Iranian Journal of Psychiatry and Behavioral Sciences
Volume:11 Issue: 4, Dec 2017

Context: Proper accountability to needs of premature infants’ parents requires recognition of these needs and how they change in different conditions.
This Meta-synthesis was conducted to understand the needs of Iranian parents with premature infants through their experiences in order to promote family-centered care.
Data Sources: The search was conducted through the Iranian database (Iran Medex, Magiran, SID) and international resources (PubMed, Scopus, Google Scholar), without time limitation to April 12, 2015.
Study Selection: The inclusion criteria for this study included the qualitative studies conducted in Iran on parents with premature infants. Consolidated criteria for reporting qualitative studies (COREQ) were used to assess the quality of articles.
Data Extraction: This study is a meta-synthesis of 16 qualitative studies based on Noblit and Hare’s (1988) methodology.
The meta-synthesis presented 5 correlated metaphors derived from 13 categories and 78 integrated codes. The metaphors indicated the most important needs of parents who have premature infants for emotional, instrumental, spiritual, appraisal, informational, and communicational support. In most cases, these needs overlapped with blur boundaries. The categories included: cultural challenges of parental role, parental development versus psychological stress, psychological stress stimuli, economic challenges of parental role, physical irritation, the need for family-centered care, the need for policy making regarding the constant presence of parents in the NICU, spiritual prosperity vs. spiritual alienation, spiritual self-care vs. spiritual self-harm, guided participation in caring for the infant, the efforts to meet parental role, informational challenges of parents, and informational-communicational supports.
This Meta-synthesis provided a better understanding of the experiences of Iranian parents with premature infants and different areas of their needs. These findings could be used to design a comprehensive support system for such parents, which incorporate a holistic view of patient concerns, including religion and spirituality.

Context: Obsessive jealousy is a highly disturbing disorder that is usually unrecognized, as most studies are concerned with delusional jealousy. The aim of the present article was to provide a narrative review of studies conducted on obsessional jealousy and associated factors.
Evidence Acquisition: A literature search was conducted using electronic databases, including MEDLINE/PubMed, Google Scholar, Psycho INFO, EMBASE, Web of Science, and Scopus for articles published between 1976 and April 2016.
The core of jealous concerns was found to be different between males and females. Patients with obsessive compulsive disorder (OCD) had greater concerns about their partner than healthy individuals. Studies suggested a phenomenological overlap between OCD and obsessional jealousy, for which anti-OCD treatment could be useful.
Different terms were found for symptoms associated with obsessive jealousy, such as cognitive jealousy or neurotic jealousy. The term obsessional jealousy should be standardized in psychiatry reference books. It could be used in scales applied for diagnosis and evaluation of OCD.

Context: Sexual dysfunction is a health problem; but there is no comprehensive review on this subject in Iran.
By reviewing recent studies, this systematic review was performed to estimate the prevalence rate of sexual dysfunction in Iranian general population.
Data Sources: By using related keywords, data were obtained by searching PubMed, Google scholar, Scopus, and 2 Persian databases (IranMedex and Scientific Information Database (SID)). Moreover, hand searching the key journals and reviewing the references of included articles were done.
Study Selection: This study reviewed all available published data on the prevalence of different types of sexual disorders/dysfunctions among Iranian general population until June 2016.
Data Extraction: Data were extracted independently by two observers using a researcher-made checklist.
23 studies were finally evaluated. Most of the articles did not have acceptable standard quality. Most of the reviewed original articles were conducted in females. Besides, it was noted that there was a large diversity among the results of different studies that may be due to not using standard methodologies. The reported ranges of the prevalence rates for total sexual disorders, sexual desire disorder, sexual arousal disorder, and lubrication disorder were estimated to be 19.2 to 77%, 15.4 to 65.8%, 9.8 to 88.3%, and 11.9 to 71.4%, respectively. In addition, the reported prevalence rates for pain disorder, female orgasmic disorder, and sexual dissatisfaction were estimated between 9 to 95.9%, 10.5 to 76%, and 2.4 to 78.5%, respectively.
Despite the large diversity in the findings of this review, it seems that the prevalence of sexual disorders is relatively high among Iranian populations. It is suggested that researchers pay more attention to the duration of evaluation in cross-sectional studies, reporting the response rates, utilizing reliable and valid measures, and applying appropriate sampling methods in order to improve the quality of future research. Educating general population by health professionals who are involved in the treatment of sexual disorders is highly recommended.

