فهرست مطالب

Psychiatry and Behavioral Sciences - Volume:10 Issue: 4, Dec 2016

Iranian Journal of Psychiatry and Behavioral Sciences
Volume:10 Issue: 4, Dec 2016

  • تاریخ انتشار: 1395/09/30
  • تعداد عناوین: 20
|
  • Mohsen Maroufi, Maryam Tabatabaeian*, Mahshid Tabatabaeian, Behzad Mahaki, Gholamreza Teimoori Page 1
    Background
    Patients with schizophrenia have abnormal skin flush response to niacin. We aimed to evaluate the accuracy of niacin skin test in these patients.
    Objectives
    We aimed to evaluate the accuracy of niacin skin test in these patients.
    Materials And Methods
    This diagnostic trial with parallel-group design was conducted at the Noor university hospital in Isfahan (Iran) from January to September 2014. Participated Subjects were hospitalized schizophrenic adult and their first degree relatives, bipolar disorder patients and healthy controls (n = 25 in each group). Niacin skin test was performed using 0.5 mL of 0.1 M and 0.01 M diluted methyl nicotinate solutions applied every 5 minutes for a total of 20 minutes and graded from 0 (no redness) to 3 (extreme redness). Sensitivity, specificity, and positive and negative predictive values were calculated.
    Results
    The time point at which there was no further significant change in the skin response was 10 minutes after the test. At this set point, schizophrenic patients had lower response to each solutions compared to others (P 0.05). A grade of ≤ 1 skin response to the 0.01 M solution of methyl nicotinate would provide sensitivity, specificity, positive and negative predictive values of 80%, 93.3%, 80%, and 93.3%, respectively, in differentiating schizophrenic from other groups. Using 0.1 M solution provide lower sensitivity (32%) and negative predictive value (81.5%), but higher specificity (100%) and positive predictive value (100%).
    Conclusions
    Niacin skin flush response is impaired in schizophrenic patients. This phenomenon may be used as a complementary diagnostic test in psychiatric workups.
    Keywords: Bipolar Disorder, Niacin, Schizophrenia, Sensitivity, Specificity
  • Mehrdad Talakar, Sayed Abbas Haghayegh*, Bahram Mirzaian Page 2
    Background
    There is a growing body of literature in favor of cognitive therapy on anger in the world.
    Objectives
    The aim of the present study was to evaluate the efficacy of cognitive-behavioral group therapy in the reduction of state-trait anger and increase of general health among female students of Khorasgan Azad University, Isfahan.
    Materials And Methods
    This study was a quasi-experimental research. A number of 40 students from the humanity sciences faculty of Khorasgan Azad University, who accepted the invitation to the study, were selected and randomly assigned to the experimental (n = 20 participants) and control (n = 20 participants) groups. The group therapy, based on Reilly & Shropshire’s model (2000), was held in 8 weekly sessions at Khorasgan Azad University. The participants were asked to fill out the Spielberger’s state-trait and general health questionnaires in the pre-test, post-test and follow-up test (6 months later).
    Results
    The results of multivariate analysis of covariance (MANCOVA) showed a significant difference between the groups in the mean scores of state anger, anxiety, social dysfunction, depression, and general health in the post-test (P
    Conclusions
    Cognitive-behavioral group therapy could be an appropriate approach in decreasing anger and improving general health among female students.
    Keywords: Cognitive, Behavioral Group Therapy, General Health, State, Trait Anger
  • Pouya Zandian*, Mojtaba Habibi, Seyed Vahid Shariat, Nasrin Tayeri Page 3
    Background
    Both capital punishment and euthanasia are highly disputed practices that are considered justified by their proponents. Emotional component of attitude has been ignored in the scales developed to assess attitude on capital punishment and euthanasia.
    Objectives
    This development study aimed to develop an assessment tool to evaluate emotional attitude (ignored by previous scales) toward capital punishment and euthanasia that are considered justified by their proponents in 2015. The scale, as defined by the authors, measures individuals’ attitude revealing their sense of self or non-self, although lawis in no condition to tackle the exception either crime or euthanasia. After assessing face validity with two psychologists, a clinical psychologist and a psychometric expert at the school of behavioral sciences and mental health, a justified death attitude scale (JDAS) was performed on 571 students of national universities of Tehran to evaluate construct validity of the scale. Data were analyzed using the exploratory factor analysis, chi-square, and multivariate analysis of variance.
