Iranian Journal of Psychiatry
Volume:4 Issue: 2, Spring 2009

The physician-patient relationship has been undergoing significant changes in recent decades in Western countries. Taking a client-centered approach, society has given more autonomy and freedom to patients. The patient is regarded as a consumer who is looking for the best and most scientific approach and is free to choose among different methods of treatment. The role of the physician is only a guiding role. On the other hand, in Eastern countries, we still experience a parent-child relationship in the therapeutic setting. Eastern patients expect direct advice from their physicians and the family has an important role in decision-making. An approach which is considered coercive in Western countries could still be a useful and acceptable one in Eastern culture. The main goal of the authors in this paper is comparison of different attitudes toward this issue in Eastern and Western cultures.

The aim of this research was to compare the characteristics of assertiveness, locus of control and general health among the following three groups of Iranians: The first group included drug addicts who had volunteered for treatment and had registered in the local Welfare Organization; the second group included addicts who were in the prison; and the third group held non-addicts. All the participants were male and were matched for age and educational level.The following instruments were used in the present study: locus of control Questionnaire (Strikland, 1973), Assertiveness Scale (Shrink, 1980) and the General Health Questionnaire, GHQ (Goldberg, 1979).The results of the present research showed that there were significant differences among the three groups in assertiveness, locus of control and GHQ scores. It was found that participants in the non addictive group were more assertive and more internal in their locus of control and had higher GHQ scores than the other two groups. The participants in the prison group reported less assertiveness and lower GHQ scores than the non addictive group; and their locus of control was more external. The results are discussed in terms of possible strategies for changing an attributive style in young adults in the framework of psychotherapy.

Few study have examined the relationship between childhood maltreatment and personality disorder in later life especially in Eastern Mediterranean countries. The study was conducted to explore the relationship between adverse childhood experiences and personality disorder during Later life in an Iranian sample. a cross - sectional study was conducted in kerman, a city Located in East sourthern of Iran in 2005. Cases were 148 substance - dependent women admitted in shahid Beheshti hospital and also kerman women prison for detoxification.With emphasizing the confidentiality and obtaining oral consent the subjects were asked to fill out a questionnaire including demographic variables and 27 questions concerning all types of abuse, neglect and household dysfunction. using multivariate Logistic regression the associations between baseline characteristics, childhood maltreatment and household dysfunction variables and personality disorder were analyzed. The mean age of cases was 33.13 ± 10.94 and Borderline personality disorder (24.3%) was the most frequent type of personality disorder in this sample. Physical abuse (45.4%) and emotional abuse (36.2%) and emotional neglect (92.1%) were the most frequent type of maltreatment. while dependency considered as independent variable, with logistic regression analysis, sexual abuse was the only type of childhood maltreatment which showed significant association statistically with personality disorder. (P - value < 0/05) There was significant association statistically between increased prevalence of severe personality disturbances among those experiencing multiple types of abuse and neglect. such studies are important for a more complete understanding of these problems and for practical efforts to alleviate them.

Endocannabinoid produce analgesia that is comparable which of opioids. The mechanism of antinociceptive effects of (∆) - 9 tetrahydrocannabinol (THC) is suggested to be through cyclooxygenase (COX) pathway. In the present work, the effect of two extreme dose ranges of celecoxib (mg/kg and ng/kg), a cyclooxygenase-2 (COX-2) antagonist, on arachidonylcyclopropylamide (ACPA, a selective CB1 agonist) induced antinociception in mice was examined. We have investigated the interaction between celecoxib, at the doses of mg/kg (50, 100, 200 and 400 i.p.) and ultra low dose (ULD) (25 and 50 ng/kg, i.p.), on the antinociceptive effect of intracerebroventricular (i.c.v.) administration of ACPA (0.004, 0.0625 and 1 μg/mice), using formalin test in mice. I.C.V. administration of ACPA induced antinociception. Intraperitoneal administration of celecoxib (mg/kg) and its ULD (ng/kg) attenuated and potentiated, ACPA antinociceptive effects, respectively. It is concluded that the mg/kg doses of COX-2 antagonist showed opposite effects compare to the ultra-low dose of the drug.