The most common suicide attempt (SA) is deliberate self-poisoning (DSP) in Iran. Although the proportion of fatal suicide by DSP is much lower compared to other methods, repeated suicide attempts (RSA) are very high.
This study aimed at determining the effective factors on RSA among patients referred due to DSP in west of Iran.
All cases attempting DSP, who were referred to the only main poisoning treatment centre in the west of Iran, were assessed during year 2014. They were interviewed by psychologists in order to determine the number of SAs for each person individually, using data linkage. Data was analyzed by zero-truncated poisson regression.
During year 2014, of 1790 cases committed with DSP, 64 (3.5%) died because of the severity of poisoning. Among non-fatal DSP attempters, 1069 (61.94%) attempted suicide for the first time and 334 (19.34%) for the second time. In the multivariate model, age was an important predictor of RSA, so that the risk of RSA in 26 to 35 year-old age group was lower than in the 18-year-old age group (IRR 0.3, 95 % CI, 0.2 to 0.4 P = 0.001). Also, SA history was the first risk factor for RSA, so that individuals with SA history had higher RSA than individuals without SA history (IRR 3.1, 95 % CI, 2.8 to 3.3, P = 0.001). After SA history, psychological disorders were the most important risk factor for RSA (IRR 2.7, 95 % CI, 2.1 to 3.6, P = 0.001).
Psychological disorders and SA history are the most important factors on RSA. Because of the high prevalence of psychological disorders in SA individuals than the normal population, it is necessary to present psychological and surveillance consultation to suicide attempters to decrease the number of SAs.

Depression is one of the most prevalent psychiatric disorders that imposes a heavy economic, emotional and social burden on patients, families and society.
The present study aimed to compare the effectiveness of acceptance and commitment therapy (ACT) and cognitive therapy (CT) in treating Iranian women patients with major depressive disorder (MDD).
Nineteen women outpatients meeting DSM-IV-TR criteria for MDD without any axis 2 disorders were randomly (goal-oriented and convenience sampling) assigned to one of two treatment conditions, i.e. ACT and CT. The intervention in acceptance and commitment therapy group that was conducted was based on the Zeattle manual for major depressive disorder. Twelve therapeutic sessions were administered in the consulting center of Tehran university twice a week. The control group received 12 sessions of cognitive therapy based on Ferry manual twice a week in the consulting center of Tehran university, too. The Beck depression inventory-II-second edition (BDI-II), acceptance and act questionnaire (AAQ-II) and dysfunctional attitude scale (DAS) were administered for pre-treatment, post-treatment and follow-up. The data was analyzed by repeated measures analysis of variance (ANOVA).
ANCOVA results showed that there were significant differences between ACT and CT in dysfunctional attitude. The ACT group demonstrated significant improvement in acceptance in the pre-test and post-test stage. All the participants demonstrated significant improvement in depression.
As ACT improved depression and acceptance of internal experiences, it is recommended for depression as an effective psychotherapy.

Substance abuse in adolescents and its outcomes is one of the important public health concerns.
The present study aimed at estimating the prevalence of substance abuse and evaluating some of its associated factors in Iranian adolescents.
A self-administered questionnaire was completed by 730 randomly selected students with a mean age of 17.6 ± 0.61 years during a cross sectional study in Yazd, a central province of Iran, during 2014. The aim of the questionnaire was to obtain information on substance abuse and socioeconomic information. Logistic regression model and Chi-square, or Fisher exact test were used for statistical analysis using SPSS; and P The highest frequency of one time and more than one time drug usage among students pertained to hookah 41.1% and 31.1%, cigarette 17.5% and 8.1%, alcohol 10.8% and 7.5%, Opiates 4.1% and 0.8%, hashish, bang or marijuana 1.9% and 0.7%, stimulants and hallucinogens 3.4% and 0.8%, and glue and lighter gas 0.8% and 0.7%, respectively. Based on the results in logistic regression models, male gender (AOR:3.02), mathematical physics (AOR:1.8), hookah and alcohol experience (AOR:14.4 and 3.4) for regular smoking in Model 1; male gender(AOR:2.7), cigarette and hookah experience (AOR:3.2 and 7.6) for ever use of alcohol in Model 2; and male gender (AOR:2.5), mathematics course studding (AOR:1.6), poor educational condition (AOR:1.7), high level of father education (AOR:3.9), and tranquilizer experience (AOR:5.8) for ever use of illicit drugs in Model 3 were considered as predicting factors. For all the above- mentioned, p-values were less than 0.05.
In the present study, it was found that drug abuse is at a warning rate. The findings pointed to the need for interventional plans to improve adolescents’ health with regards to substance abuse. Conducting more studies on this population is necessary to approve the observed results of the present study.

