Zahedan Journal of Research in Medical Sciences
Volume:16 Issue: 10, Oct 2014

The effectiveness of various atypical antipsychotics in the treatment of acute mania is reported repeatedly, but those for typical antipsychotics are restricted to haloperidol and chlorpromazine. As there is a comparative importance of side effects for typical and atypical antipsychotics, we decided to compare the therapeutic effect of thiothixene and risperidone as a combination with lithium for the treatment of patients with bipolar disorder. In 8 week double-blind clinical trial, 84 patients with a diagnosis of bipolar disorder were randomized for treatment with lithium plus thiothixene (N=42) or lithium plus risperidone (N=42). Manic, positive-negative symptoms, anxiety and depression were measured bi-weekly with Young Mania Rating, positive and negative symptom scale (PANSS) and Hamilton rating scale score. Fasting blood sugar, weight, general side effects and extrapyramidal symptoms were also evaluated. The measures analyzed using SPSS-17 software. To compare demographic characteristics t-test, χ2 test and fixed effects method were used. A fixed effects method was applied to omit missing data effects. There was no significant difference between the thiothixene and risperidone groups in Young mania rating scale and other outcome measures during the 8 week trial. There was no significant difference in weight, blood sugar and clinical global impression (CGI) between groups. Thiothixene is as effective as risperidone in the improvement of manic and sychotic symptoms. There was no significant difference with risperidone in developing extrapyramidal symptoms, so it can be used as an appropriate combination with lithium for the treatment of bipolar patients in psychotic manic episode.

Electroconvulsive therapy (ECT) is utilized for treatment of a range of psychiatric disorders including major depressive disorder (MDD). One of the major complications in using ECT is cardiovascular problems i.e., bradycardia. The present study was designed to investigate the effect of atropine on the pulse rate (PR) of the patients under treatment with ECT.

In this randomized clinical trial, 30 patients with diagnosis of MDD who received atropine before ECT treatment (control group) were compared with 30 patients with the same diagnosis without receiving atropine (experimental group) under ECT treatment. Both groups received ECT under the same term and condition. The PR of the patients were recorded 7 times (twice before anesthesia and ECT and 5 fixed one min intervals immediately after receiving ECT); for 10 sessions of treatment with ECT (3 times a week). The results were analyzed using repeated measure analysis of variance. The PR under 50 was the cut off point for diffe ntiating the patients suffering from bradycardia and those without it.

Slight increment in PRs for experimental group (patient who did not receive atropine) in contrast to control group were observed, but it did not reach a statistically significant level. The gender (male/female) did not have different PR. The age of the patients and initial PR (regarded as co-variances) did not show significant effect on PR for total sample.

There seems to be not necessary to use atropine treatment for depressed patients receiving ECT.

The aim of this study was to compare the effectiveness of acceptance and commitment therapy (ACT), selective serotonin reuptake inhibitors (SSRIs), and the combination of ACT and SSRIs in the treatment of adults with obsessive-compulsive disorder (OCD). In This experimental study 32 outpatients meeting DSM-IV-TR criteria for OCD were randomly assigned to one of three treatment conditions: ACT, SSRIs, and combined treatment. The Yale-Brown Obsessive-Compulsive Scale (YBOCS), Beck Depression Inventory-II-Second edition (BDI-II), and Beck Anxiety Inventory (BAI) were administered at pre- and post-treatment. Twenty-seven patients completed the study. Data were analyzed by one-way analysis of variance (ANOVAs) and one - way analysis of covariance (ANCOVAs), clinically significant change, and complete remission status. Analyses with ANCOVA revealed that the patients treated with ACT and combined treatment experienced a significantly greater improvement in obsessivecompulsive symptoms at post-treatment as compared to those treated with SSRIs alone. However, there were no significant differences between ACT and combined treatment on OC symptoms. In addition, no significant differences were found between all the 3 treatment groups regarding reduction in the BDI-II and BAI scores at post-treatment. Clinically significant change and complete remission status results also showed that, unlike the SSRI, the ACT and combined treatment lead to more improvement in OC symptoms. ACT and combined treatment are more effective than SSRIs alone in treating OC symptoms. However, it seems that adding SSRIs to ACT does not increase the effectiveness of ACT in the treatment of adults with OCD in the short-term.

