فهرست مطالب

Iranian Journal of Psychiatry
Volume:14 Issue: 4, Autumn 2019

  • تاریخ انتشار: 1398/09/02
  • تعداد عناوین: 10
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  • Mohammad Reza Mohammadi, Seyed Ali Mostafavi*, Zahra Hooshyari, Ali Khaleghi, Nastaran Ahmadi Pages 253-264
    Objective

    Body mass index undergoes a substantial change in some psychiatric disorders. This study aimed to explore the status of body mass index (BMI) in different psychiatric disorders in a national survey among children and adolescents and to identify the role of gender in this regard.

    Method

    A total of 30 532 children and adolescents were randomly selected using cluster sampling method with equal blocks of 3 age groups and 2 genders. Psychiatric disorders were assessed using a standardized face-to-face diagnostic interview of Kiddie Schedule for Affective Disorders and Schizophrenia-Present and Lifetime Version (KSADS-PL), and Body Mass Index (BMI) was measured for each participant.

    Results

    In this study, 22 730 children and adolescents (109 46 boys and 11784 girls), with valid data of BMI, completed the KSADS-PL interview. The prevalence of psychiatric disorders was 21.2% among underweight participants, 22.8% among overweight participants, and 22.2% among obese participants, which was significantly higher than normal weight participants with 19.6% (X2 = 17.55; p = 0.001). In boys’ subgroup, depression and separation anxiety were mostly seen among the underweight category, while tic disorder was mostly seen in the obese category. In girls’ subgroup, on the other hand, generalized anxiety was mostly observed in the underweight category, while oppositional defiant disorder (ODD), depression, and mental retardation were mostly observed in the obese category. In total, the highest mean BMI rates were among the children and adolescents with alcohol abuse disorder, mania, and panic disorder. However, the lowest BMI rates were among those with attention deficit hyperactivity disorder (ADHD), separation anxiety disorder (SAD), and enuresis.

    Conclusion

    This study gives an overall picture of BMI status in different psychiatric disorders according to gender. Furthermore, in a multidisciplinary approach, the results of this study drew the attention of child psychiatrists to the status of BMI in their clients.

    Keywords: Adolescent, Body Mass Index, Child, Gender, Psychiatric Disorders
  • Mohadeseh Agahi, Zahra Noormohammadi, Iman Salahshourifar*, Niloufar Mahdavi Hezaveh Pages 265-273
    Objective

    Schizophrenia is a complicated mental disorder that affects about 1% of the world's population. It is a complex disease and is approximately 80% inherited. One of the candidate genes in schizophrenia is transcription factor 4 (TCF4), which is positioned on chromosome 18 and is a transcription factor that plays a role in the transcription of Neurexin 1(NRXN1) gene, which is one of the candidate genes for developing schizophrenia. This case-control study aimed to investigate the correlation of TCF4 rs13381800 and NRXN1 rs17039988 polymorphisms with the risk of schizophrenia in a sample of Iranian patients with schizophrenia.

    Method

    A total of 200 individuals were included in this study: 100 patients with schizophrenia (65 males and 35 females), with the mean age of 40.80 ± 11.298 years, and 100 as a control group (63 males and 37 females), with the mean age 32.92 ± 7.391 years. Allele specific polymerase chain reaction and restriction fragment length polymorphism (PCR-RFLP) were done, respectively, for genotyping of rs13381800 (T/C) and rs17039988 (A/C) polymorphisms.

    Results

    The results showed that the frequency of C / C genotype in rs13381800 in patients’ group was 9%, while it was 13% in the control group. Also, the frequency of C / C genotype in rs17039988 was 9% in patients and 7% in control groups. Statistical analysis of polymorphisms showed no correlation between patients and controls in rs13381800 (OR = 1.51; CI = 95%; P = 0.366) and rs17039988 (OR = 0.76; CI = 95%; P = 0.602).

    Conclusion

    No significant difference was found between rs13381800 and rs17039988 genotypes between patients and control groups in terms of gender, age and education in the patients group. Our study suggests that there was no correlation between desired polymorphisms with schizophrenia in the studied population.