Cancer is one of the most serious chronic diseases and risk factors for population health. Breast cancer is the most common cancer diagnosed in females. Today, some researchers in the field of clinical psychology by the implementation of psychosocial interventions sought to examine these effects on psychopathology in patients with breast cancer.
The present study aimed to assess the efficacy of mindfulness-based cognitive therapy on the improvement of cognitive emotion regulation and decrease of clinical symptoms in females with breast cancer.
Sixteen females with breast cancer who referred to radiation oncology centers of Mashhad, Iran, were selected and randomly assigned (with Graph Pad software) into two groups of eight as intervention and control groups .The participants in the pretest, posttest and follow-up (four months) were examined by cognitive emotion regulation questionnaire (CERQ-P) and depression, anxiety and stress scale (DASS-21). Intervention group received eight sessions of two hours (one day per week) of mindfulness-based cognitive therapy and controls were placed on a waiting list. Data were analyzed by SPSS using multivariate analysis of covariance (MANCOVA).
The intervention group showed a significant reduction in the rate of maladaptive cognitive emotion regulation strategies. But no significant differences were observed in the increase of adaptive cognitive emotion regulation strategies and decrease of clinical symptoms between the two intervention and control groups.
Mindfulness-based cognitive therapy may be effective to reduce maladaptive cognitive emotion regulation strategies.

During the last two decades, much effort is put to better understand the etiology of schizophrenia. Studying negative symptoms such as endophenotypes is a plausible approach to elucidate the genetic basis of schizophrenia. Neuregulin-1 (NRG1) is a key candidate gene to develop schizophrenia and its negative symptoms. The NRG1 variant rs6988339 was previously characterized as a schizophrenia susceptibility locus in different Scottish populations.
The current study aimed to examine the association of rs6988339 with schizophrenia and its negative symptoms in an Iranian population.
The current case-controlled study enrolled 469 subjects (276 unrelated schizophrenia patients and 193 healthy controls). The study investigated the association of rs6988339 with schizophrenia and its negative symptoms (assessed with the positive and negative syndrome scale; PANSS) in an Iranian population.
The obtained results showed that rs6988339 was a schizophrenia susceptibility locus in the Iranian population, the minor allele G was the risk allele and A the protective allele (P = 0.0007). Of the four subscales of the PANSS test, the negative score showed the strongest association with this variant (P = 0.001).
The results further supported the implication of NRG1 in the pathogenesis of negative symptoms in schizophrenia.

Quality of life, self-esteem and attribution styles have important effects on people’s individual and social functions. Through determining the interactional relations of these factors, parents and schools can plan to change each one of them and improve their children’s functions.
The current study aimed to investigate the interactional relations among students’ quality of life, self-esteem and attribution styles.
The research sample included 365 primary school students (154 boys and 211 girls), who were selected through random cluster sampling. They filled in the questionnaire after each item was read by their teacher. Research tools included three questionnaires including Sieberer’s quality of life, Seligman’s attribution styles and Rosenberg’s self-esteem questionnaires. Statistical analyses were conducted by Pearson correlation and analysis of regression.
The results indicated that there was a significant positive relationship among dimensions of quality of life (except for physical well-being and peers relation and support) and self-esteem. Furthermore, there was a significant negative relationship between self-esteem and negative mood (from components of quality of life) and all components of quality of life were significant predictors of self-esteem. On the other hand, self-esteem was the greatest predictor of negative mood (0.13) and efficiency in the school environment (0.02) (from components of quality of life) (P = 0.01). The results also showed that there were significant positive correlations among optimistic attribution style, self-perception and peers relation and support (from components of quality of life).
Since variables of negative mood and efficiency at the school environment were effective factors on self-esteem and, optimistic attribution style was affected by peers relation and support, educational planning for each indicator can improve the quality of life of primary school students.