Transdiagnostic cognitive-behavioral treatments for emotional disorders are a new approach that empirically supported. Despite this most of the researches in this field have no control group and so there is a little information about comparing of the effect of transdiagnostic approach to others. The current study was compared transdiagnostic with cognitive-behavior therapy on patients with depression and anxiety disorders. This study was a pretest-post test randomized control trial. A diagnostically heterogeneous clinical sample of 23 patients with a principal depression and anxiety disorders that randomly assigned in two groups and participated in eight sessions. Participants were recruited from clinical psychology and psychiatry clinics of Taleghani hospital, Tehran, Iran. Beck Depression Inventory (BDI-II), Beck Anxiety Inventory (BAI), and Quality of life Scale (IRQL) were completed pre and post intervention by participants. The results were analyzed by dependent sample t-test and analyses of covariance (ANCOVA). Data analyses showed that transdiagnostic therapy was effective for decreasing anxiety and depression symptoms, and have more effect for anxiety in comparing to cognitive-behavior therapy. Transdiagnostic therapy was confirmed in decreasing depressive and anxiety symptoms and improving quality of life in patients with depression and anxiety disorders and transdiagnostic therapy was more effective than cognitive-behavior therapy for decrease anxiety symptoms. Transdiagnostic therapy was confirmed in decreasing depressive and anxiety symptoms and improving quality of life in patients with depression and anxiety disorders and transdiagnostic therapy was more effective than cognitive-behavior therapy for decrease anxiety symptoms.

The present study aims to investigate the impact of mindfulness-based cognitive therapy on mental and physical well-being indicators in diabetic patients. In the present study is that of experimental, all women with type 2 diabetes in Yazd Diabetes Research Centre were considered as statistical community from which 80 women were selected by random sampling. They completed questionnaire of Problem Areas In Diabetes and diabetes-dependent quality of life questionnaire and then were introduced to lab for blood test. Data was analyzed by SPSS-18 software using t-test for separate groups. Statistical analysis showed that the scores of experimental group on quality of life and diabetes related stress were significantly lower in post-test compared to pre-test. Moreover, experimental group and control group showed a significant difference in these variables in pre-test and post-test. Also HbA1c level had a significant decrease in post-test of experimental group compared to pre-test of this group. This difference was observed in control group too. The results showed that mindfulness-based cognitive therapy has positive effects on glycemic control in diabetic patients and leads to well-being and a better quality of life in those patients.

World Health Organization reports described migraine as one of the 4 most disabling chronic medical disorders. A day with migraine is as disabling as a day with quadriplegia, schizophrenia, or dementia in who is view 87% of people with migraine has some degree of disability. Migraine headaches are associated with psychological factors and personality characteristics. This study compares the personality characteristics of migraine patients with Attention Deficit Hyperactivity Disorder (ADHD) and without ADHD. Eighty patients with migraine were evaluated in this cross sectional study with simple sampling method. All participants were assessed with semi structured clinical interview, adult ADHD self-report scale (ASRS) and Millone clinical multiaxial inventory questionnaire. The migraine patients were divided into two groups, with and without ADHD. The correlation of variables was tested by χ2 test and t-test with 0.05 significance with the use of software SPSS-20. Our participants were 80% female, 56% married and 36.2% with at least graduation from high school. Patients with migraine and ADHD were younger and their first headache experience had occurred in lower age compared with non-ADHD patients (p<0.05). In current study, we showed that there is a significant correlation between ADHD and depressive and independent personality traits and dysthymic clinical syndrome in migraine patients (p<0.05). Our results demonstrate that personality characteristics in migraine patients may be affected by some other mental disorders such as ADHD. These findings might be helpful in early treatment and prevention of dysfunctioning in patients with migraine.

