فهرست مطالب

Psychiatry - Volume:13 Issue: 2, 2018
  • Volume:13 Issue: 2, 2018
  • تاریخ انتشار: 1397/02/16
  • تعداد عناوین: 10
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  • Massimiliano Buoli, Alice Caldiroli, Marta Serati, Giulia Orsenigo, Elisabetta Caletti Pages 85-94
    Objective
    Purposes of the present study were to assess the social cognitive impairment in schizophrenia and to detect if some clinical variables (particularly age at onset) are predictive of general/social cognitive deficit in schizophrenia patients.
    Method
    Thirty-five clinically stabilized schizophrenia outpatients were assessed by the Brief Assessment of Cognition in Schizophrenia (BACS) and by Torralva’s social cognition battery. Binary logistic models were performed to find an eventual association between continuous clinical variables and cognitive test failures. The total sample was divided in groups according to dichotomous variables (gender, diagnostic subtypes and type of abuse) and the presence of cognitive deficits was compared between groups by χ2 tests.
    Results
    An earlier age at onset was found to be predictive of frontal cognitive impairment (Tower of London p=0.038, OR=0.702). Female gender was more probably associated with mistakes at MET-HV (χ2= 4.80, p=0.05, phi=0.40) and HOTEL tests (χ2= 5.25, p=0.04, phi=0.4) than male one. Cannabis abusers showed more frequently deficits on verbal fluency (χ2= 9.35, p=0.04, phi=0.52) and executive functioning (Tower of London) (χ2= 11.67, p=0.02, phi=0.58) than alcohol/cocaine ones.
    Conclusion
    Female patients with an early age at onset and cannabis abuse seem to have the worst general and social cognitive profile among patients suffering from schizophrenia
    Keywords: schizophrenia, social cognition, age at onset, gender, cannabis abuse
  • Ahmad Ali Noorbala, Hassan Rafiey, Fardin Alipour, Amir Moghanibashi-Mansourieh Pages 95-103
    Objective
    Nowadays stress and tensions are among the most important factors affecting health. Identifying the stressors and their determinants provides substantial information for understanding the health of the community.
    Method
    This descriptive cross-sectional study was conducted on citizens over 18 years who were living in all 22 districts of Tehran in 2017. The participants were selected using multistage cluster sampling method. The research tool was a checklist that evaluated various factors. Different statistical tests, such as descriptive tests and logistic regression, were used for data analysis.
    Results
    Of the participants, 82.7% experienced at least 1severe stress during the past year. In the last year, 45.6% of the participants had at least 1severe economic stress, 32.3% had at least 1severe family-related stress, 28.8% had at least 1severe health-related stress, and 25.7% experienced at least 1severe future-related stress. The most common psychosocial stressors experienced in the last year were concerns about personal/family future (53.7%), concerns about the financial and economic future (47.1%), and the high cost of living (41.7%). However, the most severe stresses were due to the participants’ concerns about family health (14.4%), personal/family futures (13.2%), and financial and economic future (12.7%). Furthermore, health status, subjective socio-economic status, and age were the most important predictors of severe stress experiences.
    Conclusion
    It is necessary to take actions to reduce the prevalence of common severe stresses. In addition, psychologists, psychiatrists, counselors, and social workers need to provide stress management interventions carefully to their patients.
    Keywords: Psychosocial Stress, People, Stressor, Tehran
  • Malihe Farahani, Seyyed Salman Alavi, Mahmood Mirzamani Bafghi, Soudeh Esmaeeli Alamooti, Mohammadreza Mohammadi Pages 104-111
    Objective
    Problematic internet use is an important social problem among adolescents and has become a global health issue. This study identified predictors and patterns of problematic internet use among adult students.
