فهرست مطالب
Iranian Journal of Psychiatry and Behavioral Sciences
Volume:17 Issue: 4, Dec 2023
- تاریخ انتشار: 1402/10/09
- تعداد عناوین: 24
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Page 2Background
Treatment-resistant Depression (TRD) does not respond to conventional treatments. Despite the efforts made to control depression, the outcomes are controversial and inconclusive. New strategies such as ketamine use are accompanied by promising outcomes; however, the best dosage remains a question.
ObjectivesThe current study aimed to compare the effect of 1 and 2 mg/kg of oral ketamine in TRD subjects.
MethodsThe current randomized clinical trial was conducted on 29 patients suffering from TRD. The patients were randomly assigned into two groups of treatment with low dose (1 mg/kg; n = 17) versus high dose (2 mg/kg; n = 12) oral ketamine twice a week for six weeks. The Hamilton Depression Rating Scale (HDRS) and the Beck Depression Inventory-II (BDI-II) were applied to assess the outcomes of the interventions at baseline, within 2, 4, and 6 weeks after the interventions, and then, within a week, a month, and 2 months after the end of the intervention.
ResultsBaseline HRDS (P-value = 0.393) and BDI-II (P-value = 0.0.919) were similar in both groups. Neither HDRS (P-value = 0.97) nor BDI-II (P-value = 0.71) had a significant trend of changes when low versus high-dose ketamine uses were compared. The comparison of the frequency of ketamine-related adverse effects revealed a significantly higher incidence of drowsiness (P-value = 0.021) and lightheadedness (P-value = 0.004) in high-dose ketamine.
ConclusionsWe achieved no conclusive superiority or efficacy of 1 mg/kg over 2 mg/kg of oral ketamine; however, considering the adverse effects, a 1 mg/kg dose is preferred.
Keywords: Adverse Reactions, Depression, Drug-related Side Effects, Ketamine, Treatment-resistant Depressive Disorder -
Page 3Background
The physiological changes in postmenopausal women, especially age-related physical changes, may lead to negative experiences in body image among these women.
ObjectivesThis study aimed to determine the effectiveness of cognitive behavioral group therapy on the negative body image of postmenopausal women.
MethodsThis parallel randomized clinical trial study was conducted on 22 eligible postmenopausal women attending a health care center in Ahvaz, Iran, in 2018. They were randomly selected and assigned to intervention and control groups (n = 11 per group). The intervention group attended eight 90-minute sessions of cognitive behavioral therapy (CBT) based on the Cash 8-step model. All participants completed the body image concern inventory (BICI) and Multidimensional Body-Self Relations Questionnaire (MBSRQ) before, immediately after, and 1 month after the intervention. The chi-square test, independent t-test, and repeated measures test were used to investigate the trend of changes in BICI and MBSRQ and their domains over time in both groups. P values less than 0.05 were considered statistically significant for all tests.
ResultsBefore the intervention, there were no statistically significant differences in demographic characteristics (such as age, age of menopause, and body mass index (BMI)) between the 2 groups; also, there were no statistically significant differences in themean scores of MBSRQ and BICI between the 2 groups (P < 0.05). After the intervention, a significant increase was observed in the mean scores of MBSRQ and its 3 out of 6 domains (appearance evaluation (AE), appearance orientation (AO), and body areas satisfaction (BAS); P < 0.05), while a significant decrease was observed in the mean scores of BICI in the intervention group compared with the control group (P < 0.05).
ConclusionsCognitive behavioral group therapy based on the Cash 8-step model in postmenopausal women can promote satisfaction with their body image.
Keywords: Body Image, Cognitive Behavioral Therapy, Postmenopause, Randomized -
Page 4Background
Vitiligo is a disease of progressive and permanent skin depigmentation. This disease impacts patients’ quality of life through psychological distress, which shows itself in various ways. This distress includes shame and internal self-criticism in patients with vitiligo. Resilience can appear as the strength against distress.
ObjectivesThis research aimed to assess the impact of compassion-focused therapy (CFT) on various outcomes, including resilience, shame, internal self-criticism, and quality of life in individuals with vitiligo.