Today, within creased substance, type of substance used has changed. Therefore, drug abuse in population of crack to the stimulant drugs (amphetamine) particularly crystal is expanding and increasing. Therefore, the purpose of the present study was the comparison of attentional bias and difficulty of emotional states regulation and their correlation with craving severity in drug abuser methamphetamines and crack. Type of research was descriptive analytical correlation. Population was total of users with methamphetamines and crack in summer and fall 2011 at the city of Isfahan, and 34 users with crystal with daily at least one year were selected on the basis of the snow ball sampling and 31 users with crack with daily at least one year were selected on the basis of the sample sampling. The difficulties emotion regulation scale (DERS), Stroop test and OCDUS were used as the outcome measures. For findings used of descriptive statistics and multivariate analysis of covariance (MANCOVA) and regression analysis were used. The results of analysis of variance showed that between drug abuser crystal and crack significantly differed of attentional bias and difficulty of emotional states regulation. The greatest differences to components of a lack of transparency, lack of emotional awareness, limit emotional states regulation strategies and of emotional responses. But, only the variable non-acceptance negative emotional of subscale of the difficulty of emotional states regulation was able to craving (as an important indicator of durable use substance) in of both crack and crystal predicted. This variable is only 13% of the variance craving in drug abuser crack and crystal can be explained. Other findings showed that although there is no difference between the two groups in the intensity of craving, but attentional bias among drug abuser crack and crystal was a significant difference. Overall, can be said the difference in difficulty of emotional states regulation, attentional bias and craving among abusers of amphetamines (crystal) substance opiate (crack), two groups of abusers requires different approaches to interventions.

Post traumatic stress disorder (PTSD) is referred to feed back of exposure in severe stressful situations such as natural disasters, severe accidents and so on. The aim of this study is to evaluate the effect of metacognitive therapy on reduction of PTSD symptoms between accident survivors of Shahr-e-Kord city. This research is semi-experimental. A hospital was selected by cluster sampling that for choosing sample, 36 male who were accident survivors, were selected by using interview based on DSM-IV-TR who were experienced PTSD situation. The subjects were randomly assigned into experimental group (N=18), control group (N=18). There were attrition in sample that finally experimental and control groups included 15 subjects. The experimental group received eight 90 min weekly sessions of metacognitive therapy. These tools were used in this research: 1-Clinical interview based on DSM-IV-IR, 2-Mississipi PTSD scale (Used in pretest-posttest and follow up sessions). The results showed that metacognitive therapy, reduced PTSD symptoms in experimental group in post-test and two-month follow up sessions were done (p<0.01). Statistically significant differences between pre-test and post-test results in experimental group confirmed the effect of metacognitive therapy on reduction of PTSD symptoms.

Coronary heart disease is the universal principal cause for decreased quality of life, morbidity, and mortality in adulthood. This study seeks to indicate the psychological and socio-demographical determinants of the health related quality of life in patients with coronary heart disease in Iran. In this cross-sectional descriptive design, 205 patients with coronary heart disease among the patients diagnosed with coronary heart disease in Shahid Rajayee heart hospital were selected by compliance sampling and were completed the demographical questionnaire, The WHOQOL-BREF, Tehran-Stockholm marital stress scale (TSMSS) and Mental Health Inventory (MHI-38). Then, data analyzed by stepwise multiple regression analysis by using of the PASW-18. Findings revealed that psychological wellbeing and socio-economic status had significantly positive predictive role on health related quality of life and marital stress, psychological distress, and gender had negatively significant predictive role on health related quality of life (p<0.001). There was no significant role at prediction of health related quality of life in terms of patient''s age. It concluded that adverse socio-economic status, female gender, decreased psychological well-being, higher psychological distress and higher marital stress might make patients with coronary heart disease more prone to decreased health related quality of life. Thus, it is important to emphasize the worth of tailored intervention for addressing these issues in therapeutic and rehabilitation agendas. Likewise, the identification and treatment of psycho-social correlates in these patients could be very important.

Public speaking anxiety is a prominent problem in the college student population. The purpose of this study was to determine the effectiveness of eye movement desensitization and reprocessing on public speaking anxiety of college students. The design of research was quasi-experimental with pre-post test type, and control group. The sample consistent of 30 students with speech anxiety that selected base on available sampling and assigned randomly in experimental (N=15) and control (N=15) groups. The experimental group was treated with EMDR therapy for 7 sessions. In order to collect the data, Paul’s personal report of confidence as a speaker, S-R inventory of anxiousness was used. To analyze the data, SPSS-19 software and covariance analysis were used. The multivariate analysis of covariance showed that the eye movement desensitization and reprocessing reducing public speaking anxiety. The one-way analysis of covariance for each variable shows there are significant differences in confidence of speaker (p=0.001) and physiological symptoms of speech anxiety (p=0.001) at the two groups. These results suggest that treatment of eye movement desensitization and reprocessing is effective on reducing physiological symptoms of speech anxiety and increasing the speaker’s confidence.