    Materials And Methods
    The justified death attitude scale included 59 items; other than the first 4 warm-up questions, each item included a scenario in which a decision should be made by the subject on life of the personage. Scenarios are related to rape, adultery, murder, drug trafficking, and active and passive euthanasia. The aforementioned scenarios and items are developed based on social interviews.
    Results
    The justified death attitude scale showed an acceptable reliability and included eight factors that could explain 80.56 variance of the scale. A comparison with warm-up items and main items indicated that poll did not assess euthanasia attitude (P > 0 .05), but it could assess death penalty attitude (P
    Conclusions
    The justified death attitude scale has acceptable validity and reliability in emotional attitude assessment of capital punishment and euthanasia.
    Keywords: Capital Punishment, Euthanasia, Legal, Medical, Reliability
  • Zahra Dehghanizadeh, Ali Asghar Firoozi, Majid Eydi-Baygi *, Nilofar Khajeddin, Fateme Sajjadi Page 4
    Background
    This study aimed to clarify the relationship between dissociation experience, and alexithymia and eating attitudes in female students of Ahvaz University.
    Materials And Methods
    The present study had a cross sectional design. Overall, 325 female undergraduate students were selected by multi-phase random clustering and completed the following rating scales; eating attitudes test-26 (EAT-26), alexithymia questionnaire (TAS-20), dissociative experiences scale (DES-28). Data analysis was done using the Pearson correlation and stepwise multiple regression analysis.
    Results
    With the Pearson method, we found a correlation between alexithymia and eating attitudes (P = 11.3), and a significant positive correlation between dissociative experiences and eating attitudes (P = 36.8) was also found. The multi-variable correlation coefficient for alexithymia and dissociative experiences with eating attitudes in female students was respectively MR = 37.0 and MR = 11.3, and F ratio was respectively equal to 36.7 and 2.86, which was significant at P = 0.001 and P = 0.092.
    Conclusions
    This study highlights the association between eating attitudes, and dissociation experiences and alexithymia, yet dissociation experiences were more relevant and a stronger predictor for eating attitudes.
    Keywords: Alexithymia, Dissociative Experiences, Eating Attitudes
  • Shahram Vahedi *, Rahim Badri Gargari, Somayeh Gholami Page 5
    Objectives
    This study investigated the relationship between cognitive emotion regulation, emotional problems and attachment style among students in a causal model.
    Materials And Methods
    The sample group included 285 bachelor students of Tabriz University that were selected randomly by multi-stage cluster sampling. The study instruments were revised adult attachment scale (RAAS), cognitive emotion regulation questionnaire and depression anxiety and stress scale (DASS 21).
    Results
    The findings indicated that attachment dimensions predict negative and positive emotion regulation strategies. The cognitive emotion regulation mediated between attachment dimensions and emotional problems. Furthermore, attachment dimensions had a direct and indirect effect on emotional problems.
    Conclusions
    Findings of the current study are consistent with previous findings and theoretical stance indicating the predictability of mental health indices from quality of attachment in student.
    Keywords: Anxiety, Attachment, Cognitive Emotion, Depression, Regulation Strategies, Stress
  • Hadi Hassankhani, Koroush Rashidi *, Azad Rahmani, Farahnaz Abdullahzadeh, Ali Golmohammadi, Shadi Ozairi, Erfan Ayubi Page 6
    Objectives
    This study aimed to unveil the effect of depression death and anxiety death on coping style among coronary heart disease (CHD) patients in Tabriz, a city in the Northwest of Iran.
    Materials And Methods
    In this cross-sectional study, 293 coronary heart disease patients were recruited from three hospitals in Tabriz from January to July 2015. Socio-demographic characteristics and CHD clinical history were archived by a checklist. Validated self-administered questionnaires were used to measure death depression, death anxiety, and coping style. The association between death depression and death anxiety with coping style was evaluated, using multivariable linear regression.
    Results
    In this study, the participants were 60 ± 11 years of age. Death depression was most significantly influenced by occupation, and the death anxiety level was affected by the history of hospitalization with CHD. The coping style level was not statistically significant across sociodemographic and CHD clinical history characterises. In death depression, the third quartile was significantly and inversely associated with coping style, compared to reference category; β (95% CI); -1.60 (-2.97 to -0.27), P value = 0.02.
    Conclusions
    Among CHD patients, death depression and death anxiety could be influenced by sociodemographic and CHD history background characteristics, respectively. Death depression could be considered as a determinant for coping style.
