فهرست مطالب

  • Volume:14 Issue: 3, 2020
  • تاریخ انتشار: 1399/06/18
  • تعداد عناوین: 6
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  • Narges Karimi *, Ashraf Zarvani, Seyyed Ali Akbarian Page 2
    Background

    Epilepsy is a severe problem incorporating a high degree of the misconception that influences the quality of life of individuals suffering from the disease.

    Objectives

    The purpose of the present study was to assess the knowledge and attitudes of patients with epilepsy toward the disease.

    Methods

    A cross-sectional study was conducted on 155 individuals with epilepsy aged ≥ 18 years from August 2016 to Jun 2018 in an outpatient clinic of a medical university in Sari City, North of Iran. Thirty-four closed-ended questions were developed, including 14 items about knowledge, 11 items about attitudes, and nine questions about knowledge profile-personal toward epilepsy. Answers to the questions were either “yes,” “no,” or “I do not know.” The chi-square (χ2) test was used to explain the association between variables and demographic information.

    Results

    The mean age of the participants was 31.73 ± 11.06 years. Regarding the cause of epilepsy, 85.8% of the participants reported that epilepsy is a brain disorder. Moreover, in terms of the knowledge score, 54.8% of the participants had a fair knowledge of epilepsy. Accordingly, patients with university education had good knowledge about the disease (P = 0.007). In terms of attitudes toward epilepsy, 82.6% of the patients had a positive attitude toward the disease but had no good awareness of it. These positive attitudes were associated with a high education level (P = 0.001).

    Conclusions

    This study showed that despite the positive attitude toward epilepsy, good knowledge about the disease was still below 50%.

    Keywords: Epilepsy, Iran, Attitude, Knowledge, Patient
  • Ideh Ghafour, Forouzan Elyasi * Page 3
    Context

     Neuroleptic malignant syndrome (NMS) has been introduced as a rare but lethal and idiosyncratic reaction to neuroleptics/antipsychotics. The most obvious risk of this syndrome is the use of neuroleptics, especially high-potency ones. Metoclopramide is also known as an anti-nausea medication administered before surgery to manage digestive problems.

    Evidence Acquisition

     Formerly, it had been assumed that metoclopramide was a type of chlorobenzamide that was not in the phenothiazine group but free of extrapyramidal side effects (EPSs). The sequential reports of complications indicate that metoclopramide can cause EPSs and drug-induced motor side effects. A total number of 5044 articles were obtained after the initial search. Then, two researchers independently screened out their titles, and abstracts and 20 articles were finally selected based on the inclusion criteria.

    Results

    Of the 20 articles reporting metoclopramide-induced NMS, treatments had been successful in 16 (80%) cases, but it had led to death in four (20%) patients. There were 11 and 8 male and female patients, respectively, and gender was not mentioned for a patient in one article. The age range of the patients was from six months to 84 years, and the mean age was 50.92 years.

    Conclusions

    Although NMS following metoclopramide intake is reported very rarely, it should be considered for any psychiatric symptoms with unexpected mental changes, muscle rigidity, and fever after being treated with metoclopramide. The neuroleptic malignant syndrome can occur following multiple doses or just one dose of metoclopramide. Also, metoclopramide use in patients affected with kidney failure is accompanied by a higher risk of NMS. A previous history of NMS, a recent episode of catatonia, and severe agitation are all taken into account as risk factors in this domain.

    Keywords: Treatment, Prognosis, Metoclopramide, Neuroleptic Malignant Syndrome (NMS)
  • MohammadEbrahim Sarichloo, Farhad Taremian*, Behrouz Dolatshahee, Seyed Alireza Haji Seyed Javadi Page 4
    Background

    Obsessive-compulsive disorder (OCD) is known as a non-psychotic mental disorder resistant to treatment. It has been found that eye movement desensitization and reprocessing (EMDR) can increase the effectiveness of its standard treatments.

    Objectives

    The current study aimed at evaluating the impact of exposure/response prevention (ERP) combined with EMDR as a treatment method on patients with OCD who had experienced stressful life events by comparison to ERP alone.

