فهرست مطالب منصور شکیبا

Various factors, including the type of coping style and patience, can be effective in the management of substance dependence and chronic pain. In this study, we intend to investigate the effect of using coping strategies and patience on the control of chronic pain in substance-dependent patients using acceptance and commitment strategies (ACT) and dialectical behavior therapy (DBT) with and without exercise.

The research method was semi-experimental with pre-test, post-test with two-month follow-up and control group. Seventy-five volunteer patients with chronic pain entered the study with a targeted method and were randomly assigned to groups (ACT and DBT with and without exercise and control group). The data were collected using the pain coping strategies questionnaire (Rosenstein and Keifi, 1983) and the patience questionnaire (Khormai, Farmani and Soltani, 2014) and then using the ANOVA statistical methods, analysis of variance with repeated measurements and We analyzed Bonferroni post hoc test in spss software version 26. The significance level of the tests was considered 0.05.

Variance analysis with repeated measurements, for ACT and DBT interventions with and without exercise for the within-group effect (time) in three stages of evaluation in the variables of coping with pain and patience at the level (P≤0.001), and for interaction Time and group were also significant at the level (P≤0.001). In addition, based on the results of the group effect test in the three stages of evaluation, the difference between the groups in the variable of coping with pain and patience is significant at the level (P≤0.01) and finally ACT with exercise is more efficient than other interventions for The improvement of strategies to cope with pain and patience had a level of (P≤0.001).

Since coping strategies and patience can help control chronic pain and recovery of people, according to the results of the present study, it is suggested that to improve coping strategies and patience and control relapse in substance dependent patients with chronic pain from ACT therapy should be used along with exercise.

Chronic renal failure is a disabling condition with multiple complicationsuch as depression and anxiety; they are common in hemodialysis patients and have negatively effect on quality of life. In this study we investigate the prevalence of depression and anxiety in Zahedan hemodialysis patients.

A total 200 patients undergoing regular hemodialysis for more than six months included in this descriptive cross-sectional study. After consent The Hamilton Rating Scale for Depression and anxiety (HAM-D7) in a version translated into and adapted to Persian, were used.

The patients median age was (43.06 ± 16.11) years and 38.5% was male. Mild depression was observed in (15) 7.5%, moderate in (81) 40.5% and sever depression in (104) 52% of patients. In this study 19.5% (39) of patients has moderate anxiety and 80.5% (161) patients with sever anxiety.A significant correlation was found between duration of dialysis, older age and depression. But there wasn’t any relationship between age and duration of dialysis with anxiety. Anxiety and depression found without any significant differences in both males and females.

We found high level of depression an anxiety in Zahedan hemodialysis patients

Addiction as a crisis and a chronic long-term disorder can lead to mental health symptoms in the users and their family members, the most common of which are stress, anxiety and depression. The aim of the study was to determine the effect of a quality of life intervention on the psychological reactions in family caregivers of addicts.

 This study is a clinical trial. The research population included the family caregivers of addicts admitted to Baharan psychiatric hospital in 2018. The sample consisted of 80 subjects who were randomly divided into intervention and control groups. The caregivers in the intervention group received eight sessions of group counseling based on quality of life therapy and based on specified content, every other day. Eight weeks after the intervention, the data were collected using the DASS-21, and were analyzed by the SPSS software version 21 using paired t test, independent t test, Chi-square and Covariance.

After the quality of life intervention, the mean scores of stress, anxiety and depression in family caregivers in the intervention group (11.50±4.36, 11.05±3.49, 10.57±4.67) were significantly lower than those of in the control group (14.67±4.93, 14.02±4.33, 13.40±4.77) (P<0.01). There were no significant differences in these variables between the two groups before the intervention.

Counseling based on quality of life therapy in this study had a positive and significant effect on reducing the severity of psychological reactions in family caregivers of addicts. Therefore, health care providers are recommended to use this counseling approach along with addiction treatment programs to increase the welfare and psychological well-being of family caregivers.