    Keywords: Anxiety Disorders, Coping Behaviour, Coronary Disease, Depressive Disorder, Iran
  • Ahmad Hajebi, Masoud Ahmadzad Asl *, Farnoush Davoudi, Raoofeh Ghayyomi Page 7
    Background
    Suicide behaviors cause a large portion of Disability adjusted life years worldwide.
    Objectives
    The aim of this research was to study the trend, correlations and discrepancy of registered suicide incidents in Iran from 2009 to 2012 using data from the Iranian suicide registry.
    Materials And Methods
    Suicide registry entries throughout the country between 2009 and 2012, including suicidal attempts and suicides, were collected. Data on age, gender, occupational, marital and residential status along with suicide method, history of previous attempt and history of medical or mental disorders were registered by health service provision staff at the service centers. Geographic mapping and statistical analysis were performed.
    Results
    Amongst the 252911 attempted suicides during the period, we found suicide attempt and suicide rate of 30.5 - 44.8 and 1.76 - 2.23 per 100000 individuals, respectively, denoting overall suicide fatality rate of 2.63%. The rate of suicide attempt in different provinces ranged between 0.7 and 271.1 and the rate of suicide between 0.17 and 17.7 per 100000 individuals. Attempted suicides showed more fatality in males, elderly, widow/widowers, divorced and unemployed subjects as well as in residents of rural areas. The most common attempt methods were medication overdose (84%), and the most common suicide methods were hanging (30.3%), medications overdose (28.1%) and self-burning (17.9%); these methods are found at different rates in various parts of the world.
    Conclusions
    While the registry could provide us the most valid data on suicide, the wide range of suicide and suicide attempt rates in different provinces not only could question this statement but also could highlight the importance of studying the ethnic/geographic variations in suicide epidemiology with improved suicide registry and surveillance systems.
    Keywords: Attempted Suicide, Iran, Registries, Suicide
  • Hana Brborovic *, Ognjen Brborovic, Jadranka Mustajbegovic Page 8
    Background
    Stress is an important occupational hazard in numerous occupations. The consequences of stress have been associated with a number of health conditions.
    Objectives
    The aim of this study was to investigate whether nurses’ perceived levels of stress are associated to presenteeism and absenteeism.
    Materials And Methods
    In a cross-sectional study, conducted at a public general hospital in Croatia, medical nurses filled the perceived stress scale (PSS-10) and short-form of the World health organization health and work performance questionnaire (WHO HPQ).
    Results
    Nurses experiencing absenteeism (26, 53%) had a little higher levels of stress (X = 18.85, SD = 7.31) when compared to those without absenteeism (X = 17.52, SD = 6.63), t (144) = 1.037, P = 0.301. Nurses with presenteeism (15.74%) had statistically significantly higher levels of stress (M = 21.42, SD = 5.62), compared to nurses without presenteeism (X = 17.35, SD = 6.84), t(144) = 2.47, P = 0.015. Linear regression (R2 = 0.032, P = 0.036) showed an association between presenteeism and stress (B = 3.952, S.E. = 1.26, β = 0.069). No association was found between absenteeism and stress.
    Conclusions
    Although there is an association between presenteeism and stress, we cannot draw a causal line from this finding.
    Keywords: Absenteeism, Nurse, Presenteeism, Stress, Work Performance
  • Abdolreza Mirzavand, Mousa Riahi *, Ali Mirzavand, Mahmoud Malekitabar Page 9
    Background
    Couple burnout results from plethora of non-realistic expectations, irrational thoughts, past awareness and understanding of each other’s needs and wide difference of couples past expectations and reality.
    Objectives
    The present research was conducted to investigate the effectiveness of solution-focused therapy on couple burnout among couples referred to Shahryar city court for divorce.
    Materials And Methods
    The population included all couples referred to this court during the month of May, 2014. The sample consisted of 20 couples, who were selected via convenience method and then randomly assigned to two groups for this study. The instrument used in this study was Pines’ couple burnout scale. The design of this study was pretest-posttest with a control group. All subjects answered the scale, and then the experimental group received intervention of Solution-focused therapy for eight, ninety-minute sessions. At posttest stage, the two groups answered the scale again. Data of this research were analyzed by the method of multiple covariance analysis.
    Results
    The result of this study showed that solution-focused therapy decreased couple burnout of the experimental group compared with the control group.