    Methods

    The present randomized controlled trial was conducted among 60 OCD patients who experienced stressful life events and were resistant to medication treatment. The participants were randomly assigned to the ERP plus EMDR (n = 30) and ERP (n = 30) groups. The Yale-Brown Obsessive-Compulsive scale (Y-BOCS) and Beck Anxiety Inventory (BAI) were completed before and after the intervention, as well as, after a follow-up period of three months. The scores were compared using the chi‐squared test, analysis of covariance (ANCOVA), and repeated measures analysis of variance (ANOVA).

    Results

    ANOVA results demonstrated that both treatment protocols had a significant effect on the reduction of anxiety and severity of OCD symptoms, while the results of ANCOVA showed a significantly higher effect of ERP plus EMDR compared to the ERP protocol (P = 0.001), and sample attrition was significantly higher in the ERP group (P < 0.05).

    Conclusions

    The ERP plus EMDR protocol compared to the ERP protocol showed a higher rate of completion and efficacy in OCD treatment.

    Keywords: Anxiety, Obsessive-Compulsive Disorder, Eye Movement Desensitization, Reprocessing, Exposure, Response Prevention
  • Zahra Farsi, Arsia Taghva *, Samantha C. Butler, Hanif Tabesh, Yavar Javanmard, Afsaneh Atashi Page 5
    Background

    The stigma associated with mental health disorders has an enormous impact on decisions concerning receiving mental health services.

    Objectives

    The current qualitative study aimed to describe the stigma toward mental disorders in Tehran, Iran.

    Methods

    The current grounded theory study conducted from 2013 to 2016 in Tehran (Iran). Fourteen participants were sampled using purposive and theoretical sampling techniques. Data were collected through face-to-face interviews, focused groups, and written narratives. The Corbin and Strauss coding paradigm (2008) was used to analyze data.

    Results

    Three main categories of stigmatization toward patients with mental health diagnoses were extracted: (1) barriers to stigma reduction; (2) strategies to reduce stigma; and (3) outcomes of stigma reduction such as negative consequences of stigma toward mental disorders and positive impacts of stigma reduction toward mental disorders.

    Conclusions

    To improve mental health services for patients in Tehran (Iran), it is imperative to reduce the stigma toward mental disorders, educate the community, including the general population and healthcare professionals, and remove existing barriers to receive mental health services.

    Keywords: Psychiatry, Mental Health, Qualitative Research, Mental Disorder, Grounded Theory, Stigmatization
  • Masoumeh Mahmoudi *, Mehdi Pourasghar, Kamaledin Alaedini Page 6
    Background

    Some studies indicated that the study of stories in which physical or mental illnesses are described helps to better understand the patient and his/her sickness; but unfortunately, this approach is neglected in the Persian literature. Paying attention to this issue can increase the attractiveness of studying such literary works for the Iranian and non-Iranian audience and can grant new sights to readers, as well.

    Objectives

    This research is conducted to describe and explain the symptoms of the PTSD in the characters of modern Persian fiction, based on the clinical symptoms.

    Methods

    This is qualitative research. Seven characters from the seven stories were selected purposefully to fit the researcher’s goals. Then, they were analyzed according to the DSM-5 criteria.

    Results

    The results indicated that the selected stories represent individuals with PTSD consistent with the clinical criteria for the diagnostic of the disorder. In these stories, the authors, in addition to describing clinical symptoms, have considered inheritance, gender, and cultural factors to create characters in accordance with the specifications of the people who have been damaged in the real world.

    Conclusions

    Reading these stories can be useful due to applying descriptions based on clinical criteria for the diagnosis of this disorder (PTSD), and thanks to the use of literary language in representing the victim’s inner and spiritual status, are useful in creating an engagement resulting from a proper understanding of the person who is suffering from such disorder.

    Keywords: Post-Traumatic Stress Disorder (PTSD), Humanities, Medicine in Literature