MethodsIn this study, an RCT design was employed, incorporating both pre- and post-test evaluations alongside a control group, to examine the impact of CFT on resilience, shame, internal self-criticism, and quality of life in patients with vitiligo. Forty patients with vitiligo were selected from Razi Dermatology Hospital in Tehran in 2019. The participants were randomly assigned to either a control or experimental group. The World Health Organization Quality of Life Questionnaire, Connor-Davidson Resilience Scale, levels of self-criticism scale, and Internalized Shame Scale were used to complete the pre-and post-test phases. Compassion-focused therapy based on the Gilbert therapy package was held in eight 2 h sessions once a week for the experimental group. The control group received the intervention after the end of the experimental group intervention.
ResultsThe results of the covariance analysis indicated that CFT significantly increased the quality of life (P < 0.05, F = 308.97) and resilience (P < 0.05, F = 125.75) and reduced shame (P < 0.05, F = 228.30) and internal self-criticism (P < 0.05, F = 53.44) of patients with vitiligo.
ConclusionsCompassion-focused therapy can improve the quality of life and resilience and reduce the shame and internal self-criticism of patients with vitiligo.
Keywords: Psychological, Resilience, Self-assessment, Self-compassion, Shame, Vitiligo -
Page 5Background
Family-focused therapy (FFT) has been developed to address the significant impairments in psychosocial functioning among individuals with bipolar disorder (BD).
ObjectivesThis study investigated the effectiveness of FFT combined with drug therapy in patient support in managing this disorder.
MethodsIn this randomized controlled trial, 50 patients and their caregivers were randomly divided into 2 groups: A drug therapy group that only received medication and a family therapy group that received 15 one-hour sessions of FFT with their caregivers in addition to medication. The Expressed Emotion Questionnaire (EEQ), a modified version of the standard internal label questionnaire for the mentally ill, and theWorld Health Organization Quality of Life–Brief (WHOQOL-BREF) were used in the present study. Data were analyzed using the t-test.
ResultsExpressed emotion (EE) significantly decreased in the family therapy group (P = 0.001). Also, mental health and social health were better in the family therapy group than in the drug therapy group (P = 0.001). Nevertheless, no significant change was observed in the dimensions of physical and environmental health in both groups. The results of the study were relatively stable in all measurements in follow-up, except for the stigma.
ConclusionsSignificant improvements were observed in EE and quality of life (QOL) in the family therapy group. This difference was not statistically significant in the stigma score despite the difference in the means of the 2 groups.
Keywords: Bipolar Disorder, Expressed Emotion, Family-focused Therapy, Quality of Life, Stigma -
Page 6Background
Acute psychiatric problems are increasingly observed following substance abuse in emergency departments. To address this significant societal issue, it is essential to understand its various dimensions in order to develop comprehensive control policies.
ObjectivesThis study aimed to evaluate substance use and its related factors in patients admitted to a psychiatric emergency ward in Sari, Mazandaran, Iran.
MethodsThis cross-sectional study was conducted on all patients admitted to the Emergency Department of Zare Referral Psychiatry hospital during 2011 - 2012. A checklist of demographic and psychiatric factors was completed for each patient based on their medical records. Urine rapid tests were routinely conducted in this department to screen for drug consumption. Descriptive statistics, central and dispersion indices, and the chi-square test were used to analyze the data.
ResultsA total of 578 cases, comprising 406 males (70.2%) and 172 females (29.8%), were examined. Themeanage of patients was 34.7 ± 11.2 years. The most common symptoms reported were aggression (50.5%), insomnia (11.2%), paranoia (10.7%), and self-talk (8.1%), respectively. The most frequent final clinical diagnosis was bipolar disorder in 145 cases (25.1%), followed by schizophrenia in 131 cases (22.7%), and substance-induced psychotic disorder in 63 cases (10.9%). In the substance use screeningamongpatients, the urine test was positive for morphine in 17.6% of the patients. Methamphetamine, methadone, and cannabis tests were positive in 16.1%, 9.5%, and 3.5% of cases, respectively. Among patients with positive urine tests (for methamphetamine, methadone, or morphine), the most common clinical diagnosis was substance-induced psychotic disorder, followed by schizophrenia. Schizophrenia and substance-induced psychotic disorder were the two most common diagnoses in patients with positive cannabis urine tests, respectively.
ConclusionsThe high rate of substance abuse among psychiatric emergency patients, often co-occurring with other psychiatric disorders, the significant prevalence of psychosis, and the behavioral risks associated with these patients emphasize the need for special attention to this biopsychosocial problem.