    Conclusions
    Solution-focused therapy decreased couple burnout among couple referred to Shahriar city court for divorce.
    Keywords: Solution Focused Therapy, Burnout Married Couple
  • Nasrin Tayeri *, Mojtaba Habibi, Pouya Zandian Page 10
    Background
    Susanne Jaeggi developed the Dual N-Back task in 2003 and proved that dual tasks can improve the activation of Prefrontal cortex as the centre of executive functions. However, Gray and Thompson suggested that this effect is not long-lasting.
    Objectives
    Fluid intelligence, working memory, and short-term memory are very important factors in the achievement of educational objectives. Neuropsychological training concentrates on achievements instead of educational intervention. We aimed to evaluate the effectiveness of collective cognitive training in an interventional study because collective components of training have been ignored at schools. We selected dual n-back task because it is a computerized task and the efficiency of the task has been demonstrated in previous studies.
    Materials And Methods
    It was a quasi-experimental study. We performed the study in a middle school in Hamadan in 2014. There were a total of 66 teenage participants who were assigned to one of the two control and experimental groups. All of them completed a series of tests, namely Wechsler’s memory subtest and Raven’s progressive Advanced Matrices (RAPM), in pre-test, and post-tests as well as follow-up. Thirty six participants were trained in twelve sessions of collective training during three months.
    Results
    Our results indicated that fluid intelligence, working memory, and short-term memory in the intervention group improved significantly than the control group even in the follow-up stage (P
    Conclusions
    Dual N-back task can improve working memory, short-term memory, and fluid intelligence, but the improvement of aforementioned cognitive skills does not promote educational achievement.
    Keywords: Intelligence, Memory, Training
  • Vandad Sharifi, Azadeh Sedighnia *, Shima Ataie, Maryam Tabatabaee, Mehdi Tehranidoost Page 11
    Background
    Cognitive impairment is a chronic and disabling manifestation of schizophrenia.
    Objectives
    This before-after study was conducted to examine the effect of a short course computer-assisted cognitive remediation on improving cognitive functions of patients with schizophrenia.
    Materials And Methods
    Twenty patients with schizophrenia were enrolled into the study. The intervention consisted of 10 one-hour sessions held 2-3 times a week, using the Cogpack software that includes tasks to improve attention, memory, and executive function. The patients’ cognitive functioning was assessed before and after the remediation, using tests in the CANTAB battery, including stop signal task (SST) and choice reaction time (CRT) to assess attention levels, pattern recognition memory (PRM) and Paired associate learning (PAL) to examine memory, and stocking of Cambridge (SOC) and intra-extra dimensional task (IED) to evaluate executive function.
    Results
    IED and SOC revealed a statistically significant improvement in executive function after the intervention. PAL revealed a significant improvement in memory functioning in most aspects after the intervention, while PRM did not. CRT showed a significant improvement in some aspects of attention and concentration after the intervention, while SST did not.
    Conclusions
    This before-after study revealed that a relatively short course of a computer-assisted cognitive remediation can be applied to improve several aspects of cognitive functioning in patients with schizophrenia. A randomized controlled trial is required to establish the effectiveness of the intervention.
    Keywords: Cognitive, Rehabilitation, Schizophrenia
  • Zohreh Rahimi *, Amin Gravand, Habibolah Khazaie, Sahar Mohammadi, Ziba Rahimi, Asad Vaisi Raygani, Ebrahim Shakiba Page 12
    Background
    Brain-derived neurotrophic factor (BDNF) might involve in the pathogenesis of mental disorders. There are inconsistent reports related to the role of BDNF Val66Met in susceptibility to bipolar disorder (BD).
    Objectives
    The aim of the present study was to investigate the role of BDNF Val66Met and its synergism with 5-HTT gene-linked polymorphic region (5-HTTLPR) variants in susceptibility to bipolar I disorder (BP-I) in Western Iran.
    Materials And Methods
    In this case-control study, 153 patients with BP-I and 146 age- and gender-matched healthy individuals were investigated for BDNF and 5-HTTLPR variants using PCR-RFLP method.
    Results
    The frequency of BDNF A (Met) allele in patients (17.7%) was slightly lower than that in controls (19.9%, P = 0.5). The concomitant presence of BDNF G (Val) and 5-HTTLPR S alleles tended to increase the risk of BP-I by 1.41 times (P = 0.064) compared to the combined presence of BDNF G and 5-HTTLPR L alleles. Also, interaction between BDNF G (Val) and 5-HTTLPR S tended to increase the risk of BP-I by 1.28-fold (P = 0.062) compared to the concomitant presence of BDNF A and 5-HTTLPR S alleles.