    Method
    In this study, 400 students were recruited using stratified sampling technique. Participants were selected among students from 4 universities in Tehran and Karaj, Iran, during 2016 and 2017. Internet Addiction Test (IAT), Millon Clinical Multiaxial Inventory - Third Edition (MCMI-III), Structured Clinical Interview for DSM (SCID-I), and semi-structured interview were used to diagnose internet addiction. Then, the association between main psychiatric disorders and internet addiction was surveyed. Data were analyzed using SPSS18 software by performing descriptive statistics and multiple logistic regression analysis methods. P- Values less than 0.05 were considered statistically significant.
    Results
    After controlling the demographic variables, it was found that narcissistic personality disorder, obsessive- compulsive personality disorder, anxiety, bipolar disorders, depression, and phobia could increase the odds ratio (OR) of internet addiction by 2.1, 1.1, 2.6, 1.1, 2.2 and 2.5-folds, respectively (p-value
    Conclusion
    The findings of this study revealed that some mental disorders affect internet addiction. Considering the sensitivity and importance of the cyberspace, it is necessary to evaluate mental disorders that correlate with internet addiction.
    Keywords: Psychological Factors, Internet Addiction Disorders, Mental Illnesses, Personality Disorders
  • Zahra Shahrivar, Ronak Mihan, Javad Mahmoudi-Gharaei, Alia Shakiba, Mostafa Hosseini Pages 112-119
    Objective
    Attention-deficit hyperactivity disorder (ADHD) is common in adulthood, and it is associated with different high- risk behaviors, particularly substance use. Evidence suggests a high prevalence of ADHD in adults who take methamphetamine (METH). This study aimed at comparing functional level, quality of life, and psychiatric comorbidities in METH users with and without adult ADHD (A-ADHD).
    Method
    In this cross-sectional study, 134 patients who had a history of METH use (at least once in lifetime) were selected from among inpatient and outpatient referrals to a psychiatric hospital. DIVA was performed for those who were positive on the Conner's Adult ADHD Rating Scales–Self-Report-Screening Version (CAARS-SR-SV). The Global Assessment of Functioning (GAF) and World Health Organization Quality of Life Scale-Brief (WHOQoL-BREF) were used to assess the participants’ level of functioning and quality of life, respectively. Psychiatric comorbidities including substance use disorders were evaluated using the Structured Clinical Interview for DSM-IV-Axis I (SCID-I).
    Results
    Among the METH users, 10.4% were diagnosed as having A-ADHD. A-ADHD was more prevalent among female METH users than males. The hyperactive-impulsive and combined types were more common than the inattentive type. Opiates and cannabis were the most commonly abused drugs by the 2 groups, while sedative-hypnotic use was significantly higher in the individuals with A-ADHD. Substance-induced mood disorder was the most prevalent comorbidity in the 2 groups and was higher in those with A-ADHD. quality of life and the GAF scores were significantly lower in those with A-ADHD and duration of METH use was higher Compared to the METH users without A-ADHD, (p>0.05).
    Conclusion
    This study provided some preliminary findings supporting the prevalence of Adult ADHD among METH users and its negative impacts on their global functioning and quality of life. To provide more effective intervention for METH users, detection and treatment of those with A-ADHD can be of clinical value.
    Keywords: Adult, Attention Deficit Hyperactivity Disorder, Comorbidity, Function, Methamphetamine, Quality of Life
  • Saeed Vaghee, Masoud Kashani Lotfabadi, Azam Salarhaji, Nastaran Vaghei, Bibi Maryam Hashemi Pages 120-128
    Objective
    Empathy is an important and valuable tool in therapeutic communication. Improvement barriers of empathy in psychiatric nursing education are associated with challenges, such as stress due to negative attitudes toward psychiatric disorders. The current study aimed at comparing the effects of contact-based education and commitment and acceptance-based training on empathy toward mental illnesses among nursing students.
