Iranian Journal of Psychiatry and Behavioral Sciences
Volume:8 Issue: 1, Mar 2014

The present article discusses the reaction of psychiatric professionals and specifically the academia in Iran to the publication of the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, (DSM-5). It is argued that the reaction to changes and the approach of the new revision of DSM has been neither technical, nor emotional. This argument has further been examined for the previous revisions of the DSM and the conclusion is that the Iranian psychiatry has become alienated from the need and necessity of classification of mental disorders from a local and national point of view. The reason for this alienation has further been discussed and has been focused on the lack of contact between the psychiatric catchment areas and the academia.

Providing treatment and educational services for consumers and their caregivers is more effective if those services are implemented based on their characteristics and differences. To partly address this objective, the present study aimed to describe and compare characteristics and differences of chronic hospitalized and household maintained consumers and their caregivers who were regular users of educational and rehabilitation programs of the Iranian Society Supporting Individuals with Schizophrenia (ISSIS) in Tehran, Iran. Two hundred and thirty one consumers were evaluated based on demographics, and clinical and symptom-related characteristics. Their caregivers (n = 231) were independently evaluated based on their knowledge on schizophrenia, family function, burden, and availability of social services and support for them. Data were analyzed by performing independent sample t-test and Mann-Whitney U. The study findings revealed hospitalized consumers were older, had longer length of illness, greater severity of positive and negative symptoms and lower efficacy in basic life skills in comparison with household maintained consumers. The caregivers of the hospitalized consumers had greater objective and subjective burdens and lower knowledge on schizophrenia in comparison with caregivers of household maintained consumers. While household maintained consumers had more access to medical insurance, their caregivers had more access to the supportive organizations, more availability of substitute caregiver and assistant caregiver compared with caregivers of hospitalized consumers. Our findings suggest the need to promote specific interventions and treatment programs for Iranian consumers and their caregivers based on their characteristics and differences due to schizophrenia.

The present study aimed to clarify dissociative symptoms in patients with schizophrenia and its association with negative and positive symptom of schizophrenia. Based on the 4th edition of Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) criteria, 80 schizophrenic subjects were randomly selected from patients who referred to the clinics of psychiatry hospital in Kerman, Iran. Eighty non-schizophrenic patients were chosen as the control group. Both groups were evaluated for dissociation symptom using the Dissociative Experience Scale (DES). Positive and Negative Syndrome Scale (PANSS) score was also used in the case group for determination of positive and negative symptom of schizophrenia. The prevalence of dissociation symptom was 13% and 4% among schizophrenic and control groups, respectively (p = 0.02). In addition, there was a statistical significant association between DES score and positive symptom in schizophrenia (p = 0.02). The association between dissociative symptom and schizophrenia was significant and dissociative symptoms were associated with positive symptoms of schizophrenia.

Parental self-efficacy is associated with increasing mental health in children. There is a paucity of research in Iran on the role of parental self-efficacy in increasing mental health status of children. In this preliminary study, we studied the effectiveness of the World Health Organization international child development program (2002) for children aged 3 years and younger in increasing positive interaction between child and mother as an important component of mental health. Forty mothers from a central hospital child-caring center in Mashhad participated in the study and were randomly divided into an experimental group (n = 20) and a control group (n = 20). The experimental group received the World Health Organization international child development program for 6 consecutive weeks while the control group remained without manipulation. The Parenting Self-Agency Measure (PSAM) was administered at pre-test, post-test and at 1-month follow-up. The study findings indicated that parental efficacy in the experimental group increased after 6 consecutive weeks of training and remained unchanged after 1 month of follow-up while the control group showed no difference regarding scores obtained at three stages of the study. International programs such as the World Health Organization international child development program can increase positive child-mother interaction as an important factor which contributes to mental health in early years of life but further studies with larger samples in longer terms and with more follow-up periods in Iran are suggested.

Studies have identified high prevalence of depression among people living with HIV/AIDS, but only few studies have looked into this association in this environment. The objectives were to determine the prevalence of major depressive disorder, associated socio-demographic and psychosocial variables in people living with HIV/AIDS attending an out-patient clinic at the Olabisi Onabanjo Teaching Hospital (OOUTH), Sagamu, Nigeria. A cross-sectional survey was carried out on one-hundred and thirty subjects living with HIV/AIDS attending out-patient clinic at the OOUTH, Sagamu. They were assessed with a socio-demographic questionnaire designed by the researchers, and they also had a clinical interview with the depression module of the Structured Clinical Interview Schedule for Axis 1 DSM-IV disorders (SCID). The diagnosis was made according to the DSM- IV criteria and severity assessed with the Hamilton Rating Scale for depression. The prevalence of depression was 23.1% and was higher than figures reported in the general population studies in Nigeria. Of this proportion 46.7%, 50%, 3.3% were mildly, moderately and severely depressed. Majority (40%) were within the 30-39 years range. Women accounted for 69.2% of the study population and 46.9% of the subjects were either divorced/separated or widowed. Depression was significantly associated with being female and having suicidal thoughts or attempt. There was no association between marital status, disclosure of status and duration of HIV diagnosis. The prevalence of depression is high among people living with HIV/AIDS in Nigeria. An appropriate mental health intervention programme would be necessary as part of national programme for people living with HIV/AIDS to reduce the negative impact of depression on them.