    Conclusions
    This study, conducted for the first time on Kurdish population in Western Iran, did not indicate any association between BDNF Val66Met with BP-I. However, the interaction between BDNF and 5-HTTLPR variants tended to increase the susceptibility to BP-I.
    Keywords: Bipolar I Disorder_Brain_Derived Neurotrophic Factor Val66Met_Polymorphism_Serotonin Transporter Gene_Synergism_5_HTTLPR
  • Reza Abdi *, Gholamreza Chalabianloo, Afsaneh Joorbonyan Page 13
    Background
    Anxiety disorders which influence physical and psychological strength and the quality of individual and social life are afflicting great numbers of people both in the modern developed societies and in underdeveloped ones. As two cases of transdiagnostic factors influencing a wide range of psychological disorders, especially anxiety disorders, repetitive thinking (RT) and perfectionism are now receiving greater attention from psychologists and psychotherapists.
    Objectives
    The current study was an attempt to investigate the mediating role of RT in predicting the relationship between perfectionism and severity of anxiety.
    Materials And Methods
    For this purpose, 385 students of Azerbaijan Shahid Madani University were selected using cluster random sampling and evaluated through the three inventories of depression and anxiety symptoms, repetitive thinking questionnaire (RTQ) and perfectionism questionnaires in 2015. Data were analyzed using SPSS software and hierarchical regression analysis.
    Results
    Findings suggested that there were correlations among three variables of perfectionism, RT and anxiety; results also revealed that RT played a significant mediating role in predicting the relationship between perfectionism and anxiety.
    Conclusions
    These findings can be an effective step toward designing plans to prevent different emotional disorders and treatment protocols.
    Keywords: Anxiety, Perfectionism, Repetitive Negative Thinking, Transdiagnosis
  • Behshid Garrusi *, Mohammad Reza Baneshi, Mstafa Pakgohar Page 14
    Objectives
    Eating disorders are important health issues of body image disturbances. These disorders are not limited to Western countries or females. The current study aimed to investigate the prevalence of eating disorders among Iranian male adolescents and the associated factors.
    Materials And Methods
    This cross-sectional survey was conducted on 433 male high school students. The study assessed the effects of demographic characteristics, social pressures from family and friends, self-esteem, body satisfaction and media on eating disorders. Results are presented in terms of odds ratio (OR) and confidence interval (CI). P-values less than 0.05 were considered as statistically significant.
    Results
    About 15% of male adolescents had eating disorders. There were significant differences between the two groups (with and without eating disorders) in terms of social pressure, body dissatisfaction and body mass index (BMI). Body dissatisfaction (OR = 1.23, 95% CI: 1.01-1.50) and BMI (OR = 1.14, 95% CI: 1.06-1.21) were identified as predictive factors in eating disorders.
    Conclusions
    The results indicated the need for more attention to eating disorders and predictive factors in Iranian adolescents as an example of Asian cultures.
    Keywords: Adolescents, Eating Disorders, Iran, Male
  • Mahmoud Shirazi, Mohammad Ali Fardin *, Ali Arab, Gholamreza Sanagoue, Allah Nazar Alisofi Page 15
    Objectives
    The aim of this study was to examine the effect of 15 positive psychological states (trust in God, optimism, a sense of efficacy, accepting responsibilities, a sense of control, purposefulness, hope, meaningfulness in life, life satisfaction, positive mood and happiness, being social, self-esteem and self-worth, a sense of peace, appreciation, and forgiveness) on predicting sleep quality among pregnant women.
    Materials And Methods
    This descriptive study followed a correlational-predictive design. The statistical population of this study included all pregnant women referred to health care centers in Khash in the first half of 2015, which included 890 individuals. The sampling method was multistage cluster sampling. Overall, 268 questionnaires were distributed among pregnant women, who had the inclusion criteria of the current study, in order to be answer freely and voluntarily. Moreover, to collect data, two questionnaires including positive psychological states (PPS) and the Pittsburgh sleep quality index (PSQI) were used.