Keywords: Psychiatric Emergency Services, Substance Use, Psychiatric Disorders -
Page 7Background
According to DSM-5, sensory processing problems are among diagnostic criteria in children with autism spectrum disorder (ASD). Various studies have shown that games, as the main occupation of children, can be helpful in performing sensory interventions. Solving sensory problems isoneof themostcommondemandsof families with children withASD. Children’s families play a key role in the implementation of occupational therapeutic interventions.
ObjectivesThis randomized clinical trial investigated the effectiveness of sensory play activities performed by parents at home on the sensory patterns of children with ASD.
MethodsFifty-one children with ASD, aged 3 to 6 years, were divided into the intervention and control groups. All participants attended 16 sessions of in-person individualized sensory integration therapy (SIT) in a clinic for 8 weeks. In the intervention group, children received 8 sessions of a sensory play activity intervention performed by parents at home. Data collection instruments included the Gilliam Autism Rating Scale-2 and the sensory profile 2. Parametric (independent and paired t-test) and non-parametric (Mann-Whitney and Wilcoxon tests) were used for statistical analysis to compare between-group and within-group mean differences.
ResultsThe resultsshowedthat althoughall four sensory processing patterns improved significantly in both groups (P< 0.05) (i.e., the within-group effect), children in the intervention group showed significant improvements in three sensory patterns, including sensory avoiding, sensory sensitivity, and sensory registration (P< 0.01). There was no significant difference in the mean score of the sensory seeking pattern between the 2 groups (P > 0.05).
ConclusionsSensory integration therapy improved dysfunctional sensory processing patterns in ASD children, an effect that was enhanced by the simultaneous implementation of sensory play interventions.
Keywords: Autism Spectrum Disorder, Parents’ Engagement, Sensory Integration Therapy, Sensory Play, Sensory Processing -
Page 8Background
Autism spectrum disorder (ASD), characterized by challenges with social skills, repetitive behaviors, speech, and nonverbal communication, has greatly affected family caregivers, leading to subjective and objective care burdens on them.
ObjectivesThe aim of this study was to explain the care burden of family caregivers of children with ASD from the perspective of family caregivers.
MethodsIn this qualitative study, 14 family caregivers were purposefully selected. The data were collected using semi-structured, in-depth interviews. The coding of the data was performed using MAXQDA 10 software, and then the data were analyzed by the content analysis method.
ResultsAfter the data coding, 266 codes were obtained, which were then classified into three main categories, including context and background, health factors (physical and mental health), and social support (formal and informal support).
ConclusionsThe results of the study showed that family caregivers bear the caregiving and mental burden of taking care of their autistic children. Besides adding to our body of knowledge and understanding of the problems encountered by caregivers, this study showed that the caregiving burden can be reduced by providing social support for the caregivers of autistic children.
Keywords: Autism Spectrum Disorder, Caregiver Burden, Caregivers -
Page 9Background
Domestic violence is any act to gain authority and control over a spouse, intimate partner, girlfriend/boyfriend, or close familymember. Domestic violence against women or intimate partner violence (IPV) is prevalent in many parts of the world, ranging from 15% to 75%, depending on the definition and perception of violence.
ObjectivesThis study aimed to evaluate the effectiveness of the short-time empowerment intervention package for women with domestic violence developed at the Ministry of Health and Medical Education in Tehran.
MethodsThe method of this study was a historical cohort. The researcher-made tool consisted of 30 questions based on the materials contained in the short-time empowerment intervention package. It was provided to 200 women referred to comprehensive healthcare centers who had previously been screened for domestic violence. Of these, 100 people in the experimental group received telephone intervention from a psychologist, and 100 people in the control group received telephone intervention without receiving the intervention. They were asked questions about the tool.
ResultsThe results showed that there were no significant differences between the two groups of women with intervention and women without intervention in 5 areas of safety capabilities, recognizing high-risk situations, designing strategies to deal with high-risk situations, skills to deal with spouse anger, reduce anxiety and stress for themselves and their children (P > 0.05).
ConclusionsThe findings indicate that the short-time empowerment intervention package for women with domestic violence could not empower women to prevent the recurrence of violence and needs revision.
Keywords: Effectiveness, Empowerment, Domestic Violence -
Page 10Background
Since the beginning of 2020, the world has been grappling with a common problem, the coronavirus or COVID-19, causing a significant increase in worry, anxiety, and stress worldwide. In Iran, the rapid spread of the COVID-19 virus has posed serious threats to individuals’ physical and mental health. Due to their extensive physical contact with infected individuals, medical staff experience high anxiety levels compared to other members of society.
