Iranian Journal of Psychiatry
Volume:1 Issue: 3, Summer 2006

Following a personal, community or national crisis or disaster there is a need to provide some form of early intervention and crisis support. The essential components of successful early interventions include planning, education, training and support for those affected. The goal of all early interventions should be to maximize the likelihood of a positive mental health outcome using the person’s own adaptive coping mechanisms and support structures. Psychological debriefing (PD) has been described as an intervention conducted by trained professionals shortly after a catastrophe, allowing victims to talk about their experience and receive information on “normal” types of reactions to such an event. Psychological debriefing has been developed and has been at the centre of significant levels of controversy during the past 15 years. Talking through traumatic or stressful events may help the psychological recovery of those who have suffered psychological insults.

This study aimed to describe the characteristics of Iran’s child and adolescent mental health research published from 1973 to 2002. The articles were drawn from IranPsych, which is a national database of published research in mental health and related fields. This database gathers scientific papers on psychiatry, psychology, and neuroscience published in both national and international journals. Bibliometric data, general scientific areas of research, specific subject topics and research design, were extracted from aticles. Egypt was selected as one of the Middle East countries that has some similarities with Iran. Iranian and Egyptian child and adolescent mental health research articles indexed in ISI 1994 to 2004 also were compared. From a total of 883 articles, 9% appeared in international journals. There was a marked increase in the number of publications over time, especially in the last 5 years. Psychology and clinical research constituted 70%, and 32% of articles, respectively; followed by epidemiology 11%, health service research 2% and neuroscience 0.7%. During the first five years of the mentioned period Iran fell behind Egypt in terms of international child and adolescent mental health research articles; however, in the last five years, Iranian articles numbered 2.75 times the Egyptian’s. This study showed that it is feasible to outline the status of research activity of a country by using databases that cover publications and would yield several remarkable findings that could be used as a basis for policy making and strategy development in child and adolescent mental health research.

The purpose of this study was to examine whether attitudes toward psychiatry improved during psychiatric attachment as well as the relationship between attitudes to psychiatry and intention to pursue psychiatry as a career. It also assessed the relationship between students’ characteristics with their attitudes toward psychiatry and intention to pursue psychiatry as a career before and after psychiatric attachment. On the first and last day of their psychiatric attachment 109 fifth year medical students of Shaheed Beheshti Medical University who entered medical school in September 2000 were asked to participate in the study. They completed a demographic form and “Attitude toward Psychiatry Questionnaire”. They also responded to two questions which measured their intention to pursue psychiatry as a prospective career. Students had favorable attitude toward psychiatry before the attachment, with mean score of 84.14 on Attitude to Psychiatry Questionnaire (neutral score 72). These attitudes become more positive after attachment. Students’ intention to pursue psychiatry as a career increased during attachment. There was also a significant increase in students’ intention to pursue psychiatry as a career during attachment. Improvement in attitudes was related to an increased intention to pursue psychiatry as a career. The study confirms earlier reports of a significant positive impact of undergraduate psychiatric attachment on medical students’ attitudes toward psychiatry and their intention to pursue psychiatry. Thus, teaching psychiatry at an undergraduate level may well have important implications, not only in terms of the way future doctors who are not psychiatrists respond to patients psychological difficulties, but also in terms of future recruitment into the specialty.

Examining the interrelationship between quality of life, hardiness, selfefficacy and self-esteem among working (professional and non-professional), and non-working married women has motivated the researcher to launch this study. The samples in the present study consisted of 250 married employed women and 250 married unemployed women in the age range of 24-41 years old belonging to lower, middle, and upper socioeconomic status groups, with educational qualification of 10±2 and above and having at least one school child. Stratified convenience sampling technique was used for the selection of the sample. The World Health Organization -Quality of Life (WHO QOL) – BREF, the Personal View Survey (PVS), the General Self-Efficacy Scale (GSE), The Coopersmith Self-Eesteem Inventory (CSEI) and demographic questionnaire Sheet were chosen for collection of the data. Obtained Pearson r values revealed significant positive interrelationship between quality of life, hardiness, self-efficacy, and self-esteem in the whole sample, within the subgroups of professional and non-professional employed and unemployed women. Obtained pearson r values revealed significant negative relationship between employment and the above variables in women. It indicates that women with higher quality of life score rank also higher on hardiness, self-efficacy, and self-esteem and vice versa.

