- Volume:14 Issue: 2, 2019
- تاریخ انتشار: 1398/02/18
- تعداد عناوین: 10
Pages 113-119ObjectiveThe present study was conducted to compare neurocognitive profile in patients with borderline personality disorder (BPD) and bipolar II disorder (BD-II) and to find whether BPD can be classified as one of bipolar spectrum disorders.
MethodA total of 35 patients with BPD and 35 euthymic patients with BDII disorder were selected by convenience sampling method. These 2 groups were compared with 30 healthy individuals using neurocognitive battery tests that assessed cognitive flexibility and set-shifting, response inhibition, problem-solving, decision-making, and sustained and selective attention. Data were analyzed using independent t test, X2 and ANOVA.ResultsPatients with euthymic BDII and BPD had poorer performance than the healthy group in most neurocognitive domains (p<0.05). Both patient groups showed similar functions in cognitive flexibility and set-shifting, decision-making, sustained and selective attention, and problem-solving (p<0.05). BPD patients had more elevated response inhibition deficits than BD-II patients (P<0.05). Also, BPD patients had poorer performance in planning compared to BD-II patients (P<0.05).The results provided empirical support for previous findings which have reported that patients with BPD and BD-II show neurocognitive dysfunctions. Despite the similarity between these 2 clinical groups in terms of neurocognitive profile in this study, more extensive studies are needed to confirm the hypothesis that BPD can be conceptualized as one of bipolar spectrum disorders.
ConclusionKeywords: Bipolar Disorder, Borderline Personality Disorder, Neurocognitive Profile
Developing a Comprehensive Evidence-Based Service Package for Toddlers with Autism in a Low Resource Setting: Early Detection, Early Intervention, and Care CoordinationPages 120-129ObjectiveThe number of children with autism, who have many unmet needs, is increasing dramatically. However, the existing evidence shows that early identification and intervention are effective in reducing the later costs and burdens of autism spectrum disorder (ASD). Thus, the present study aimed to develop evidence-based services for children with autism in Iran to reduce its impacts on the affected children and their families and to decrease its burden on the society.
MethodA 3-step study was conducted based on a modification of the Replicating Effective Programs (REP) framework (step 1: need assessment and situation analysis; step 2: identifying current evidence-based services; step 3: designing the first draft of the package and its core elements). Each step was conducted by a specific methodology.
ResultsBy considering the obtained data, it was found that a package of services with 4 core components to respond to the perceived needs in Iran was needed: (1) early detection of at-risk children; (2) care coordination and facilitation of access to current services; (3) implementation of an evidence-based early intervention program; and (4) training interventionists using an effective educational framework based on evidence-based material.
ConclusionREP framework was used in the present study, which has been shown to be effective in adapting and implementing health care services. By considering the preconditions of REP, a comprehensive package of services, with 4 components was designed for toddlers with autism in Iran. The next step will be to study this package using a multicenter hybrid effectiveness-implementation randomized control trial.Keywords: Autism, Care Coordination, Early Detection, Early Intervention
Efficacy of Acceptance and Commitment Therapy in Reducing Disappointment, Psychological Distress, and Psychasthenia among Systemic lupus erythematosus (SLE) PatientsPages 130-136ObjectiveThe aim of this study was to evaluate the efficacy of acceptance and commitment therapy (ACT) in the reduction of disappointment, psychological distress, and psychasthenia among patients with systemic lupus erythematosus (SLE).
MethodThis quasi-experimental study was conducted on 24 females with lupus who referred to the Rheumatoid Disease Research Center (RDRC) of Ghaem hospital in Mashhad, Iran. This study had a pretest-posttest control group design. The participants were randomly assigned into 2 groups of experimental and control. The experimental group was treated with ACT. Data were collected using the Beck’s Hopelessness Scale, Kessler’s Psychological Distress Inventory, and Krupp’s Psychasthenia Inventory.
ResultsMean age and mean duration of illness were 37.25±4.61 and 5.12±2.33 years, respectively. The mean disappointment score and psychological distress in the experimental group were lower compared to those in control group at the post experimental stage (P<0.001). Moreover, there was a significant difference between the experimental and control groups in the mean scores of psychasthenia in the posttest stage (P<0.001).