    Keywords: Neurexin 1, rs13381800, rs17039988, Schizophrenia, Transcription Factor 4
  • Masoumeh Seydi, Isaac Rahimian Boogar*, Siavash Talepasand Pages 274-282
    Objective

    This study aimed to model risky driving and predict its occurrence according to the constructs of personality organization and mentalization considering the role of aggressive driving as a mediator construct.

    Method

    A total of 428 individuals (219 men and 209 women) were selected using convenience sampling. The participants completed self-report questionnaires on aggressive driving, risky driving, mentalization and personality organization Also, data were analyzed using structural equating model and weighted regression.

    Results

    The results of this study showed a goof fit of the proposed structural model for predicting risky driving after some modifications (CFI = 0.95, RMSEA = 0.09). According to the results of regression weights, personality organization (regression weighted: 0.044) and aggressive driving (regression weighted: 0.98) were the strongest and mentalization (regression weighted: 0.004) was the weakest predictor of risky driving. Aggressive driving was the strongest direct predictor and personality organization the strongest indirect predictor of risky driving.

    Conclusion

    Risky driving is a function of direct and indirect personal factors. Moreover, emotional factors have a direct effect on risky driving and more substantial constructs, such as personality, have an indirect effect on risky driving.

    Keywords: Aggressive Driving, Mentalization, Personality Organization, Risky Driving
  • Fatemeh Zargar, Nasim Bagheri*, Mohammad Javad Tearrahi, Mehrdad Salehi Pages 283-290
    Objective

    Psychological and environmental factors, such as difficulties in emotion regulation (ER) and marital problems, are involved in relapse and craving in patients with substance use disorders. Emotional regulation therapy can help maintain opioid withdrawal and improve marital relations by focusing on appropriate adjustment of emotions. This study aimed to evaluate the effectiveness of emotion regulation therapy on craving, emotion regulation, and marital satisfaction in patients with substance use disorders.

    Method

    This randomized controlled clinical trial with pretest and posttest was performed in 2014 in Noor hospital, Isfahan, Iran. In this study, 30 patients who were admitted to the addiction center of Noor hospital were selected using purposive sampling. They were assigned into 2 groups randomly: (1) 15 patients in treatment as usual (TAU group); (2) 15 patients in emotion regulation group therapy (ERGT). The ERGT group received 8 weekly treatments, based on Gross model, to learn recognize emotions and their effects, overcome obstacles of positive emotions, accept emotions, identify regulatory maladaptive and adaptive strategies of emotions, and modify behavior. Before and after the emotion regulation sessions in experimental group, Craving Beliefs Questionnaire (CBQ), Emotion Regulation Questionnaire, and Dyadic Adjustment Scale (DAS) were administered in both groups.

    Results

    The results of analysis of variance indicated that mean scores of marital adjustment increased in ERGT (93.66 ± 15.81) compared to TAU group (55.26 ± 20.98) and the mean scores of craving were decreased in ERGT compared to TAU group (56.66 ± 18.39 and 105.2 ± 34.5, respectively). Also, most aspects of ER improved in ERGT compared to TAU group, and the total score of ER was increased in ERGT significantly (96.69 ± 5.38 in ERGT versus 73.70 ± 5.05 in TAU).

    Conclusion

    Based on the findings of this study, emotion regulation group therapy has a significant effect on reducing Craving and improving marital adjustment and emotion regulation in Patients with Substance Use Disorders. So, it can use as a useful psychotherapy in addiction treatment centers.

    Keywords: Craving, Emotion, Marital Relationship, Substance Use Disorder
  • Nader Hajloo*, Asghar Pouresmali, Jaber Alizadeh Goradel, Mehri Mowlaie Pages 291-296
    Objective

    Tobacco smoking is an addictive behavior with many psychological side effects, and many smokers are unable to quit it. Despite various treatments for smoking cessation, there is an urgent need to develop and utilize a noninvasive technique with high efficacy. This study aimed to determine the effects of transcranial direct current stimulation (tDCS) of dorsolateral prefrontal cortex (DLPFC) on reduction of craving in daily and social smokers.