ObjectivesThe present study aimed to investigate the effectiveness of the acceptance and commitment approach on the resilience, self-compassion, and corona disease anxiety of medical staff involved in the COVID-19 response in Hamadan, Iran.
MethodsThis study utilized a semi-experimental design, including pre-test, post-test, follow-up, and control group. The study population included all medical staff involved in the COVID-19 response in Hamadan in 2021. From this population, 40 individuals were purposively selected and randomly assigned to either the experimental or control groups (20 participants in each group). Before the intervention, both groups underwent measurements (pre-test) using the Connor and Davidson Resilience Questionnaire (2003), the Neff Self-Compassion Scale (2003), andAlipour et al.’sCoronaDisease Anxiety Questionnaire (2018). After the intervention of acceptance and commitment therapy for the experimental group, the same tests were conducted again for both groups (post-test). Finally, three months later, the same measurements were repeated for both groups (follow-up). The data were analyzed using repeated measures analysis of variance in SPSS-25.
ResultsThe findings demonstrated the significant impact of acceptance and commitment therapy in enhancing resilience (P 0.001) and self-compassion (P 0.001), as well as reducing COVID-19 anxiety among the medical staff in Hamadan (P 0.001). Moreover, these effects remained stable during the follow-up phase.
ConclusionsThe results underscore the importance of utilizing acceptance and commitment therapy to enhance resilience and self-compassion while reducing anxiety among medical staff managing the disease. Additionally, hospital educational and executive managers should prioritize training medical staff in acceptance and commitment skills to effectively address COVID-19 anxiety.
Keywords: Acceptance, Commitment Therapy, Corona Disease Anxiety, COVID-19, Resiliency, Self-compassion -
Page 11Background
Various physical and mental problems and diseases may develop with aging. Poor sleep quality is the third most common major problem in older adults, affecting all aspects of life. Emotional Freedom Techniques (EFT) can be used to treat the disease in older adults.
ObjectivesThis interventional study attempted to investigate the effect of EFT on sleep quality, sleepiness, and quality of life of older adults.
MethodsThis was a quasi-experimental study. The selection of the participants was based on the convenience sampling method. Twenty-one people participated in the study and were divided into two groups of interventions. The study was conducted in the adult day-care center. In one group, 11 peopleandin the other group, 10 people were included. First, an educational session regarding sleep hygiene was held. Then, the EFT was administered for 4 weeks, 2 sessions per week, and each session lasted for 30 - 45 minutes in the intervention group by the student (first author); sleep hygiene training was also provided for the second group. Study measures included the PSQI (Pittsburgh sleep quality index), the Epworth Sleepiness Scale (ESS), and the Quality-of-Life Scale. Follow-ups were performed after the intervention and one month later. The statistical tests used were repeated measures and chi-Square tests. A P-value < 0.05 was considered as statistically significant.
ResultsThe trend of changes in sleep quality (P = 0.001, P = 0.001, respectively) and sleepiness (P = 0.023, P = 0.001, respectively) was incremental and significant before and after the intervention and one month later in each of the groups, but results show that there was no significant interaction effect for any subscale, including subjective sleep quality (P = 0.786), sleepiness (P = 0.568), and quality of life (P = 0.289).
ConclusionsAccording to the results, the EFT was effective on sleep quality, sleepiness, and quality of life of older adults in the adult day-care center, and sleep hygiene was influential.
Keywords: Adult Day-Care Centers, Emotional Freedom Techniques, Older Adults, Quality of life, Sleep Quality, Sleepiness, Tapping -
Page 12Background
Alzheimer’s disease (AD) is a neurodegenerative condition characterized by a gradual onset and progressive deterioration. Recent studies have demonstrated that certain antihyperglycemic drugs can slow down the progression of AD.
ObjectivesThis study aimed to investigate the effects of sitagliptin (SG) and metformin (MTF) on scopolamine (SCP)-induced learning and memory impairment in both diabetic and non-diabetic mice.
