Iranian Journal of Psychiatry and Behavioral Sciences
Volume:4 Issue: 2, Dec 2010

Long-acting (depot) anti-psychotic injection (LAI) is an essential component of the treatment of schizophrenia. In this editorial, the journal tries to give a short account of the current ideas and practical aspects of LAI, with respect to the Iranian experience. Two categories of the Long-acting injections are discussed; mainly regarding their dosage, intervals of their injections and availabilities.

Previous suicide interventional studies are controversial in their results. The present study compared brief intervention and contact (BIC), with treatment as usual (TAU) in their influence on the repetition of suicide attempts 6-month after the index suicide attempt. Adults who had attempted suicide were assigned two groups randomly: 311 in the TAU and 321 in the BIC. The brief intervention and contact contained a brief one-hour psycho-educational session combined with follow-up contacts by phone calls or visits after discharge. We used Mann-Whitney U test, ANOVA, and Chi-Square for analysis of variables. The brief intervention and contact did not significantly reduce the repeated suicide attempts, but the patient's need to get support increased significantly (alpha value = 63.67, p<0.001) compared to the treatment as usual group. Also, the brief intervention and contact group patients tried to get support from outpatient/inpatient services, relatives, friends or by telephone contact to a significantly larger extent (alpha value = 69.2, p<0.001) compared to the treatment as usual group. brief intervention and contact seems to have an effect on the patient's attitude towards seeking support from outpatient/inpatient services, relatives and friends.Declaration of interest: This study was funded by the Department of Mental Health and Substance Abuse, World Health Organization [Multi-site Intervention Study on Suicidal Behaviors (SUPRE-MISS)]. Additional support was received from Tehran Psychiatric Institute, Mental Health Research center. Manuscript ID of WHO is CJMH-2008-0093. The SUPRE-MISS study is registered in the ANZCTR Clinical Trials Registry (ACTR Number ACTRN12607000114448)

Carpal Tunnel Syndrome (CTS) is the most frequent local neuropathy which often relapses despite treatment. This study is performed to determine the frequency of obsessive compulsive disorders in CTS as a main reason for relapse in patients referring to Electro-diagnosis clinic during year 2007. In a case control study we considered two groups of subjects: with CTS (cases) and without CTS (controls), diagnosed by electro-diagnosis (EDX) and clinical assessment. Patients with underlying diseases such as diabetes mellitus, thyroid diseases and polyneuropathy, and patients with previous history of treatment, and also, pregnant women were excluded from the study. The EDX study has been performed by a physiatrist. All patients had an interview with a psychiatrist for assessment of obsessive compulsive disorder of cleaning type. Chi square test was used for data analysis. The study was conducted on 300 patients in two equal groups of cases and controls. Two hundred and fifty one patients (83.7%) were female and forty nine patients (16.3%) were male. Age range was from 20 to 80 years old. The Frequency of obsessive compulsive disorder was 42% in cases versus 28% in controls which is statistically significant (P<0.05) and calculated odds ratio was 1.86 (95%CI=1.15-3.01). According to the significance of co morbidity between CTS and obsession, we suggest further researches for better clarifying the relationship. Perhaps contemporary treatment is useful for treatment and preventing CTS relapse and/or lowering the number of surgical treatment cases which decreases the overall treatment.

Although treatments with demonstrated efficacy exist for Obsessive-compulsive disorder (OCD); researches on the effectiveness of combined treatment versus psychotherapy or drug treatment are controversial. The aim of this study was to compare the efficacy of Metacognitive therapy (MCT), fluvoxamine and the combination of MCT with fluvoxamine treatment in treating patients with OCD. Twenty-one outpatients meeting DSM-IV-TR criteria for OCD without any other axis I and II disorder were randomly assigned to one of three treatment conditions for 10 weeks of treatment: MCT, fluvoxamine, and combined treatment group. The Yale-Brown Obsessive-compulsive scale (Y-BOCS), Beck depression inventory-II-second edition (BDI-II), and Beck anxiety inventory (BAI) were administered at pre-treatment and post-treatment. Group differences were examined using chi-square (for gender and marital status), one-way analysis of variance (ANOVAs) and one-way analysis of covariance (ANCOVAs) statistical procedures on each of the outcome measures using the SPSS-16 statistical package. Nineteen patients completed this study. All patients in MCT and combined treatment groups showed significant improvement at post-treatment. ANCOVA results showed that MCT and combined treatment lead to a more significant improvement in the severity of OCD symptoms (p<0.001), depression (p<0.001), and anxiety (p<0.001) than fluvoxamine treatment. There were no significant differences between MCT and combined therapy (all p>0.05). It seems that adding drugs to treatment does not increase the efficacy of metacognitive therapy.