    Method

    This pretest-posttest quasi-experimental study, in which the participants were randomly assigned into sham and active groups, was performed on 40 daily and social smokers. Stimulation was delivered over the left DLPFC at a 2 m/A during 10 twenty-minute sessions for 5 weeks. The participants filled out the Desire for Drug questionnaire (DDQ) before and after intervention. Analysis of covariance was used for data analysis.

    Results

    A significant decrease was found in the number of cigarette smoking in both daily and social smokers compared to the sham group. Moreover, the results indicated that anodal tDCS on F3 and Cathodal tDCS on F4 has significant effects on nicotine craving (P < 0/000).

    Conclusion

    The results of the present study showed that the current tDCS of DLPFC decreases the craving of smoking. This noninvasive brain stimulation technique targeted at DLPFC area may be a promising method for reducing and treating smoking craving.

    Keywords: Smokers, Transcranial Direct Current Stimulation (tDCS)
  • Abdulaziz Aflakseir*, Muhammad Rasooli Esini, Muhammad Goodarzi, Javad Molazadeh Pages 297-301
    Objective

    Stigma has a significant impact on the life of individuals with mental illness. The purpose of this study was to examine the association of contact with the mentally ill with stigmatizing attitudes in a group of college students.

    Method

    A total of 287 college students participated in this study. The participants were recruited from Hormozgan University of Medical Sciences using convenience sampling and completed the research measures including the Level of Familiarity (LOF) and the Attribution questionnaires (AQ). The data were analyzed using SPSS.

    Results

    The descriptive findings of this study showed that the participants’ highest score on stigmatizing attitudes was related to pity and the least score was related to anger towards people with mental illness. Furthermore, the regression analysis results indicated that personal contact, family contact, and work contact with individuals with mental illness significantly predicted stigma reduction, while other types of contacts with the mentally ill, such as friend contact, social contact, and media contact, did not significantly predict stigma reduction.

    Conclusion

    This study highlighted the significant role of having contact with the mentally ill in reducing stigmatizing attitudes towards them.

    Keywords: Contact, College students, Dangerousness, Mental illness, Stigmatizing Attitude
  • Leila Jahangard, Helen Behmanesh, Mohammad Ahmadpanah, Seyedeh Mahsa Poormoosavi, Alireza Soltanian, Mohammad Haghighi* Pages 302-308
    Objective

    Health behaviors are defined as activities that affect either health status or disease risk. They can be divided into 2 categories: risky behaviors and health promoting behaviors. The growing body of evidence indicates that unhealthy behaviors often cluster in young individuals. Patterns of health-related behaviors are significantly different among countries and even among various regions of a certain country.

    Method

    The present study was conducted to assess the youths’ patterns of health attitude, health-related behaviors, and their mental and physical wellbeing. In this cross-sectional study, 800 university undergraduate students were selected using multistage cluster sampling method. Standard questionnaires were filled by students.

    Results

    About 13.3% of students smoked regularly and 14.3% reported at least one occasion of drinking, and heavy drinking was quite prevalent. Of the students, 95% reported regular physical activity and exercise. Eating habits were not healthy among the majority of students, as there was a high consumption of fast food and salt, and only 23.9% had normal body weight. Self-care behaviors were not prevalent among the students (3.2% breast self-exam and 8.5% testicular self-examination).

    Conclusion

    Many factors may affect positive and negative heath behaviors, including knowledge, beliefs and attitudes, legal constrains, social context, and economic status. However, lower health literacy leads to more negative health behaviors.

    Keywords: Adult, Behavior, Healthy, Risky
  • Elham Bazmi, Abbas Alipour, Mohammad Taghi Yasamy, Ali Kheradmand, Soosan Salehpour, Soheila Khodakarim, Hamid Soori* Pages 309-316
    Objective

    Job burnout can cause physical and psychological damage and reduce job efficiency, especially in difficult jobs such as health care fields. This study aimed to assess the association between the level of job burnout and some contributing factors among health care providers in Iran.

    Method

    This study was performed on the data derived from 1807 participants from the first phase of the employees’ health cohort in 2017-2018. The data were collected using as a self-administrated tool utilizing Maslach Burnout Inventory. The questionnaire scores ranged from never to everyday, with 3 levels of burnout as well as burnout itself; then, the scores were categorized as low, moderate, or high. Ordinal logistic regression model was used to adjust ordinal dependent variables.

