مجله روانپزشکی و روانشناسی بالینی ایران
سال بیستم شماره 1 (پیاپی 76، بهار 1393)

The purpose of this paper was to systematically review current researches about self-harm and suicide attempt in adolescents. Keywords of “suicide attempt”, “nonsuicidal self-injury” (NSSI), “self-harm”, and “deliberate self-harm” (DSH) were searched through PsycINFO and PubMed. The SID and Mental Health Research Network (MHRN) databases were also searched for domestic resources. Of 120 collected English articles, and after eliminating the irrelevants, 30 articles were selected based on the study design, the sampling methods, and the goals of the study. The Persian articles were studied separately. Suicide attempt could be predicted by severity of self-harm. There exists many common risk factors for self-harm and suicide attempt. Symptoms of depression, the frequency of posttraumatic stress disorder and borderline personality disorder in adolescents with history of suicide attempt are greater than that of adolescents with history of self-harm. Difficulties in regulating emotions and red uction of fear of death which are gained through repetition of self-harm were two factors explained relationship between self-harm and suicide attempt. It seems that the difference between self-harm and suicide attempt is quantitative, but reasons for self-harm was differ from suicide attempt.

Severe and nonepisodic irritabilities are prevalent in 3.3% of children and needs intensive clinical care. Diagnostic and Statistical Manual of Mental Disorders (DSM) lacks any guidance on their diagnosis and this has led to controversies among clinicians in their diagnosis and treatment. Workgroups of DSM-5 have tried to remove this paucity. Data were collected through review of the literature appeared until the end of 2012 by searching in relevant English and Persian databases. Of retrieved materials, 66 studies including systematic reviews, meta-analyses, original articles and case reports were extracted. Full-texts of 46 studies and inevitably 20 abstracts were reviewed. The quality of studies were checked separately and qualified ones were reviewed. There has been controversies among professionals about significance of irritability in diagnosing psychiatric disorders in children and adolescents. The dominant clinical school in past decade, formulated severe and nonepisodic irritabilities as being characteristic of bipolar disorder in children. Studies suggest that the diagnostic value of irritability depends on its severity and being episodic or nonepisodic. It seems that irritability can have diagnostic and predictive value for bipolar disorder, only if being severe and episodic. In DSM-5, this condition is called Disruptive Mood Dysregulation Disorder (DMDD) and its criteria is established. It is important that children suffering severe nonepisodic irritabilities have a home in DSM-5 to eliminate clinicians’ confusion, while facilitating precise research for classifying them accurately according to diagnosis and treatment.

The aim of this study was to examine the effectiveness of rivastigmine on reducing tardive dyskinesia (TD) symptoms in patients with schizophrenia receiving antipsychotic treatment. Forty male patients with schizophrenia and tardive dyskinesia symptoms [based on the Diagnostic and Statistical Manual of Mental Disorders, 4th. ed., Text Revision (DSM- IV-TR) criteria] hospitalized in Razi Psychiatric Hospital with a stable mental status within a month prior to the study were selected using convenience sampling. The subjects were randomly divided into two groups each with 20 individuals; one group received placebo and the other rivastigmine. At the beginning of the study and after eight weeks, severity of symptoms of TD was assessed by Abnormal Involuntary Movement Scale (AIMS). Data analysis was done by analysis of covariance. There were significant difference between posttest mean scores of the two groups (p<0.05). Rivastigmine is effective in reducing TD symptoms in patients with schizophrenia.

The goal of the current 3-year follow-up study was to investigate characteristics, course and clinical outcomes of a group of patients with first episode psychosis admitted to Roozbeh Hospital during 2007-2009. Patients admitted to Roozbeh Hospital with a first presentation of any psychotic symptoms were included. At admission, the patients were assessed with regard to severity of symptoms, global functioning and quality of life. For data collection, the Positive and Negative Symptoms Scale (PANSS), Global Assessment of Functioning (GAF), and World Health Organization Quality of Life Scale-Brief (WHOQoL-BREF) were used. These assessments were repeated at the time of discharge, and on six, 12, and 24 months as well as three to four years after discharge. Readmissions in the follow-up period were also recorded. The data were analyzed using repeated measure analysis of variance and paired t-test. Of 104 recruited patients, 59 (56.7%) were male. Their mean age (±SD) was 30.6 years (±9.7). Based on discharge diagnoses, 48 individuals had bipolar I disorder (with psychotic features), 22 patients had schizophrenia, seven cases had major depressive disorder (with psychotic features), and the remaining 27 were diagnosed with other psychotic disorders. Patients’ global functioning, and positive, negative and general psychotic symptoms were improved noticeably during follow-up. Nonetheless, the improvement was apparent at solely the time of discharge and none of these measures changed between discharge and follow-up intervals. The patients’ quality of life showed no changes during any of these intervals. Of those with available data, the rate of readmission was 41.1%. A significant proportion of the patients experienced relapse leading to rehopitalization during the first three years after the index hospitalization. This finding along with the lack of improvement of functioning and quality of life during the follow-up period underlines the importance of providing effective interventions for relapse prevention and rehabilitation

