Iranian Journal of Psychiatry
Volume:9 Issue: 2, Spring 2014

The aim of the current study was to examine the effectiveness of Barkley''s parent training program, working memory training and the combination of these two interventions for children with Attention deficit hyperactivity disorder (ADHD). In this study, 36 participants with ADHD (aged 6 to 12 years) were selected by convenience sampling. Revision of the Swanson, Nolan and Pelham (SNAP) questionnaire (SNAP–IV), Child Behavior Checklist (CBCL) and clinical interviews were employed to diagnose ADHD. Wechsler Intelligence Scale for Children-Fourth Edition was also implemented. The participants were randomly assigned to the three intervention groups of Barkley''s parent training program, working memory training and the combined group. SNAP-IV and CBCL were used as pre-tests and post-tests across all three groups. Data were analyzed using MANCOVA (SPSS version18). There was a significant difference (p< 0.05) in the decline of attention deficit and hyperactivity /impulsivity symptoms between the combined treatment group and working memory training group and also between the combined treatment group and the parent training group in SNAP. In terms of attention problems (experience-based subscales) of CBCL, there was a significant difference (p< 0.001) between the combined treatment group and working memory training group. Furthermore, compared to the working memory training and parent training groups, the combined group demonstrated a significant decline (p< 0.01) in clinical symptoms of ADHD (based on DSM). It was revealed that combined treatment in comparison with the other two methods suppressed the clinical symptoms of ADHD more significantly.

Siblings of children with autism are at a greater risk of experiencing behavioral and social problems. Previous researches had focused on environmental variables such as family history of autism spectrum disorders (ASDs), behavior problems in the child with an ASD, parental mental health problems, stressful life events and «broader autism phenotype» (BAP), while variables like parenting style and family function that are shown to influence children’s behavioral and psychosocial adjustment are overlooked. The aim of the present study was to reveal how parenting style and family function as well as BAP effect psychological adjustment of siblings of children with autism. The Participants included 65 parents who had one child with an Autism Spectrum Disorder and one typically developing child. Of the children with ASDs, 40 were boys and 25 were girls; and they were diagnosed with ASDs by a psychiatrist based on DSM-IV-TR criteria and Autism Diagnostic Interview-Revised (ADI-R). The Persian versions of the six scales were used to collect data from the families. Pearson''s correlation test and regression analysis were used to determine which variables were related to the psychological adjustment of sibling of children with ASDs and which variables predicted it better. Significant relationships were found between Strengths and Difficulties Questionnaire (SDQ) total difficulties, prosocial behaviors and ASDs symptoms severity, parenting styles and some aspects of family function. In addition, siblings who had more BAP characteristics had more behavior problems and less prosocial behavior. Behavioral problems increased and prosocial behavior decreased with permissive parenting style. Besides, both of authoritarian and authoritative parenting styles led to a decrease in behavioral problems and an increase in prosocial behaviors. Our findings revealed that some aspects of family function (affective responsiveness, roles, problem solving and behavior control) were significantly correlated with behavioral problems and prosocial behaviors in typically developing (TD) siblings of children with ASDs. Siblings of children with ASDs, due to genetic liability, are at a greater risk of psychological maladjustment. Furthermore, environmental factors like parenting styles and family function also have a significant effect on psychological maladjustment.

Bone Marrow Transplantation is considered one of the main procedures used in the treatment of both malignant and non-malignant diseases. Psychological factors after Bone Marrow Transplantation have an important role in the survival of the patients undergoing this procedure. In the present study, some parameters including depression, anxiety and cognition were assessed during both pre and post-transplantation in patients undergoing Bone Marrow Transplantation. The evaluations were performed by utilizing several questionnaires including Hospital Anxiety and Depression Scale and Wechsler Memory Scale within 72 hours after hospitalization (pre-transplantation) and one month after transplantation (post-transplantation). All patients received intensive chemotherapy during the first 72 hours after hospitalization. Paired t test was used to compare pre and post values. SPSS (version 18) was used to analysis the data. The significance level was defined as p < 0.05. Twenty one patients who were not receiving any antianxiety agents at least for two weeks prior to and during this study were included. It was noted that anxiety was significantly less at post-transplantation compared to its pre-transplantation level (P = 0.008). However, no significant difference was found between pre and post-transplantation depression. Memory function was significantly improved at post-transplantation compared to pre-transplantation (P = 0.001). The authors suggest that the improvement of anxiety and memory status of the patients one month after the bone marrow transplantation is expected even in the absence of consumption of any antianxiety agents. However, antidepressants may be needed to help those patients who undergo bone marrow transplantation.

