Iranian Journal of Psychiatry
Volume:8 Issue: 4, Autumn 2013

The aim of the present study was to investigate the epidemiology of psychological problems in adolescents in five provinces of Tehran, Khorasan Razavi, Isfahan, East Azerbaijan and Fars in Iran. In the present cross-sectional and descriptive – analytical study, 5171 adolescents aged 12 to 17 years were selected through multistage cluster sampling method from Tehran, Isfahan, Fars, Khorasan Razavi and East Azarbaijan provinces. The self-report form of Strengths and Difficulties Questionnaire (SDQ) was used to obtain the demographic data of each adolescent. Descriptive analysis and 95% confidence interval were used to investigate the relationship between scores of the SDQ questionnaire and demographic factors. Based on the results, the highest prevalence of psychological problems in the five provinces was related to conduct problems (24%), and the lowest prevalence was related to social problems (5.76%). Also, comparison of 95% confidence interval of prevalence of psychological problems between the two genders suggested a significant difference only in emotional problems of the self-report version of the SDQ between the two genders. The result revealed no significant difference in the psychological problems of the self-report version of the SDQ between the two age’s groups and between the middle and high school graduates (p≤0.05). Among the 5 provinces, Fars allocated the highest rates of conduct problems (28.4), hyperactivity problems (21.5%) and overall criterion problems (17.3%); Esfahan had the highest rates of emotional problems (9.1%) and problems with peers (8.1%); and Khorasan Razavi had the highest rates of social problems (7.6%). In this study, the highest prevalence of psychological problems in the five provinces was related to conduct problems, and the lowest prevalence was related to social problems. It was determined that girls have more emotional problems than boys. Also, no significant difference was found in the psychological problems of 12 to 14 and 15 to 17 year old adolescents or between middle and high school graduates. In the current study, the prevalence of psychological problems in adolescents in the urban population in Fars province was higher than expected.

Based on Pittsburg Sleep Quality Index, it has been reported that most human immunodeficiency virus (HIV) positive patients suffer from various degrees of sleep problems. Sleep disorders can affect quality of life, physical and social functioning and can also cause chronic fatigue. Some psychological and physiological factors are related to sleep quality. The purpose of the present study was to evaluate sleep quality and its related psychological and physiological factors in Iranian human immunodeficiency virus positive patients who were candidates for initiation of antiretroviral therapy. This was a cross- sectional study of 59 HIV positive out-patients in stages 2 or 3 of HIV disease who were candidates for initiation of antiretroviral therapy. Pittsburg Sleep Quality Index (PSQI), Hamilton Depression Rating Scale (HDRS), Hamilton Anxiety Rating Scale (HARS) and Somatization Subscale of Symptom Checklist 90 (SCL-90) were used to assess the patients’ sleep quality, depression, anxiety and physiological factors, respectively. SPSS software version 12 was used for data analysis. The Pearson correlation coefficient was utilized to analyze the correlation between PSQI and other quantitative variables. Based on the sleep quality assessment, 47.5 % of the patients had PSQI > 5 that was defined as sleep disturbances. A significant correlation was found between sleep quality and HDRS (r = 0.531, p = 0.0001), HARS (r = 0.627, p = 0.0001) and somatization subscale of SCL-90 (r = 0.36, p = 0.05). This study showed that human immunodeficiency virus positive individuals suffer from sleep disorders at least as same as the general population, and that psychological variables including depression and anxiety and physiological variables including physical morbidities in different systems of the body lead to sleep disturbance in this population.

Nursing is one of the stressful jobs that affect nurse''s well-being. The aim of this study was to assess the relationship between spiritual intelligence, hardiness and well-being among Iranian nurses. Samples of this cross- sectional study selected by Randomized stratified sampling, 125 nurses who have been working in different wards of Bushehr university hospitals. Data were collected using spiritual intelligence, hardiness, well-being and demographic characteristics questionnaires. Correlation, t-test, ANOVA, Tukey and regression analysis were applied. The results revealed a significant relationship between spiritual intelligence and hardiness, spiritual intelligence and well-being, Hardiness and well-being. It also showed that among the demographic characteristics (age, gender, working ward, marital status, job experiences, and education) working ward significantly correlated with spiritual intelligence. Improvement of spiritual intelligence and reinforcement of hardiness could help increase the well-being of nurses.

Sleep problems are common complaints among pregnant women. This study was designed to compare subjective sleep problems in non-pregnancy condition, healthy and preeclamptic pregnancy as a major complication of pregnancy. We hypothesized that some sleep problems are more prevalent in females with preeclampsia. In this cross-sectional study, 102 women with preeclampsia, 106 healthy pregnant women in the third trimester and 103 healthy non-pregnant women were selected through random sampling. Age and parity were matched in the three groups. We used Global sleep assessment questionnaire (GSAQ) to check the subjective sleep problems, and then we performed statistical analysis using Analysis of variance (ANOVA) and Pearson Chi-square tests. Our findings revealed significant differences in initial insomnia (p = 0.034), fragmented sleep (p = 0.022), snoring (p<0.001), non-idiopathic insomnia (p = 0.045) and sadness and anxiety (p = 0.001) between the three groups. Some sleep problems were more common in preeclampctic compared to healthy pregnant women including initial insomnia, fragmented sleep, snoring, sleep apnea and non-idiopathic insomnia. Moreover, the subjects with preeclampsia revealed more fragmented sleep, snoring, sadness and anxiety and lack of getting enough sleep due to other activities compared to non-pregnant women. Different kinds of sleep problems can occur in subjects with preeclampsia in comparison with the non-pregnant and healthy pregnant subjects. Sleep problems should be evaluated during pregnancy, particularly in pregnant women with preeclampsia, and suitable treatment should be provided for any specific sleep problem