This cross-sectional study was performed to give us a comprehensive view on the prevalence of cigarette smoking, alcohol consumption, psychostimulants, and cannabinoid drug abuse among teenagers and adults ranging 15 to 35 years old residing in Tehran during the first 6 months of the year 2005. Eight thousand one hundred and seventy five individuals from the 22 city councils participated in a survey from January to June 2005. In answer to the question about psychostimulant drug abuse, 89. 5% answered «No», 7% answered «Yes» and 3. 6% did not answer this question. The prevalence of cannabinoid drug abuse was 3. 8%, psychostimulant drug abuse 7. 2%, and alcohol consumption 25. 7%. Mean age in each group of substance abusers was similar to that of the whole sample and significantly higher in males. Marriage was a variable which had a significant correlation with low prevalence of drug abuse and alcohol consumption. The frequency of alcohol consumption is high in our sample (25. 7%) proceeded by psychostimulant (7. 2%) and cannabinoid drug abuse (3. 8%).

In Iran few studies have investigated the association among the dimensions of perfectionism with the academic achievement and other psychopathologies, such as depression and anxiety. This study has investigated these relationships in an Iranian school-age sample. Using multistage cluster random sampling, 793 students completed the questionnaire anonymously in the classroom in 2007. The positive and negative perfectionism scale, the Revised Children’s Manifest Anxiety Scale, the Children’s Depression Inventory, and term point average (academic achievement) were assessed. Data was analyzed with descriptive statistics and multiple linear regressions, using SPSS. Negative and positive perfectionisms were found to be positive and negative predictors, respectively, for depression (p<0.001) and anxiety (p<0.001) and conversely, negative and positive predictors for academic achievement, respectively (p<0.001). Distinguishing positive and negative aspects of perfectionism is important in understanding the implications of perfectionism on academic achievement. Our findings indicate that although we must take care of unhealthy and neurotic consequences of negative perfectionism, such as depression and anxiety, which may have negative effects on academic achievement, but positive striving for perfection can help the students to improve their academic achievement.

According to the fact that university students are role models for the whole society, this study was performed to evaluate reasons of and attitudes toward cigarette smoking among Iranian university students. This study was performed as a cross-sectional self-reported questionnaire based study among university students of Kerman city of Iran. Our questionnaire was attributed to 1750 university students who were selected randomly. Current smoking was defined as using cigarette within the last 30 days. Participants’ demographic data in addition to their reasons for and attitudes toward smoking were obtained. Frequency, distribution and factor analysis of attitude items followed by a varimax rotation was used to evaluate the attitudinal statements. From 1750 university students, who filled our questionnaire, 31% were ever smokers (51% males and 15% females) and 11% were current smokers (21.5% males and 2% females). Avoiding depression and taking pleasure were the reasons mentioned as important reasons the most frequently. Besides, the most frequently attitudinal statements were as follows:” My parents upset knowing my habit” and “Cigarette causes disease”. Furthermore, the mean score of encouraging attitudes was significantly higher among males, current smokers and those with a tendency toward cigarette smoking. This study confirmed that addressing attitudes toward smoking while developing preventive strategies against it among university students is an obvious necessity.

