مجله روانپزشکی و روانشناسی بالینی ایران
سال نوزدهم شماره 1 (پیاپی 72، بهار 1392)

The current study aimed to provide a systematic review of studies conducted between 1998 and 2008 on the primary healthcare program (PHC) in Iran. Electronic and manual search of a number of internal and external databases and resources (including Pubmed، IranDoc، SID، IranPsych، Embase، PsycINFO، and Iranmedex) were conducted as well as interviews with professionals in the sector. In total، of the 156 research abstracts that were obtained، 26 reports and research programs relating to the subject of integration of mental health care in PHC in Iran were selected. Studies suggest that، in its 20-year gradual expansion، the integrated program has covered 54. 6% of the country’s population (specifically 95. 2% of rural and 36. 6% of urban population). Moreover، the total number of case findings by health workers increased from 4. 3 to 14. 7 persons in every thousand of the population. Nine assessments conducted to examine knowledge and attitudes of health workers and individuals in the community towards mental health indicated positive improvements in these factors. The integration of mental health care in PHC program has been successful in smaller cities and rural areas، but it has not been responsive to populations of large metropolitan cities in Iran. Therefore، there is an urgent need to revise this program.

The objective of this study was to determine the effects of dietary magnesium supplementation on mental health in elderly individuals with insomnia. A double-blind randomized clinical trial was conducted on 46 elderly subjects with insomnia randomly allocated to the magnesium or placebo (control) group. The groups received either 500 mg elemental magnesium or placebo، respectively، daily for eight weeks. General Health Questionnaire-28 (GHQ-28) and Insomnia Severity Index (ISI) were conducted at baseline and at the end of the intervention period. Serum magnesium and cortisol levels were also determined in the participants. In addition، information was obtained on anthropometric confounding factors and daily intake of magnesium، calcium، potassium and caffeine using the 24-hour Recall Questionnaire. The “Nutritionist 4” software was used for nutritional analysis. Statistical analysis was done using paired t-test to compare within-groups differences and Student''s t-test to compare between-groups differences. No significant differences were observed in the assessed variables between groups at baseline. Compared to the placebo group، dietary magnesium supplementation in the experimental group brought about statistically significant decreases in total GHQ-28 score (p=0. 01)، somatic symptoms (p=0. 04)، anxiety/insomnia symptoms (p=0. 02)، depression symptoms (p=0. 001)، Insomnia Severity Index (p=0. 006)، and serum cortisol concentration (p=0. 008). Magnesium supplementation can affect some indices of mental health and insomnia and may hence result in improvements in general mental health in elderly people with insomnia.

The aim of this study was to investigate the prevalence of nonmedical use of methylphenidate and the attitude toward this use in residents of clinical specialties of Tehran University of Medical Sciences. Two hundred and forty residents of clinical specialties (88 women) were selected using convenient sampling from Rasul Akram and Firouzgar Hospitals. The sample responded to a modified version of the Alcohol، Smoking and Substance Involvement Screening Test (ASSIST)، as well as a questionnaire of attitude toward methylphenidate use. The data were analyzed by descriptive statistics and chi square test. The lifetime، one year، and one month prevalence of methylphenidate use in the sample was 48%، 23%، and 6. 6%، respectively. The prevalence was significantly higher in men than in women (2=13. 16; p<0. 01). The main reason for the use of methylphenidate was getting prepared for the residency exam. Twenty percent of the residents had a positive and 40% had a negative attitude toward methylphenidate use. Nonmedical use of methylphenidate is high among residents of different specialties and many of them did not have a negative attitude toward nonmedical use of methylphenidate.

the current study aimed to investigate self-esteem and attitude toward body appearance before and after cosmetic rhinoplasty surgery. In this pretest-posttest semi-experimental design، simple accidental sampling method was used in all patients referred for rhinoplasty surgery at the Amir Alam hospital and also at a private clinic in Tehran during the second half of 2010. Patients included in the study were those who had sought rhinoplasty surgery for cosmetic (not medical/reconstructive) reasons. 40 participants completed demographic questionnaires، and the Cooper-Smith self-esteem and Appearance Schema Inventories. There were no differences in mean self-esteem scores before and after surgery. However، there was a significant difference in mean bodily appearance scores pre versus post surgery (t=3. 01، df=39، p<. 05) and gender did not influence this difference. Cosmetic Rhinoplasty surgery plays a role in improving psychological attitude toward bodily appearance and it seems that psychological factors play an important role both in seeking cosmetic rhinoplasty and in its outcome. Hence consideration of psychological factors prior to cosmetic rhinoplastic surgery is crucial.

