amirabbas keshavarzakhlaghi

The hierarchical taxonomy of psychopathology (HiTOP) aims to address the limitations of traditional nosologies. This model organizes borderline personality disorder (BPD) along two dimensions: The distress sub-factor of negative affectivity and antagonism.

For the HiTOP model to be effectively integrated into clinical practice, its clinical utility must be established. This study aimed to assess the clinical utility and diagnostic validity of HiTOP in diagnosing BPD.

This cross-sectional study included 113 inpatients with a primary diagnosis of BPD and 100 nonclinical individuals. The Structured Clinical Interview for diagnostic and statistical manual of mental disorders (DSM-5) Personality Disorders, Structured Clinical Interview for DSM-5-Screening Personality Questionnaire, Personality Inventory for DSM-5, and the Personality Assessment Inventory–Borderline Features Scale were used for BPD diagnosis and severity assessment. Multiple regression analyses were conducted on BPD-HiTOP-related and other maladaptive personality domains to identify the best predictive factors for BPD. Borderline personality disorder scales were created based on the regression algorithms. Receiver operating characteristic (ROC) analyses and diagnostic efficiency statistics were used to assess the relative diagnostic efficiency of these scales.

Regression analyses indicated that negative affectivity and disinhibition significantly predicted BPD severity, whereas antagonism did not. The ROC analysis demonstrated that both the HiTOP-BPD algorithm (antagonism/negative affectivity) and the proposed BPD algorithm (disinhibition/negative affectivity) showed excellent accuracy. Regarding diagnostic validity, the proposed BPD algorithm exhibited higher sensitivity and specificity levels compared to the HiTOP-BPD algorithm.

These findings support the clinical utility of the disinhibition-negative affectivity algorithm in diagnosing BPD.

Considering the benefits that a welcoming environment can have for the patients and their families, and specifically for people with mental disorders, this study aims to launch a welcoming program in the Iran psychiatric Hospital and assess its effectiveness in improving the quality of and satisfaction with the services for patients with mental disorders.

The welcoming unit of the hospital was officially launched and began to operate since September 2017. In the welcoming program, the nurse first introduced herself to the patients and their families, and if needed, made them familiar with the hospital and its goals and environment, how to reach psychiatrists, and regulations during hospitalization. This program continued by acquainting patients with their rights, the hospital's rules, treatment team, welfare amenities, inpatient wards, electroconvulsive therapy unit, clinics, support center, and by handling complaints and criticisms. For internal evaluation, a survey form with 5 open-ended questions was designed without including demographic characteristics and distributed among the hospital departments. The responses were collected and analyzed using the content analysis method.

The results of internal evaluation showed that 92% of the patients and their families were satisfied with the welcoming program and perceived it as very good and excellent. Half of the patients and their families (50%) believed that some nurses were caring and some were careless and did not take care of problems well. They perceived that psychiatrists and psychologists did not spend much time with the patient, and their visits were done very late.

Based on the perceptions of the patients and their families about the welcoming program, it seems that they are satisfied with the program in overall. The result can motivate other psychiatric and non-psychiatric centers in Iran for the implementation of a welcoming program.

The negative experience of hospitalization in psychiatric wards is a common issue that can have destructive effects on treatment outcomes. Considering the significance of improving inpatient psychiatric care, this qualitative study was implemented to elucidate the patients’ experience of hospitalization in a psychiatric hospital from September 2017 to February 2018.

The information was gathered using two approaches: focus groups, and in-depth individual interviews with hospitalized patients. Twenty-two patients, including 16 women and 6 men, participated in this research. Content analysis method was used for analyzing the data. 

Participants’ negative experiences were categorized into three main categories: imprisonment, loneliness, and untrustworthy atmosphere. According to our study, the numerous restrictions and inflexible regulations of the ward, insufficient interaction with the psychiatrist and nurses, coercion, and insufficient physical facilities caused negative experiences. 

It seems to be critical that the extent of care for each patient be individualized and free of humiliation. 

Mental health in Iran was approved in 1988. However, and then this program was integrated into the primary care system in our country and was implemented within the villagerschr('39') family physician program with great success. In urban areas, there is no structured health network. However, regarding the demographic changes in the countrychr('39')s population, huge sprawling of cities, and the changes in urban-rural population proportion, demands for a coherent plan to provide mental health services to the urban population are felt more than ever. This study aimed to investigate the feasibility and establishment of a model of urban mental health network for severe psychiatric patients.