MethodsThis experimental study was conducted with two subgroups of mice, one diabetic and one non-diabetic. Over a 14-day period, the animals received different doses of SG and MTF in addition to a combination of these two drugs. On the 14th day, SCP was administered, followed by a memory impairment test (passive avoidance learning) conducted 45 minutes later. Subsequently, the animals were sacrificed, and brain samples were collected to measure oxidative stress biomarkers, including malondialdehyde (MDA), glutathione (GSH), glutathione peroxidase (GPx), catalase (CAT), and superoxide dismutase (SOD).
ResultsThe obtained findings revealed that intraperitoneal injection of SCP impaired learning and memory function and caused brain oxidativedamagein both diabeticand healthy mice. In healthy mice, the administration of high doses of MTF(500 mg/kg) and SG (20 mg/kg), in addition to the combination of these two drugs, significantly reduced memory impairment and oxidative stress. However, in the diabetic groups, only MTF and the combination of MTF with SG could reduce memory impairment and oxidative stress.
ConclusionsThe authors concluded that these antidiabetic drugs ameliorated oxidative stress by increasing antioxidant capacity and improved scopolamine-induced memory impairment. Furthermore, the combination of these two drugs yielded more favorable results.
Keywords: Alzheimer, Diabetic, Memory Impairment, Metformin, Scopolamine, Sitagliptin -
Page 13Background
High resistance-to-treatment rates in obsessive-compulsive disorder (OCD) and various treatments remain significant obstacles to psychiatric disorder treatments.
ObjectivesThe current study used network analysis to predict treatment response by psychiatric symptoms in the contamination/cleaning and danger/checking OCD subtypes.
MethodsWe evaluated 136 patients (mean age: 30.50 ± 5.25) who finished a 12-week selective serotonin reuptake inhibitor (SSRI) course. We used the convenience sampling method. All patients completed structured clinical interviews for the diagnostic and statistical manual of mental disorders, fifth edition research version (SCID-5-RV) at baseline and post-test. After treatment completion, the patients were categorized as responders and resistant according to their OCD severity scores (at the post-test). We used a network approach to determine the network structure of patients before and after the treatment. Network analysis was used by “the R programming language” to compare patterns of psychiatric symptoms. Additionally, we contrasted treatment-responsive patients’ network structure with treatment-resistant OCD patients in each subtype.
ResultsIn baseline, dysthymia, insomnia, binge eating, agoraphobia, and panic were the most central (important) nodes in the danger/checking subtype. However, hoarding, ADHD, insomnia, depression, and panic were the most central nodes in the contamination/cleaning group at baseline. Also, global strength and symptom connectivity were higher in the contamination/cleaning subtype than in the danger/check subtype (P < 0.05). In the contamination/cleaning subtype, “insomnia” was the most significant predictor for categorizing patients as resistant at the post-test. For contamination/cleaning, panic and binge eating played similar roles in treatment outcomes.
ConclusionsPsychiatric symptoms can predict treatment responses in OCD subtypes. So, it is necessary to consider psychiatric comorbidities regarding OCD subtypes.
Keywords: Fluvoxamine, Fluoxetine, Obsessive-Compulsive Disorder, Network Analysis -
Page 14Background
Cloninger first proposed the personality theory, considering both normal and abnormal personality traits. Later, different complementary versions of the Temperament and Character Inventory (TCI) found their way into the academic milieu to enhance their psychometric properties and efficiency in both experimental and clinical settings.
ObjectivesThe main objective of the current research was to investigate the principal psychometric properties of the Persian version of the Temperament and Character Inventory (TCI-140).
MethodsThis research is a cross-sectional study. The data included information on psychiatric outpatients visiting Roozbeh psychiatric hospital in 9 months in 2021. Purposive sampling was performed on volunteers. A total of 471 outpatients filled out the TCI-140, 150 of whom also filled out the Personality Inventory for the DSM-5 (PID-5). Exploratory factor analysis (EFA) was performed using principal component analysis (PCA) by Promax rotation.
ResultsThe internal consistency of all dimensions (Cronbach’s alpha: Above 0.70, except for reward dependence) was proved to be satisfactory, but that of some subscales (NS1, NS4, RD4, CO3, and CO5) was quite poor. Test-retest reliability confirmed that for all dimensions, ICC > 0.70, indicating a high reliability. The findings of the PCA revealed that all dimensions were loaded in accordance with the theoretical expectations. At the facet level, all the facets were loaded on their factors except for sentimentality and dependence. According to the correlation findings, the concurrent validity of TCI-140 was acceptable for PID-5. The results showed that HA had relatively high positive correlations with detachment (r = 0.55) and negative affect (r = 0.48).