The objective of this research was to study the relationship between autistic-like and schizotypal traits. One hundred and eighty four students from Rey city، aged 16-19 were selected by cluster random sampling. They completed the Autism Quotient-Persian version (AQ) and the Schizotypal Personality Questionnaire (SPQ). The data was analyzed using Pearson’s correlation coefficient and Structural Equation Modelling (SEM). Analysis found a correlation between the overall AQ and SPQ scores and also between their subscales. SEM results indicated that there is a strong structural relationship between schizotypal traits and autistic-like traits (r=0. 91، p<0. 05) and that negative schizotypy (r=0. 91) and the “communication” subscale from the AQ (r=0. 61) played a central role in this relationship in comparison to other subscales. Thus autistic-like traits and schizotypal traits overlapped on interpersonal and communication dimensions. Disorganized schizotypy was also positively correlated with the “communication” subscale from the AQ. Autistic-like traits showed a strong structural correlation with schizotypal traits. It was also positively correlated with positive schizotypy، negative schizotypy and disorganized schizotypy. Given the considerable similarities in the symptoms of these two spectra، especially in the interpersonal domain، it is recommended that more specific and accurate criteria be considered for diagnostic distinction between the two disorders.

The current study aimed to design and assess an inventory for the level of knowledge of and attitudes toward domestic violence against women. This study was conducted in two stages. Initially we drafted an inventory based on experts opinion، then validated it based on comments from ten experts. We then piloted the inventory in a sample of 30 married women in Tehran، using Cronbach’s alpha to measure reliability. In the second stage of the study، the inventory was used in a sample of 615 married women from 22 districts in Tehran (15 samples in each cluster from 42 neighborhoods in the 22 districts in Tehran)، and finally factor analysis was conducted to examine the statistical determinants in the inventory. The mean (±SE) age and marriage duration in the sample were 42. 6 (±0. 9) and 22 (±0. 8) years، respectively. 42. 3 percent were educated at diploma level and 22. 4% had higher levels of education. 82. 4 percent were unemployed/housewives and 96. 1% were in their first marriage. With respect to ‘knowledge’، five factors relating to violence were determined; the overall mean score for ‘correct’ knowledge obtained by the study participants was 51%. Specifically، participants had the greatest knowledge about the consequences and preventability of violence، and the least amount firstly about its epidemiology and secondly about its consequences on offspring (in particular on female offspring). Reliability levels for the ‘knowledge’ and the ‘attitude’ sections of the inventory were 0. 769 and 0. 64، respectively. The developed inventory showed acceptable validity and reliability in Iranian women. Research on different aspects of knowledge about domestic violence، especially consequences on daughters، is required for appropriate interventions.

The purpose of the present study was to determine whether kata training leads to reductions of stereotypic behaviors in Asperger syndrome. In this single-subject study، three boys with Asperger syndrome were required to exercise Heian Shodan kata for 12 weeks. Changes in the severity of stereotypy was assessed at one-week intervals during the experimental phase and one month after termination of the intervention using multiple baseline method. The Gilliam Autism Rating Scale-Second Edition (GARE-SE) was used to measure stereotypic behaviors. Analysis of within and between subject effects was done using diagrams for stability envelope and data trending. Training in Heian Shodan Karate decreased stereotypy in all three participants [Percentage of Non-overlapping Data (PND) =83. 33% for first and second participants، PND=91. 67% for the third participant] and this reduction was maintained one month after termination of the intervention. Long-term kata training resulted in reductions of stereotypic behaviors in three boys with Asperger Syndrome. However، research with larger sample sizes is required to examine the effectiveness of this intervention and improve confidence in the current findings.

The aim of the study was to investigate factor structure of the Persian version of the Postpartum Stress Scale (PSS). From accessible population and using a purposive sampling method، the current correlational study screened 142 people from all postpartum women at Zeinabiye State Maternity Hospital and gynecology and obstetrical departments in some non-state run hospitals (including Ordibehesht، Farahmandfar، Shafa، and Pars) in Shiraz during 1389 (2010-2011). Having no history of mental and physical disorders was considered as sample inclusion criteria. Data collection was based on Postpartum Stress Scale (PSS)، Rosenberg Self-Esteem Scale (RSES)، Multidimensional Scale of Perceived Social Support (MSPSS)، and Beck Depression Inventory-II (BDI-II). Data analysis was performed using Pearson correlation coefficients and exploratory factor analysis (EFA). Factor structure analysis by Varimax rotation method revealed two factors including “concerns about maternal role attainment and negative body changes”، and “concerns about lack of social support” accounted for 48. 98% of the scale variance. Internal consistency for the whole scale and the extracted two factors depicted the high reliability of the scale. Divergent validity coefficients were confirmed using MSPSS and RSES and convergent validity coefficients using BDI. The results supported the validity and reliability of the PSS with regard to testing and conceptualizing postpartum stress of Iranian citizen women.