This plan is based on resource reviews, Use the experiences of other countries, Model World Health Organization, The services available in the country currently run by the beneficiary organizations, Description of the responsibilities of the responsible organizations, Collaboration between the Ministry of Health and various organizations responsible for mental health, Having the views of national expert and international constant in this field from other countries cooperated with the aim of examining how to compile a coherent and integrated urban health service plan. This model is estimated by community-based services for 100,000 people.

 The proposed model for providing immediate psychiatric services with greater cohesion and increasing training and skills capacity among staff 110, 115, 1480, and 123 services, as well as a space for hospitalization of 3 to 5 emergency patients next to the public hospital, is recommended. Depending on the number of patients in a population of 100,000, we will need community-based services, including 2 to 3 home visit teams to cover 80 patients per team, and 3 daily centers to provide services to 40 patients. If community-based services are provided, we will need 12 acute psychiatric beds and 5 beds for mid-term rehabilitation to provide inpatient services. In terms of employment and accommodation, 50 patients will need supported employment, respectively, and two apartments with an area of about 60 meters will be needed to accommodate about eight people. The provision of the above services requires the equal participation of the interested organizations. The family physician will play an essential role in continuing medical care for severe and mild psychiatric patients under the constant supervision of specialists

To achieve a better model of mental health services in cities that can cover a wide range of people in urban areas and at various levels from prevention and care to treatment and rehabilitation, we need the coordination between the organizations providing these services for the accurate planning of the interests of each organization, elimination of duplicate services, and saving human capital and resources of the country.

This study was conducted to determine the frequency of unconventional treatment use by psychiatric patients in Tehran.

In this cross-sectional study, 404 patients diagnosed with psychiatric disorders were studied. The participants responded to a checklist and filled a questionnaire about their demographic characteristics.

Simultaneous use of conventional and unconventional treatment was seen in 39.4% of patients, and among them, herbal therapy was the most common type (20.5%). No relationship was observed between patient satisfaction and the use of such treatment (p=0.347).

There is a high frequency of unconventional treatment use in psychiatric patients. However, the exact reasons for patients’ tendency towards such approach and also advantages and disadvantages of its application need more investigation.

The present study was conducted to compare occupational burnout scores and determine their correlation with different dimensions of Temperament and Character Inventory (TCI) questionnaire among psychiatry, internal medicine, and surgery residents during the academic year 2013-14.

In this cross sectional analytical study, 201 residents were recruited. Colinger's 125-item TCI and Maslach's Burnout Inventory were completed by residents. The mean severity of burnout and the mean scores in the subgroups of temperament and character were compared between the 3 groups of residents, and the correlations were calculated. Data were analyzed using SPSS software version 16. Also, A 2-sided p value of less than 0.05 was considered significant.

A significant positive correlation was found between severity of burnout and harm avoidance in internal medicine residents (r=0.7, p<0.001). Also, a significant correlation was found between severity of burnout and self-directedness in surgery residents (r=0.5, p=0.003), self-transcendence in internal medicine residents (r=0.04, p=0.009), and persistence in internal medicine (r=0.17, p=0.003) and surgery residents (r=0.10, p=0.004). A significant correlation was found between frequency of burnout and harm avoidance in internal medicine residents (r=0.6, p=0.001), self-directedness in surgery residents (r=0.9, p<0.001), persistence in surgery (r=0.14, p<0.001) and psychiatry residents (r=0.19, p<0.001), and finally self-transcendence in internal medicine residents (r=0.6, p<0.001).

Dimensions of character were different among surgery, internal medicine, and psychiatry residents. Likewise, the severity of burnout was different among them according to personality traits. Occupational burnout appears to be less if personality traits match the chosen specialty.

This study was conducted to compare temperament and character among psychiatry residents, internal medicine, and surgery residents in hospitals affiliated to Iran University of Medical Sciences in the academic year 2013–2014.

This cross sectional analytical study was conducted on 201 residents using the non-probability method of convenience sampling. Cloninger’s 125-item Temperament and Character Inventory (TCI) and Maslach’s Burnout Inventory (MBI) were distributed among all the residents in their morning session. Once the questionnaires were completed and submitted, the data were analyzed in SPSS 16. The frequency of different personality traits was analyzed among the selected residents. 