The number of patients with chronic renal failure is increasing in Iran. Quality of life is an important indicator that reveals the sense of well-being, positive understanding of their, and the effectiveness of health care in patients undergoing dialysis, which could be affected by duration of dialysis.
This study aimed at investigating the relationship between quality of life and duration of dialysis in hemodialysis patients.
In this descriptive correlational study, 246 patients with chronic kidney failure were selected by Single-stage stratified cluster sampling. Hemodialysis patients were put into 2 groups with a duration of hemodialysis less than and more than 36 months and were then compared with each other. The quality of life was measured using the kidney disease quality of life short form (KDQOL- SF36). Data analysis was performed by the Pearson correlation coefficient, independent t-test, and ANOVA
The mean duration of hemodialysis patients was 34.03 months. There was no significant relationship between the quality of life in patients and duration of hemodialysis. Poor quality of life had a significant correlation with old age (P The findings showed poor quality of life in patients on dialysis. The length of the disease and other accompanying diseases reduced the quality of life in dialysis patients as their age increased. It is evident that educated people who have better access to sources of support and are able to cope with disease complications have a higher quality of life.

Death penalty and euthanasia are disputed practices in the world. However, they are considered “justified” by their proponents. We newly developed a scale for assessment of the attitude toward justified death, which determines “hot cognition” using a number of scenarios.
This study aimed at assessing the effects of the major demographic items including gender, major, religion, and mental health on the justified death attitude.
A total of 481 participants including 419 university students and 62 seminarians participated in the study in Tehran, Iran. The Persian versions of the justified death attitude scale and the general health questionnaire-12 were used for data collection. Data were analyzed using the multivariate analysis of variance.
Capital punishment was suggested more frequently for rape and drug trafficking and less frequently for murder, and infrequently for adultery. Men and religious subjects showed a more positive attitude toward execution. Furthermore, most of the subjects did not agree with euthanasia; surprisingly, active euthanasia was more acceptable than passive euthanasia. Finally, death penalty and euthanasia did not show an association with mental health.
Individual characteristics like gender, major, and religiosity could significantly affect the attitude of people toward justified death. Further studies including neuropsychological methods are suggested.

Attention deficit hyperactivity disorder (ADHD) symptoms are difficult to treat. As ADHD is naturally a disorder of attention and related executive functions, attention training (ATT) has been considered as a treatment for the disorder. Although there are few studies investigating the utility of ATT in the ADHD population, published studies provide support for ATT in reducing the symptoms of ADHD.
The aim of the current study was to examine the effects of training attention on ADHD symptoms in a group of preschool-aged children at risk for ADHD disorder.
In this study, a group of 5-year-old children (n = 30) with ADHD symptoms were assigned randomly to either a training- group who participated in 11 sessions of visual attention training based on Pay Attention Program or a non-trained control group. Both versions of Child symptom inventory-4 (CSI-4) were employed to assess ADHD symptoms based on parent and teacher’s rating. Also the accuracy and the continuous performance of children were examined with Tolouse-Pierron test. The Assessment was performed in three phases: (1) before, (2) after, and (3) one month after the termination of training.
Results of the multivariate analysis of the covariance demonstrate that there was a significant difference (P It seems that the performance of children’s attention with ADHD improves by visual attention training.

Happiness and its associated factors are of critical importance in human health.
This study was conducted to examine the association between social capital (social relations) and happiness among health personnel in Iran.
In this cross sectional study, 537 health personnel were selected from the West of Iran through stratified random sampling. The study tools included a demographic checklist, a social relations questionnaire, and Oxford happiness inventory (OHI). For statistical analysis, independent t test, ANOVA, Pearson’s correlation test, and multiple regression analysis were performed, using SPSS version 18 and AMOS software.
Among happiness dimensions, the mean score of “sense of vitality” was significantly higher in men, compared to women (P The findings showed that family and family relations are still the most important sources of happiness. Reinforcement of social relations, as the central aspect of social capital, can play an essential role in increasing happiness in different social groups.

Test anxiety is one of the most common and important problems of students in their educational course which affects performance, well-being, and success of students adversely. The prevalence of test anxiety in the students of the University of Medical Sciences is more than in other students. It`s maybe due to their hard educational condition.
This study aimed to examine the mediating role of emotional intelligence in coping strategies and test anxiety in university students.
The present study is a correlational descriptive study. Statistical population was all of the students in Kermanshah University of Medical Sciences, Kermanshah, Iran, 2013-2014. Among them, 196 ones were selected by convenience sampling. In this study, participants were assessed by Sarason Test Anxiety Inventory, Lazarus and Folkman coping strategies, and Schutte et al’s emotional intelligence. Data were analyzed by Pearson correlation tests and path analysis.
The results showed that there was a relationship between coping strategies (problem-focused and emotion-focused) and emotional intelligence with test anxiety (P According to the results, it can be concluded that students who use problem-focused coping strategies have more emotional intelligence and with increasing emotional intelligence, test anxiety reduces significantly. So in order to reduce the test anxiety, the important role of emotional intelligence should be considered. Test anxiety is related to coping strategies (problem-focused and emotion-focused) and emotional intelligence.