ConclusionAccording to the obtained results of this study, the enhancement of psychological flexibility based on ACT positively affected disappointment, psychological distress, and psychasthenia among the lupus patients. Therefore, it can be concluded that this therapeutic approach could reduce psychasthenia in patients through clarification of the values.Keywords: Acceptance, Commitment Therapy, Disappointment, Psychological Distress, Psychasthenia, Systemic Lupus Erythematosus
Pages 137-146ObjectiveThe burden of mental disorders continues to grow with significant impacts on health. This study aimed to investigate the prevalence of stress, anxiety, and depression in Yazd adult population and to examine the associated socioeconomic factors.
MethodIn a 2-step cluster sampling process, 10 000 residents of Yazd Greater Area (200 clusters of 50) were selected during 2014-2015. The short version of Depression, Anxiety and Stress Scale (DASS) Questionnaire was used to assess relevant depression, anxiety, and stress. Data were analyzed by chi-square test. All statistical analyses were done using SPSS version 16.0. P-values less than 0.05 were considered statistically significant.Depression, anxiety, and stress were seen in 29%, 32.2%, and 34.8% of adult residents of Yazd Greater Area, respectively. The symptoms of the disorders were moderate, severe, and very severe in 18.2%, 20.2%, and 23.4% of the population, respectively. Also, a significant difference was found between the symptoms of depression, anxiety, and stress and sex, age group, education, employment, marriage status, and country of birth. Of the total population under study, 3.7% were depressed, 7.7% were anxious, 9.5% had stress alone and 16.4% had symptoms of all the 3 disorders. Frequency of depression among Zoroastrians was more than muslims (42.1% vs 29.7%).
ResultsDespite achievemments in higher education and economic development of Yazd population over the past 2 decades, the trend of these disorders has alarmingly been increased. Considering the findings, it is necessary to develop evidence-based and appropriate community-based primary and secondary mental health prevention programs.
ConclusionKeywords: Anxiety, Stress Scale (DASS), Depression, Iran, Prevalence, Stress
Effect of Radiance-Dimmer Devices Simulating Natural Sunlight Rhythm on the Plasma Melatonin Levels and Anxiety and Depression Scores of the Submarine PersonnelPages 147-153ObjectiveNot perceiving circadian shifts of sunlight due to living in enclosed environments may have deleterious effects on mental health and plasma parameters. This study aimed to determine the effect of dim regulation on the submarine personnel of Iranian Navy forces by radiating devices according to natural circadian sunlight shifts. Also, this study aimed to investigate the impact of mimicking sunlight circadian by artificial radiance luminating devices on the serological and psychological measures of submarine personnel.
MethodParticipants were randomly assigned to experimental and control groups in this non-randomized controlled trial. There were 26 participants in each group, and they were all male aged 21-29 years. Both groups were living in the submarine underground hall, with 120 meters 2 area with constant radiance with the same intensity. The experimental group had been given extra lighting devices with changing radiance intensity according to the natural sunlight circadian cycles. Plasma melatonin levels and depression and anxiety scores were determined before and after the experiment for both groups. Minnesota Multiphasic Personality Inventory (MMPI) and Cattell’s Anxiety Scale Questionnaire (IPAT) were used to measure depression and anxiety, respectively.
ResultsFindings indicate that the plasma melatonin levels (-16.2±13.6 vs 8.0±9.3 mg/dL, respectively; p<0.001), depression scores (-6±6 vs 3.9±5.4, respectively; p<0.001), and anxiety scores (-1±1.2 vs 0.73±1.04, respectively; p<0.001) significantly reduced in the experimental group compared to the control group.Using radiance dimmers, with a radiance intensity regularity according to the sunlight, is effective in improving psychiatric and plasma parameters and can be used in closed occupational environments such as underground environments and submarine halls.
ConclusionKeywords: Circadian Rhythms, Light, Melatonin, Submarine
Can Parents Improve the Quality of Life of Their Children with Attention Deficit Hyperactivity Disorder?Pages 154-159ObjectiveThe aim of this study was to evaluate the effectiveness of mothers’ Group psychoeducation on Quality of Life (QoL) of children with Attention Deficit Hyperactivity Disorder.
MethodIn this clinical trial, 60 mothers of ADHD children were randomly divided into two groups (30 participants in each group). An educational program based on Positive Parenting Program (Triple P) was performed for the intervention group, while only pharmacotherapy was provided for the control group. Pediatric Quality of Life Inventory (Peds QL) was completed by all 60 mothers before, eight week, and three months after intervention. Data were analyzed using mean and standard deviation, and K-square or paired t test were used for data analysis.