Attention is an important factor in information processing; obsessive- compulsive disorder (OCD) and generalized anxiety disorder (GAD) are two main emotional disorders with a chronic course. This research examined the relationship among attentional control and intrusive thoughts (worry, rumination and obsession) in these disorders. It was hypothesized that attentional control is a common factor in OCD and GAD. In addition, we compared worry, rumination and obsession among OCD, GAD and non- clinical participants. The research sample included three groups: OCD (n = 25), GAD (n = 30) and non- clinical samples (n = 56). Data were collected using the Attentional Control Scale (ACS), Rumination Response Scale (RRS), Pennsylvania State Worry Questionnaire (PSWQ), Beck Depression Inventory (BDI), Beck Anxiety Inventory (BAI), Obsessive-Compulsive Inventory-Revised (OCI-R) and General Health Questionnaire (GHQ-28). Data were analyzed using MANOVA and MANCOVA by SPSS-17. Multivariate Analysis of Variance revealed that the OCD and GAD groups reported greater deficits in attentional control, higher obsessive-compulsive symptoms, rumination, worry, anxiety and depression compared to the control group. This research indicated a great attentional deficit in obsessive- compulsive disorder and generalized anxiety disorder. However, no significant difference was found between these two disorders.

The aim of this study was to determine the oxidative stress; serum level of Total Antioxidant Capacity (TAC)and Malondialdehyde (MDA) level and the depression score among the depressed rotational shift workers in Shahid Tondgouyan Refinery in Tehran (Iran). A cross-sectional study was conducted among all the 189 shift workers in Shahid Tondgouyan oil refinery who were eligible to participate in the study. They did not take any antidepressants for two months or any supplements for two weeks prior to the study entry. Written consent was obtained from the participants. 21- Item Beck Depression Inventory was used to measure the depression level. Furthermore, body weight, height and systolic and diastolic blood pressure were collected from all the participants. The levels of Total Antioxidant Capacity (TAC) and Malondialdehyde (MDA) were measured by 8 ml fasting blood sample. MDA was determined by thiobarbituric acid reaction. Serum total antioxidants were measured using the spectrophotometric ABTS. In the ABTS test, 2,2’-azinobis (3-ethylbenzthiazoline-6-acid) (ABTS) is converted into its radical cation (ABTS•+) by addition of sodium persulphate. This blue-green radical cation absorbs light at 734 nm. ABTS•+ is reactive towards most antioxidants. Descriptive statistics, ANOVA, ANCOVA and regression tests and correlation were used to analyze the data using SPSS software version 16. The age of the participants ranged from 21 to 52 years. The mean age of the participants was 30.58 year (±6.97yr). Of all the participants, 28% (n= 53) had no depression symptoms (depression score between 0 and 9), 65.1% (n=123) were categorized as having mild depression (depression score between 10 and 18) and 6.9% (n=13) were categorized as having moderate depression (depression score between 19 and 29). The participants’ BMI ranged from 15.9 to 34.3; the mean BMI of the participants was 24.82 kg/m2 (+ 3.81 kg/m2). The mean of the serum TAC level was 2.51 (± 0.56) mg/dl, and the mean serum MDA level was 3.67(± 1.08) μmol/l. There was a significant difference in the mean TAC concentration between the non-depressed group and the group with mild depression (p=0.029). Depression was associated with reduced mean TAC concentration and an increase in MDA level. There was a linear relationship between the depression score and shift work experience among the rotational shift workers, which showed a high level of stress and depression among the shift-workers.

Attention deficit hyperactivity disorder in adults (adult ADHD) is gaining more attention nowadays. Nevertheless, very few studies have addressed this issue in Iran. The present study was conducted to determine the prevalence of adult ADHD in Tabriz, North-West of Iran. Four hundred urban inhabitants of Tabriz- with an age range of 18 to 45 years were selected through the probability proportional to size cluster sampling in 2009. The screening was performed by Conner''s Adult ADHD Rating Scale, and the definite diagnosis of Adult ADHD was performed via clinical interview according to DSM-IV-TR and Wender Utah criteria. The prevalence of adult ADHD was estimated to be 3.8%. Men when compared with women were more likely to have ADHD (5.5 % in men versus 2 % in women). Marital status, birth order, educational level and occupational status showed no significant association with adult ADHD. History of psychiatric treatment, alcohol drinking and smoking had similar relative frequency in subjects with and without adult ADHD. The prevalence of adult ADHD in this region of Iran seems to be substantially higher than expected or treated. This would require more attention to be drawn by health sector managers in order to improve the knowledge of the general population and the knowledge of the health care professionals about the disorder.