Mental health of those with ischemic heart disease (IHD) has been a focus of attention of researchers since it has always been considered as a psychosomatic disorder. The present study was designed to investigate mental health status of a group of patients before and after coronary artery bypass graft (CABG). In this longitudinal descriptive study 63 candidates for CABG, referred by cardiologist and cardiac surgeon in a 6 month period were asked to take part in the study if they didn''t have any exclusion criteria. The patients were the out-patients of cardiac clinics in Shiraz, Iran. The patients were assessed by general health questionnaire (GHQ-28) and beck depression inventory (BDI) at 3 phases, before surgery, 1 month after surgery and three months after surgery. The analysis did not show significant statistical change in GHQ-28 and BDI measures before and after CABG. There were statistically significant differences in the mentioned measures between male and female participants in initial assessment, i.e., women scores were higher than men in distress scores measured by GHQ-28 and BDI. In our study, we observed no statistically significant differences between pre and post operation in general health and depression scales. However women showed higher degrees of depressed mood at any step of assessment.

A culture-bound syndrome common in Baluchistan is Djinnati that is classified as trance and possession state, a sub-class of dissociative disorders NOS, in DSM IV-TR. The present study aims to determine the frequency of Djinnati syndrome among in-patients at Baharan psychiatric hospital in Zahedan, Iran. In this descriptive study, the statistical community includes all patients (N=773) who were admitted in Baharan psychiatric hospital during a 6 months period. After considering the inclusion and exclusion criteria, 150 subjects (61 males and 89 females) were selected. Semi-structural interview and Dissociative Experience Scale (DES) questionnaire were performed for them. Spearman’s rank correlation coefficient, χ2, and t-tests were employed for analysis of data in SPSS-18. Frequency of Djinnati syndrome among patients admitted in this referral psychiatric hospital was 4.1% and this syndrome showed a significant dominance in female sex (M/F=1/3). There was also a positive and significant correlation between child abuse and dissociative experiences including Djinnati. The study has shown that dissociative disorders NOS, in the form of trance and possession states (such as Djinnati), are not rare especially in the eastern parts of Iran and among poor and young women. It is important to define Djinnati syndrome in this region and prepare medical students and psychiatric residents for diagnosing and managing this condition. Its relationship with child abuse should be considered in preventive medicine.

Acceptance and commitment therapy (ACT) is a new method of psychotherapy for major depressive disorder (MDD). The aim of this experimental study is evaluating the effectiveness of acceptance and commitment therapy and cognitive therapy. In this randomized clinical trial, 19 depressive out-patients were randomly divided into 2 groups (acceptance and commitment therapy and cognitive therapy). Twelve therapeutic sessions administered in consulting center of Tehran University twice a week. All the subjects were tested by Beck Depression Inventory (BDI-II)) and the Ruminative Response Scale (RRS) before and after the treatments. Data were analyzed by multivariate analysis of covariance (MANCOVA). The results show no significant differences between the two groups in terms of the variables of depression and rumination. Overall, the results suggest that ACT is an effective treatment, the effectiveness of which appears equivalent to that of CT

This research was carry out with aim of study of factors affecting the IQ of children 4-6 years old born preterm. This analytical-cross sectional study was carried out on 102 premature children with age 4-6 years old during years 2004 to 2006. The tools used in this study were Wechsler intelligence scale for children and questioner including demographical characteristic. In this study we used t-test and spearman correlation and also SPSS-18 was used to analyze data. In this study there was statistical relationship between normal child development and gestational age, birth weight, maternal education, multiple pregnancies, but there were not any statistical significant relationship between the history of preterm birth and child s gender, consanguinity parents, apgar, mother job. IQ in preterm babies who admitted in the NICU was lower than non-admitted preterm or term babies.

The aim of the study was to determine the prenatal care behaviors status among pregnant women using by BASNEF model. This Descriptive-Analytical study was carried out on 360 pregnant women in their 28th-42th week of pregnancy, attending health care centers for the study using random sampling selection method. Data-gathering tools consisted of a 2-part questionnaire: demographic variables and one scales for measuring prenatal care based on the BASNEF constructs. Inferential and descriptive statistics via SPSS-16 software was used for data analysis. The subjects reported 92.5, 94.3, 62.7, 73.4 and 90.2% of receivable scores of attitude, subjective norms, behavioral intention, enabling factors and prenatal care behaviors scores, respectively. In liner regression, factors influencing prenatal care behaviors were subjective norms, intention and enabling factors (p< 0.05). Regarding the results, status of prenatal care behaviors are related meaningfully indicating that pregnant women should be considered as vulnerable group.