Substance use as a crisis and a long-term chronic disorder can lead to psychological burden and reduce the quality of life of family caregivers. The aim of this study was to determine the effect of the quality of life therapy intervention on the burden of the family caregivers of addicts.

This is a clinical trial. The research population included all the family caregivers of the recovering addicts, admitted to Baharan psychiatric hospital in Zahedan in 2018. The samples were 80 people who were randomly divided into either intervention or control group. Caregivers in the intervention group received eight sessions of group counseling based on the quality of life therapy and on the basis of the determined content, every other day. Before the intervention and eight weeks after the intervention, the data were collected using the Zarit burden questionnaire and were analyzed by statistical tests through the SPSS software version 21.

Before the intervention, there was no significant difference in the mean score of burden between the two groups (P=0.25). After the intervention, the mean score of family caregiver burden in the intervention group (40.10±12.92) was significantly lower than in the control group (46.80±13.58) (P<0.01).

The quality of life therapy intervention in this study had a positive and significant effect on reducing the burden of family caregivers of addicts. Therefore, it is recommended that healthcare providers use this counseling approach along with addiction treatment programs to improve the psychological well-being of family caregivers.
Clinical trial registry: IRCT20160924029954N11

The experience of domestic violence has negative consequences on the mental health of pregnant women, and interventions must be designed to reduce these negative consequences. Therefore, the aim of this study was to determine the effect of supportive-educational intervention on psychological distress among pregnant women subjected to domestic violence.
Methods & Materials: This clinical trial was conducted on 100 pregnant women subjected to domestic violence, referred to comprehensive health centers of Zahedan for receiving prenatal care in 2018. Eligible women were selected by the convenience sampling method and randomly assigned into two groups of intervention and control. The intervention group received four supportive-educational individual sessions during two weeks. The control group received routine care during this period. Data were collected in two groups by the Kessler Psychological Distress Scale (K10) and Hurts, Insults, Threaten, Screams (HITS), before the intervention and four weeks after the intervention. The data were analyzed by statistical tests using the SPSS software version 21.

The results showed that the mean score of psychological distress of pregnant women dropped from 30.9±4.58 to 22.18±3.81 (mean change score -8.72±3.93) in the intervention group and from 25.22±4.15 to 24.06±4.16 (mean change score -1.16±1.48) in the control group. Analysis of covariance demonstrated that there was a statistically significant difference in the mean score of psychological distress of pregnant women exposed to violence between the two groups after the supportive-educational intervention (P<0.001).

The results of this study showed that the supportive-educational intervention is effective in reducing psychological distress in pregnant women subjected to violence. Therefore, it is recommended to integrate supportive-educational interventions into prenatal care for pregnant women subjected to violence in order to improve fetal and maternal health.

Menopause has been recognized as a critical stage in women’s life. Menopausal symptoms and problems can affect women’s health and well-being. Health promoting behaviors may be useful in alleviating these symptoms. The purpose of this study was to determine the effect of couple counseling on severity of menopausal symptoms in women. In a quasi-experimental study, 80 women with their husbands were selected by the convenience sampling method from health care centers in Zahedan in 2017, and were assigned to either experimental or control group. The data gathering tool included a demographic questionnaire and Menopuse Rating Scale questionnaire. Couple counseling for the intervention group was conducted in four 60-minute sessions. Data were collected before and 12 weeks after the intervention, and analyzed by independent and paired t-test, analysis of covariance and χ2 using the SPSS software version 21. There was no significant difference between the two groups in terms of demographic variables, but the mean of score changes for menopausal symptoms in the intervention group was -1.42±1.95 and in the control group was -0.10±1.10. The independent t-test showed a significant difference in the mean of score changes for menopausal symptoms in the two groups (P<0.0001). Given that couple counseling has a positive effect on severity of menopausal symptoms in women, it is suggested that this counseling strategy be integrated into healthcare programs for menopausal women.