    Results
    The results of the correlation coefficient indicated that optimism, purposefulness, hope, meaningfulness in life, life satisfaction, positive mood and happiness, a sense of peace, trust in God and forgiveness were significantly related to high sleep quality (P ≤ 0.01). However, sleep quality was not correlated with a sense of efficacy, accepting responsibilities, a sense of control, being social, and a sense of self-esteem and self-worth (P ≥ 0.05). Additionally, the results of stepwise regression analysis showed that positives mood, meaningfulness in life and hope together predicted 0.47 of the variance in sleep quality among pregnant women (P ≤ 0.01).
    Conclusions
    Since psychological states and emotions have great impacts on sleep quality of pregnant women, paying attention to women’s psychological states and emotions, especially in the last trimester of pregnancy, seems essential.
    Keywords: Positive Psychological States, Pregnancy, Sleep Quality
  • Mohammad Ali Soleimani, Saeed Pahlevan Sharif, Ameneh Yaghoobzadeh, Fon Sim Ong* Page 16
    Background
    Hardiness as one of the personality traits is an important factor in predisposing risky behaviors including addiction.
    Objectives
    This research examines the relationship between hardiness and addiction potential and identifies socio-economic determinants of hardiness and tendency to addiction among medical students in Iran.
    Materials And Methods
    In this study, 577 medical students selected based on the convenience sampling method were examined. They were selected from five faculties of Qazvin University of Medical Sciences. Data were collected on hardiness scale, addiction potential scale and demographic variables. Data analysis included descriptive and inferential statistics powered by SPSS (v. 22).
    Results
    Research results showed that there was a negative relationship between hardiness and addiction potential (r = -227, P
    Conclusions
    Hardiness had a significant negative relationship with tendency to addiction. Regarding demographic factors that were found to be the predictors of hardiness and addiction potential, a consistent pattern was observed in which those who had high tendency for addition were low in hardiness. This is not surprising since hardiness is a shield that provides a defense mechanism for coping behavior when a person is faced with negative life events or adverse life conditions. Based on the results, individuals high in hardiness are perhaps less likely to resort to drugs. However, further researches are recommended on this subject.
    Keywords: Addiction, Hardiness, Medical Students, Socio, Economic Factors
  • Ahmad Hajebi, Morteza Naserbakht, Alireza Noroozi * Page 17
    Background
    It is estimated that there are 180,000 people who inject drugs (PWID) in Iran. To reduce HIV-related high-risk behaviours among PWID, primary needle and syringe programs (NSPs) are delivered through drop-in centres (DICs) in Iran since 2002, but there is a paucity of research on the differential effectiveness of psychosocial components of NSPs on high-risk injection and sexual behaviours of drug users.
    Objectives
    The current study aimed to examine the effectiveness of adding-on a brief skill-based HIV prevention psychoeducation on HIV-related high-risk behaviours among clients of two drop-in centres (DICs) in Tehran, Iran.
    Materials And Methods
    One hundred and twenty consecutive clients with the mean age of 34 years who met diagnostic and statistical manual of mental disorders, 4th edition, text revision (DSM-IV-TR) criteria for opioid dependence were selected and randomly assigned into intervention and control groups. Demographic data, history of drug abuse, high-risk sexual behaviours and drug-related behaviours were gathered using a researcher-made questionnaire. The intervention group received two brief sessions of skill-based HIV prevention psychoeducation added on routine needle and syringe program; while the control group received routine services. The two groups were followed in months one and three, respectively.
    Results
    The intervention group showed significantly more reduction in high risk injecting behaviours including average number of daily injections (F = 4.32, P
    Conclusions
    The study results indicated that adding-on a brief skill-based HIV prevention psychoeducation consisted of two individual sessions to routine NSP could significantly increase its effectiveness. The importance of integration of HIV prevention psychoeducation programs within routine harm reduction services was discussed.
    Keywords: Behavior Therapies, HIV, Needle, Exchange Programs, Prevention, Psychoeducation
  • Roya Noori *, Reza Daneshmand, Ali Farhoudian, Salahedin Ghaderi, Sepideh Aryanfard, Afsaneh Moradi Page 18
    Background
    Dependence on amphetamine-type stimulants (ATS) is a health concern in Iran (i.e. the most populated Persian Gulf country). However, there are no literature reports on ATS dependence in the community.
    Objectives
    The current study aimed to investigate the prevalence of ATS-dependence, the reasons associated with this problem and the treatment barriers among a group of adults in 22 districts of Tehran.