The purpose of this study was to evaluate the effects of life skills workshops on marital satisfaction. Eighteen female counselors, psychologists and social workers working at welfare organizations of Khozestan participated in life skills workshops. The program focused on communication skills training, assertiveness training, anger management and negative mood management. Data was gathered before the first and after the last sessions, through Golombok Rust Inventory of Marital State (GRIMS). Obtained data were tested using paired t-test. The probability level of 0.05 was accepted statistically significant. The data were analyzed using SPSS (version 17). The paired T test has shown statistically significant differences between participants’ marital satisfaction before and after workshops (p=0.001). It has also been observed that means of marital satisfaction scores have changed as 7.277 points. These interventions have a positive effect on marital satisfaction by improving life skills. This type of educational workshops may have merits as a preventive and/or intervention measure for other couples and may be a valuable and efficient resource for clinicians.

There is some evidence that chronic skin diseases like dermatitis could affect the quality of life of sufferers. In addition, patients with dermatological disorders are at greater risk to develop psychiatric morbidity. The aim of this study was to explore the quality of life in patients with chronic eczematous dermatitis. We also examined the effect of a convenient dermatologic intervention on quality of life of the participants. Fifty patients with chronic dermatitis (29 females and 21 males with mean age of 29.3 years) were recruited. Data were collected before and after six weeks of dermatological treatment using Dermatology Life Quality Index (DLQI) and a sociodemographic questionnaire. The relevant data were analyzed using paired t test. Mean base score for dermatology life quality index in our sample was 10.94, which was within low limits of averaged for their norm. Moreover, after 6 weeks of treatment, quality of life significantly improved particularly in domains of symptoms and feeling. Dermatologic diseases like chronic dermatitis influence quality of life of patients. Even a feasible dermatologic intervention could significantly improve the quality of life in people who are suffering from such disabling illnesses.

University students account for human resource of each society and will make the future of their country. Psychological disturbances such as depression and hopelessness can affect daily life and scholastic process of university students. The authors intended to determine the prevalence of depression amongst students of Shahid Sadoughi University of Medical Sciences, Yazd, Iran. Fifteen percent of the total population of students of the mentioned university [254 subjects consisted of 73 (28.7%) males and 181 (71.3%) females] were selected by stratified random sampling method. The tools of enquiry were interview and Beck Depression Inventory. The association of demographic factors such as sex, marital status, residence place, and educational characteristics like course and mean of educational scores with levels of depression were studied. Half of the students (50%) were suffering from different grades of depression; 35.4% mild, 13.4% moderate and only 1.2% were in the sever grade of depression. Mean pre-university score, National University Entrance Examination score, interest rate of the students to the selected university course, lose of friends and relatives and important events in their life were those factors which were significantly associated with depression. A considerable number of the students had depression. Specific attention to the factors which showed significant association with the presence of depression should be made.

Autism and fragile X syndrome have multiple behavioral phenotypes in common, however there has been little research into the potential role of fragile X mental retardation protein (FMRP) in autism. We sought to measure protein levels of FMRP in the lateral cerebella of subjects with autism and matched controls. We found significantly reduced levels of FMRP (p<0.0063) in subjects with autism. The loss of FMRP expression in subjects with autism may help explain behavioral deficits, presence of seizure, and reduction in GABA receptors in subjects with autism.

Catatonia is a syndrome that can be treated with electroconvulsive therapy (ECT). Hence, onset of catatonia during treatment of patients with ECT is not expected. In this manuscript, a schizoaffective disorder patient with a positive history of traumatic brain injury and no consumption of benzodiazepines is being reported, who became catatonic during ECT.

A 56-year old schizophrenic patient developed three episodes of Neuroleptic Malignant Syndrome (NMS) after age of 50. Patient was under treatment with risperidone and clozapine during the first two episodes respectively. But no antipsychotic was ever used during the 45-month period between 2nd and 3rd lethal episodes of NMS, and the patient was only treated with ECT, and promethazine as needed base. Patient used to show sub syndromal catatonia throughout this period. This might reflect a «trait vulnerability» to NMS which for full expression of the disorder need some sort of «state variable» such as a drug.