ConclusionsThe results confirmed the satisfactory reliability and validity of the Persian version of TCI-140 despite its drawbacks. Hence, it can be employed to examine personality traits.
Keywords: Character, Outpatients, Personality Inventory, Psychometrics, Temperament -
Page 15Background
According to the perceptual load theory, distractor processing is determined by the perceptual load. Alternatively, some explanations suggest that perceptual load and distractor salience may have opposing effects.
ObjectivesAlthough numerous studies have been conducted on the effect of distractor salience on attentional capture, even under conditions of high perceptual load, it is still unclear whether spatial cueing of the distractor interferes with the perceptual load.
MethodsIn two experiments, the effect of the predictability of distractor cueing on attentional capture due to threatening facial stimuli was studied using a modified flanker task. In experiment 2, unlike the first experiment, heterogeneous targets and distractors were used to mimic real-life experiences.
ResultsIn experiment 1, the high perceptual load was associated with decreased distractor processing, whether the cueing was completely valid, invalid, or absent. However, the distractor processing between low and high perceptual loads was not different in ambiguous cueing. In the second experiment, contrary to the first experiment, no perceptual load effect was observed in the absence of spatial cueing.
ConclusionsEven in displays with high perceptual load, some stimulus-driven features-inability to predict the distractor’s location—can interfere with attentional control. Therefore, although the perceptual load is an influential factor in the selection, it clearly cannot be the only factor determining attentional control. Additionally, this study reveals that the effect of perceptual load on attentional control in everyday life should be further studied and questioned.
Keywords: Attention, Cues, Expressed Emotion, Facial Expression -
Page 16Background
Miners are frequently exposed to toxic metals in the environment. Excessive intake of heavy metals, such as arsenic, lead, and copper, is neurotoxic and promotes neurodegenerative diseases, such as Alzheimer’s and Parkinson’s diseases.
ObjectivesThis study aimedto investigate the creativityamongpersonnel of the Sarcheshmeh Copper Complex, the second-largest copper deposit worldwide.
MethodsThe research population included personnel working at the Sarcheshmeh Copper Complex in Rafsanjan, southeast Iran. The convenience sampling method was used to identify 204 participants based on inclusion and exclusion criteria. Convergent and divergent thinking were assessed using the remote associates test (RAT) and the alternative uses test (AUT), respectively.
ResultsThe total mean scores of RAT and AUT were 3.05 ± 2.05 and 10.91 ± 6.63, respectively. The mean scores of both AUT and RAT in miners with more than 10 years of work experience were lower than others. Moreover, AUT scores were lower in miners who used opium and also in those who were less educated (with no college or university education).
ConclusionsThe results of this study demonstrated that cognitive abilities might be more affected in copper miners. However, more future studies using two groups of miners and non-miners are needed to conduct a more accurate interpretation.
Keywords: Alternative Uses Test, Copper Miners, Creative Cognition, Remote Associates Test -
Page 17Background
Phenylketonuria (PKU) is an autosomal recessive disorder in the metabolism of the amino acid phenylalanine. This disease affects not only the life of the child but also the life of the parents.
ObjectivesThe current study aimed to examine the direct and indirect relationships between perceived social support, self-compassion, and distress tolerance in a sample of parents with PKU children.
MethodsOne hundred and fifty-seven parents were recruited from the Province Metabolic Patients Support Charity in Zanjan (Iran) through available sampling. The study utilized three instruments: The Multidimensional Scale of Perceived Social Support (MSPSS), the Self-compassion Scale (SCS), and the Distress Tolerance Scale (DTS).
ResultsThe data were analyzed using SmartPLS software (version 3.3), and the relationship between variables was assessed through partial least squares structural equation modeling. According to the bootstrapped results, the direct effects of perceived support from significant others on distress tolerance (β = 0.39, P = 0.0001) and self-compassion on distress tolerance (β = 0.68, P = 0.0001) significant others (β = 0.26, P = 0.0001) via self-compassion on distress tolerance were significant and positive.
ConclusionsThe study indicates that joining support groups and exchanging experiences with other parents of PKU children can enhance feelings of effectiveness and reduce isolation among these individuals as parents. Self-compassion plays a crucial role in perceiving challenges as part of the human experience, providing a valuable defense against personal distress that might arise while caring for a child with PKU.