    Method
    In this clinical trial, 111 nursing students were selected using cluster and quota sampling methods in Mashhad, Iran. They were divided into 3 groups: (1) contact-based education (interpersonal contact among individuals with improved mental illnesses), (2) acceptance and commitment-based training, and (3) control group. The study tool was Jefferson Nurses Empathy Questionnaire, which was completed in 3 stages of pretest, posttest, and follow- up. Data were analyzed by repeated- measures ANOVA.
    Results
    There was no significant difference between contact-based education and acceptance and commitment-based training groups in increasing the average score of total empathy during pretest, posttest, and 1-month follow- up (p = 0/92). However, a significant difference was found between contact-based education and control group (p = 0/004) and between acceptance and commitment-based training and control group (p = 0/02).
    Conclusion
    Both methods of contact-based education and acceptance and commitment-based therapy were effective in increasing the level of empathy into mental illnesses in nursing students.
    Keywords: Acceptance, Commitment Therapy, Education, Mental Disorders, Nursing, Empathy, Students
  • Seyed Omid Sotoudeh Navroodi, Mojgan Nicknam, Ameneh Ahmadi, Fatemeh Pooragha Roodbarde, Saeed Azami Pages 129-135
    Objective
    Parents of children with autism spectrum disorders are exposed to mental distress because of having a disabled child more than parents with children with other psychological disorders, and their children's disorder has a negative effect on their hope and life satisfaction. The present study aimed to examining the effectiveness of group positive parenting training on increasing hope and life satisfaction in mothers of children with autism.
    Method
    This was a quasi-experimental study with pretest, posttest, and control and experimental groups. Mothers with autistic children (6-15 years) in Rasht consisted the statistical population of the study. All the children had a medical record and autism diagnosis based on DSM-IV-TR by a psychiatrist. Hope Questionnaires by Snyder and Life Satisfaction Questionnaire by Diener were implemented. Participants of the experimental group received positive parenting training for 8 sessions, and participants of the control group were put in the state of waiting. Descriptive statistics (mean, standard deviation, frequency, and percentage) and inferential statistics (univariate and multivariate covariance analysis) were used for data analysis.
    Results
    In this study, 27 mothers of children with autism were examined. The mean and standard deviation of the age of mothers in the experimental group was 36.14± 2.47 years and it was 37± 3.62 years for mothers in the control group. The results of univariate covariance analysis revealed a significant difference between the scores of pretest and posttest of the experimental and control groups in life satisfaction (Sum of square = 16.558, F = 13.534, DF = 1, P = 0.002, 〖=ƞ〗^2 = 0.361).
    Conclusion
    The results of this study showed that using group positive parenting training can have a positive effect on dimensions of hope and life satisfaction in mothers of children with autism spectrum disorder.
    Keywords: Autism Spectrum Disorder, Hope, Life Satisfaction, Positive Parenting
  • Maryam Davoodvandi, Shokouh Navabi Nejad, Valiollah Farzad Pages 136-142
    Objective
    The present study aimed at examining the effectiveness of Gottman couple therapy on improving marital adjustment and couple's intimacy.
    Method
    This was a semi- experimental study with pretest, post-test, and follow-up assessments. A total of 16 couples (32 individuals) were selected using convenience sampling method considering inclusion- exclusion criteria; they were then randomly assigned into experimental (N = 16) and control (N = 16) groups. Participants of the experimental group received ten 45-minute sessions of Gottman’s couple therapy. The research tools were Spanier Questionnaire and Walker and Thompson’s Questionnaire. Data were analyzed using Mixed design MANOVA.
    Results
    Findings revealed that Gottman’s couple therapy approach had positive effects on improving marital adjustment (P = 0/001) and couple's intimacy (P = 0/001). Furthermore, the results of assessments in the follow-up period indicated that Gottman’s couple therapy had enduring effects on marital adjustment and couple's intimacy.
    Conclusion
    According to the results of the present study, Gottman method can be used as an effective treatment to improve marital relationships, adjustment, and intimacy. Therefore, researchers, therapists, and other authorities should pay particular attention to this method.