The main aim of this study was to investigate the psychological and social adjustment of parents whose adolescent children had experienced a disaster. Mediating factors were considered; such as whether the child developed post-traumatic stress disorder (PTSD), dysfunctional attitudes, other intervening life events, and especially, social support. Participants were 37 women whose adolescent children had survived the ‘Jupiter’ sinking in 1988. Subjects were divided into a subgroup of women (n=20) whose children had PTSD, and a subgroup (n=17) whose children did not develop PTSD. Comparison groups were widows (n=18), and women who had suffered no major negative life events (n=15). Measurements were done on the Schedule for Affective Disorders and Schizophrenia, Lifetime Version (SADS-L), the Social Adjustment Scale (SAS), and other questionnaires. Mean total scores on social support in all groups in comparison with SADS-L scores, showed a significant correlation with the post-event panic disorder and a trend of negative correlation with all post-event psychopathologies. Results supported the hypothesis that social support was probably a protective factor for the participants in this study.

Fax: +98-21-5419113 Several studies have shown that following disasters, major depressive disorder is the most common psychiatric disorder that occurs with posttraumatic stress disorder (PTSD). Comorbidity of anxiety symptoms have also been shown. The objective of this study was to show the comorbidity of depressive and anxiety symptoms in adolescent survivors of Bam earthquake. In a case–control study, two groups of PTSD and non-PTSD Bami adolescents were assessed 7–9 months following the Bam earthquake. DSM-IV criteria and Posttraumatic Stress Scale (PSS) were used to diagnose PTSD and assess symptoms; Beck’s Depressive Inventory (BDI) and Hamilton’s Anxiety Scale were used for assessing the severity of depressive and anxiety symptoms. And the groups were compared. 284 subjects were included, aged 11–18 years (mean 14.8±2.1 years). 24.3% were boys and 75.7% girls; 45.1% met criteria for PTSD. In the PTSD group, mean BDI and HAS scores were 31.4±11.7 and 22.7±10.9, respectively; in the non-PTSD group, it was respectively 20.6±12.7 and 11.8±8.1. The difference between the PTSD and non-PTSD groups was significant. There was statistical correlation between the severity of depressive and anxiety symptoms and the severity of PTSD symptoms. Adolescent survivors of Bam earthquake who had PTSD had more severe depressive and anxiety symptoms than the non-PTSD group, which was correlated with the severity of PTSD symptoms. PTSD may be a predictor of depressive and anxiety symptoms.

The aim of the current study was to assess the impact of computer games and computer-assisted type instruction on dictation scores of elementary school children with attention deficit – hyperactivity disorder (ADHD). In this single-blind clinical trial, 37 elementary school children with ADHD, selected by convenience sampling and divided into group I (n=17) and group II (n=20), underwent eight one-hour sessions (3 sessions per week) of intervention by computer games versus computer-assisted type instruction, respectively. 12 school dictation scores were considered: 4 scores preintervention, 4 scores during interventions, and 4 scores post-intervention. Dictation test was taken during each session. Data was analyzed using repeated measure ANOVA. Two groups were matched for age, gender, school grade, medication, IQ, parent’s and teacher’s Conners’ scale scores, having computer at home, history of working with computer, and mean dictation scores. There was no significant difference in dictation scores before and after interventions and also between the study groups. The improvement in school dictation scores had no significant correlation with age, gender, Ritalin use, owning a computer at home and past history of computer work, baseline dictation scores, Ritalin dose, educational status, IQ, and the total score of parent’s and teacher’s Conners’ rating scale. Absence of significant improvement in dictation scores in study groups may be due to the confounding effect of other variables with known impact on dictation scores. Further studies in this field should also assess the change of attention and memory.

To report the case of a 46-year old male with major depressive disorder, who represented manic symptoms, when olanzapine was added to his treatment. A 46-year old female, with a diagnosis of treatment resistant depression was referred to the authors. He had past history of depression for more than 20 years. The symptoms were present nearly every day since 1981, without any distinct period of remission, nor any noticeable fluctuation. His irritability had been disruptive to his family all these years. His doctor had prescribed maprotiline 25 mg/day, and lorazepam, 2mg/day, in addition to fluoxetine for the last 5 months. He is also a father of two children with methylphenidateresistant and sodium valproate-responsive attention-deficit hyperactivity disorder. Considering the antidepressant effects of olanzapine and its positive effects on irritability, the authors added olanzapine, to the patient’s previous medications. After one week, he showed new problems such as talkativeness and beginning to smoke for the first time in his life, elevated mood, grandiosity about his intelligence and abilities, talkativeness, and shopping sprees. The score on the mania rating scale was 14. Fluoxetine was discontinued and sodium valproate, were prescribed. It took around 2 months to completely control the manic symptoms. In the patients with depression who show bipolar spectrum disorder features, adding mood stabilizers may be preferred to the drugs as olanzapine which could induce mania.