Regarding the principle of ethical relativity in different societies, the time and place of damage assessment are two independent factors in determining the amount of damage; a bunch of damages are related from the angles of the factor of time, moment, and time. Like the damage caused by the failure to get the value of the subject of the commitment, in the committed asset, which is, in fact, the time merely to distinguish a price from the price values of a commitment within a time interval, Another category is the loss of a period of time, in which the damage is an abnormal phenomenon of morality. For example, in view of the different moral interest in money-making, to determine the interest of the money or the interests of the Lords, when is the origin of the time of the evaluation of interest and benefits; In terms of the factor of time in Iranian law, by looking at the abnormal phenomenon of usurpation, from the point of view of ethical jurisprudents and legal value lawyers, there are various criteria that have different effects. The most appropriate moral time to pay damages is Umm al-Dawa, and in terms of location, location, loss; In UAE's law, the moral time of the damage assessment, the time of the incident or the arrival of the damage and the place of damage assessment, the place of delivery of the goods, the conclusion of the contract and the residence is committed; In the International Convention on the International Sale of Goods, various indicators, such as the time of conclusion of the contract, the reasonable period leading to the termination of the contract, is the common ethical customs of the time for the termination of the contract, which is based on the basis of calculation and evaluation. From the point of view of the place of evaluation, with a morphological look, the place of delivery of the goods is the most appropriate place compatible with the spirit of the provisions of the Convention.

In pregnancy following stillbirth, the parental relationship and attachment to the dead child are denied, and this can impair the mother’s attachment to the new child. The present study aimed to determine the effect of cognitive behavioral training on maternal-fetal attachment in subsequent pregnancy following stillbirth.
Methods & Materials: This quasi-experimental study was performed on 100 pregnant women with the history of stillbirth, referred to health centers in Zahedan in 2017. Mothers were selected using convenience sampling and assigned into two groups of 50 each. Data were collected by a demographic questionnaire and the Cranley maternal-fetal attachment scale. After pre-test, the intervention group received 4 sessions of cognitive behavioral training during 4 weeks. After 8 weeks, the post-test was performed for two groups and data were analyzed using independent t-test, chi-square, Fisher's exact and ANCOVA tests through the SPSS software version 21.
The mean score for maternal-fetal attachment was not significantly different in the baseline but was significantly higher in the intervention group (92.36±11.89) than in the control group (80.90±16.36) after the intervention (P Considering the effect of cognitive behavioral training on the promotion of maternal-fetal attachment, it is recommended that this training be integrated into the care program for pregnant women with a history of stillbirth.

Backgrounds & Aim: A relationship enrichment program involves family therapy with psychosocial training and skill-based approach that aims to improve couples’ psychological and emotional satisfaction. The aim of current study was to determine the effect of a couples’ relationship enrichment program on couple burnout from the perspective of spouses of patients with multiple sclerosis (MS).
A quasi experimental study was conducted in 2016 on 80 patients with MS and their spouses who were members of MS center in Zahedan. The participants were randomly divided into two groups including control and intervention The Couple Burnout Measurement was used to collect the required data. The individuals in the intervention group participated in a five-session couples’ relationship enrichment program. The control group did not receive any intervention except routine programs. Marital burnout was evaluated in two groups 12 weeks after the last session. Data were analyzed by independent t-test, paired t-test, chi-square and analysis of covariance.
After the implementation of the couples’ relationship enrichment program, the mean score of couple burnout in the intervention group significantly decreased from 86.17 ± 21.80 to 51.57 ± 12.93 in comparison with the control group (from 84.42 ± 21.43 to 87.55 ± 21.64) (P Considering the positive effect of couples’ relationship enrichment program on reducing couple burnout from the perspective of spouses, the application of the program is recommended to improve marital relationship quality as the most important sources of support for patients with MS.