Children with epilepsy have behavioral and social interactions problems more often than their peers. The purpose of this study was to investigate the effect of social skills training on the social interaction of children with epilepsy.
The aim of this study was to examine the influence of social skills training on the social interaction of children with epilepsy
This was a 1 group quasi-experimental study with pretest and posttest design. Through convenience sampling, 40 children between the ages of 6 and 12 years (mean = 11.8 years, SD = 1.8) with epilepsy were selected from the Iranian epilepsy association from August to December 2014. The social skills rating system scale was used to collect data. Social skills training in 4 sessions’ were conducted for the group. Training consisted of 1 session per week. Paired-samples t-test was used for analyzing the pre- and post- results of intervention. The significance level was considered less than 0.05.
The mean score of the social interaction of children with epilepsy was increased after social skills training intervention. This difference between before and after intervention was statistically significant (P The results showed that social skills training due to increase social interaction could improve the social function and maybe reduce high-risk behaviors in children with epilepsy.

Spiritual intelligence is an important factor for effective functioning of emotional intelligence.
The present study was conducted with the aim to determine the relationship between spiritual and emotional intelligence among Iranian medical students.
This cross sectional study was conducted in 2015 on 324 students, who were selected through stratified random sampling from Mazandaran University of Medical Sciences, Sari, Iran. Data were collected using Bradberry-Greaves emotional intelligence and Eysenck spiritual intelligence questionnaires.
The participants included 94 males and 230 females. The mean total scores of emotional and spiritual intelligence were 110.52 and 89.37, respectively. The mean score of spiritual intelligence was higher among women in comparison with men, whereas the mean score of emotional intelligence was higher among men. A significant correlation was found between emotional and spiritual intelligence (r, 0.48; P Based on the findings, students’ emotional intelligence can be fostered by reinforcing their spiritual intelligence, and correct behaviors can be promoted in accordance with social values.

These days, selective serotonin reuptake inhibitors (SSRIs) are the most commonly prescribed and used antidepressants. Serotonin syndrome is a potentially fatal complication with hyper-serotonergic situation. Its symptoms result from over activation of the central and peripheral receptors caused by high serotonin levels. The use of SSRIs is associated with the frequency of syndrome. Hyponatremia is one of the side effects of SSRIs, especially in elderly patients. The mechanism by which SSRIs cause hyponatremia is thought to be secondary to the development of the syndrome of inappropriate antidiuretic hormone (SIADH). Patients with hyponatremia secondary to SIADH have been reported with fluoxetine, paroxetine, sertraline, fluvoxamine, and citalopram. There are very few reports about the concurrent incidence of serotonin syndrome and hyponatremia.
The patient was a 66-year-old woman with rheumatoid arthritis. She was treated with a fixed dose of fluoxetine and buspirone added with the amount of 15 mg per day. The patient was hospitalized 8 weeks with symptoms of confusion, lack of insight into time and space, inability to stand and walk, continuous involuntary tremor, uncoordinated and uncontrolled movements of arms and legs, hyperreflexia, and mydriasis. She also showed severe hyponatremia in the experiments. She was admitted to an academic general hospital in Iran on 2014. Based on the clinical findings, taking buspirone aside fluoxetine, as well as old age of the patient, she was diagnosed with serotonin syndrome. Treatment was carried out after discontinuation of fluoxetine and buspirone, restriction of fluid therapy, as well as prescription of sodium chloride 5%, cyproheptadine, and diazepam.
Consumers of SSRIs are at a higher risk of hyponatremia compared to those taking other antidepressants, especially if they are simultaneously treated by diuretics. Hyponatremia and SIADH need to be considered if a patient experiences disorientation receiving SSRIs. Physicians should be aware of the probability of acute hyponatremia and serotonin syndrome secondary to SSRIs in simultaneous use of fluoxetine and buspirone with diuretics. Moreover, physicians should note that serotonin toxicity is dose-dependent rather than idiosyncratic.