A total of 49.8% of the respondents were female (n=100) and 50.2% were male (n=101). The results of data analysis showed more novelty seeking, reward dependence, and harm avoidance and less persistence (33.93, p=0.006; 9.00, p=0.056; 32.55, p=0.021; and 2.48, p=0.028, respectively) in psychiatry residents than in surgery residents (31.97, 7.87, 30.74, and 3.12 respectively). Reward dependence was more frequent in internal medicine residents than in surgery residents (9.44 and 7.87 respectively, p=0.002). The self-directedness score was lower in psychiatry residents than in internal medicine residents (p=0.761) and higher than in surgery residents (17.96, 18.30, and 17.57 respectively, p=0.824). The cooperativeness and self-transcendence scores were higher in psychiatry residents than in internal medicine (p=0.943, p=0.199, respectively) and surgery residents (p=0.105, p=0.069 respectively).

The different dimensions of personality varied between the surgery, internal medicine, and psychiatry residents. Particularly, this study did not show statistically significant differences in dimensions of character (cooperativeness, self-directedness, and self-transcendence) among surgery, internal medicine, and psychiatry residents. The selection of medical specialties based on character traits significantly contributes to more effective treatment of patients and higher satisfaction of the residents.

Obsessive-compulsive personality disorder (OCPD) is the most common personality disorder in the general population, with prominent features of inflexibility, excessive attention to details, extreme perfectionism, and excessive self-control and interpersonal control. This study aimed at assessing the experiences of daughters living with OCPD fathers. Fifteen daughters of fathers with obsessive-compulsive personality disorder were selected by purposive sampling method and were subjected to semi-structured in-depth interviews. Interviews were analyzed using qualitative content analysis. Analysis led to emergence of 17 subcategories and three main categories, which included experiences of negative emotions, disorientation, and fear. Children of these patients were found to be under severe mental pressure, requiring serious attention, and interventions as preventive measures.

The relationship between Attention Deficit Hyperactivity Disorder (ADHD) and drug abuse has been indicated in earlier studies. This study was aimed to compare the prevalence of ADHD between Methamphetamine (Glass) abusing and dependent adults, referring to addiction treatment centers in Tehran, with a Control group
In this cohort study, the case group included the over-18-year individuals with only glass abuse background and an at least 1-month interval from their last abuse, referring to the specialist addiction treatment clinic of Iran Psychiatry Hospital and two outpatient addiction treatment centers on West and East Tehran, September 2014 to August 2015. The control Group included some 18-year and above staff at that hospital. The cases were given a combination of three questionnaires and provided with the necessary explanations to answer them. The obtained information was analyzed statistically using SPSS (chi square Test and the t-test).
Both the case and the control groups included 60 individuals with a mean of 30.8 years (SD = 8.92) and 32.29 years (SD = 6.85) respectively. The females in the case and control were 10 16.7%) and 37 (62.5%), respectively. The mean scores for the Wender Utah Rating Scale were also 20.21 ± 62.16 and 10.31 ± 14.37. Based on the test analysis, there were some evidence for childhood ADHD for 71.7% of the case group and only 1.6% of the control group. The results of the CAARS questionnaire represent a possible diagnosis of adulthood ADHD for 63.3% of the case group and 1.6% of the control Group.
ADHD is much more prevalent over Methamphetamine abusers than the normal population. This dramatic difference indicates the necessity of ADHD examinations to plan an appropriate treatment plan and implementing a more effective treatment for them.

Context: The objective of the present review was to collect published spiritual needs questionnaires and to present a clear image of the research condition of this domain.
Evidence Acquisition: First, an electronic search was conducted with no limits on time span (until June 2015) or language in the following databases: PubMed, Scopus, Ovid, ProQuest and Google Scholar. All derivations of the keywords religion and spiritual alongside need and its synonyms were included in the search. Researches that introduced new tools was then selected and included in the study. Due to the limited quantity of questionnaires in this domain and with no consideration given to the existence or lack of exact standardization information, all of the questionnaires were included in the final report.
Eight questionnaires were found: patients spiritual needs assessment scale (PSNAS), spiritual needs inventory (SNI), spiritual interests related to illness tool (SpIRIT), spiritual needs questionnaire (SpNQ), spiritual needs assessment for patients (SNAP), spiritual needs scale (SNS), spiritual care needs inventory (SCNI), and spiritual needs questionnaire for palliative care.
These questionnaires have been designed from a limited medical perspective and often involve cultural concepts which complicate their cross-cultural applicability.