To compare the effectiveness of rational, behavioral and emotive therapy (REBT) and person-centered therapy (PCT) on self-differentiation and intimacy among divorce clients. In quasi-experimental study, 42 divorce clients (both males and females) who presented to the Counsling Center of Sanandaj, Iran were sampled. They were categorized into three groups of PCT, REBT, and control group (each group contained 14 subjects). The recovery indices (dependent variables) employed were the subject of selfdifferentiation and intimacy, which were measured twice before and after intervention of Differentiation of Self Inventory-2 (DSI-2) and intimacy. The therapy involved 8 one-hour sessions. It was held twice a week and therapeutic effects were traced after 8 months. The results showed that REBT and PCT were effective on self-differentiation scale and intimacy. Also they were influential in recovery self-differentiation scale and intimacy follow up stage. REBT and PCT were effective on self-differentiation and its subscales (Emotional reactivity, “I” position, Emotional cut off and Fusion with other) and general intimacy.

The aim of the current study is to investigate the relationship between metacognition and obsessive beliefs, and procrastination. 285 students of Tabriz and Mohaghegh Ardabili Universities, Iran, were selected by random sampling, and completed the metacognition (MCQ-30) questionnaire, obsessive beliefs questionnaire (OBQ-44), and General Procrastination Scale. The research method was descriptive. Data was implemented by structural equation modeling, using Amos software (version 19) and Anderson and Greenberg’s (1988) two-step approach was followed. First, the model measurement, and then the structural model were examined. Results showed that obsessive beliefs and metacognitive beliefs, directly and indirectly, predict the behavior of procrastination. Cognitive confidence, need for control of thoughts, and positive beliefs about worry from metacognitive beliefs were positively and significantly correlated with procrastination. In addition, cognitive self-consciousness was inversely correlated with procrastination. Perfectionism/certainty from obsessive beliefs was inversely correlated with procrastination. Moreover, the relationship between obsessive beliefs and metacognitive beliefs were positive and significant. Our findings show a significant relationship between obsessive and metacognitive beliefs and procrastination. To reduce behaviors of procrastination, control of obsessive beliefs and metacognition seems to be necessary. Moreover, controlling and shaping metacognitive beliefs can be effective in reducing compulsive behavior.

The present study aimed to evaluate the effect of parenting education on improvement of reading and writing disabilities in children. A randomized controlled trial was done on primary school students with reading and writing disabilities and their mothers. The subjects were divided into three groups with 26 members in each group. The first group (mothers’ education group) received 6 one-hour new educational sessions. The second group (standard group) received 12-15 standard educational sessions for learning disability, and the third group (control group) which consisted of students with learning disability did not receive any treatments. Research instruments included reading and writing tests, and demographic questionnaire. The three groups were evaluated via pretest and posttests at baseline and after one and three months of educational interventions. Data were analyzed using the chi-square, t-test, and repeated measures multivariate analysis of variance (MANOVA). The mean reading speed had the most progression in the mothers'' education group. Comparison among reading speed, reading accuracy, and spelling scores has been statistically significant (F 2, 6 = 90.64; p < 0.001) but the mean of these scores has been insignificant among the three groups (F 2, 67 = 0.583; p > 0.05). The mean reading accuracy, mostly increased after 3-month interventions in the mothers group. The control group had the lowest mean reading accuracy scores. Parenting education in mothers had a positive effect on the treatment of children with reading and writing disabilities.

Attention deficit hyperactivity disorder (ADHD) is a chronic, highly prevalent neurodevelopmental disorder which affects 9% of school-age children. Triple P-Positive Parenting Program is an evidence-based parenting program reported to be useful in the management of this disorder. The aim of this randomized controlled trial was to evaluate the effectiveness of Triple P in mothers of ADHD children. In this study, 30 mothers with ADHD children aged between 6 to 10 were randomly assigned to two groups (15 participants in each group). Parenting style, mother-child relationship, maternal depression, anxiety and stress, and children’s behavioral problems were evaluated. The intervention group received 120 minute sessions for 5 weeks and 15-30 minute telephone contacts for 3 weeks while no intervention was done for the control group. Analysis of covariance revealed that mothers of the Triple P group showed significant (p < 0.01) improvements in parenting style, mother-child relationship, and considerable decrease in depression, anxiety and stress. Women trained in the Triple P group also reported significantly lower rates of child misbehavior than women of the control group. Triple P-Positive Parenting intervention is effective and acceptable for mothers of ADHD children.

The present study aimed to review the relapse rate in patients with schizophrenia treated with orally taken atypical agents (serotonin dopamine antagonists, SDAs) and depot preparation of conventional (typical) antipsychotics. In this historical cohort study, mean relapse per month (MRM) index, duration between initiation of antipsychotic treatment and the first relapse episode, and the time gap between successive relapses were compared between 84 patients on SDAs-except clozapine (group 1) and 81 others on depot typical antipsychotics (group 2). The two groups were comparable regarding mean (±SD) MRM index [0.033 (±0.004) in group1 and 0.044 (±0.05) in group 2; p = 0.345]. Mean (±SD) duration of time between initiation of maintenance treatment and the first relapse was 15.5 (±13.67) months in group 1 and 16.40 (±15.31) months in group 2, (p = 0.876). Mean (±SD) duration of remission periods between successive relapses were 17.92 (±14.2) and 15.8 (±16.9) months for group 1 and group 2, respectively (Mann-Whitney test, (p = 0.048). Orally taken atypical antipsychotics were able to keep the duration of remission periods between successive relapses more prolonged compared to depot conventional preparations. This could be added to their other remarkable benefits especially if the patient is expected to experience multiple relapses.