مجله روانپزشکی و روانشناسی بالینی ایران
سال نهم شماره 3 (پیاپی 35، زمستان 1382)

This report introduced a single case with the initial diagnosis of gender identity disorder. The case was a 40 year old divorced woman and a mother of two children (custody of child- ren was given to the father after the divorce). The subject had undergone 6 sex reassignment sur-geries.One month after the sex operation, the subject requested to return to her original sex in order to remarry her previous husband and retake the custody of her children as their mother once again. By the request of the Forensic Psychiatry,the patient was evaluated in Tehran Psychiatric Institute. Upon implementation of a number of psychiatric interviews and completion of a battery of psycho- logical tests, the Institute declared that any intervention which can return the case to her original condition was accepted and encouraged. The result of genotype evaluation of the case was 46 XX which is compatible with the female sex.Rorschach, MMPI, and MCMI-2 did not show any disorders, but indicated characteris- tics of dependent personality, need for dependency and attention seeking, self doubt, and a self critical attitude. Although the sex reassignment surgeries for the patients with primary diagnosis of gender identity disorder is the most effective therapeutic method, reviewing psychiatric evaluation of the case, approval of sex reassignment demands a more precise reassessment of the diagnostic criteria.

This project was to investigate the effectiveness of cognitive-behavioral therapy with emphasis on spiritualism in treatment of a 20 year old university student diagnosed with transsexual disorder. In 30 treatment sessions, once a week, methods and techniques of self-reassessment, prob- lem solving, positive attitude (individual and family), and spiritual-moral therapy was utilized. The patient’s inclination for same sex preference was reduced; the level of his participa- tion in same sex activities was increased and he refrained from pursuing the sex change surgical operation. The pre-test, post-test, and a follow up assessment indicated the effectiveness of this method in treatment of transexualism.

Present research based on cognitive- behavior theory aimed to investigate the efficacy of cognitive- behavior therapy (CBT) on perfectionism, need for approval, and affective, cognitive, and physical symptoms of depression in pain disorder patients. Using single case study design, 3 female patients afflicted with pain disorder were asse-ssed on stages at pre-test, mid- test, post-test, and one month later, as follow-up by Dysfunctional Attitudes Scale (perfectionism and need for approval subscales) and Beck Depression Inventory. CBT was more efficacious in reduction of need for approval, and affective and physical symptoms of depression. The efficacy of CBT on perfectionism and need for approval was varied in pain disorder.

Considering the high prevalence of thalassemia in Mazandaran province, this study evalu- ated the relationship between depression and major thalassemia. An anterograde cohort study was conducted on all thalassemic patients (86 girls and 79 boys) between the ages of 9 and 16 years old referred to Booali Sina Thalassemia Clinic.They were assessed by Children Depression Scale (CDS). Level of depression was higher in thalassemic patients (14%) than in the control group (5.5%), even though the average score of depression in females of control group was higher than the thalasse- mic females. The prevalence of depression is remarkable in thalassemic patients.

The aim of this study was to assess the correlation of parental loss in childhood and adole- scence with major depressive disorder in adulthood. This was a case-control and post hoc study of 64 patients diagnosed with major depressive disorder based on DSM-IV criteria.The control group was comprised of 68 patients,none diagnosed with depression. Both groups were selected from university hospitals of Tehran.19 patients in the case group (29.7%) had experienced the loss of at least one parent before the age of eighteen,whereas seven patients in the control group (10.3%) had the same experience. In another words,the prevalence of parental loss before the age of eighteen years old was significant- ly more in the group with the diagnosis of major depressive disorder than the control group (P<0.05). There is a statistically significant correlation between parental loss in childhood and adole- scence with major depressive disorder in adulthood.

The aim of this study was to compare the prevalence of minor physical anomalies in schizophrenic and physically ill patients. This was a case-control study.50 patients with the diagnosis of schizophrenia were com- pared with 50 physically ill patients on the basis of the prevalence of congenital anomalies.Selected in a three month period, the first group was comprised of patients in two psychiatric hospitals in Tehran. The physically ill patients were selected randomly from a general outpatient center during the same time in Tehran.Collection of data was completed by clinical examination,psychiatric interview, and a questionnaire. The rate of minor congenital anomalies in schizophrenic patients was higher than the control group.Total scores were 258 and 143 respectively for the schizophrenic and the control groups; the average number of anomalies was 5.5 for each schizophrenic patient and 2.6 for each partici-pant in the control group.The most anomaly sited was the mouth area (25%) in schizophrenic pa-tients and the feet (25%) in control group. The complete cohesion of auricle to the face was the most frequently identified anomaly in both groups.Except for lax and soft auricle,on the whole, anomalies were more prevalent in schizophrenic patients than non psychotic ones;the commonness of anomalies was more in males than females in both groups.The prevalence of minor physical anomalies in schizophrenic patients was more than phy-sically ill patients.