Keywords: Distress Tolerance, Parents, Phenylketonuria, Self-compassion, Social Support -
Page 18Background
Empathy has been known as one of the fundamental principles of medical professions.
ObjectivesThis study aimed to explore the perspectives of midwives’ trainers, students, and personnel about empathy in maternity hospitals.
MethodsA qualitative design using a content analysis approach was used to explore the experiences of midwives’ trainers, students, andpersonnel in the maternity setting in Gachsaran, Iran. The study involved the recruitment of 41 participants, including 24 students, 14 personnel, and 3 midwifery trainers, who were selected using purposive sampling. Data were collected through 2 rounds of semi-structured interviews conducted via WhatsApp, with participants responding to 2 sets of questions. The text was analyzed using conventional qualitative content analysis, and the extracted codes were managed using MAXQDA software.
ResultsIn general, 265 codes were extracted from the participants’ interviews, which were classified into 3 categories (ie, ”Client management is a top priority for every midwife, ”the meaning of empathy,” and “essentials in empathy”) and 9 subcategories. A total of 121 codes explained how to manage clients, 64 codes were related to the meaning of empathy, and 77 codes were linked to what people must consider in empathy.
ConclusionsEmpathy is a crucial concept in the field of midwifery and should be included in the curriculum. It is essential to emphasize the correlation between empathy and other aspects of midwifery, such as communication skills, clinical competence, and ethics. We recommend that both staff and students undergo ongoing training in the area of professional conduct to enable them to make informed decisions in challenging situations.
Keywords: Empathy, Responsibility, Rules, Midwife, Maternity hospital, Qualitative research, Professional staff -
Page 19Background
Many studies have investigated the rate of suicide attempts and their risk factors during the coronavirus disease 2019 (COVID-19) pandemic; however, the results are still challenging.
ObjectivesThis study investigated and compared the risk factors effective in suicide attempts during the pandemic period and one year before.
MethodsThis case-control study was conducted at Loghman Hakim hospital, Tehran, Iran. Random sampling included all patients in the inpatient ward who were over 12 years of age and committed suicide during the pandemic within October 1, 2021, to August 30, 2022 (case group; n = 160) or one year before within March 11, 2019, to March 11, 2020 (control group; n = 160). Demographic information, mental-psychological status, and socioeconomic status (SES) of the patients in the case group, before and after the COVID-19 pandemic, were recorded during face-to-face interviews using a predesigned semi-structured questionnaire by study staff trained and supervised by a clinical psychiatrist. Additionally, the data of the patients in the control group were retrospectively recorded during the review of medical records and telephone interviews. The Wilcoxon signed-rank test was used to compare the variables in the case group before and after the COVID-19 pandemic. The Student’s t-test and chi-square test were used to compare the variables between the case and control groups. Additionally, to determine the risk factors predicting suicide attempts during the pandemic, a multivariable logistic regression test was used. The data were analyzed using PASW18 software.
ResultsThe results showed that the patients in the case and control groups had significant differences in terms of age (P = 0.01), underlying mental disorders (P = 0.032), and parental relationship (P = 0.001). Moreover, the variables of suicidal ideation (P = 0.002), feeling lonely (P = 0.023), sleep disorder (P = 0.32), and domestic violence (P = 0.004) in the case group were significantly higher than the control group. In addition, the comparison of these variables in the patients of the case group, before and after the COVID-19 pandemic, showed that the start of the pandemic triggered these factors and led to an increase in suicide attempts in this population. Finally, the logistic regression analysis showed that the variables of SES, having a close friend, parental relationship, previous planning for suicide, domestic violence, andjob loss could be considered predictive risk factors for suicide attempts during the pandemic period.
ConclusionsAccording to the present study’s findings, the psychological and socioeconomic conditions triggered by the COVID-19 pandemic led to an increased likelihood of suicidal ideation or attempts in vulnerable individuals.
Keywords: Suicide, Mental Disorders, Social Class, COVID-19, Pandemics -
Page 20Background
The coronavirus disease 2019 (COVID-19) pandemic affected working conditions in healthcare systems and caused occupational stress and challenges for the majority of healthcare workers (HCWs).
ObjectivesThis study aimed to examine the prevalence of anxiety, depression, burnout, and career resilience and assess the personal and occupational risk factors contributing to psychological symptoms in Iranian HCWs during the COVID-19 pandemic.