    Results

    The mean score of the total burnout was 16.5±7.77 and was associated with work experience and age group (p < 0.001). The components of burnout consisted of emotional exhaustion (8.9± 9.0), depersonalization (23± 2.9), and personal accomplishment (34± 8.6). Emotional exhaustion was related to sex (less among males, OR=0.48) and type of job (less among officials compared to health care staff, OR=0.488). Composite burnout was more common among younger staff (OR= 3.85). Depersonalization was associated with duty shift workers (OR=2.42).

    Conclusion

    Job burnout is a major concern, and lack of personal accomplishment, as a component of burnout, was highly prevalent among Iranian health care employees. Being a single woman, health care provider, and having more than 20 years of work experience with a duty shift were contributing factors for burnout experience. Monitoring symptoms of burnout and its associated factors in the workplace and proposing an alternative organizational and behavioral system and sharing it with relevant authorities may help prevent or reduce job burnout and its deleterious effects.

    Keywords: Associated Factors, Burnout, Employees, Health Care
  • Mohsen Koushan, Nematullah Shomoossi, Zahra Parsaei Mehr, Mostafa Rad* Pages 317-324
    Objective

    Mental disorders are often accompanied by serious problems in personal and social communication, including marital problems. In this regard, women whose spouses have mental disorders are less likely to express their mental experiences and emotions due to the cultural barriers of the community. This study aimed to identify and explain the shared mental experiences of women whose spouses suffered from psychotic disorders.

    Method

    This was a qualitative study with a content analysis approach. In total, 15 women whose spouses were admitted to the psychiatric ward of a hospital due to psychotic disorders were selected through purposive sampling. Data were collected by conducting in-depth semi-structured interviews on experiences of women regarding their spouses’ psychotic disorder. Data were analyzed using conventional content analysis techniques.

    Results

    In this study, 28 subcategories and 7 main categories (lack of intimacy, social constraints, dual emotions, confusion and mental exhaustion, fear and concern, coping strategies, and life problems) were developed.

    Conclusion

    Based on the results of the study, women whose spouses suffered from psychotic disorders experienced various psychological challenges. Therefore, it is recommended that the health care staff take such psychological challenges into consideration to design and implement effective strategies to solve the related problems.

    Keywords: Psychotic Disorders, Qualitative Research, Spouse, Women
  • Ali Sahebi, Katayoun Jahangiri*, Sanaz Sohrabizadeh, Mohammad Golitaleb Pages 325-334
    Objective

    Workplace violence is one type of occupational hazards that is increasingly growing worldwide. In the health system, one of the important groups subject to workplace violence is emergency medical services (EMS) personnel, who provide emergency services for patients and casualties as the first responders. The aim of this study was to determine the prevalence of workplace violence and its different types among Iranian EMS personnel.

    Method

    This study was conducted based on PRISMA guideline for systematic review and meta-analysis. The data were extracted from Scopus, PubMed, Web of Science, Google Scholar, MagIran and SID databases using Persian and English keywords. The search was conducted up to December 2018 without any limitation in publication year. The qualities of selected papers were assessed by STROBE checklist. I2 index was used to evaluate heterogeneity, and random effects model was used in meta-analysis. Data were analyzed using Stata14.

    Results

    A total of 9 studies entered the meta-analysis. The total sample size was 1257 Iranian EMS personnel, with an average age of 32.21 ± 2.01 years. The prevalence of physical, verbal, and cultural workplace violence among EMS personnel was 36% (CI 95%: 27 – 45, P < 0.001, I2 = 90.8%), 74% (95% CI = 69-78, P = 0.046, I2 = 55.7%), and 17% (95% CI =.3- 30, p < 0.001. I2 = 94.7%), respectively.

    Conclusion

    Considering the high prevalence of workplace violence among EMS personnel in this study, more studies should be conducted to determine the underlying causes of EMS staff workplace violence in Iran. Training violence prevention methods as well as assigning national protective rules is highly suggested. Insufficient studies on workplace violence among EMS personnel and high heterogeneity were the limitations of this study.

    Keywords: Emergency Medical Services (EMS), Systematic Review, Meta-Analysis, Workplace Violence