Background and Low self-efficacy is a major barrier that plays a significant role in non-adherence to self-care practices in patients with Chronic Heart Failure (CHF) and depression. This study was designed to determine the effectiveness of motivational interviewing on self-efficacy in CHF patients with depressed mood in two hospitals in Zahedan, south east of Iran, 2016.
A randomized clinical trial was carried out in 82 patients suffering from heart failure, who were confined in hospital and whose depression was confirmed by Beck’s questionnaire and a mental status examination. They were randomly divided into intervention and control groups (n= 41 per group). The Self-Efficacy for Managing Chronic Disease was administered. The intervention group received four sessions of self-care behavior education (based on principles of motivational interviewing), and the control group received four routine sessions of self-care behavior education. Eight weeks after the intervention, the level of self-efficacy was evaluated in both groups. Data was analyzed applying paired t-tests, independent t-tests, Chi-square test and analysis of covariance.
The mean score for self-efficacy was significantly higher in intervention group (42.92 ±4.13), compared to that in the control group (37.21±5.16) (P= 0.0001).
Motivational interviewing had a significant positive effect on adherence to self-efficacy in patients with heart failure and depression. Therefore, using motivational interviewing is recommended in these patients.

The main purpose of this study was to assess and compare mental health of high school girl students living in dormitories of Welfare Organization and University of Sistan and Balouchestan.

A cross-sectional study was done to evaluate the mental health of students living in dormitories. The sample of study consisted of 40 girl students recruited from students in dormitories of Zahedan welfare organization and the high school of Sistan and Balouchestan University. Mental health of participants was assessed by SCL-90-R and the data were analyzed using SPSS soft ware.

Findings of study showed significant differences between students living in dormitories of Welfare Organization and University of Sistan and Balouchestan.. The most prevalent symptoms among students in dormitories of Welfare organization were depression (90%), phobia (90%), anxiety (80%) and sensitivity in interpersonal relationships (80%), while the most prevalent symptoms among students in dormitories of university were depression (50%), paranoid ideation (45%) and compulsion (35%).

High prevalence of psychological symptoms among students living in dormitories, especially among students in Welfare Organization suggests that effective strategies for preventing and treatment of psychological disorders must be developed and used in dormitories.

Teachers have an important effect on mental health and development of students. Teaching and counseling may be stressful jobs. The objective of this study was to compare psychological status of high school teachers and educational counselors measured by the Minnesota Multiphasic Personality Inventory (MMPI). In a cross-sectional study 60 teachers (20 male and 40 female) and 60 educational counselors (20 male and 40 female) from high schools of Zahedan city were recruited randomly and asked to complete Minnesota Multiphasic Personality Inventory (Iranian short form of MMPI). Data were analyzed using descriptive statistics and t test. The results showed significant differences between teachers and educational counselors in 6 clinical scales of MMPI so that the teachers had higher scores than educational counselors in D (depression), Pd (psychopathy), Pa (paranoid), Pt (Psychastenia), Sc (schizophrenia) and Ma (hypomania) scales of MMPI. Mean scores of Male counselors in hysteria and psychopathy were higher than female's scores and also female teachers had higher mean scores in hypochondria, hysteria, paranoid, psychastenia and schizophrenia than male teachers. Although the profiles of both teachers and educational counselors were normal but teachers had higher mean scores than counselors, thus, efforts need to be made to explore possible factors associated to those differences.

Mental health of war veteran's spouses and martyr's widows is expected to be more susceptible due to their specific stresses. This study aims to find the mental health situation related to different variables. This is a cross-sectional and descriptive study. One hundred martyr's widows and the same number of war veteran's spouses were selected and divided into two groups by systematic randomized sampling from among the list of those followed up by Zahedan War Veterans Foundation. Mental health of the individuals in the study was assessed by "General Health Questionnaire" and also semi-structural interviews. The data were analyzed by ANOVA and Toky Post Hoc Test. The results revealed that the mean scores of both groups and also 70% of the whole number of contributors in the study were higher than the GHQ cut-off point. Comparing the means in GHQ scores of the two groups showed no statistically significant difference. Women whose husbands had physical injuries showed a better mental health than those with mentally ill husbands (p=0.001). The findings of this study in concordance with other similar researches confirm that generally martyr's widows and war veteran's spouses suffer from low level of mental health. The relationship between the type of injury and mental health of veteran' spouses calls for special cares and services for different groups.