    Keywords: Couple's Intimacy, Gottman's Couple Therapy, Marital Adjustment
  • Padideh Ghaeli, Fatemeh Shahhatami, Mojtaba Mojtahed Zade, Mostafa Mohammadi, Mohammad Arbabi Pages 143-148
    Objective
    Delirium is a clinical syndrome associated with multiple short- and long-term complications; therefore, prevention is an essential part of its management. This study was conducted to review the effective non-pharmacological interventions that can reduce the incidence or duration of delirium in critically ill patients.
    Method
    A search was made in PubMed, Scopus, Psych INFO and Google Scholar databases without any time constraints. The information available was collected and sorted, and a secondary study of narrative review was done. The views of specialists on this topic were received via email and included in the texts and recommendations.
    Discussion
    Delirium is a common, costly and potentially damaging illness in patients who are staying in hospitals, especially older patients in ICU. Thus, preventing delirium could be one of the most effective methods in preventing the complications. The present study aimed at conducting a review-validity study to generate a general view on the activities which might be effective in preventing delirium in patients.
    Keywords: Complication, Delirium, Intensive Care Unit, Non-Pharmacological, Prevention
  • Zeynab Khanjani, Shahin Azmoodeh, Majid Mahmoudaliloo, Gholamreza Noorazar Pages 149-154
    Objective
    This study aimed to identify autistic like traits in relatives of patients with schizophrenia and autism spectrum disorder.
    Method
    causal-comparative research design was utilized. Fifty individuals among the first degree relatives of patients with autism spectrum disorder and 50 individuals among the first degree relatives of patients with schizophrenia spectrum disorder were selected. Autistic-like traits were evaluated by Autism-Spectrum Quotient (AQ). Multivariate analysis of variance was used to compare the autistic like traits in two groups.
    Results
    First degree relatives of individuals with autism spectrum disorder got higher scores in deficiency of social skill, deficiency of communication, deficiency of attention, and attention to details. As well as they got lower scores in deficiency of imagination, in comparison to relatives of individuals with schizophrenia spectrum disorder.
    Conclusion
    Relatives of individuals with autism spectrum disorder compared to relatives of patients with schizophrenia spectrum disorder showed higher rates of autistic like traits. Only the exception was imagination subscale
    Keywords: Autistic Like Traits, Autism Spectrum Disorder, Relatives of Individuals with Autism, Relatives of Patients with Schizophrenia, Schizophrenia Spectrum Disorder
  • Hoda Doos Ali Vand, Banafsheh Gharraee, Ali-Asghar Asgharnejad Farid, Mir Farhad Ghaleh Bandi, Mojtaba Habibi Pages 155-160
    Objective
    Similar cognitive and behavioral factors underlie and perpetuate insomnia and emotional disorders. This brief case report aims to evaluate the effectiveness of the Unified Protocol (UP), a transdiagnostic treatment designed to target emotional disorders in treating comorbid insomnia.
    Method
    The patient was a 32-year-old male, who met the DSM-IV-TR criteria for chronic insomnia, major depressive disorder, and generalized anxiety disorder. After 3 baseline weeks, the patient underwent 14 sessions of UP and was retested after a 1-month follow-up. Consensus Sleep Diary (CSD), Insomnia Severity Index (ISI), and Pittsburgh Sleep Quality Index (PSQI) were completed during baseline, treatment, and follow-up.
    Results
    The treatment led to improvements in sleep onset latency, time awake after sleep onset, terminal awakenings, sleep quality, and insomnia severity. These gains were maintained at 1-month follow-up.
    Conclusion
    UP is effective in improving different symptoms of chronic insomnia. Controlled clinical studies with more cases are required to investigate the effects of UP in the treatment of insomnia.
    Keywords: Anxiety, Depression, Sleep Initiation, Maintenance Disorders, Unified Protocol