activity and phone communication with friends, and less use of the internet and TV.

Bad news disclosure is one of the complex communication tasks of the physicians. Bad news is defined as: «any news that adversely and seriously affects an individual''s view of his or her future». Recent studies indicate that the patients’ and physicians’ attitudes toward disclosure of bad news have been changed since few years ago. The evidence of breaking bad news is also different across different cultures. In the present study, we aimed to evaluate the patients'' prospect about breaking bad news and to provide a clinical guidance for Iranian patients and those patients in countries with a similar cultural background. A cross sectional descriptive study was conducted on a sample of 200 cancer patients at a cancer institute in Tehran. The patients'' demographic characteristics and their attitudes toward the manner of disclosing the diagnosis were registered in a research based questionnaire. In this study, 165 patients (82. 5%) claimed to be aware of the diagnosis; however, only 121 patients (73%) were aware of the actual diagnosis of their disease. Most patients tended to know the diagnosis (n = 186, 93%) and accepted patient as the first person to be informed (n = 151, 75. 5%) by their physician (n = 174, 87%). The preference of being alone or with a family member when exposed to bad news was almost the same. Most patients (n = 169, 84. 5%) believed that physicians should consult the patients to make treatment decisions. Treatment options (n = 140, 70%) and life expectancy (n = 121, 60. 5%) were the most desirable topics to be discussed. Most patients (n = 144, 72%) agreed upon allowing them to express their emotional feelings. According to the patients'' preferences about being fully informed about the diagnosis, it is suggested that the disclosure of cancer diagnosis be done by a physician and in the presence of a family member. It is also recommended that physicians consult the patients about treatment options.

The aim of present study was to verify possible cognitive dysfunction in the patients with Juvenile Myoclonic Epilepsy (JME) and its correlation to factors related to epilepsy and patients demographic variables. Thirty two consecutive patients with JME and 32 healthy controls were evaluated in neuropsychological domains including orientation, mental control, logical memory, forward and backward digit spans, visual memory, associative learning, and memory quotient (using Persian version of Wechsler Memory Scale (WMS)-Revised), preservative errors (using Wisconsin Card Sorting Test (WCST)), Stroop Test (color and word), IQ score (using Raven''s Progressive Matrices test), and depression (using the Persian version of Beck Depression Inventory (BDI)). SPSS 11.0 (SPSS Inc., Chicago, Illinois, USA) software was used for statistical analysis. Student’s t-test and the Mann–Whitney U-test were used for independent normally and non-normally distributed continuous variables, respectively. Our study showed significant differences between patients with JME and control group with respect to scores of mental control (p=0.015), forward digit span (p=0.004), total digit span (p=0.008) and IQ (p=0.003). In addition, age, education level, duration of epilepsy and medication showed an impact on several cognitive functions in the patients with JME. It is indicated that JME is associated with impairment in specific cognitive domains, despite any evidence in favor of depression.

Object: Bipolar disorder (BD) is associated with abnormalities in emotional competence. One of the main aspects of this competency is emotion recognition which is presented in the face. This study aimed to evaluate facial emotion recognition in adolescents with bipolar disorder when they are free of acute symptoms. Thirty patients diagnosed with BD aged 12 to 18 were selected from a large sample of consecutive admitted adolescents in Roozbeh hospital. They were compared with 30 matched normal developing adolescents who were recruited from mainstream schools at Tehran. All participants were evaluated using a facial emotion recognition task. The participants needed to recognize happy, sad, angry and neutral facial expressions The ANOVA was used to analyze the differences between the two groups in terms of emotion recognition variables. The patients with BD showed a significant deficit in recognizing emotions in general (p=.01) which was prominent in the angry faces. Their response time to recognize the facial expressions was longer compared to the normal individuals. This difference was significant in recognizing the happy and neutral faces (p<0.05). This study suggests an inaccurate recognition of facial expressions in adolescents with BD, particularly for anger, as well as slowness in detecting emotions especially happiness.