    Materials And Methods
    A rapid situation assessment was conducted. A mixed quantitative-qualitative methodology was applied. The study was conducted between September 2009 and January 2010. A researcher-made checklist was designed to collect data. The SPSS version 23 and Atlas-ti qualitative software were used for data analyses.
    Results
    In total, 6027 individuals were randomly recruited and interviewed. Among them, 261 participants were ATS-dependent. A desire to increase performance and reduce psychiatric problems, beauty-related issues and a desire to stop opiate use were the main reasons for the illegal use of ATS. Poor knowledge of ATS treatment services in the community, poor knowledge of the side effects of the illegal use of ATS and stigma were the main current treatment barriers. Amphetamine-Type Stimulants dependence was associated with unemployment (adjusted OR = 3.1 CI 95% 1.0 - 4.6), lack of leisure activities (OR = 2.9 CI 95% 1.0 - 5.3), curiosity (OR = 3.2 CI 95% 2.1 - 5.6) and increasing sexual performance (OR = 2.6 CI 95% 2.3 - 5.4).
    Conclusions
    The study results indicated that ATS-dependence was present among the study participants. This issue necessitates treatment, which should be considered by health policy makers. Prevention programs should be provided on the large scale in the Persian community to prevent ATS use and dependence.
    Keywords: Amphetamine, Type Stimulants, Drug, Iran, Methamphetamine, Treatment
  • Daniel Teck Lung Wong, Lai Fong Chan, Suzaily Wahab *, Aqmar Suraya Sulaiman, Muhammad Zurrusydi Zainuddin, Voon Yee Lee, Thambu Maniam Page 19
    Introduction
    Blood-injection-injury (BII) phobia is a common anxiety disorder that is non-fatal in most cases. Nevertheless, BII phobia in pregnancy can pose intricate medico-legal management issues.
    Case Presentation
    A 24 year-old post-term (40 weeks 9 days) primigravida refused induction of labour because of BII phobia, thereby presenting a serious obstetrical dilemma due to the precarious balance between patient’s autonomy and the pressing risk of intrauterine death. Caesarean section was successfully performed after sessions of urgent graded exposure therapy.
    Conclusions
    This case highlights the importance of close multidisciplinary teamwork.
    Keywords: Blood, Injection, Injury Phobia, Graded Exposure Therapy, Pregnancy
  • Ahmed Al Imam* Page 20
    Introduction
    Generalized anxiety disorder (GAD) is a common psychiatric condition, which is more common in females. The associated individual-societal burden of GAD is substantial. GAD can be further complicated by panic disorder (PD), a disabling condition, which is often accompanied by other psychiatric and medical conditions, including GAD. In this case, PD was accompanied by facet joint osteoarthritis (FJOA) of the lumbar spine. FJOA is a functional failure of synovial facet joints due to variable degrees of loss of the synovial cartilage. This case report aimed to present a unique interaction of psychiatric manifestations and a physical disability, both of which interacted and augmented each other substantially.
    Case Presentation
    This was a challenging case of a young 32-year old male patient from Baghdad,Iraq. His psychiatric medical condition lasted for about three years (2012 - 2015). Almost all the patient’s problems originated from an imbalanced relationship with an older female colleague. This relationship was the source of psychological disturbance that gradually affected the patient’s routine life, work and professionalism, social interactions, and family relationships. The patient’s psychological distress was centered around the female’s past sexual life, including her past marital life, and her pre-marital experience with multiple sexual partners. The patient became gradually convinced that the female was in desperate need of his persistent support to overcome her recent divorce, which eventually exhausted the patient. Later, he developed a parallel medical condition, facet joints’ degeneration of the lumbar spine. His psychiatric condition manifested as signs and symptoms of generalized anxiety, relapsing depression, and frequent panic attacks.
    Conclusions
    This unique case of persistent lumbar back pain became a two-faceted agent, interfering with patient’s daily physically activity, causing significant emotional distress, depression, anxiety, and frequent panic attacks. His lumbar spine problem persisted for approximately a year, but it was improved dramatically in late 2015; since then no residual effects interfered with his psychological improvement, apart from the sporadic and negligible flashbacks of his emotionally traumatic experience. In this peculiar case, the physical illness of the patient played a key role in augmenting, impending, and delaying the full psychological recovery.
    Keywords: Anxiety, Case Reports, Depression, Lumbar Vertebrae, Panic, Spondylosis, Zygapophyseal Joint