Studying suicide can be of assistance to prepare the ground for the adoption of effective preventative measures. In the present study, our aim was an in-depth review of suicide epidemiology in the city of Sari, in the northern part of Iran. Our focus was on geo-demographic and other risk factors affecting the frequency of suicide in order to demonstrate populations with greater risk of suicide for future preventive and protective measures. In a prospective study, during a one year period, a descriptive semi-structured questionnaire was used to conduct interviews with subjects who attempted suicide and referred to one of the four major trauma and emergency centers in the city of Sari, or with the relatives of those who completed their attempt. Convenience sampling method was used. Statistical analysis was performed using SPSS-20 software. Multivariate tests were based on χ2 values. Logistic regression was performed estimating the effect of risk -factors. In this study, 228 suicide attempters were enrolled; of whom, 78.5% were female; 28.5% of all the attempts resulted in death. The odds of suicide completion were significantly increased in the following cases: married status (OR: 3.49; 95% CI 2.82,4.53), illiteracy (OR:2.71;95%CI 2.10,3.64), presence of comorbid physical illness (OR:2.22;95%CI 1.64,3.21), history of previous suicide attempt (OR:2.03; 95%CI 1.56,2.81), and age over 50 (OR: 2.01, 95% CI 1.14,3.05). Suicide outcome estimated worst in the married illiterate attempters. The leading method of use was suicide by burn (SBB). The variety observed in the regional distribution of suicide risk factors calls for more non-discriminatory attention and adoption of precautionary, preventative and protective measures for each section of the society accordingly.

Iranian Mental Health Survey (IranMHS) was conducted to assess the twelve-month prevalence and severity of psychiatric disorders in the Iranian adult population and to determine the pattern of health care utilization and cost of services. IranMHS is a cross-sectional national household survey with face-to-face interviews as the main data collection method. The study was carried out between January and June 2011. A three-stage probability sampling was applied for the selection of a representative sample from the non-institutionalized population aged 15 to 64. The primary instrument utilized for assessing the prevalence of mental disorders was the Persian version of Composite International Diagnosis Interview, version 2.1. The instruments for assessing the service and cost of mental illness were developed by the research team. The response rate was 86.2%, and a total of 7886 individuals participated in the study. Sampling weights were the joint product of inverse probability of unit selection, non-response weights and post-stratification weights. This paper presents an overview of the study design, fieldwork organization and procedures, weightings and analysis. The strengths and limitations of the study are also discussed.

In the present study, we investigated the attitude of psychiatrists who graduated in 2002-2009 towards Objective Structured Clinical Examination (OSCE) and conventional clinical interview examination (Individual Patient Assessment). We studied 134 psychiatrists graduated; half of whom were examined with conventional clinical interview and the others with OSCE. A questionnaire was prepared by a specialist workgroup to assess the participants’ attitude towards the exams. The questionnaire was initially examined in a pilot study. The findings of the questionnaire were used to assess the graduates’ attitude towards each examination, as well as to compare the examinations. The OSCE group indicated a significantly more positive attitude compared to the conventional group (p = 0.03). Furthermore, the OSCE group believed the role of theoretical knowledge (p = 0.01) and pre-test practice (p = 0.03) to be significantly greater for success compared to the other group. The structure of OSCE was reported to be superior to conventional examination in terms of fairness and homogeneity (p = 0.004). First participation in exam (p = 0.04) and ultimate success in the exam (p = 0.009) were predictors of graduates’ attitude.Based on examinees ’attitudes, OSCE may be a more appropriate choice for graduation examinations of psychiatry compared to the conventional clinical interview examination.

The aim of this study was to evaluate the effectiveness of acceptance and commitment therapy (ACT) in treating obsessive compulsive disorder (OCD). In a single-subject experiment trial, the treatment process was carried out on a 39-year old male subject. The patient satisfied the DSM-IV-TR criteria for OCD and was assessed for pre-duration and post treatment. The scales used in this study included: The Yale-Brown Obsessive Compulsive Scale(Y-BOCS), Beck Depression Inventory-II-second edition (BDI-II), and Beck Anxiety Inventory (BAI). In addition, all scales were again completed by the subject at 1-month, 3-months, and 6-months follow-ups. The treatment led to reductions in symptoms of OCD, depression and anxiety. Gains were maintained at follow-ups. The treatment approach appears to be effective in the treatment of OCD.