Premenstrual syndrome (PMS) is a common disorder with prevalence about 30%, which its concurrence with psychiatric symptoms will change it to a disabling condition that is resistant to usual treatment. this study was enrolled to assess the co-morbidity of PMS and psychiatric disorders, in a sample of girls with PMS compared to those without PMS. This study was conducted through cross sectional method with 362 participants (166 with PMS and 196 healthy girls) who were selected randomly and completed the demographic questionnaire, premenstrual syndrome symptom daily record scale and the symptom checklist 90-revised (SCL-90-R).According to the result of independent t test, the mean of all psychiatric symptoms score in PMS group was significantly higher than healthy group (P<0.001). According to SCL-90-R measurement, most of participants in PMS group were categorized as extremely sick for somatization (44%) and as sick for obsessive-compulsive (59%), depression (58.4%), anxiety (64.5%), hostility (47%), and psychoticism (69.3%). In interpersonal sensitivity (44.6%) and paranoid (42.8%), most of participants were diagnosed as having borderline severity of disorders. Only in phobic anxiety most of respondents with PMS (46.4%), were diagnosed as healthy.There is a considerable relationship between PMS and different psychiatric symptoms that can complicate the diagnosis of PMS and its treatment for health care provider. Then all health care providers who are in contact with women in reproductive age should be sensitive to mental health status in women with PMS.

This research has been done according to the cognitive-behavioural theories and biochemical model in order to evaluate the efficiency of Group Cognitive-Behaviour Therapy in combination with Pharmacotherapy on Mania and Depression Symptoms and Awareness of warming signs of relapse in patients with Bipolar Disorder.Methods and Materials: In this study with the experimental pretest- posttest- follow up plan, 30 women suffering from bipolar disorder, randomly assigned to receive either the group cognitive-behaviour therapy (experimental group, n=15) or usal treatment (control group, n=15);and were follow-up for a six months. patients in both groups were prescribed standard Pharmacotherapy. First all subjects were put to a pretest in equal conditions with measures of scale 2 and 9 of MMPI Test, and warming signs checklist. Then the experimental group received group cognitive-behaviour therapy for 8 sessions in addition to their medication therapy. The control group only received medicine. At the end of the experiment, all subjects were tested under equal conditions. After completion of the treatment process, the subjects of both groups were supervised for 6 months. The findings of the study were analyzed by the statistical method of Multi-variable analysis of variance with repetitive measurements. The findings showed that the group cognitive-behaviour therapy had been significantly more efficient in reduction of mania symptoms{p=0/03} and increment of awareness of warming signs of relapse {p=0/00} in comparison with control group; but there is no significantly differences in depression symptoms between two groups. The findings of this study suggest the beneficial effect of Group cognitive-behaviour therapy in reducing of mania symptoms and increment of awareness of warming signs of relapse. Therefore, it can be used as a complementary treatment by clinicians.

The relationship between suicidal attempt and opioid use disorder in patients with bipolar disorder (BD) is unknown. This study aimed at shedding some light on this issue.178 inpatients aged 18-65 with BD type I with or without opioid use disorders were face-to-face interviewed through the Persian Structured Clinical Interview for DSM-IV axis I disorders (SCID-I), the Global Assessment of Functioning (GAF) scale, and a questionnaire including demographic and some clinical factors.Gender was the only demographic factor with a statistical significant difference between suicidal and non-suicidal bipolar patients. Also, comorbidity with anxiety disorders and the type of index and current mood episodes were significantly different between the two groups (p<0.05). But after using a logistic regression analysis, the only statistical significant different factors (p<0.05) between the two groups were gender, comorbidity with anxiety disorders, and GAF. Opioid dependence comorbidity can not be considered as a risk factor for suicidal attempt in patients with BD.

Post traumatic stress disorder (PTSD) may be the first reaction after disasters. Many studies have shown the efficacy of cognitive– behavioral therapy in treatment of post traumatic stress disorder. The main objective of this study is to evaluate the effect of group CBT in adolescent survivors of a large scale disaster (Bam earthquake). In a controlled trial, we evaluated the efficacy of a short term method of group cognitive-behavioral therapy in adolescent survivors of Bam earthquake who had PTSD symptoms and compared it with a control group. The adolescents who had severe PTSD or other psychiatric disorders that needed pharmacological interventions were excluded. We evaluated PTSD symptoms using Post traumatic Stress Scale (PSS) pre and post intervention and compared them with a control group. 100 adolescents were included in the study and 15 were excluded during the intervention. The mean age of the participants was 14.6±2.1 years. The mean score of total PTSD symptoms and the symptoms of avoidance was reduced after interventions, and was statistically significant. The mean change of re-experience and hyper arousal symptoms of PTSD were not significant. Psychological debriefing and group cognitive behavioral therapy may be effective in reducing some of the PTSD symptoms.