Attention Deficit/Hyperactivity Disorder (ADHD) is a prevalent and serious disorder affecting such key cognitive components as working memory. Working memory serves to facilitate and check attention in any individual and to focus on those affairs that need to be retained in mind. This study examines whether a combination of the two therapeutic methods of working memory training and Methylphenidate might be more effective in treating ADHD in children aged 6 to 12 years of age than when methylphenidate is applied alone. Subjects of the study are 48 children suffering from ADHD. They were selected by random sampling. The experimental group included 23 children with ADHD who received a combination of working memory training and Methylphenidate, and the control group which included 25 children with ADHD received Methylphenidate only. To check the effects of the intervention, Conners'' Parent Rating Scale (CPRS-48) was applied before and after the intervention. After intervention, data were collected from the remaining samples in the two groups. Data were examined both through descriptive statistical methods and analytic statistical methods, including T-student test and Quantile-Quantile Plots diagram. The study demonstrated that a combination of the cognitive intervention of working memory training and methylphenidate is more effective in alleviating ADHD symptoms rather than when methylphenidate is applied in isolation. In the CPRS pre-test and post-test, the mean difference of the experimental and the control group was 8.39 and 1.88 respectively, indicating that the working memory group has improved more than the control group. The study reveals that the ADHD symptoms were more contained in the test group than the control group due to working memory training. The cognitive intervention through working memory training may be effective in alleviating the severity of disorder measured in the pre-test.

Childbirth is one of the most vulnerable moments and the most important and memorable events in the lives of women that despite of bringing happiness, it can be associated with psychological trauma and endanger the mother and neonate health. Mothers'' perception of the psychological birth trauma is a highly subjective process that depends on the cultural, social and biological conditions of mothers that is not achievable except with examination of their views. This study aimed to understand psychological birth trauma from the perceptions of Iranian mothers. A qualitative research design using in-depth interviews of 23 Iranian mothers was conducted from Tehran and Isfahan health centers. The interviews were transcribed and analyzed using conventional content analysis. Two themes were extracted from the data: impact of psychological birth trauma and trends of psychological birth trauma. Several categories and sub-categories also emerged from the data. Feelings of fear, anxiety, helplessness and sense of impending death (collapse) were reported by the mothers. By considering the unforgettable experience of mothers from the psychological birth trauma, a plan for supportive care before, during and after birth is critical.

The aim of this study was to compare the clinical temperaments and characters of Iranian patients with Major Depressive Disorder (MDD) with healthy controls The study participants included 47 outpatients with Major Depressive Disorder (MDD) and 120 normal controls with no psychiatric disorders. Sampling method was convenience. The MDD patients were diagnosed as MDD by a psychiatrist using the Persian structured clinical interview for axis I disorders (SCID-I), and they completed at least 8 weeks of antidepressant treatment. All the patients filled out the Persian version of the Temperament and Character Inventory (TCI). Data were analyzed using SPSS version 17, Chi square, T test and Multiple Regression. The level of significance was set at 5%. The present study demonstrates a link between depression and lower persistence (p≤0.001), self-directedness (p≤0.001) and cooperativeness (p≤0.001) scores. A negative correlation between age and Harm Avoidance (p≤0.001) was observed in both groups. Lower scores of persistence (P), self-directedness (SD) and cooperativeness (CO) were observed in patients with depression more than controls even in the remission phase which could indicate a relationship between these traits and depression.

Dyke-Davidoff-Masson Syndrome (DDMS) is a syndrome associated with refractory epilepsy. DDMS is a rare syndrome characterized by seizures, facial asymmetry, contralateral hemiplegia and mental retardation. The characteristic radiologic features are cerebral hemiatrophy with homolateral hypertrophy of the skull and sinuses. The case was an 18 years old female with seizures, hemiparesis of the right side and mental retardation who was diagnosed with DDMS based on computed tomography.

A 67-year-old male suffering from depressive symptomatology was admitted to the inpatient clinic at Firat University School of Medicine; and his psychiatric evaluation revealed major depressive episode according to DSM-IV. He developed chest discomfort, chest pain and shortness of breath of acute onset accompanying pulseless ventricular tachycardia (VT) leading to cardiac arrest following sertraline and mirtazapine combination treatment. He died after two days in the Intensive Care Unit. The present case suggests that psychiatrists should be aware of unexpected cardiac events, especially when they use combination treatments.