Iranian Journal of Psychiatry
Volume:3 Issue: 1, Winter 2008

This paper highlights a variety of personality disorders in individuals with eating disorder and also emphasizes the importance of identifying clinically meaningful eating disorders subtypes based on concurrent personality disorder. The relationship between personality disorders and eating disorders is an important issue as this association has implications for assessment and treatment. Different hypotheses concerning the relationship between personality disorders and eating disorders will be reviewed. The prevalence rates of concomitant personality disorder diagnoses in eating disorder patients is highlighted to illustrate some of the pertinent conceptual issues concerning the meaning of the co-occurrence of separately defined diagnostic entities. The literature review reveals a robust finding that patients with ersonality pathology have a poorer response to treatment of Axis I disorders than those without such pathology. It is also argued that therapeutic relationship deserves more attention in the assessment and treatment of eating disorder patients with a co morbid personality disorder.

Evaluation and diagnosis are determinants of treatment outcome; therefore, diagnostic tools should be accurate. The purpose of the present research is construction and norm-finding of a rating scale for the diagnosis of attention deficit hyperactivity disorder (ADHD). A checklist based on behavioral symptoms of ADHD from clinical sources was constructed, based on interview with patients and the medical records. After being studied by specialists, this checklist was reduced to items and arranged in a rating scale format. The study population included Tehran''s elementary school students (boys and girls) from which a sample of 800 children was chosen in a random-cluster manner. Then teachers were asked to rate the students according to the scale characteristics. After two weeks, the subjects were tested and interviewed using a corrected form of the scale, the rating scale of Swanson, Nolan and Pelham (SNAP-IV) and Diagnostic and Statistical Manual of Mental Disorders (DSM-IV). After data analysis the scale was reduced to 23 items. According to the results of the analysis, the scale had two factors: The first factor was hyperactivity that explained 37.41%, and the second factor was attention deficit that explained 33.78% of the total variance. Cronbach''s alpha was 0.96 and the alpha of the two subscales, hyperactivity and attention deficit, was 0.94 and 0.96, respectively. Spearman-Brown Coefficient was 0.78 and scale coefficient correlation with a similar from (SNAP-IV) was 0.82. Criterion validity coefficient of the scale was 0.76 and the content validity of the scale was confirmed by the experts. According to sensitivity analysis of the trait, the cutoff point of the scale was 35. Considering the above findings, we can safely use the above scale in clinical studies. Considering the obtained values in the psychometric indexes and the consensus among specialists on the basis of test content validity and also considering the calculation methods of the cutoff point, we can safely use this scale in different clinical situations, epidemiological studies, and other researches and also for studying ADHD children especially when teachers deal with evaluation of children''s behavior.

This study aimed to detail the phenomenology and psychiatric comorbidities in patients with pathologic skin picking (PSP). Forty five subjects (30% males) with PSP (mean± S.D. =33.2±10.9) were assessed. Subjects were assessed for psychiatric co morbidity using General Health Questionnaire (GHQ). The Yale-Brown Obsessive Compulsive Scale (Y-BOCS) was used to assess obsessive compulsive symptoms; the Dermatology quality of life index(DLQI) was utilized to evaluate the quality of life in patients; and clinical severity using Visual Analogue Scale(VAS) was employed for evaluating skin picking behavior. The mean time after (±S.D.) the onset of PSP was 6.6±2.4years.Twenty eight (62.2%) individuals had a bimodal GHQ score higher than five which implied probable mental disorder, and twenty two (48.9%) of the individuals with PSP had significant obsessive compulsive disorder. The severity of impairment of quality of life status was increased with increment of mental disorder severity.PSP appears to be time consuming and frequently associated with psychiatric co morbidities. Considerations should be made on the relationship between psychiatric co morbidity and quality of life in PSP diagnosis and treatment of mental disorders.

The present study focuses on the effectiveness of problem-solving training program on female and male PTSD survivors of Bam earthquake in Iran. Female and male subjects were requested to fill in several questionnaires including clinical interview, coping skills questionnaire, and a demographic form. The subjects also participated in a problem-solving training program. The results showed that the training program was effective for both sex groups. The sex groups did not show significant differences on PTSD symptoms in the post-test phase. Females tended to maintain their emotionfocused skills in post-test phase while the males did not. However, for both groups the mean scores of problem coping skills similarity increased. Although the mean scores of some PTSD symptoms were increased for the female group, the majority of PTSD symptoms decreased for both sexes in the posttest phase. It may be concluded that females are more likely to show PTSD symptoms than males. In addition, they may predispose to maintain negative attitudes towards life events than males.