The present study was conducted as a part of a broader study on gender roles in patients with gender identity disorder (GID), and its goal was to determine patients’ sexual orientation comparing to healthy controls. In current cross-sectional study, 12 males and 27 females with GID were compared with 81 male and 89 female controls. The participants’ gender orientation and gender self-identity were investigated via asking two questions. Data analysis was carried out using t-test, analysis of variance, chi-square, and kappa statistic. In the male-to-female GID patients, one participant was sexually attracted to females and the rest (91.7 percent) to males. In the female-to-male GID patients, the frequency of sexual orientation to females and males were 96.3 percent and 3.7 percent, respectively. The frequency of heterosexuality in male and female controls was 93.8 percent and 69.7 percent, respectively. The frequency of individuals with GID who sexually attracted to the same-sex showed no statistically significant difference between males and females (p>0.05), though a substantial concordance was observed between these patients’ biological sex and sexual orientations (κ=0.653, SE=0.164, p<0.001). In Iranian patients with GID, a substantial concordance was observed between biological sex and sexual orientation.

The aim of this study was to pilot implementation of the code of conduct for the children and adolescents in a child and adolescent psychiatric center. The present quasi-experimental and prospective study was carried out in child psychiatric ward and clinic of Imam Hossien Hospital, Tehran, Iran, in two six-month phases. The first phase included the research executive-educational strategy and during the second phase the code of conduct for the children and adolescents was implemented in the psychiatric ward and clinic. The subjects were parents of children referred to child psychiatry clinic and ward. The used questionnaire was extracted from the code of conduct for the children/ adolescents and completed by the parents. Pretest questionnaires were filled out in the first phase and prior to any intervention, and posttest questionnaires after pilot implementation of the guideline. The number of pretest (and posttest) subjects in the ward and clinic were 33 (24) and 60 (56), respectively. The data was analyzed using Chi-square and dependent and independent t-tests. There was significant difference between pretest and posttest scores of the subjects referred to psychiatric ward in receiving instructive and informative booklets (p<0.001), but there was no change in the level of satisfaction for the physical conditions and facilities of the ward. In the clinic, the level of satisfaction of clients with the staffs communication behavior (p<0.01), and with the clinic conditions and facilities (p<0.001) increased in the posttest compared to the pretest. Some simple changes such as improving the physical conditions and facilities, and information services could increase the clients’ satisfaction. Nonetheless, changes like modifying the staff behavior, and their interaction and communication with the clients require more time, training, practice, and rehearsal.

The purpose of this study was to investigate the risk and protective factors of youth addiction susceptibility. From target population-associate’s degree and undergraduate male and female students from Islamic Azad University branches in West Azerbaijan province aged 18 to 41 years- 592 students were chosen using cluster random sampling method from Islamic Azad University branches in Uremia, Khoy, Mako, Mahabad and Bokan based on sex, course of study, and academic grade. Data was gathered through Addiction Susceptibility Questionnaire-Student Version (ASQ-SV) and analyzed using one way analysis of variance and path analysis. The addiction susceptibility in male students was more than the females’, single more than the married, higher academic grades more than the lower grades, regular and sporadic users more than non-users of cigarettes, and the same in different educational groups. Mother employment with increasing the student's academic achievement indirectly decreased their addiction susceptibility, but directly was ineffective to the increase and decrease of student academic status and addiction susceptibility. The number of friends did not affect the increase and decrease of academic achievement, but directly and indirectly increased their addiction susceptibility with increasing the unfavorable academic status. The academic achievement, favorable academic status, few friends, nonsmoking and employed mothers were considered as protective factors; and being male, single, academic drop, unfavorable academic status, the number of friends, and regular or sporadic smoking as the risk factors for addiction susceptibility.

The purpose of this research was to investigate the psychometric characteristics of the Rowland Universal Dementia Assessment Scale (RUDAS) in a sample of Iranian elderly population. Using convenience sampling, 500 elderly individuals were selected from two senior centers including Kahrizak Geriatric Nursing Home (n=305) and Jahan-Didegan Elderly Charity Foundation (n=195). Then, 61 other individuals were investigated for test–retest reliability evaluation. In addition to the RUDAS, data were collected through Mini Mental State Examination (MMSE), the Informant Questionnaire on Cognitive Decline in the Elderly (IQCODE), Generic Depressed Scale (GDS), and European Quality of Life 5 Dimensions (EuroQul-5D). Data were analyzed was by Pearson correlation and exploratory and confirmatory factor analysis methods. The findings indicates a signification correlation between the RUDAS and other scales (p0.001), and thus its appropriate convergent and discriminate validity. The 2-week test-retest reliability and Cronbach’s alpha for RUDAS were 0.88 and 0.77, respectively. The cut-off point, specificity and sensitivity were 20, 0.79, and 0.86, respectively. On the other hand, RUDAS factor analysis depicted its saturation for one factor. The RUDAS possess suitable psychometric characteristics to be used among Iranian elderly population.

History of Psychiatry and Psychology