MethodsThrough a cross-sectional study, HCWs were surveyed within January to February 2022 to evaluate the prevalence of anxiety and depression (using the Hospital Anxiety and Depression Scale [HADS]), burnout (using the Maslach burnout inventory health services survey for medical personnel [MBI-HSS-MP]), and career resilience (using the Career Resilience Questionnaire [CRQ]). The correlation between demographic-occupational factors and psychological symptoms was analyzed. A total of 610 complete responses were received from Iranian HCWs.
ResultsApproximately 87.9% of HCWs had symptoms of both anxiety and depression (HADS score 11). The results indicated that most HCWs experienced various signs of burnout (i.e., emotional exhaustion, decreased sense of personal accomplishment, and depersonalization, respectively). The mean score for career resilience reported by the participants was appropriate; however, a fifth of the HCWs had poor career resilience. The highest scores of burnout, anxiety, and depression, in addition to the lowest scores of career resilience, were reported by intensive care unit (ICU) professionals.
ConclusionsMarital status, long daily working hours, night shift work, access to personal protective equipment (PPE), and direct exposure to patients with COVID-19 had a significant impact on the anxiety, depression, burnout, and resilience of the HCWs.
Keywords: Anxiety, Burnout, COVID-19, Depression, Health Personnel, Resilience -
Page 21Background
A significant proportion of hospitalized patients suffer from psychiatric disorders. A timely request for psychiatric consultation results in the early recovery of such patients.
ObjectivesThis study aimed to determine the frequency of causes and diagnoses in psychiatric consultations in the Afzalipour Hospital in Kerman, Southeastern Iran, in 2018.
MethodsThis study was a cross-sectional descriptive study. The required data, including age, gender, marital status, occupation, level of education, counseling wards, and psychiatric diagnosis, were extracted from the patient’s clinical records.
ResultsIn this study, 1106 patients’ records were reviewed. Most participants were female (54.7%), and the most frequent (30.3%) age range was 20-30 years. The most common reason for seeking consultation was suicide (56%), and the most common diagnosis made by consultant psychiatrists was major depression (27.8%). The highest number of requests for consultation was made by the internal ward (68.06%). Psychiatric disorders were widespreadamongmarried subjects (P = 0.024) and patients holding high school and diploma degrees (P = 0.019).
ConclusionsPsychiatric problems are common in the inpatient wards of general hospitals. According to this study, psychiatric issues and problems are highlighted more in married, young, and undergraduate women admitted to general hospitals and need further consideration.
Keywords: Consultation-Liaison Psychiatry, General Hospital, Psychiatric Consultation, Psychiatric Disorders -
Page 22Introduction
Since many movement disorders are associated with schizophrenia, it is important to distinguish various motor manifestations of the disease itself from associated abnormal movements.
Case PresentationWe present a 35-year-old single man with schizophrenia who was admitted for seizure-like tics. The disease started 7 years earlier with psychotic manifestations, including persecutory delusion, negative symptoms, and impaired function. About a year ago, movements in the limbs, abdomen, and spine (similar to those seen in tonic-clonic seizures) were added to the patient’s symptoms, lasting for a few seconds to a few minutes. After some time, these movements were accompanied by expressing words and phrases that had sexual content. Due to the exacerbation of these attacks, the patient was admitted to the hospital. He was unable to explain the cause of these movements, and differential diagnoses included stereotype, extrapyramidal effects of antipsychotic drugs (particularly tardive dyskinesia), and temporal lobe epilepsy. However, the patient had no history of epilepsy. Urine screening for illegal substances, electroencephalography (EEG), brain magnetic resonance imaging (MRI), and neurological counseling were all normal. The adverse effects of medications were ruled out because the patient had taken antipsychotics very irregularly and in low doses. A short time after starting 4 mgof oral risperidone (as the main treatment), the patient showed better cooperation and was able to describe his symptoms in more detail. He explained that a stranger or a copy of himself occasionally compelled him to do the movements, and if he refused to do it, he would be punished by them. Ten days after continuing treatment and starting weekly flupentixol decanoate, the motor symptoms improved significantly, and the patient was discharged after 3 weeks.
ConclusionsThis case presentation emphasizes the importance of accurate clarification of the nature of signs and symptoms in patients with mental disorders, which seems to be crucial in making a diagnosis and appropriate treatment.
Keywords: Delusion of Control, Movement Disorder, Schizophrenia