This study was performed to evaluate the mental health status of 6 - 11 year-old children of Tehran in a community-based sample using the Persian version of the Strength and Difficulties Questionnaire (SDQ) Parent-report.Parents of 799 children (6 to 11 years old) were selected from 250 clusters of the entire 22 municipality areas of Tehran; they responded to 25 questions of the Persian version of SDQ parent-report form. The mean score in each subscale and the frequency of each symptom domains based on the Goodman''s cutoff points, were determined.The prevalence of symptom domain was relatively high. Among the studied children, 25.8% had total score equal to 17 or more. The most frequent problem domain was conduct. The studied boys had statistically significant higher mean scores in hyperactivity and peer problem subscales.Frequency of all the problem symptom domains was high in children from different urban areas of Tehran. Further evaluation for the reason of such a high frequency is necessary.

Depression is the most common co-morbid psychiatric disorder in patients with epilepsy. Yet it remains under recognized and under-treated. For depression screening in this patient need to a convenient questionnaire for patients with epilepsy. This questionnaire has shown high sensitivity for depression screening in many studies. The center for Epidemiological Studies Depression Scale (CES-D) has been widely used in studies of late-life depression. The CES-D is easy to use in most settings. Two groups of patients from two hospital centers were selected to participate in this study: the control group and the experimental group which included patients with approved diagnosis of epilepsy, regardless of any type of seizures. Then all the subjects went through a semi structural clinical interview for (SCID-I) DSM-IV by one psychiatrist. Consequently, all the patients completed the CES-D 10 items questionnaire along with the interview. In the two groups, the CESD scale cut-off point was obtained using ROC analysis. The optimal cut-off score of CES-D in the both group was. 3. Sensitivity, specificity, and positive predicted values in the epileptic group were 86.4%, 55.3%and 60%; and sensitivity, specificity, and positive predicted values in the control group were 72.7%, 68.6%, 38.3% respectively. It appears that CES-D 10 items is an appropriate tool for screening patients with epilepsy, particularly if the multi-stage screening system is used with other methods.

We aimed to describe psychiatrists'' attributions on non-compliance related issues resulting in re-hospitalizations of psychiatric patients. In a cross sectional study, we included 500 randomly selected psychiatric readmitted patients and registered their demographic data (including age, sex, job, marital status, and educational level), and psychiatric clinical data including diagnosis, medications, and presence of psychiatric disorders in family members). Possible noncompliance issues by means of type and causes were asked through a structured interview by a psychiatrist. Non-compliance was reported as a possible cause of admission in 441 88.2) of the re-hospitalized cases. No insight to disease (n=295; 59%), and feeling of cure (n=138; 27.6%) were the 2 most prevalent causes for noncompliance of the patients. It seems that non-compliance, as a prevalent factor, possibly causes readmission in psychiatric wards. Providing a better insight to disease and to instruct patients to take their medications even if they have some feeling of cure is important to decrease such problems.

To study the effects of a high dose alpha-tocopherol on serum total cholesterol (TC), triglyceride (TG), and the high density lipoprotein (HDL) levels of patients with schizophrenia receiving olanzapine. Thirty six adults diagnosed with schizophrenia based on DSM-IV who were taking olanzapine for a minimum of thirty days entered this eight-week, double blind, placebo-controlled study. Patients were randomized to receive alpha-tocopherol 400IU or placebo capsules twice a day for 2 weeks, then three times a day for 6 more weeks. Fasting total cholesterol (TC), triglyceride(TG),and HDL levels were measured at the baseline and weeks 4 and 8. TC, TG and HDL levels did not change significantly during this study. There were no significant differences in TC, TG and HDL levels between the two groups at the baseline and weeks 4 and 8.High-dose vitamin may not improve triglyceride and cholesterol levels in patients who are already on olanzapine. Further studies with greater number of patients and for a longer duration are needed.