In connection with specific situation of handicaps of war in terms of both mental and physical health, their wives are dealing with peculiar stresses. In this research the mental health status of war victims was investigated. Materials and m ethod : In a descriptive-analytical study, 100 spouses of handicaps of war from Zahedan (south-east of Iran) were selected during 2007, through systematic random sampling and they were assessed by GHQ-28 questionnaire and clinical interview. In this regard the mean of whole scores as well as 70% of individual's personal scores were higher than cut-off point (i.e. 24). ANOVA results did illustrate that through several variables, type of husband's disability had significant impact on the scores exclusively. The results of Tuky Post-Hoc test showed that the lowest mental health belonged to spouses of mentally disabled victims. Whereas, women whose husbands were handicapped both physically and mentally were placed in the second category. Furthermore, women whose couples had physical injury were in better mental health situation than the other groups. The level of mental health status of war victim's wives is low and it varies with regard to type of husband's disability. This difference was concerned with the nature of husband's symptoms and behaviors, besides in conformity with cognitive theories, the possibility of attribution to husbands’ behaviors instead of their hostility is explainable.

Schizophrenia has a prevalence of 1% and accounts for 2.5% of heath-care in USA. FDA has approved the drug Clozapine for treatment of drug resistant forms of schizophrenia. The aim of this study was the comparative therapeutic’s effect of clozapine and risperidone in the drug resistant schizophrenia. In this cross-sectional study therapeutic effect of two different drugs clozapine and rispridone have been compared on 40 drug resistant male and female schizophrenia cases admitted in Rehabilitation Center of Chronic Mental Diseases of Zahedan Welfare Organization in Iran. Patients were divided in two groups for treatment with either clozapine or rispridone. The patient’s improvement was evaluated with clinical interviews and BPRS tests. The data was analyzed by Chi-Square and t-test variance analysis. Initial BPRS results was determined as an average of 52.80±7.70 for clozapine group and average of 49.80±5.98 for rispridone group. Three month after start of treatment average of BPRS and SD was 22.95, 1.57, 24.53 for clozapine group, and 2.49 for rispridone group respectively. The average decrease in BPRS was calculated as 29.58±7.08 for clozapine and 25.49±5.94 for rispridone. The statistical markers were determined as P= 0.48 and t-test =-2.13. The results confirm that clozapine acted more effectively than rispridone and has been tolerated by the patients.

Major depressive disorder is a common psychiatric disorder. It causes major dysfunction for the patient. Traditional pharmacological agents for treatment of this disorder are SSRls, TCAs, MAOls, NSRls etc. some researching have shown the effectiveness of herbal medicine in the treatment of depression. Citrus Fragrance (the essence of orange) is one of herbal drugs, which has had some reports of stimulant and anti depressant effects. In this clinical trial study, the sample was 150 adult patients with the diagnosis of major depressive disorder based on DSM-IV. They were divided in three groups randomly. The first group received Fluoxetine 20 mg daily. The second group received Citrus Fragrance 10 drops tid from 2% concentrated solution and the third group received 20 drops tid from it. The patients were evaluated by clinical interview, Hamilton's depressive rating scale and Adverse effects inventory before treatments and 3 and 6 weeks after treatment. Data were analyzed by t-test and ANOVA through SPSS software. 74 patients remained in the treatment till the end of research (19 men and 55 women). The male/female ratio was equal in the three groups. Their average age was 2804 Y. The recovery rate based on Hamilton's scale after 6 weeks was 8.15 in the first group and 15.8 and 12 in the second and third group. The most effective regimen was 10 drops of Citrus Fragrance (P<0.05). The rate of adverse effects was similar in the groups (P>0.05). Citrus Fragrance has an effective antidepressant effect especially in the does of 10 drops tid. The severity of its adverse effect is similar with Fluoxetine.