The aim of this project was to appraise the relation between pomp-time and psycho-logical states after coronary artery bypass graft (CABG). 100 CABG patients (76 males, 24 females) were assessed by Symptom Check List 90-Revised (SCL-90-R) one week after the surgery. The patients were selected through convenient sampling available during December of 1998 from four heart hospitals (Shahid Rajaee, Khatamol- Anbia, Imam Khomeini, and Dr. Shariati). The relation between psychological states and duration of pomp-time were evaluated by t-test and simple analysis of variance. There was a significant relation between the length of time connected to the pomp with both the GSI average of SCL-90-R and dimensions of depression, anxiety, and somatic complains. Pomp-time may have an impact on psychological states of patients after CABG.

This project appraised behavioral patterns of children and mental health of parents in polygamous families. 65 polygamous and 65 monogamous families from Saravan rural community were matched on factors such as having student child and place of residence.402 children in primary and guidance schools were evaluated by Rutter’s Questionnaire-Teacher Form and 325 of their parents were ass- essed by General Health Questionnaire (GHQ-24) and Davidian Screening Questionnaire-17. Data were processed by analysis of variance. No significant difference was found in Rutter Questionnaire between the two groups on none of the variables of family type, sex, age, age of father, and number of children in the family. Comparison of GHQ-24 outcomes for both types of families showed that mental health of women in polygamous families was significantly worse than their own husbands and also that of the wives and husbands in the monogamous families. There was no significant difference in mental health of men in polygamous families, and men and women in monogamous families. Mental health of women in polygamous families is poorer than mental health of women in monogamous families.

This project aimed to evaluate the correlation between mothers’ mental stress during pregnancy with birth effects. The subjects were 100 mothers (pregnant women from the city of Isfahan) and their newborns selected through random cluster multistage sampling.The correlation of the mothers’ mental stress during pregnancy was assessed with the newborns’ weight and height,Apgar scores at one and five minutes, size of the babies’ head circumferences, and the length of pregnancy obtained by Mater-nal Stress During Pregnancy and its Resources Questionnaire. Data related to birth effects were collected by Apgar Rating Scale and medical records of the mothers and their newborns. Multivari- ate analysis of variance (MANOVA) and Pearson correlation coefficient were used for statistical ana- lysis of data. There is a significant correlation between mothers’ mental stress during pregnancy with newborns’ weight and height,Apgar’s score at one minute, size of the babies’ head circumferences, and the length of pregnancy.No significant correlation was obtained between mothers’ mental stress during pregnancy with Apgar’s score at five minute. Mothers’ mental stress during pregnancy is correlated with birth effects.

This project assessed mental status of geriatric patients with chronic locomotor diseases and compared it with that of the control group. The experimental group comprised 60 geriatric outpatient clients (49 women and 11 men) afflicted with chronic locomotor diseases.They had been referred to Rehabilitation Outpatient Cli- nic of Shahid Faghihi Hospital in the city of Shiraz.Patients suspected of brain organic syndromes were removed from the study. Matched with the experimental group,the control group was com-posed of 60 normal geriatrics with no chronic locomotor diseases. SCL-90-R was used to evaluate the two groups. SCL-90-R showed that the experimental group scored the highest in the following dimensions: Somatization, Paranoia, Depression, and Anxiety. There were significant differences across most scales between the experimental and control groups. Furthermore, the women’s scores in most scales were higher than the men’s. The outcome also indicated that there was not a significant difference across any of the scales throughout final decades of life. Health and mental status of geriatric patients with chronic locomotor diseases is poorer than that of the geriatrics with no such diseases.Psychological difficulties of women under study were more than the men. In view of the results of this project, it stands to reason that mental condition of these patients is considered in the formulation of treatment or rehabilitation services.