Erectile dysfunction affects quality of life and is a common dysfunction in drug abusers. The aim of this study was to evaluate the frequency of erectile dysfunction in drug abusers on methadone maintenance therapy to reduce this drug side effect in the future studies. This cross-sectional study was conducted with two hundred addicted individuals on methadone maintenance therapy. Erectile dysfunction was surveyed using the International Index of Erectile Function (IIEF). Finally, all data were collected and analyzed by descriptive statistics such as measures of variability and central tendency and Chi-squared (χ²) test using SPSS Version 18.0 software. The amount of the total frequency of erectile dysfunction was pointed 30 or less among the two hundred patients and included the moderate and severe cases. In this study, the number of patients with erectile dysfunction was fifty three (26.5%). The frequency of erectile dysfunction in our study was approximately 1.5 times of prevalence of the public (16.1%). In this study, all the factors related to sexual function such as erectile function, libido, orgasm, and sexual pleasure showed a decline among drug abusers.

Incapability in face perception and recognition is one of the main issues in autism spectrum disorders (ASD). Event related potential (ERP) studies have revealed controversial insights on autistic brain responses to faces and objects. The current investigation examined the ERP components of young children with ASD compared to a typically developing (TD) group when looking at the upright and inverted images of faces and cars. Fourteen children and adolescents aged between 9 and 17 diagnosed as having ASD were compared with 18 age- gender matched normally developing individuals. All participants'' ERPs were recorded while they were seeing the images of human faces and objects in both upright and inverted positions. The ERP components including N170 (latency and amplitude) were compared between the two groups in two conditions of upright and inverted using the repeated measure analysis method. The processing speed for upright faces was faster than the inverted faces in the TD group; however, the difference was not significant. A significant difference was observed in terms of N170 latency between the two groups for different stimulus categories such as objects and faces(p<0.05).Moreover, inverted vs. upright stimuli in both groups elicited a greater response in terms of N170 amplitude in both groups, and this effect was significantly prominent in the right hemisphere (p<0.05). The N170 amplitude turned out to be greater for the inverted vs. upright stimuli irrespective of the stimuli type and group. These data suggest youths with ASD have difficulty processing information, particularly in face perception regardless of the stimuli orientation.

Stigma is a serious impediment to the well-being of those who experience it. Many family- caregivers are challenged by the stereotypes and prejudice that result from misconceptions about bipolar disorder. The purpose of this study was to explore the stigma experienced by family caregivers of patients with bipolar disorder. This was a qualitative and phenomenological study. In this study, we selected the family caregivers of patients with bipolar disorder in a psychiatric hospital (Iran) using purposive sampling in 2011. By reaching data saturation, the number of participant was 12. Data were gathered through in-depth interviews and analyzed by the «Collaizi» method. Stigma was a pervasive concern to almost all participants. Family caregivers of patients with Bipolar disorders reported feelings and experiences of stigma and were most affected by them. Analysis of the interviews revealed 3 themes: Negative judgment, Shame, Stigmatization and Social Isolation. For a person with bipolar disorder, this illness is associated with the following problems: worse recovery, difficulty accessing health services, receiving poor treatment and support, and difficulty gaining community acceptance. Rejection of people with mental illness might also affect their family caregivers at various levels

Some previous studies have reported that ADHD is often comorbid with anxiety disorders. The aim of the present study was to evaluate the effectiveness of reboxetine in treating outpatient children and adolescents with ADHD and comorbid anxiety disorders. In this open-label study, 25 outpatient children and adolescents, aged 6-16 years were selected by convenient sampling and underwent treatment with 4mg reboxetine for four weeks. Data were collected at baseline, two weeks and four weeks after the start of the medication using Conners'' Parent Questionnaire, Hamilton''s Rating Scale for Anxiety, Clinical Global Assessment Scale, Clinical Global Impression-Severity Scale and Side Effects Form. Data were analyzed using repeated measure, analyses of variance (ANOVA), Tukey post hoc test and paired t-test. There were significant reduction in the total score of ADHD (F = 31.441; P <0.001) at the end of the treatment compared to baseline (Table1).The differences between T0 and T2 in the subscales of attention deficit, hyperactivity and confrontation (F = 20.691; P <0.001, F = 28.810; P <0.001, and F = 17.463; P <0.001, respectively) were also significant. Findings also indicated significant differences between T0 and T1 (P<0.01) and T1 and T2 (P<0.01) in all of the subscales except for confrontation. A significant improvement was observed in the severity of ADHD and anxiety disorders during different courses of the treatment (p<0.001). No significant changes were observed in systolic and diastolic blood pressure and pulse and weight of the patients during the study. The most common complications were headache and anorexia. The short-term treatment with reboxetine was effective in improving ADHD with comorbid anxiety disorders. Therefore, reboxetine could be used as a treatment option for ADHD in those children who experience comorbid anxiety disorders or in those who are non-responsive or intolerant to methylphenidate.

Vitiligo is a rare side effect of carbamazepine whose exact mechanism is unknown. The aim of this report is to describe a single case of vitiligo induced by carbamazepine. The case was a patient with Bipolar I disorder whose medications were changed from valproate to carbamazepine and who developed vitiligo after a short while. We followed the case for about four years when he was rechallenged with carbamazepine. When depigmentation occurred, we immediately discontinued carbamazepine after which the depigmented areas improved gradually. About three years later, he received carbamazepine again, but depigmentation did not recur. Carbamazepine-induced vitiligo is not an absolute contraindication for the prescription of carbamazepine if other choices fail to respond or are not tolerated. The case has implications for the mechanism of medication induced vitiligo.