ResultsA total of 60 mothers participated in this study. Of their children, 80% were boys and 20% were girls. The mean of the total score of QoL increased significantly in the intervention group at week eight and three months after the intervention. Also, the mean scores of emotional, social, school and psychosocial domains, but not physical domain of QoL, found to be higher in ADHD children after intervention (p< 0.05).
The total score of QoL and mean scores of domains increased in the posttest in the control group, but it was not significant (p> 0.05).
ConclusionA significant increase in the total score of QoL was reported by mothers in the posttest compared to the pretest in the experimental group, which showed that educating parents can improve the QoL of their ADHD children.Keywords: Attention Deficit Hyperactivity Disorder, Children, Pediatric Quality of Life
What Psychiatric Interventions Are Used for Anxiety Disorders in Infertile Couples? A Systematic Review StudyPages 160-170ObjectiveInfertility causes psychological and social problems in many infertile women, men, and couples, and the most common of which is anxiety. Also, assisted reproductive treatments (ART) increase anxiety. Numerous medical and community associations have strongly recommended psychosocial interventions and counselling to help infertile couples.A review was done on studies published from 1982 to 2018 that were indexed in Medline, ISI Web of Knowledge, and Scopus. The references of each article were used for more resources and references.
ResultsMost psychosocial interventions were effective on infertile women, men, and couples. These articles showed a significant decrease in anxiety with CBT interventions, body-mind interventions, and other interventions.
ConclusionAll interventions based on CBT, most interventions based on body-mind, and some other interventions are effective in treating anxiety in infertile women and men.Keywords: Anxiety, Assisted Reproductive Technology, Infertility, Psychosocial Interventions
Unified Protocol for Transdiagnostic Prevention of Depression and Anxiety in Iranian Adolescents: Protocol Development and Initial Outcome DataPages 171-178ObjectiveCognitive-behavioral interventions have been used as effective approaches for the treatment and prevention of depression and anxiety. However, to date, no anxiety and depression prevention guidelines package has been developed for Iranian adolescents. Thus, the purpose of this study was to develop transdiagnostic prevention program of anxiety and depression for Iranian adolescents and to assess the effectiveness of this program in a sample of adolescents.
MethodBased on evidence-based literatures on CBT interventions, transdiagnostic prevention program was developed and its content and face validity was assessed and established by 3 clinical psychologies (Ph.D.) and a psychiatrist (child and adolescent postdoctoral). Then, in a semi-experimental design, 62 students were recruited from a school in Tehran by purposive sampling method and were randomly assigned in to experimental (n = 40) and control (n = 22) groups. They participated in 8 sessions of intervention based on the developed program. Revised Child Anxiety and Depression Scale (RCADS)- Child Version and Parent Version- were used to gather the data before, after, and 3 months after intervention.Results of ANCOVA, controlling for the effect of pretest score, showed no significant differences (P>0.05) between experimental and control groups in SAD, panic, MDD, separation anxiety, GAD, OCD, total anxiety, and total anxiety-depression for parent and child in pretest and posttest.
ResultsTransdiagnostic prevention package for anxiety and depression had no significant effect on reducing anxiety and depression of adolescents. Using an inappropriate measure, difficulties with timing of assessment, and lower severity of pre-intervention anxiety and depression due to universal prevention and sample recruited, might have affected the present findings. Discussion would be clearer and more complete by analyzing follow-up results and education performance in the future.
ConclusionKeywords: Adolescents, Anxiety, Depression, Prevention, Transdiagnostic, Protocol
Pages 179-181The relationship between schizophrenia and idiopathic Parkinson’s disease is still not clear and rare when they coexist. Diagnosing coexisting schizophrenia and idiopathic Parkinson’s disease is a chal-lenge, especially in developing countries due to lack of experts and advance imaging facilities. Treatment options are also limited. A 58- year- old male was admitted due to relapse of psychotic symptoms following non-compliance to antipsychotic medications. The patient was previously diag-nosed with schizophrenia and later developed Parkinson’s disease while non-compliant to antipsy-chotic medications. While the patient was at our center, his detailed history was taken and general physical examination was done to distinguish Parkinson’s disease from anti-psychotic induced ex-trapyramidal symptoms. All the routine investigations were within normal limits. This case report highlights the clinical factors that help make a distinction and help use appropriate drugs to manage schizophrenia with comorbid Parkinson’s disease in developing countries, where lack of precise di-agnostic imaging modalities interferes in making a conclusive diagnosis.Keywords: Parkinson’s disease, Schizophrenia